Kim Daniel
Department of Health Sciences, Northeastern University, 360 Huntington Avenue, Robinson Hall, Suite 312C, Boston, MA 02115, USA.
Department of Social and Behavioral Sciences, EHESP School of Public Health, Sorbonne Paris Cité, Paris Descartes University, 75006 Paris, France.
Int J Environ Res Public Health. 2017 Oct 19;14(10):1247. doi: 10.3390/ijerph14101247.
The USA is one of only a few advanced economies globally that does not guarantee its workers paid sick leave. While there are plausible reasons why paid sick leave may be linked to mortality, little is known empirically about this association. In a pooled USA nationally-representative longitudinal sample of 57,323 working adults aged 18-85 years from the National Health Interview Surveys 2000-2002, paid sick leave was examined as a predictor of all-cause and cause-specific mortality. Multivariate Cox proportional hazards models were used to estimate the impact of paid sick leave on mortality. Having paid sick leave through one's job was associated with 10% (hazards ratio, HR = 0.90; 95% CI = 0.81-0.996; = 0.04), 14% (HR = 0.86; 95% CI = 0.74-0.99; = 0.04), and 22% (HR = 0.78; 95% CI = 0.65-0.94; = 0.01) significantly lower hazards of all-cause mortality after mean follow-up times of 11.1, 6.5, and 4.5 years, respectively. This study further identified associations of paid sick leave with 24% (HR = 0.76; 95% CI = 0.59-0.98; = 0.03), and 35% (HR = 0.65; 95% CI = 0.44-0.95; = 0.03) lower hazards of dying from heart diseases and unintentional injuries, respectively. To the author's knowledge, this study provides the first empirical evidence on the linkages between paid sick leave and mortality and supports protective effects, particularly against heart diseases and unintentional injuries. The most salient association corresponded to a lag period of just less than five years. Social policies that mandate paid sick leave may help to reduce health inequities and alleviate the population burden of mortality among working adults in the USA.
美国是全球少数几个不保障工人带薪病假的发达经济体之一。虽然有一些合理的理由可以解释带薪病假可能与死亡率有关，但从实证角度来看，人们对这种关联知之甚少。在一个汇集了2000年至2002年美国国家健康访谈调查中57323名年龄在18至85岁的在职成年人的全国代表性纵向样本中，将带薪病假作为全因死亡率和特定病因死亡率的预测因素进行了研究。使用多变量Cox比例风险模型来估计带薪病假对死亡率的影响。通过工作获得带薪病假与在平均随访时间分别为11.1年、6.5年和4.5年后全因死亡率显著降低10%（风险比，HR = 0.90；95%置信区间 = 0.81 - 0.996；P = 0.04）、14%（HR = 0.86；95%置信区间 = 0.74 - 0.99；P = 0.04）和22%（HR = 0.78；95%置信区间 = 0.65 - 0.94；P = 0.01）相关。这项研究进一步确定，带薪病假与因心脏病死亡风险降低24%（HR = 0.76；95%置信区间 = 0.59 - 0.98；P = 0.03）以及因意外伤害死亡风险降低35%（HR = 0.65；95%置信区间 = 0.44 - 0.95；P = 0.03）有关。据作者所知，这项研究提供了关于带薪病假与死亡率之间联系的首个实证证据，并支持其保护作用，特别是对心脏病和意外伤害的保护作用。最显著的关联对应的滞后期略少于五年。强制实行带薪病假的社会政策可能有助于减少健康不平等现象，并减轻美国在职成年人的人口死亡负担。
