Institute for Health and Social Policy, McGill University.
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University.
Milbank Q. 2018 Sep;96(3):434-471. doi: 10.1111/1468-0009.12340.
Policy Points: Historically, reforms that have increased the duration of job-protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well-being.
Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co-operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes.
We conducted a systematic review of the peer-reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta-analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs.
We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave-taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied.
There is substantial quasi-experimental evidence to support expansions in the duration of job-protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job-protected paid leave or lack a national paid leave entitlement altogether.
政策要点：从历史上看，延长有工作保障的带薪产假的改革提高了妇女的经济成果。通过将目标对准分娩前后的时期，带薪产假的获得似乎也降低了婴儿死亡率，母乳喂养是其中一个潜在机制。在提供无薪或短时间带薪产假的国家提供更慷慨的带薪休假权益，可以帮助家庭在赚取收入和关注个人及家庭福祉之间取得平衡。
经济合作与发展组织（OECD）国家普遍制定了立法规定为新父母提供带薪休假以照顾个人和家庭疾病。然而，目前还没有对这些政策对经济、社会和健康结果的潜在影响进行全面审查。
我们对有关带薪休假与社会经济和健康结果的同行评议文献进行了系统审查。我们审查了 5538 份摘要，选择了 85 篇关于父母假政策影响的已发表论文、22 篇关于医疗假政策影响的论文以及 2 篇评估这两种政策的论文。我们通过叙述性描述综合了主要发现；由于政策属性、政策变化、结果和研究设计的异质性，无法进行荟萃分析。
我们能够得出关于父母假政策影响的几个结论。首先，将带薪产假的期限延长至 6 至 12 个月，同时也增加了休假人数和休假时间。其次，几乎没有证据表明延长带薪休假时间会对就业或经济产生负面影响。第三，无薪假似乎没有带薪假带来的好处。第四，从人群健康的角度来看，增加带薪产假与婴儿和儿童健康状况的改善密切相关，特别是在死亡率方面。第五，足够长度和慷慨的带薪陪产假政策促使父亲在孩子出生后额外休假。个人或家庭疾病的医疗假政策如何影响健康尚未得到广泛研究。
有大量准实验证据支持延长有工作保障的带薪产假的期限，将其作为支持妇女劳动力参与、保障妇女收入和收入以及提高儿童生存率的手段。这对那些提供较短有工作保障的带薪产假或根本没有国家带薪休假权利的国家尤其具有重要意义。
