Insult to Injury: U.S. Workers Without Paid Sick Leave Suffer from Mental Distress

Only seven states in the United States have mandatory paid sick leave laws; yet, fifteen states have passed preemptive legislation prohibiting localities from passing sick leave. Despite this resistance, paid sick leave is starting to gain momentum as a social justice issue with important implications for health and wellness. But what are the implications for the mental well-being of Americans without paid sick leave? Little was known about their relationship until now.

Researchers from Florida Atlantic University and Cleveland State University are the first to explore the link between psychological distress and paid sick leave among U.S. workers ages 18-64. Results of their study, published in the American Journal of Orthopsychiatry, illuminate the effects of exacerbated stress on Americans without paid sick leave who are unable to care for themselves or their loved ones without fear of losing wages or their jobs.

The researchers found that workers without paid sick leave benefits reported a statistically significant higher level of psychological distress. They also are 1.45 times more likely to report that their distress symptoms interfere “a lot” with their daily life and activities compared to workers with paid sick leave. Those most vulnerable: young, Hispanic, low-income and poorly educated populations.

“Given the disproportionate access to paid sick leave based on race, ethnicity and income status, coupled with its relationship to health and mental health, paid sick leave must be viewed as a health disparity as well as a social justice issue,” said LeaAnne DeRigne, Ph.D., co-author of the study and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry. “Even modest increases in psychological distress are noteworthy for both researchers and policy makers since we know that even small increases in stress can impact health.”

The study included 17,897 respondents from the National Health Interview Survey(NHIS), administered by the U.S. government since 1957 to examine a nationally representative sample of U.S. households about health and sociodemographic variables.

“For many Americans, daily life itself can be a source of stress as they struggle to manage numerous responsibilities including health related issues,” said Patricia Stoddard-Dare, Ph.D., lead author of the study and associate professor of social work at Cleveland State University. “Making matters worse, for those who lack paid sick leave, a day away from work can mean lost wages or even fear of losing one’s job. These stressors combined with other sources of stress have the potential to interfere with workplace performance and impact overall mental health.”

The researchers used the Kessler Psychological Distress Scale (K6), considered the gold standard for assessing psychological distress in population-based samples in the U.S. and internationally. With a theoretical range of 0 to 24, higher scores on the K6 represent increased psychological distress and scores above 13 are correlated with having a mental disorder of some type.

Results from the study showed that those with paid sick leave had a lower mean distress score compared to those without paid sick leave, who had significantly higher K6 scores, indicating a higher level of psychological distress. Only 1.4 percent of those with paid sick leave had a K6 score above 12 compared to 3.1 percent of the respondents without paid sick leave.

The most significant control variables indicated an increase in the expected psychological distress score among those who were younger, female, in fair or poor personal health, had at least one chronic health condition, were current smokers or did not average the recommended range of seven to nine hours of sleep per day.

Approximately 40 percent of respondents in the NHIS sample did not have paid sick leave; approximately half of the respondents were female; more than half were married or cohabitating; three-quarters indicated that their highest level of education included at least some college; and 62 percent were non-Hispanic white. The mean age was 41.2 years. Most of the respondents (79.1 percent) worked full-time and 82.7 percent had health insurance coverage. Respondents were in families with a mean size of 2.6 persons and 39.3 percent reported having children in the family. Approximately 32 percent had an annual family income of $35,000 to $50,000, and more than one quarter were below the poverty threshold.

DeRigne and Stoddard-Dare caution that even though there is concern about the potential burden on employers if paid sick leave laws are passed, it is important to be mindful of the overall situation regarding productivity loss and workplace costs associated with mental health symptoms and psychological concerns among U.S. workers. Furthermore, the personal health care consequences of delaying or forgoing needed medical care can lead to more complicated and expensive health conditions. U.S. workers with paid sick leave are more likely to take time off work and self-quarantine when necessary, without the worries of losing their job or income while also not spreading illness to others.

“Results from our research will help employers as they think about strategies to reduce psychological stress in their employees such as implementing or expanding access to paid sick days,” said Stoddard-Dare. “Clinicians also can use these findings to help their patients and clients as can legislators who are actively evaluating the value of mandating paid sick leave.”

Online Toolkit for Social Workers to Help Pet Owners in Crisis

Comprehensive guide from the Mayor’s Alliance for NYC’s Animals covers topics including domestic violence, homelessness, hoarding, illness, among others. 

A mentally challenged woman is evicted from her apartment but refuses to enter a shelter because it won’t allow her three cats. An elderly man refuses urgent medical care because he has no one to look after his dog. A domestic violence victim returns to her abuser because he threatens to kill the family pet if she does not.

pets-domestic-violenceThese are just a few of the many heartbreaking and complex situations faced by New York’s pet owners and by the social workers and human services organizations that help them.

Today, the Mayor’s Alliance for NYC’s Animals, a coalition of more than 150 New York City non-profit animal shelters and rescue groups, has launched the Helping People and Pets in Crisis Toolkit, a first-of-its-kind online resource for these front-line professionals.

Divided into six sections covering domestic violence, illness and hospitalization, homelessness, animal hoarding, pet relinquishment and animal-assisted therapy, the Toolkit offers a comprehensive set of resources, assessment tools and promising intervention techniques for virtually every type of crisis involving pets and their owners.

The Toolkit is an outgrowth of the Alliance’s Helping Pets and People in Crisis program, spearheaded by social worker Jenny Coffey, LMSW. Created in 2008, the program has helped in more than 1,000 individual cases in which New Yorkers faced life-challenging situations involving pets. Coffey assembled the Toolkit from her years of experience combining animal welfare and human welfare in New York City.

“This one-of-a-kind initiative extends the reach of one of the Alliance’s flagship programs,” said Jane Hoffman, President of the Alliance. “Every year, the number of calls we get about pet owners in crisis has grown exponentially, and we don’t foresee any let-up. With the launch of the Helping Pets and People in Crisis Toolkit, we’re able to share what we’ve learned, through our collaboration with dozens of other dedicated animal and human services organizations, about how to help pet owners deal with difficult and often unforeseen circumstances.”

In the Helping People and Pets in Crisis Toolkit, human services professionals will find a wide range of suggestions, intervention strategies and resources to help them assist pet owners in crisis. Each section identifies a problem, explains how to recognize it and suggests ways to address it:

Domestic Violence and Pets – Describes the role pets play in such situations and how to extricate domestic violence victims and their pets from them. Special Features: How to help clients develop a pet-safety plan, request an order of protection, or petition to have a pet registered as a therapy animal.

Homelessness and Pets – Explains how to assist the 5 to 10 percent of homeless people who own pets and who are precluded from entering homeless shelters because of the prohibitions against them. Special Features: Links to helpful organizations like the Animal Relief Fund, Feeding Pets of the Homeless, Seer Farms and Collide; information on Americans with Disabilities Act regulations and on New York City housing programs that allow pets.

Hospitalization, Illness and Pets – Explains how to arrange temporary or permanent care of pets for infirm or elderly patients without family or friends. Special Features: Information about temporary care, “re-homing” and requesting help from Animal Care & Control of NYC.

Animal Hoarding – Explains how to recognize and address animal hoarding. Special Features:  Animal Hoarding Assessment tool.

Pet Relinquishment – Explains how to help clients deal with life events that may require giving up a pet. Special Features:Tips on “re-homing” animals.

Animal-Assisted Therapy – Explains how to identify situations in which pets might play a therapeutic role, helping clients improve their physical, mental and emotional wellbeing. Special Features: An explanation of the differences among Service, Assistance and Therapy Animals; links to animal-therapy organizations.

Resources – Provides a recap of all of the resources mentioned throughout the site. Special Features: Hyperlinks and complete contact information.

Tips & Tools – Provides suggestions for social workers preparing to meet with individuals and families with pets, including tips on how pets can be used to engage otherwise reluctant clients, and what can be learned about an owner’s situation based on the condition of her pets.  Special Features:  Colorful, easy-to-read charts; links to local pet services for every possible need.

The Helping People and Pets in Crisis Toolkit is just one of the many resources available through the Alliance. To see all of them, visit

Family and Maternity Leave Around the World: How Does the USA Measure Up?


In the last few decades, women have been dominating the workforce because having a single income family is no longer enough to maintain a middle class living. More importantly, women enjoy and want to have careers and be contributors in the workforce. However, women have increasingly faced challenges in balancing work with parenthood especially with the lack of paid maternity leave.

This imbalance has created a need for substantial policy in areas such as child care assistance, reproductive rights, and family medical leave. Women who become pregnant have to take time off work for recovery time, doctor visits, and to allow appropriate time for mother and child to bond. Due to the high expense of daycare,  many women cannot afford to work full-time and being to cover day care expenses.

Often daycare expenses cost higher than what the average working mother will earn in a 40 hour work week. This cost analysis and barrier prevents many families from rising above the poverty level. In addition,  many women, married and unmarried, often have the burden of the “ unpaid second shift” which is taking on many of the domestic duties at home as well.

Some of the policy changes around the world came as a result of needed parental leave and a preschool provisions for children until the age of six. Germany and France were two of the first countries to get maternity leave. Currently, 128 countries provide paid and job protected child-birth leave. The primary factor which determines the way a country or state gives this benefit varies from place to place. However, it is important to note that some places provide longer leave times than others. For example, the United States has largely decided to make the majority of maternity leave in this country unpaid.

Eighty eight countries provide allowances for families, to help with raising them, and the United States is the only country which provides no such family allowances. According to the Organization for Economic Co-operation and Development (OECD), the United States is the single least generous country in relation to its treatment of families.

It is disconcerting that the US and Australia are the only two countries that offer no federally mandated paid maternity leave. This is a huge barrier for families and single parents raising children. Notably, France is one of the countries that has provided the most benefits for women on maternity leave such as increased leave when having more children. For example, the child rearing benefit is more if they have more than two children.

The way the a state or country attacks these problems tells provides great insight into how they value maternity leave and child rearing. Out of all the countries studied, the United States lagged behind all others in the support and balance they give to families.  Daycare was another benefited proved by many as a public services in countries like Germany. While many of the OECD countries provide this daycare regardless of income, the US only provides assistance for the abused and low-income.

The policies of Sweden and France are able to help provide women the ability to balance family and work. Whereas in the US, there are a large number of children at the poverty level due to policy decisions that do not support women and children post birth. Because of the lack of assistance in the United States, many women in single and working class families cannot afford to have day care, unless there is some subsidized program they can participate in.

Many women are forced to limit the time they work until their children begin school age. Public awareness on this issue needs to be increase in order to promote more advocacy and policy changes in these areas. Write your representatives on this matter, go in groups to speak to legislators, and set up community awareness events in your community.

I think the United States could learn from many of the policies and practices of countries like Sweden and France. This would give us the same opportunity to work full-time and pursue the American Dream. I think these countries as well as the other countries in the OECD have done a far better job to address the gender differences of women and men. As far as the United States, I feel that our policy makers have let us down. It’s unfortunate that many policy makers do not realize that addressing these issues affecting women would be the best policies to uplifting everyone.

Conway, M. (2004). Women and Public Policy: A Revolution in Progress (3rd ed., pp. 175-189). N.p.: CQ Press

Henderson, S., & Jeydel, A. (2009). Women in Politics in a Global World (2nd ed., pp. 144-169). N.p.: Oxford University Press’ Higher.

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