More people get screened for cancer when employers are mandated to provide paid sick leave, according to a new study.
For most Americans, the two major barriers to proper medical care are time and money. And while insurance can sometimes reduce health care costs, making time to see the doctor is just as important.
Over a seven-year period covered by the study, breast cancer screening rates increased by up to 4% and colorectal cancer screenings increased by between 6-8% in areas exposed to sick leave orders with ‘ remuneration based on policy.
“These non-monetary barriers to health care access matter,” says lead study author Kevin Callison, assistant professor of health policy and management at Tulane University School of Public Health and Tropical Medicine and the Murphy Institute. “Improving or reducing these barriers can have a significant impact on people’s health.”
The US is the only wealthy nation in the world that does not federally mandate paid sick leave, according to the Center for Economic Policy and Research. According to the US Bureau of Labor Statistics, about 1 in 4 American workers cannot afford a single paid sick day.
For the study, researchers looked at changes in breast and colon cancer screening rates among 2 million private-sector workers from 2012-2019, a period in which several states and cities adopted policies mandating sick leave. paid leave. Workers were distributed across 300 metropolitan statistical areas, 61 of which were exposed to a paid sick leave mandate during this time frame.
Although the increases in screening rates may seem small, these results include workers who already had paid sick leave, meaning they were unlikely to decrease or increase their cancer screening habits. If the results were scaled to focus only on workers who earn sick leave for the first time through mandates, Callison estimates that breast cancer screening rates increase by 9-12% and colon screening rates increase by 21 -29%.
“Our results become much larger if we are willing to assume that only workers who receive paid sick leave coverage are the ones who change their screening behaviors,” says Callison.
Previous studies have examined the relationship between sick days and cancer screening rates by comparing rates between those with and without leave. However, some workers are more health conscious than others and may only look for jobs that offer paid sick leave.
By focusing on the change in control rates that resulted from policy-based orders, this study removed some of the potential behavior-based biases.
“Because we focused on those policies that lead to changes in coverage rather than on people who self-select into coverage, our argument is that we have a more accurate estimate of the relationship between paid sick leave and cancer screening,” says Callison.
The results highlight the value of sick days. Callison says it’s “reasonable to assume that more cancer screenings lead to earlier detection and better outcomes,” but more research is needed to see if paid sick leave means cancers are diagnosed earlier and death rates decrease .
For Callison, these results also represent a potential way to increase health care equity in the United States.
The majority of those without paid sick leave are people of color and people with less wealth and less education. And although 17 states and 18 cities have adopted paid sick leave, 18 states have passed laws barring cities from passing similar mandates.
“We know that racial and ethnic minorities tend to have higher death rates for certain cancers,” says Callison. “So will such things improve these gaps? That’s really the next step we want to go to.”
The study appears in New England Journal of Medicine. The authors are from Georgia State University and the University of California San Francisco.
Source: Tulane University