Session
Oral: Worker Rights, Paid Sick Leave, and Health Equity (Collaborative session between Occupational Health and Safety and Law sections)
APHA 2022 Annual Meeting and Expo
Abstract
Wage theft as a determinant of health disparities among U.S. workers: an examination of the Fair Labor Standards Act, wage noncompliance, and worker health
APHA 2022 Annual Meeting and Expo
Background: Wage theft is a phenomena that occurs when employers fail to pay workers for what is legally owed to them. This exploitative practice disproportionately impacts vulnerable workers including low-wage earners, immigrants, and workers of color, with lost wages potentially leading to adverse health outcomes. While research has examined the economic costs of wage theft, there are limited studies that examine the relationship between wage theft and health. We use minimum wage noncompliance, determined by the Fair Labor Standards Act (FLSA), as a proxy to better understand this relationship.
Methods: This study (N=10,694) uses the 2014 Survey of Income and Program Participation (SIPP), a nationally representative household survey on income, economic well-being, and program participation. We classified workers based on FLSA exemptions to more precisely define wage theft. We conducted descriptive, bivariate, and multivariate analyses, examining the association between wage theft and two health outcomes - self-rated health and number of sick days - among working adults ages 18 to 64 across the United States who were not exempt from the FLSA. Additional analyses will examine effect modification by wage-level, immigration status, and race/ethnicity.
Results: 11% of FLSA-nonexempt workers experienced wage theft. A greater share of these workers were low-wage earners (39.8%), people of color (15% Latinx, 13.8% Black, 13.1% Asian, 10.8% other race/ethnicity), and immigrants (15.9% non-citizens, 10.8% naturalized citizens). Poor self-reported health may be associated with wage theft (aOR = 1.24, 95% CI: 0.98-1.55), but was not related to number of sick days. We expect disparities by wage-level, immigration status, and race/ethnicity to be present.
Conclusion: Wage theft is a public health issue that may lead to worse health outcomes among vulnerable workers. Policy intervention and enforcement are therefore necessary to protect the health of workers.
Abstract
Disparities in the availability of paid sick leave during the COVID-19 Pandemic
APHA 2022 Annual Meeting and Expo
Background and Objective: Paid sick leave may be an effective means to protect workings from spreading infections. Unfortunately, in the United States many workers do not have access to paid sick leave. This study sought to document disparities in the availability of paid sick leave according to occupation, industry, insurance status, education, social distancing, income group and race/ethnicity in 2020.
Methods: Using data from the 2020 National Health Interview Survey, we calculated the percentage of workers who reported that they had paid sick leave available at their job. We also calculated the availability of paid sick leave according to occupation, industry, insurance status, education, social distancing, income group, and race/ethnicity.
Results: In 2020, 65.6% (95% Confidence Interval (CI)=64.6%, 66.6%) of workers reported that they had access to paid sick leave. Fewer than half of workers in personal care/service; farming/fishing/forestry; construction/extraction; food preparation/serving; and arts/design/entertainment occupations had access to paid sick leave. Hispanic workers had a lower availability of paid sick leave compared to workers of other races/ethnicities. Workers without health insurance also had a very low availability of paid sick leave (33.9%, 95% CI=30.8%, 36.9%). Workers in workplaces where social distancing was not happening were also substantially less likely to have paid sick leave (35.5%, 95% CI=31.3%, 39.7%). Additionally, workers who received income from public assistance were less likely to have paid sick leave available. There was a positive association between income and paid sick leave availability. Workers with lower income were less likely to have paid sick leave available compared to workers with higher income.
Conclusion: There were wide disparities in the availability of paid sick leave during the COVID-19 pandemic. These disparities may have contributed to disparities in infections and death from COVID-19. Additionally, concerns among workers about needing to take unpaid time off from work if they or a family member became infected may have contributed to psychosocial strain among workers. Requiring employers to offer paid sick leave may be a method to protect workers from COVID-19 and other infectious diseases
Abstract
Presumptively denied: Addressing gender bias in workers’ compensation law for women-dominated healthcare professions
APHA 2022 Annual Meeting and Expo
There is glaring gender inequity with respect to which workforces presumptively receive workers’ compensation and those who do not. Nurses, who work in a profession with nearly 90 percent women, often must jump through legal hoops when they get sick or hurt at work to receive paid time off, medical, or disability benefits. While some workers’ compensation laws assume certain medical conditions are job-related for male-dominated professions, such as police officers and firefighters, similar legal presumptions do not exist for nursing or other women-dominated healthcare professions.
As a vital step in achieving economic and gender equity for nurses and other healthcare workers, California and other states are considering legislation to ensure that frontline healthcare workers have workers’ compensation presumptions. Without such presumptions, it remains difficult to establish the legal evidentiary basis of work-relatedness for many common medical conditions that nurses experience, including respiratory disease, cancer, musculoskeletal injuries, PTSD, and infectious disease exposure. The need for presumptive eligibility has become acutely apparent as nurses fight to secure benefits from employers after contracting Covid-19 on the job.
This presentation will assist public health lawyers and professionals without legal expertise to: (1) identify gender bias in workers’ compensation laws with respect to women-dominated healthcare professions, (2) assess state legislative efforts to achieve gender parity in workers’ compensation through presumptive eligibility for conditions experienced by healthcare workers, and (3) analyze how presumptive workers’ compensation eligibility for healthcare workers can spark changes to legal structures that have historically resulted gender inequality in worker protection laws.
Abstract
Racial Justice in Long-Term Care: Amplifying the Voices of Immigrant Workers
APHA 2022 Annual Meeting and Expo
The twin pandemics of 2020 – COVID-19 and racial injustice – exacerbated the inequities experienced by Black, Indigenous, and People of Color (BIPOC) workers. Women working as long-term care aides, are overwhelmingly immigrants, Latinx, and/or BIPOC, and have been disproportionately affected by hazardous working conditions throughout the pandemic. Yet, their perspectives are largely absent from the legal literature and national conversation surrounding workers’ rights, such as paid sick leave and workplace safety, which led to devastating consequences for older residents during COVID-19.
Immigrant, Latinx, and/or BIPOC women working as aides in long-term care largely lack access to and therefore do not benefit from workers’ rights laws due to fear of retaliation and underenforcement. All of this, however, is largely speculation because there is little to no information about the experiences of these women, including why and how workers’ rights laws and policies fail to protect them and what changes would facilitate their ability to access and benefit from workplace rights.
Critical race theorists have observed that laws consistently fail to benefit people of color when they are conceived without regard to the lived reality of marginalized people. This qualitative study elicits the narratives of immigrant women working as aides to fill a crucial gap in information about the shortcomings of employment, labor, and workplace safety laws in long-term care settings. This research comes at a historic moment as workers’ rights legislation is being promulgated but risks replicating existing deficiencies that limit adequate legal preparedness in future public health emergencies.