Making the Case for Paid Family Leave
Paid family leave is essential for promoting health equity and supporting family well-being. Extensive research has shown that paid family leave programs have a positive impact on adult and child mental, physical, and financial health, and the vast majority of people in America are in favor of paid family leave. Despite this overwhelming support, the United States remains one of just two countries worldwide that does provide national paid family leave.
Until comprehensive federal and/or state paid leave laws are passed, it is up to businesses to take responsibility for the wellbeing of their employees by offering paid family leave options. Offering paid leave creates positive workplace culture and supports retention and productivity by allowing family members to take the time necessary for their physical and mental health while receiving a paycheck. This includes ensuring those employees returning after leave have the support they need through providing adequate paid sick leave and schedule flexibility.
Key Terms and Definitions
- Family Leave: Family leave is time off for parental or caregiving responsibilities. These can include time for recovery and bonding after the birth, adoption, or placement of foster child, but also include time for caring for immediate family members due to illness or injury. Unpaid family leave often requires the worker to use any accumulated vacation or medical leave to receive any compensation
Medical/Sick Leave: Medical leave is often referred to as sick time. It is time off specifically for the employee’s personal recovery from mental or physical illness or injury.
- Paid Family Leave: Paid leave is time off for a guaranteed period where an employee receives some or all their regular compensation through means other than the use of accumulated sick leave or vacation time (PTO). This may be coordinated through a business or state/federal government.
- Parental Leave: Parental leave is time off specifically for recovery and bonding after the birth of a child, child adoption, or, in some cases, placement of a foster child.
Access to Paid Family Leave
In 2018, 56 percent of American workers had access to unpaid leave through FMLA, differing little from 2012 data. In many of those cases, workers must rely on other paid time off provided by their employer, such as vacation or sick time, or short-term disability to receive pay during their leave. However, as of March 2022, only 86 percent of full-time workers and 51 percent of part-time workers had access to paid sick time. As companies’ size gets smaller, that access decreases.
Only 23 percent of private industry workers had access to paid family leave, which is the least available to the lowest wage workers. Just four percent of lowest wage workers are provided paid family leave. Even in states with paid leave programs, on average, 36 percent of women aged 18 to 45 did not meet work history requirements to be eligible for them.
Length of Leave
The average leave taken by women after the birth of a child is 10 weeks, including paid and unpaid leave. However, more than half of mothers take 5 weeks or less of maternal leave including almost a third of women who take no leave at all. Just a quarter takes more than nine weeks. Most employed fathers rarely take more than one week of parental leave.
Of workers taking parental leave, more than half said they took less time than they wanted or needed to after the birth or adoption of a child most often due to concerns about finances, job security, and advancement opportunities.
Many experts believe the ideal length of leave should be about six months, allowing for adequate physical and mental recovery and family bonding. However, workplaces providing paid leave offer an average of eight weeks.
The American College of Obstetricians and Gynecologists states that a minimum of six weeks paid leave is essential for the health of mother and child and benefits the employer as well. Six weeks is also the youngest age that most childcare facilities begin offering services. The American Academy of Pediatrics recommends 12 weeks of paid leave for parental, medical, and family caregiving purposes. The recommended leave suggested by the International Labour Organization based on their research is 18 weeks, and more than half of countries globally offer more than 14 weeks.
More than one in five U.S. adults (53 million) provide care to adult family members or children with special needs, a number that increased by 21.8 percent from 2015 to 2020. An overwhelming majority of caregivers support adults over the age of 50. This is due to an aging U.S. population as well as health care and long-term care workforce shortages. Many caregivers lack sufficient and affordable support services and report physical, emotional, and financial strain. Almost half of caregivers report negative financial impacts due to their role, and 60 percent continue to work while taking on caregiving responsibilities. The majority of working caregivers do not have access to paid leave, and many do not receive paid sick leave.
Paid Leave Policy in the U.S.
Family and Medical Leave Act (FMLA)
In 1993 the Family and Medical Leave Act (FMLA) was the first national policy to provide workers with job-protected, unpaid leave. Under FMLA, eligible workers can take up to 12 weeks of leave to care for a newborn or newly adopted child or family member with a serious health condition. FMLA also allows leave for workers to recover from a serious health condition preventing them from working or for military family needs. FMLA is unpaid unless workers use paid vacation, sick, or other paid leave voluntarily provided by employers. While FMLA does provide important job protection for workers, it is far from sufficient to protect health and economic well-being. FMLA is only required by employers with 50 or more employees and not provided for part-time workers, leading to just 56 percent of U.S. workers having access to the benefit.
Additionally, because there is no federal mandate for employers to supply paid time off of any form, many workers do not have the economic means to take FMLA leave unpaid. Just 79 percent of workers have access to paid time off for use when they or a family member is sick.
Paid Family and Medical Leave (PFML)
Paid Family Leave (PFML) provides those on family or medical leave with a predetermined compensation for all or part of their leave period. Cash benefits are mandated for women during parental leave in almost all countries around the world. In some nations, paid leave is provided by the national government and in others it must be provided by the employer, with duration ranging from four weeks up to one year. Because of laws passed in recent years, Papua New Guinea and the United States remain the only two countries that do not have laws providing for paid maternity/family leave in some form.20 Almost three-quarters of countries also offer some form of paid leave to fathers; more than a quarter offer four or more weeks paid leave.
In the United States, paid family leave is mandated on a state-by-state basis. As of 2022, eleven states and the District of Columbia have paid family and medical leave programs, though none offer a universal program. All include work history requirements that leave many workers ineligible for benefits. Paid leave programs do lead to increases in the number of families taking leave and the length of leave taken.
Some states, as well as Puerto Rico, offer access to temporary disability insurance through unemployment benefits that may be used for family leave. These include California, Hawaii, New Jersey, New York, and Rhode Island.
States Mandating or Providing Paid Leave
Government Contractor Paid Leave
Passed in 2016 by the Department of Labor, Executive Order 13076 requires than any company that has a contract with the U.S. government must provide at least seven weeks paid sick leave annually to its employees, which includes paid family leave.
Federal Employee Paid Leave Act (FEPLA)
Passed in 2020, the Federal Employee Paid Leave Act amends the FMLA code to provide up to 12 weeks of paid parental leave for all federal employees. The policy does require that the employee note in writing their intent to return to the employing agency after their leave ends.
Impact of Paid Family Leave on Family Physical, Mental and Financial Health
The ability to take time off (paid or unpaid) when growing a family or dealing with medical issues has a major impact on families, businesses, and communities.
Despite being one of the wealthiest nations, the health of U.S. infants and mothers trail other developed nations. The country ranks at the very bottom for infant mortality, with rates double that of Canada, France, and Sweden. Despite advanced healthcare technology, even the poorest families in these countries see better birth outcomes than Americans at all income levels. The U.S. is the only country that does not offer paid parental leave or guaranteed home visits after childbirth. As many as 23 percent of employed mothers return to work within two weeks of giving birth, likely due to the lack of paid leave and paid sick time which results in an inability to cover without pay. Returning to work quickly after childbirth can have grave impacts on the health of women and their families.
Child Physical Health
Having the ability to take any leave after the birth of a child is shown to improve child health. Research on paid family leave policies showed improved health outcomes for children, including:
Decrease in obesity
- Decrease in post-neonatal mortality rates
- Decrease in low-birth-weight births, premature births, and infant mortality
- Reduction of postpartum re-hospitalizationIncrease in timely administration of infant immunizations
- Greater improvements were often specifically seen in children from less advantaged backgrounds.
Also, children of mothers with access to paid leave were more likely to be breastfed for longer periods, which is linked to several positive health outcomes including improved immune system and reduced risk of asthma, obesity, type 1 diabetes, and other childhood illnesses including ear infections. Research internationally echoes these results, showing lower infant mortality rates in countries offering 10 weeks paid leave.
Child Cognitive Development and Academic Achievement
Research on paid family leave policies showed improved mental health and academic outcomes for children. Those whose families had access to paid leave were found to have:
Decreased odds of being diagnosed with ADHD
- Improved infant attachment and child development
- Reduced infant behavior problem
- Achieved higher academic test scores and improved language skills
- Reduced high school dropout rates45
Increased educational attainment
Mother’s employment during a child’s first year has been found to negatively impact children’s cognitive development. This negative impact is somewhat balanced by the increase in income as parents return to work, indicating that the ability to take extended leave with pay would have the most positive impacts on child cognitive development.
"For me, there were challenges with keeping up with household bills and duties as I lived at my mother’s house while she was in home hospice care. It was difficult mentally as I was concerned about my mom and family. I was grateful I would have my job when I went back, but the worry about my financial obligations was taxing. With paid leave, I would have been able to keep up with bills and help my granddaughter more. I would have also been able to relax more and really devote myself to my mom [before her passing] without the stress of not having a paycheck for several weeks." -L.K., Philadelphia
Adult Physical Health
Family care needs affect the physical health of caregivers. The immune system can be negatively impacted by fluctuations during pregnancy and by long-term stress. This can lead to higher susceptibility to illness and the potential need for time off for self-care and recovery.
Additionally, the U.S. has a maternal and infant mortality rate over three times higher than any other high-income nation, despite its higher rate of healthcare spending. In 2020, there was 23.8 deaths per 100,000 births, an increase of 14 percent from 2019. Sixty-five percent of pregnancy-related deaths occur within the first year after childbirth, with more than half occurring a week or more after childbirth. Most pregnancy-related mortalities are considered preventable, as mental health related issue are the leading cause of pregnancy-related death. Allowing adequate time for mental and physical recovery following childbirth is essential for healthy mothers; yet many do not take sufficient leave due to financial concerns.
Research shows that paid parental leave positively impacts maternal health by allowing time to physically recover from childbirth and is associated with greater well-being during the transition to parenthood for both parents. The positive impact of paid leave can be attributed to both more time spent at home after childbirth and the income provided by it.
Adults with access to paid family leave were found to have:
- Decreased risk of being overweight and lower Body Mass Index
- Decreased risk of alcohol consumption
- Reduced odds of maternal postpartum re-hospitalization
- Reduced daytime fatigue
Decreased risk of hypertension, high risk cholesterol, and diabetes
- Decreased smoking
In California, paid leave policies had the greatest impact on less advantaged mothers who previously could not afford to take unpaid leave. However, in many cases, the impact varied depending on the length of leave.
Adult Mental Health
Changes in family situations often lead to stress, anxiety, and other mental health concerns. Mental health related issues are the most common cause of pregnancy-related mortalities in the U.S.; they account for almost a quarter of deaths.
Access to paid leave serves as a protective factor in minimizing separation between parents and infants during a high stress time.
Research on family leave policies showed improved mental health outcomes for parents, including:
Decreased risk of psychological distress including postpartum stress, with greater decreases for single and young mothers
- Increased ability to cope with stress
- Reduction in postpartum depression symptoms
- Improved self-esteem
While parents need time to recover physically from childbirth, they also must have this time to recover emotionally from traumatic and emergency birthing situations that occur in almost 45 percent of births. Maternal depression symptoms showed a decrease of up to 15 percent when mothers were able to take 12 weeks of postpartum leave compared to just eight weeks.
Longer parental leave has been shown to have positive impacts on parental mental health for up to three years following the birth of a child.
"My pregnancy was not planned. Because I found out I was pregnant after the enrollment period for short-term disability and my employer does not offer paid family leave, I will have to depend entirely on my accrued vacation and sick time after I give birth. This will likely give me less than eight weeks off, despite rarely using my sick or vacation time over the past 4 years. My partner and I cannot afford for me to take additional time off unpaid, and four weeks without pay would drain my savings. I worry about going back to work too soon, but I don’t really have a choice." -N.S., Philadelphia
Family Financial Health
For families, the birth of a child or serious medical issues can cause major financial issues. Many are forced to cut back spending, spend their limited savings, apply for public assistance, default on bills, or take on new debt to cover added expenses related to medical and caregiving needs. For the many families without access to paid leave, these expenses can cause long-term negative financial impacts and be devastating to their economic wellbeing.
The impact is even more detrimental for the lowest income families. Almost half of families making $30,000 or less who did not receive paid leave put off paying bills and had to rely on public assistance to support their families.
Even those from higher wage families are affected by the increased financial stress, which has been linked to added negative mental and physical outcomes including increased inflammation and illness.
It may seem obvious then that access to paid family leave would positively support family financial health by allowing families to take time off without lost income. Paid leave has been found to:
Decrease poverty risk and material hardship
- Increase household income
- Reduce participation in the Temporary Assistance for Needy Families (TANF) program
- Alleviate economic stress
- Increase income of children at age 30
- Reduce interfamily gender wage gap
Most significant impacts of paid family leave are seen for low-income, single mothers. As seen recently, the expansion of the Child Tax Credit during the pandemic temporarily increased income to support the basic needs of 3.7 million children from the lowest income families, which decreased depression and anxiety in parents and their children. Paid family leave offers similar support to families when it is most needed – during what can be the most expensive time of expanding a family.
By supporting the mental, physical, and financial well-being of parents and children, paid family leave also affects overall family relationships.
Studies found that the opportunity for both caregivers to utilize parental leave:
Supports parental relationship stability
- Reduces relationship conflict
- Decreases mental and physical intimate partner violence
- Reduces stress and depression symptoms, which have been shown to negatively impact both partner and parent-child relationships
- Increases relationship satisfaction
- Improves coparenting
Increases paternal engagement and responsibility
- Improves the father-child relationship in the long-term
The length of paternal leave also impacts paternal engagement. Longer periods of leave were associated with fathers taking more active roles in caretaking and child development.
However, as previously noted, fathers are much less likely to take leave after the birth of a child. Often this is due to financial concerns for the family. The implementation of paid family leave in California resulted in fathers being 46 percent more likely to take leave during the first year of their children’s lives supporting numerous positive impacts on familial relationships.
It is important to note that family bonding needs for same-sex couples and fathers are the same as for mothers, though paid leave is less available to fathers and same-sex male couples than mothers and female same-sex couples.
"I tried to limit the paid time off I used leading up to my son’s birth to maximize my pay while on leave. This resulted in me limiting vacation and working while ill whenever possible. Having so little time off on top of the physical tolls of pregnancy resulted in added stress and fatigue. Paid leave would have allowed me to take much-needed breaks during my pregnancy to improve my quality of life, allow me time to recharge, and improve my contributions at work." -E.D., Havertown, Pa.
Impact of Paid Family Leave on Businesses
Reinforcing Company Values and Improving Brand
Many business leaders cite congruence with company values as an argument in favor of paid family leave. For companies that value creating a supportive or family-friendly environment, paid leave would be an essential component of organization policy. Those who value work-life balance and wellness benefit from offering paid leave by developing a culture where supervisors are more supportive of the family needs of their teams, which is shown to reduce work-life conflict for employees.
Staff Recruitment, Retention, and Productivity
A 2021 poll found that 82 percent of people in the U.S. believe paid leave should be provided to mothers, and 68 percent felt it should be offered to both caregivers. A Deloitte study found that more than three-quarters of workers said paid family leave benefits could sway their choice of employer.
Businesses found that investing in comprehensive family benefits including paid family leave resulted in:
Increased employee recruitment and retention
- Reduced staff turnover among women
- Improved employee productivity and efficiency
- Increased employee effort
Improved employee morale and job satisfaction
- Increased profitability
- Increased employee commitment and loyalty
- Reduced absenteeism
Paid leave encourages workers to stay more attached to their jobs and be more likely to return after leave. This was found to be especially true for women in jobs that are considered lower skill as well as women who had higher educational achievement, showing that paid leave encourages retention of the qualified workers. Since the beginning of the pandemic, workforce shortages have affected all industries, leaving many employers with unfilled vacancies. Because of this, it is more important than ever to retain current staff.
When a business does not offer paid leave, expecting parents must depend solely on accumulated paid time off (sick and/or vacation). This is problematic in that it forces families to work through illness and burnout instead of taking time off for their own health or allowing them more time off after the birth of a child. This results in reduced productivity for that team member and potentially others affected by spreading illness when employees come to work sick.
Many arguments against implementing paid family leave focus on the fiscal impact on businesses, which some believe would lead to a reduction in jobs especially in small businesses. However, research in California has shown that this is not the case. In fact, paid leave has been associated with an increase in employment, lower per worker wage bill, and a lower turnover rate and the limited number of the limited number of negative impacts were primarily reported by larger businesses with 100 or more employees.
Many businesses have noted that offering paid family leave has had no effect on profitability or that the many benefits outweigh any cost to the business. The reduction in turnover of staff due to paid family leave can reduce recruitment, hiring, and training costs. A small number of employers report temporary increased costs to cover the workload of employees on leave; however, 87 percent saw no increase as the work is typically covered by temporary reassignment of tasks to other workers.
Some argue that offering paid leave would encourage more employees to take leave more often and for longer periods causing disruptions in productivity or workloads to be shifted to other members of the team. However, almost half of parental leave takers said they took less time than they wanted or needed to because of concerns about passing added work responsibilities on to their coworkers.
In the individualistic focus of many American workplaces, this can lead to feelings of inequity or resentment toward coworkers taking leave. Creating a workplace culture centered in teamwork and community as well as developing inclusive leave policies that support leave taking for a wider range of needs can avoid these negative outcomes.
Program Abuse and Fraud
Concerns about fraud and abuse of expanded paid leave, such as forged documents and workers taking more leave than necessary, has been mostly unfounded. In fact, those with state-level programs felt the additional oversight provided less opportunity for fraud. When abuse was noted, it was more likely to effect larger businesses of 500 or more employees significantly more than smaller employers.
"I was only able to accrue four weeks of time off. Upon returning to work, I had many doctor’s appointments for myself and my baby. Having used all my time off, I quickly went into negative sick time. This was incredibly stressful, and I worried about getting in trouble. Having paid leave would have provided me with sick time to use after my leave for medical appointments. We also could have afforded for my husband to take additional time off work to support me in recovering from my cesarean section." -M.K., Bala Cynwyd, Pa.
Impact of Paid Family Leave on Communities
Racial and Gender Equity
Unequal access to paid family leave worsens racial inequities. The rate of life-threatening maternal complications for women of color continue to increase as Black mothers and children are significantly more likely to die during childbirth (more than double the average), even when income is considered. Black and Hispanic mothers who are more likely to be employed in part-time, seasonal and low wage roles are also the least likely to have access to paid leave and often are unable to afford to take unpaid leave. Forty-one percent of Black workers and 23 percent of Hispanic workers have access to paid parental leave, compared to 47 percent of white workers.
While the amount of time taken on leave may not differ among racial groups, the amount of compensation does.
A study in California found that Black women received 3.6 weeks less paid leave than white women, and Black and Hispanic women were less likely to have received support in navigating leave benefits possibly leading to underutilization of leave and added job security stress within those groups. States such as California saw the largest increase in leave taking by Black mothers after the implementation of state-wide programs.
In the workplace, paid family leave supports gender equity, and is key to eliminating pregnancy discrimination. It signals that an employer values women in its workforce. Furthermore, providing the same paid leave benefits to all employees regardless of their role or how their family came together signals support for diverse gender identities, expressions and sexual orientations.
Since the onset of the COVID-19 pandemic and resulting stay-at-home orders, more than 2 million women have left the workforce, many due to lack of childcare, which can have significant impact on gender pay equity. Female caregivers experience more negative financial and career impacts than male caregivers and women without children. This is often attributed to time taken out of the work force after birth and higher probability of working part time after childbirth instead of returning to full-time roles.
The weight of caregiving and managing childcare after birth, which disproportionally affects women, has also been found to damage career progression and future pay. Five years after childbirth, just 13 percent of women had experienced opportunities to move up the employment ladder compared to 26 percent of fathers. Without access to paid leave, approximately 30 percent of women will leave the workforce in the year after childbirth. Forty percent of those women will remain out of the labor force by the time their child reaches the age of six.
Additionally, women (65 percent) are more likely than men (44 percent) to be the primary caregivers for family members with serious health conditions.
Access to paid family leave supports gender equity by:
Increasing the likelihood that women would be working in the year following childbirth
- Reducing labor force participation gaps between mothers of young children and other women by 20 percent in year of birth
- Reducing the gender wage gap
Furthermore, paid medical leave to care for oneself or family is found to have a greater impact on people of color who, because of well-documented discrimination in healthcare, racial disparities in health insurance coverage, and exposure to pollution, are more likely to suffer from chronic and life-threatening health issues.
Black, Hispanic and Asian workers are also more likely to live in multigenerational homes and bear the responsibility of eldercare than white workers who are more likely to have access to paid leave.
Reliance on employer-provided leave benefits highlights socioeconomic inequities as parental leave policies are most often provided to higher wage workers and structured to favor middle- and upper-class families who have the means for one or both parents to take time off unpaid to care for their families. Part-time and temporary workers, who are more often lower wage workers, women, and people of color, are excluded from FMLA benefits and have less accumulated time off to take leave when paid leave is not provided. With infant mortality rates linked to parental income, it is evident that expanding paid leave to lower income families would make a significant impact on reducing child health disparities.
Additionally, women with lower levels of education are less likely to return the workforce in the three to five years following a child’s birth than women with higher levels of education, thus widening disparities in pay and career opportunities beyond just those accounted for by educational differences. State paid leave programs, such as in California, have been found to reduce disparities in leave taking activity. In California, paid leave resulted in a more than threefold increase in leave taking for non-college educated mothers and a nearly fivefold increase for those who were unmarried.
"The lack of support and short amount of time off made my pregnancy feel a lot more stressful. I didn’t feel well but did not want to take time off. I felt like I couldn’t take care of myself. You don’t stop being a mom just because your 12 weeks are up. I came back with no time off. With follow up appointments for myself and my baby, I must make tradeoffs and decide if it is worth calling out and not being paid." -C.D., Philadelphia
Paid Leave Implementation and Support
Effective implementation of paid leave programs requires more than just a policy change by organizations. Many workers are confused by these policies and need information and support to take leave. It is essential to supply clear information to human resource staff and supervisors on policies to create a culture of support surrounding leave-taking and provide equitable implementation. The level of difficulty in planning for, taking, and returning from leave affects the benefits and outcomes of leave.
Research makes it noticeably clear that families and communities are positively affected by access to paid family leave, especially those in lower wage jobs who would not be able to afford unpaid leave otherwise. Also, most of the population supports widespread and fundamental paid parental leave offerings and government funding. As the only developed country without a national paid family leave program, the U.S. will continue to trail the rest of world in child and maternal health until robust and health-focused family leave supports are in place for all families. Until comprehensive federal and/or state paid leave laws are passed, it is up to businesses to take responsibility for the wellbeing of workers through offering paid family leave. This is essential to nurturing a positive workplace culture and supports the bottom line.
Implement Paid Family Leave for all Workers
To ensure the health of families, individual businesses must provide paid family leave to all workers. For paid leave policies to be effective, it is important that these policies:
- Be inclusive of all types of employees who may grow their families – birthing mothers, coparents, adoptive parents, and foster parents – by using gender-neutral language and provide the same amount of leave regardless of family formation by expanding the definition of children to include birth, adopted, and foster children and family to include a wider range of family members
- Include family care needs by allowing employees to use benefits to care for a sick or injured child, partner, parent, or grandparent or to recover from the loss of a child (miscarriage/stillbirth)
- Embrace flexibility as each family’s needs will differ
- Provide coverage that pays 100 percent of worker wages during leave
- Offer a minimum benefit for all employees regardless of work history
- Provide paid leave to both part-time and full-time workers
Implement a Nationwide Paid Sick Leave Policy
In lieu of a nationwide paid family leave policy for all workers, policy makers must pass a mandatory paid sick leave policy to provide economic support for workers who do not meet the requirements for FMLA or other employer-supplied paid leave programs, including part-time workers and businesses of all sizes.
Expand Education and Resources for Employees about Family and Medical
Information must be developed and provided to workers by all employers so that they can better understand their rights and opportunities under family or medical leave benefits. These comprehensive resources should guide workers on taking leave, including easy to understand processes to go on and return from leave. Training and resources must be provided to managers to support employee leave transitions and ensure service continuity during leave periods without placing an undue burden on other team members. Strong messages must be included about protections for workers from retaliation or discrimination for taking leave.
Create Family-friendly Policies and Programs That Support Working Parents and Caregivers
In order to develop a culture that supports leave-taking, employers must develop additional policies and programs that provide the support workers need to provide care for their families after returning from leave. These include but are not limited to:
- Flexible work schedules and locations
- Access to affordable child/eldercare through strategic partnerships or employer provided service
- Expanded access to dedicated lactation spaces
For More Information
Contact Natalie Shaak, Chair of the Staff Coordinating Committee at email@example.com
The Dornsife School of Public Health Staff Coordinating Committee is composed of elected representatives from the school’s departments and centers. Its purpose is to represent the perspective and concerns of professional staff in guiding school and university policy and practice and advise the Dean and all leadership on all matters of interest to School staff.
Policy brief by Natalie Shaak (Associate Director of Communication and Administration, Center for Hunger-Free Communities) with support from Allison Gibson (Project Coordinator, Urban Health Collaborative), Matthew Jannetti (Data Analyst, Urban Health Collaborative), Lauren Nicosia (Data Manager, Center for Nonviolence and Social Justice), and Jennifer Ware (Deputy Director, Ubuntu Center on Racism, Global Movements and Population Health Equity)