December 5, 2022
By Debi Smith, Drexel University College of Medicine

Paid parental leave is a benefit of employment that almost seems intuitive; it lets parents in the workforce care for themselves and their newborn following delivery, reducing financial insecurity and stress during those times. The United States remains the only industrialized, modernized country that does not have a paid family medical leave program. While the U.S. has implemented the federal Family and Medical Leave Act (FMLA), this only affords unpaid leave and has strict eligibility requirements, often excluding those most in need, exacerbating existing health disparities. The benefits of paid leave, such as improved maternal and infant health outcomes, have been well described in the literature, yet our nation has failed to comprehensively protect those in the workforce and their families.

The U.S. is the only member of the Organisation for Economic Co-operation and Development (OECD) and one of six nations in the world without some form of legal protection guaranteeing new parents paid time off to be with their child (bipartisan policy). While details of each nation’s policy vary, the U.S. federal FMLA fails to provide paid parental leave. Instituted in 1993, FMLA provides 12 weeks of unpaid, job-protected leave with continued health insurance coverage to attend to a newborn or adopted child, a family member or the employee’s own serious health condition. Many employees rely on this legislation for some form of parental leave, but there are strict eligibility requirements. FMLA is only extended to workers of companies with more than 50 employees, at which the worker must have been employed for the past 12 months and have worked at least 1250 hours in this period (Tanaka, 2005). It is estimated that less than 50% of American workers are eligible for this limited unpaid protection, and 46% of those eligible are unable to afford taking unpaid leave due to financial constrictions (Han et al., 2009).

In addition to the limited entitlement to FMLA benefits, the greater lack of paid parental leave exacerbates the existing health inequities in America. Only 11% of wage earners are privileged to be offered paid parental leave by their employer (Van Giezen, 2013). The children at highest risk for poor health outcomes are those whose parents are most likely to be in the 89% of workers who are not offered paid leave by their employers (Han et al., 2009). The top 40% of American workers are 2.5 times more likely than the bottom 40% to have paid parental leave benefits (Glynn, 2012). This social hierarchy perpetuates health disparities.

The health-related benefits of job-protected paid parental leave have been illustrated in the literature, suggesting that it is time for U.S. lawmakers to act. Providing new parents with paid time off and job security to care for their new child contributes to healthy development, improves maternal health, and enhances families’ economic security both in the short- and long-term (Burtle & Bezruchka, 2016). Multiple studies have reviewed the effects of paid parental leave finding decreased incidence of low birthrates, reduced infant mortality rates, increased breastfeeding, longer parental lifespan, improved parental mental health as well as long-term achievement for children (Tanaka, 2005; Ruhm, 2000; Baker & Milligan, 2008; Carneiro, 2015). A study in Norway examined long-term effects after transitioning to four months of paid family leave from three months of unpaid leave, finding and an increase in IQ and college attendance, with a decrease in dropout rates and teenage pregnancies for children born after the addition of paid leave (Carneiro, 2015). One of the most important findings was that when comparing unpaid to paid leave, the positive health outcomes were only seen for job-protected paid leave, not a protected entitlement of FMLA (Tanaka, 2005; Ruhm, 2000).

It has been well-documented that early life environment impacts individual health and economic outcomes throughout one’s life (Barker, 1990). When examining the poor infant health outcomes like preterm births and infant mortality in the U.S.,, it is apparent that the U.S. could benefit from early childhood intervention, specifically paid parental leave (Rossin-Slater & Uniat, 2019). In a time when health disparities and health outcomes between social classes are greater than ever, now is the time for our legislators to act. Now is the time for our government to do more and give our nation a fighting chance.

Sources/Resources:

• Baker, M., & Milligan, K. (2008). Maternal employment, breastfeeding, and health: evidence from maternity leave mandates. Journal of health economics, 27(4), 871–887. https://doi.org/10.1016/j.jhealeco.2008.02.006
• Barker D. J. (1990). The fetal and infant origins of adult disease. BMJ (Clinical research ed.), 301(6761), 1111. https://doi.org/10.1136/bmj.301.6761.1111
• Burtle, A., & Bezruchka, S. (2016). Population Health and Paid Parental Leave: What the United States Can Learn from Two Decades of Research. Healthcare (Basel, Switzerland), 4(2), 30. https://doi.org/10.3390/healthcare4020030
• Carneiro, P., Løken, K. V., & Salvanes, K. G. (2015). A flying start? Maternity leave benefits and long-run outcomes of children. Journal of Political Economy, 123(2), 365-412.
• Han, W. J., Ruhn, C., & Waldfogel, J. (2009). Parental leave policies and parents' employment and leave-taking. Journal of policy analysis and management : [the journal of the Association for Public Policy Analysis and Management], 28(1), 29–54. https://doi.org/10.1002/pam.20398
• Glynn, S. J. (2012). Working parents’ lack of access to paid leave and workplace flexibility. Washington: Center for American Progress.
• Rossin-Slater, M., & Uniat, L. (2019, March 28). Paid family leave policies and Population Health: Health Affairs Brief. Health Affairs. Retrieved October 6, 2022, from https://www.healthaffairs.org/do/10.1377/hpb20190301.484936/full/
• Ruhm C. J. (2000). Parental leave and child health. Journal of health economics, 19(6), 931–960. https://doi.org/10.1016/s0167-6296(00)00047-3
• Tanaka, S. (2005). Parental leave and child health across OECD countries. The Economic Journal, 115(501), F7-F28.
• Van Giezen, R. W. (2013). Paid leave in private industry over the past 20 years.