‘Before It’s Too Late’: Paid sick days for all

Why do paid sick days matter and how does a lack of paid sick days negatively impact public health? Is there a difference between public health outcomes in places that do have paid sick days versus places that don’t?

CJ: With respect to the public health outcomes, we know that [paid sick days] are good for a number of things. The most obvious thing is containing and preventing infectious disease transmission in the workplace; we know workplaces are vectors for that. In US cities… [there was] a study that was done a couple of years ago which showed that there was a 40% reduction rate of influenza in cities that had paid sick days, in comparison to the cities that didn’t have paid sick days. And so obviously it contributes to less morbidity and mortality among the population.

It’s also really good for accessing preventative health care. [Access to paid sick days] increases vaccinations, and increases cancer screenings like mammograms, for example. We know that it’s important for people who are managing chronic or comorbid conditions, who have to see specialists and so on, and we also know that it’s associated with positive mental health impacts. 

The other piece to that is that it’s also good for healthcare systems, because it prevents accessing downstream services, which tend to be more expensive to the healthcare system overall. Something that we’d like to say is that paid sick days are an investment in public health, by allowing workers to take that day off to recuperate when they’re feeling ill, by allowing them to access their family doctor, and not go to work sick, so that they don’t get worse or spread the illness to other people, or have to go to an emergency department, which we know is not an ideal place for people to get healthcare. 

The link between paid sick days and a safe return to schools in September isn’t necessarily immediately obvious. Can you talk about why paid sick days will be important to ensure a #SafeSeptember when children return to school?

CJ: I like to think of it as twofold. We always say that workplaces are key sites for infection transmission, and schools are workplaces. And not just for educators, but all of the other support staff. We need to make sure that everybody employed in the school ecosystem is able to stay at home and isolate [when sick].

There was a study that was done that showed parents who had paid sick days were 20% less likely to send sick children to school. If you also think about this from an equity perspective, the workers that don’t have paid sick days are more often racialized, precarious workers, who are making low wages, and who also come from neighbourhoods where there are higher rates of COVID-19 in general. Oftentimes these people work in sectors where they are unable to work from home. So they’re already more likely not only to have COVID-19 in their communities, but also more likely to come in contact with COVID-19 in the workplace. If they don’t have paid sick days, and they can’t afford childcare, they’re more likely to send sick children into school. It’s a disaster waiting to happen, and one which will hurt racialized and low-income families the most. 

The other piece is that a lot of students are also workers. A lot of times, students are in very precarious working conditions, working at places like fast food restaurants for example. If they don’t have paid sick days, then they are also more likely to come into contact with a contagion at work.

You’ve already talked about how everyone isn’t impacted equally by a lack of paid sick days. Can you talk in more detail about what makes this an issue of racial and gender equity and justice?

CJ: 58% of workers in Canada don’t have paid sick days, but that number jumps to over 70%, for those who are making $25,000 or less. So low-income folks are less likely to have paid sick days, and we know that people in low-wage jobs often don’t have a lot of other protections. Their work is precarious, and they’re often in workplaces that are hazardous. Cumulatively, we can think of this disproportionately impacting racialized folks – specifically Black and Indigenous workers – and women workers as well, who are much more likely than men to be working in precarious positions.

Especially, we’ve seen tragedies in long-term care homes and in the care and home care sector, where there are a lot of women workers, specifically racialized women, who are deeply impacted by COVID-19; these things are not a coincidence. There is also the piece around migrant farm workers and the link between [citizenship] status and the abysmal protections – or no protections – that these folks have. 

Trudeau has temporarily called for 10 paid sick days for COVID-19 related illness. Why is it important for public health that we have permanent, mandated paid sick days for non-COVID-19 related illness? Why is it important that paid sick days are employer-paid, rather than being government-funded? 

CJ: So, the program that Trudeau has called for… that is not the paid sick days we have been calling for. They’re two very different things. I think we’re really heartened to see the three new supports that have been brought in for people who don’t typically qualify in the EI system, and for lots of gig workers and stuff… then also the personal sickness and caregiving benefit. Those are more like income supports for people who have to take time off because of COVID-19; it’s not paid sick days. It’s an additional program.

So, yes, we’re concerned. It’s not actually legislated, it’s temporary, and it’s only for COVID-19 reasons. If you think about it logically, we’re coming up to flu season… [What if you] have symptoms, you don’t know whether it’s COVID-19, and you’re worried about a potential interruption of income? From a health perspective, the important thing is that people are able and have the income support to stay home at the first sign of illness. For a lot of people who are living paycheque to paycheque, that program is not going to cut it. It’s going to leave people behind, whereas paid sick days that are legislated through employment standards and without exceptions. The important piece is that they’re legislated, so everyone has access to it. There is no medical evidence to support providing income supports only for COVID-19, but not for the other illnesses. It doesn’t really make sense to cherry pick conditions. The flu kills 3,500 Canadians a year. It doesn’t really make much medical or public health sense to say, “Yeah, you can stay home because of COVID-19, but not because of the flu.”

There’s a lot of questions around whether paid sick days are affordable or not. We’ve already talked about it being an investment into public health. I can definitely understand a lot of the concerns from smaller businesses who are already struggling to get by, but we still believe that the most effective way to have those days automatically, for it to be an effective public health intervention, for workers to not have to apply through another program – could be COVID-19 or not – is that they’re delivered through their employer. It becomes a little dicier from a medical perspective to say where that pot of money is coming from. This is not necessarily from the medical standpoint, but we really don’t want to support subsidies for corporations. 

You started writing this report in 2019, well before COVID-19 was a concern. Can you explain in what ways this pandemic has specifically highlighted the need for mandated paid sick days? 

CJ: A lot has changed with COVID-19, but we’ve been knowing that [paid sick days] are really important to contain infectious disease, curb the spread of illness, and a lot of other things. I feel like COVID-19 has been an example of what can really go wrong – the individual threat and the threat to our collective society – when we don’t have these protections.

It has also highlighted a lot of the equity concerns, in the sense of who is really affected. This whole idea of essential workers… Everybody’s essential, and especially those people who we deem as essential are the ones that don’t have essential protections. I think from an equity perspective, it’s also been really clear that these are workers who are consistently systematically neglected by health institutions and public health policy.

In the report, you address common misconceptions about employer-paid sick days. Specifically, you address the myths that employees abuse paid sick days, and that employer-paid sick days negatively impact small business owners’ bottom line. Can you tell me what the current best available research says about these concerns?

CJ: Research has come from a couple of years ago in San Francisco and New York, two jurisdictions that were kind of first to put forth more progressive paid sick day policies. I think the findings confirmed what we already knew: Workers use paid sick days as a form of insurance for when they get sick. For example, when San Francisco mandated between five to nine paid sick days, the majority of workers took only three, and about a quarter of workers took none.

They also surveyed small businesses in San Francisco, and six out of seven didn’t report a negative impact on profitability. We also know that paid sick days are really good for workplace morale. At the end of the day, we really have to think about this. If that is a concern for employers, that should not come at the expense of protecting public health; that’s an HR problem. We know that a lot of corporations, of course, can afford it.

Have you or the organization experienced any push-back in regard to your demands for mandated employer-paid sick days? If so, who is pushing back and why? 

CJ: I think this really feeds off of the question that we just spoke about in terms of the small business argument, which we debunked pretty easily. Pushback around the affordability piece is something that we always get. I think that it just seems like a really radical idea to some stakeholders, policy makers, and government officials.

We always try to point to all the jurisdictions in the States [which have legislated paid sick day policy]. Over the past several years, 13 different States and 23 different cities or counties in the US have put forth paid sick day policies. The most comprehensive policy happened during the Pandemic last month in July, put forth by Colorado; and New York state expanded their policy – put in at the beginning of the pandemic – to make it permanent. 

It’s not ludicrous that we’re calling for [seven] days. That’s another question that we get. It’s based off of the median time that it takes for people to get better; after influenza it’s three days. There have been guidelines that have come from the Canadian Association of Family Physicians, and their recommendation for someone’s staying home for the flu is a week. That’s what a lot of family physicians prescribe for the flu. It makes medical sense.

Can you tell us a bit about the Decent Work and Health Network, it’s goals, and who is involved?

CJ: The Decent Work and Health Network was essentially a group that was created to support workers’ demands, to really speak out on these issues from a perspective of the social determinants of health. We know that income, employment, and working conditions are really important. It’s really important to think, as health providers, how does that look in practice? That can look like changing the laws so that your patients, the community that you serve, can have access to improved health. 

So, we started in 2014 with an original petition for paid sick days, no sick notes, and job-protected personal emergency leave. At that time, I think it was around 1.6 or 1.7 million workers who didn’t have access. If they took a day off unpaid for an emergency, they could be fired. We know that still happens, but at least now there’s protection against it. So that was sort of the original petition that was able to really mobilize health workers.

Our group is composed as a sort of working group of two different organizations: Health Providers Against Poverty – who have a much more broad anti-poverty framework – and we’re part of the Worker’s Action Center, and the Fight for $15 and Fairness. So we take a lot of leadership from them, in lending our support and our voice to help that movement. The way that that’s looked over the years has been: Trying to be active around the Changing Workplaces Review, winning some of our demands through Bill-148, and fighting to not get that stuff taken away. At this point, we’re doing a report to hold the government accountable for reckless policy decisions, and also creating a body of literature and a first-of-its-kind report on the state of paid sick days in Canada. 

Contemporarily, it’s a very physician-driven network. Namely because a lot of the people from Health Providers Against Poverty and the founding members of the Decent Work and Health Network are physicians. One of the things that we really want to continue working towards is to diversify. In terms of our membership, we have a core steering committee of mostly physicians. There are two full-time staff at the Decent Work and Health Network – myself, the Coordinator, and a Media & Communications person. But we do represent a broader network of health workers. Originally, we had a very provincial focus, but I think now with the pandemic, the scope of the report and the advocacy that we want to do is much more national. So, we’re thinking through how to continue to build those connections outside of Ontario, with other worker groups, and other health workers. We really welcome anyone at all who’s interested in the links between work and health.

How can people reading this get involved with the fight for paid sick days? 

CJ: We meet with the Fight for $15 and Fairness, which meets monthly. The next meeting is going to be on the 15th of September.* There’s also a letter petition tool that we launched as part of the report, which is really awesome. That’s on our website: decentworkandhealth.org, where you can also read our full report and join to be a member. We like to send bi-weekly emails, providing updates on the campaign, and to share information about our pan-Canadian days of action for paid sick days, which we had in May, July and August. There’s no fee, and you don’t have to come to a meeting. If anyone wants to get in touch with me more directly and chat, my email is info@decentworkandhealth.org. We’re also really happy to come and present at anyone’s meetings or events, and share the findings of the report. 

*RSVP to receive the link to join Fight for $15 and Fairness’/ Decent Work and Health Network’s up-coming meeting on Zoom.

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