This story was originally published at Prism. 

By Cecille Joan Avila

Paid family and medical leave is getting all the attention right now, and there is no doubt that the United States needs to catch up to the rest of the world. Offering federal paid benefits to parents or caretakers to assist with new child responsibilities or care for those long-term illnesses can help everyone. But for federal paid family and medical leave to work to its truest potential, we need to start with federal paid sick leave.

Too often women’s health is immediately confined to maternity, sexual, and reproductive health. If they’re lucky enough to have family and maternal leave benefits, women are barely allowed to take sick time from work to care for the health of others. While similar, the two types of leave are separate. But what about when women need time to tend to their own health? Viewing women’s health exclusively through the lens of maternity and childbirth excludes women who aren’t cisgender.

We need to remember that women’s health matters even if they are not a mother or caretaker, and benefits like paid family and maternal leave are not the only way to support women as individuals in their own right. The implementation of paid sick leave for employees across every industry would have an enormous impact on women’s health. If people—especially women or anyone with a uterus—can’t take care of themselves, it also makes it harder for them to care for their children, families, and wider communities.

A women’s health issue

Like paid family and medical leave, paid sick leave is beneficial regardless of gender, but women could benefit from it the most. Our society undervalues women, but “at least” tends to place more value on women if they are mothers. This current recognition is far from enough, and the idea that maternity leave can be classified as a short-term disability is highly problematic. However, it’s equally important to break free from the idea that children are the expectation and end goal—or that having children is even possible for everyone.

After all, shouldn’t women be able to take care of their own health so they can decide if motherhood is right for them? And shouldn’t taking care of one’s health be accessible to all women, not just those who make a certain amount of money or women who work in certain industries? Women deserve time to care for themselves unconditionally, regardless of where they work, their level of income, or whether or not they have dependents.

Evidence shows that individuals with paid sick leave are more likely to access preventative services (i.e., visiting their primary care provider, going to the dentist, getting Pap smears, or influenza vaccines) when compared to those who do not have access to paid sick leave. Without paid sick leave and even with health insurance, people are more likely to skip prescription refills or delay necessary treatments.

But it’s likely not a choice anyone actually wants to make to forego any of these services, and it’s telling who has to make this “choice.” Those who do not have paid sick leave tend to be younger, low-income workers, part-time workers, and people—especially women—who are not white. Many don’t have the luxury to choose between a day’s wages (“Do I feed myself? Pay rent?”) or being able to take care of their health. Preventative services can promote health, but only if people have the time to access and use them before these problems compound into something extremely costly or potentially deadly.

Those who already have paid sick leave tend to be older, work high-income jobs, and have comprehensive health insurance. As a result they’re less likely to feel the pressure between deciding to take a day off to take care of their health or losing out on money. And they might not even realize that paid sick leave, which is currently determined by employers or the state one resides in, is not a guarantee.

A stepping stone for the invisible

The disparate effects of no federal paid sick leave policy showed during the pandemic. Some were able to transition to working virtually from the relative safety of their own homes, but many essential workers did not have the luxury to stay at home. Not only could they not afford to quit their jobs to reduce exposure, but many who got sick were unable to afford time off to recover from COVID-19.

Even as the pandemic eases, there are still disparities. Vaccination rates are lower among Black and Latino folks, who also make up a large number of essential workers. They report wanting to get a COVID-19 vaccine, but are unable to get time off to do so. President Joe Biden called for employers to give their workers time off to get vaccinated, but without a mandate it’s still up to employers to offer it.

A federal paid sick leave policy would allow workers to take time off to be vaccinated or recover from COVID-19 and other illnesses without fear of losing their job or pay—regardless of employer. This would protect the health of those recovering from illnesses and also help protect others by preventing the potential spread of illness by people who face the untenable choice of caring for their health or keeping their job.

Paid sick leave is essential to women’s health. It addresses those who hold up society but are often invisible. They are women and nonbinary folk, and especially those who either choose not to have children, or cannot bear the children they want. They are the women who care for family members in need at home after long days of caring for others in medical facilities. They are the women with no one to depend on but themselves, who still care for the needs of others by working hourly shifts at the grocery store or holding service industry jobs—deemed essential last year, but since forgotten.

A woman’s ability to take the time they need to care for their health should never come at the expense of lost income, nor depend on the income they make or the industry they work in.

Cecille Joan Avila (she/her), MPH, is a policy analyst at Boston University School of Public Health. A former photojournalist, she now writes about domestic health policy issues. Her areas of interest are in ethics, getting people to care about historically excluded populations, and sexual and reproductive health.

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