The lack of paid sick leave as a barrier to cancer screening and medical care-seeking: results from the National Health Interview Survey.
BACKGROUND
Preventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce.


METHODS
Data from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT), and medical-care seeking.


RESULTS
More than 48 million individuals (38%) in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12 months or had at least one visit to a health care provider during the previous 12 months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors.


CONCLUSIONS
Lack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.
Epidemiology and Applied Research Branch, DCPC, CDC, 4770 Buford Highway, NE, Mailstop K-55, Atlanta, GA 30341-3717, USA. LBP6@CDC.GOV
Lucy A
LA
Peipins
Ashwini
A
Soman
Zahava
Z
Berkowitz
Mary C
MC
White
D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D009790:Occupations / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D018582:Sick Leave / Q000706:statistics & numerical data*; D014481:United States; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult