Paid family leave associated with reduced burden of infant respiratory infections
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Key takeaways:
- Before 2018, respiratory tract infection rates were similar in New York and control states.
- After the state introduced paid family leave, acute-care encounter rates were 18% lower than predicted.
Acute-care visits for respiratory tract infections were nearly 20% lower than predicted among infants in New York after the state implemented paid family leave, according to a study published in JAMA Pediatrics.
“That effect was pretty big, especially because paid family leave policies are enacted for reasons unrelated to infant health, like women's labor force attachment,” Katherine A. Ahrens, PhD, MPH, epidemiologist and associate research professor at the University of Southern Maine Muskie School of Public Service, told Healio.
New York state introduced paid family leave in 2018, guaranteeing 8 weeks of paid time off for parents within 1 year of their child’s birth. The researchers noted that in its first year, eligible parents claimed leave for one-third of births in the state.
Ahrens and colleagues conducted a population-based study of acute care visits for infants aged 8 weeks or younger in New York state that occurred from Oct. 1, 2015, through Feb. 29, 2020. They compared data from New York with four control states in New England: Maine, Massachusetts, New Hampshire and Vermont.
The researchers created a model to estimate monthly trends for acute-care visits, which took into account the seasonality of respiratory tract infections.
During the study period, there were 950,020 births in New York compared with 426,342 in the control states. Overall, there were 52,943 acute-care encounters for infants with respiratory tract infections in all five states.
Before paid family leave was implemented in 2018, rates of acute-care encounters were similar in New York and the control states, the researchers wrote. After paid family leave went into effect, New York experienced lower rates of respiratory tract infections than the control states, which experienced more severe respiratory infection seasons from 2018 to 2020.
Before 2018, the actual rates of respiratory infection visits were similar to those predicted by the model Ahrens and colleagues built, “establishing that the model was well fitted to observed data prepolicy,” they wrote.
The post-2018 rates were 18% lower than predicted (95% CI, –20% to –16%). For respiratory syncytial virus in particular, the actual rates were 27% lower than predicted after implementation of paid family leave (95% CI, –31% to – 24%).
In a related editorial, Justin S. White PhD, from the Boston University School of Public Health, and Rita Hamad, MD, PhD, from the Harvard School of Public Health, argued that the study adds to the growing evidence supporting nationwide paid family leave. The United States is the only high-income country that does not have a national paid leave policy, and only two in five workers qualify for unpaid leave through the Family and Medical Leave Act, they wrote.
Ahrens noted some limitations of the study, including the fact that the study period was conducted before the COVID-19 pandemic and the rollout of RSV vaccines for pregnant women and young infants.
“Future research can examine the effects of paid family leave policies in other states on respiratory tract infection-related acute-care encounters in newborns,” Ahrens said. “These studies will be different because of the introduction of a maternal RSV vaccine and immunoprophylaxis of RSV in young infants. They might also be different if the duration of paid family leave and the extent of wage replacement is different from New York, and the uptake of paid family leave is different.”
References:
- Ahrens KA, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.3184.
- White JS, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.3181.
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