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Who in the U.S. gets paid sick leave, in four charts

Where you live, where you work and what industry you’re in all affect the likelihood of getting paid time off for illness.
Labor advocates hold a press conference in   favor of paid sick leave
Supporters of earned paid sick leave listen during a press conference at Portland City Hall in Maine in 2019. Shawn Patrick Ouellette / Portland Press Herald via Getty Images file

As lawmakers in Congress battled over a labor deal to increase pay for railroad workers and avert an impending strike, a key element was left out of the bill sent to President Joe Biden’s desk this week: mandating paid sick leave

After a separate vote to add seven days of paid sick leave for the freight workers failed, the finalized deal highlights a decision millions of employees face — choosing between their health and their income. 

Roughly 1 in 5 civilian workers in the U.S. don’t have paid sick leave, according to the federal Bureau of Labor Statistics. And although the share of the workforce with access to these benefits rose from 67% to 79% from 2010 to 2022, whether an employee can call in sick and still get paid depends on several factors, including where they live and what industry they work in.

Teachers were the most likely to receive paid sick leave in 2022, followed by management employees and nurses, Bureau of Labor Statistics data shows. Construction, extraction and farm workers have the lowest likelihood, with two-thirds able to take paid sick days. This group also represents the highest increase in access from pre-pandemic levels. 

Paid sick leave was at the heart of the dispute between rail workers and freight companies, with some workers demanding seven days paid sick leave. Bureau of Labor Statistics data shows that the vast majority of the country’s unionized workers are able to take paid time off.

Many sick leave mandates allow workers to take 5 to 8 paid sick days, depending on how many hours they work and the number of employees in the business.

The U.S. is an outlier when it comes to national sick leave policy, a point President Biden called attention to in a statement urging Congress to pass the legislation earlier this week. 

Sick leave mandates have been enacted in 17 states, numerous cities and Washington, D.C. And most of the states requiring paid sick time off — including Arizona, Massachusetts and Michigan — passed these laws years before the Covid-19 pandemic.

Bureau of Labor Statistics data shows access to paid sick leave increased across most of the U.S. from 2019 to 2022, except for the region including Arkansas, Louisiana, Oklahoma and Texas. Several states including these four have passed legislation blocking cities and counties from enacting paid sick leave. In 2021, Texas became the latest to ban municipal ordinances requiring businesses to provide paid sick leave.