Study reveals that rural workers are more likely to lack paid sick leave

About half of the workers in rural communities lack paid sick leave, and fewer than half (48%) have unpaid job protection through the federal Family and Medical Leave Act (FMLA), a new report finds.

The report from New America, a Washington, D.C.-based think tank, painted an alarming picture of the lack of medical leave for Americans in rural communities. “Among U.S. states with more than 20% of the population living in rural areas, none guarantee workers access to paid family and medical leave and only two (Vermont and New Mexico) guarantee access to paid sick time,” the report says. “In the absence of legislative requirements or programs, just over half of workers in rural communities (55.7%) report having employer-provided paid sick time through their jobs, and both men and women in rural communities are seven percentage points less likely than metropolitan-area workers to have access to paid sick time.”

Overall, the study outlined the health care issues faced by Americans in rural areas: they tend to be older, poorer, and farther away from health care facilities. This has a direct impact on their ability to get preventive care, or health care at all. The data suggests that companies based in rural areas who do offer paid medical leave might have a significant advantage in attracting and retaining workers.

The U.S. is behind the curve on worker protections

The New America researchers note that the United States is one of the only countries in the world that does not guarantee any form of paid sick time or paid family and medical leave to workers.

The U.S. does have the Family and Medical Leave Act of 1993 (FMLA), which provides workers job-protected, unpaid leave for up to 12 weeks per year. But that coverage is limited to workers with serious health conditions or who are caring for a new child or a parent, spouse, or child with a serious health condition. The report notes that many employers in business areas are exempt from FMLA rules because they have a small number of employees or employees that do not work full time.

The report notes that states are free to make their own medical leave rules; and 20 states and the District of Columbia have adopted more generous employment protection requirements that apply to employees that may not be covered by FMLA. In addition, 11 states and the District of Columbia have created paid family and medical leave programs, which guarantee paid leave to working parents and family caregivers and to workers with their own serious health issues. And more than a dozen states, the District of Columbia, and a number of local governments require employers to provide earned paid sick time to employees based on the number of hours an employee works. However, states with more rural workers tend not to have legislated requirements on paid medical leave.

“Notwithstanding state progress, without federal requirements or systems in place, most workers’ access to paid leave is left to the discretion of their employers. Overall, in the United States, as of March 2022, 25% of civilian workers and 24% of private-sector workers had paid family leave through their jobs to care for a new child or a seriously ill loved one,” the report says. “Access to benefits varies dramatically by wage level, industry and employer size — with lower-wage workers, service- and front-line occupations and workers in smaller companies less likely to have access.”

A barrier for rural employee retention

The report concludes with policy recommendations to address the unequal access to paid medical leave that is seen in rural communities. Leaving this policy issue up to the private sector has historically not been effective, the report says, and government regulation is seen as the best way to level the playing field.

Such regulation is generally popular with the public, the researchers add, with surveys showing that rural voters support expanding paid sick leave benefits. In 2020, 78% of rural voters said they supported a national paid medical leave law, and 80% expressed support for a permanent paid family and medical leave policy for people who have an illness or need to provide care to family members.

But the study finds that private businesses have traditionally seen these programs as fringe benefits and put a lower priority on them. Especially in rural areas, too many workers are left out, the researchers say.

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“While higher-wage, professional workers may be offered paid leave, middle- and lower-wage workers generally are not — even though their needs may be greater and going without pay is more difficult,” the report says. “The rural employment outlook — the types of jobs that are likely to be created, especially in leisure and hospitality, retail, and (to a lesser extent) education, health and social services where wages tend to be low, and benefits are typically sparse — makes significant expansion of paid leave access unlikely without public policy interventions.”