Marion Johnson, Think NC First Policy Analyst

Imagine that the cook who made your sandwich today has been sneezing and coughing all day. His coworkers in the kitchen are sniffling too, and now you’re starting to feel a tickle in your throat. Don’t you wish the cook had just stayed home instead?

For thousands of North Carolinians, staying home sick isn’t a real option. Over one million working North Carolinians lack access to paid sick leave.[i] That means that if they get sick, they have to make a difficult choice: stay home and miss out on the day’s wages, or go to work and risk getting sicker or making someone else sick.

The disparities between different industries have troubling moral and public health implications. In North Carolina, 77 percent of employees in the food preparation and serving industry lack paid sick days.[ii] People whose jobs depend on interacting with the public and preparing food are the most likely to have to come to work sick or lose a paycheck. These employees are also typically economically vulnerable – missing a day’s wages can be financially disruptive. Put another way: 60 percent of full-time employees earning less than $20,000 a year lack paid sick days, while fewer than 20 percent of North Carolina’s top earners lack them.[iii]

“Workers without paid sick days are more than twice as likely as those with paid sick days to seek emergency room care because they can’t take time off during normal work hours.”[iv]

Employees who don’t have paid sick days are more likely to work sick, which creates multiple issues. Sick employees are less productive, so less work will get done. One study estimated that presenteeism – the decreased productivity from working while sick – costs employers an average of $255 per employee every year.[v] Sick employees could also get their co-workers sick, which would cause a domino effect of lost productivity. And deferring medical attention can lead to serious – and expensive – health issues.

A lack of paid sick days endangers our health and our economy. On the other hand, businesses that offer paid sick days report higher productivity, fewer occupational injuries, and lower turnover rates.[vi] Working parents who can use their sick leave to care for their sick child help “prevent illness from spreading in schools and child care centers.”[vii] And employees with paid sick leave are less likely to use emergency care – and that holds true even when accounting for differences in income and insurance coverage.[viii]

As long as working North Carolinians lack access to paid sick days, the state will continue to pay serious health and economic costs.


[ii] Institute for Women’s Policy Research. (2014). “Research Brief: Access to Paid Sick Days in North Carolina.” Available at

[iii] See note ii

[iv] National Partnership for Women and Families. (April 2013). “Paid sick days improve our public health.” Available at

[v] NC Budget and Tax Center. (2007). Don’t Get Sick: Nearly Half of Working North Carolinians Lack Paid Sick Days. Available at

[vi] See note ii

[vii] See note ii

[viii] Ibid.