High Job Flexibility And Paid Sick Leave Increase Health Care Access And Use Among US Workers

Health Aff (Millwood). 2022 Jun;41(6):873-882. doi: 10.1377/hlthaff.2021.01876.


Job flexibility is an important yet underresearched aspect of work that has implications for health care access and use. This study explored the impact of job flexibility, including both its informal aspects and access to paid sick leave, on health care access and use. We analyzed data from a nationally representative sample of US workers responding to the Medical Expenditure Panel Survey-Household Component during 2017-19, combined with occupational data from the Occupational Information Network database, version 25.0. Results showed that a one-unit increase in job flexibility was associated with a 2.15-percentage-point increase in the likelihood of having an office-based health care visit in the past year and a 2.42-percentage-point increase in the likelihood of having a usual source of care. Access to paid sick leave was associated with a 3.83-percentage-point increase in the likelihood of having an office-based health care visit. Black and Hispanic workers, as well as workers with low-wage jobs, had less job flexibility and less access to paid sick leave. Reforms that increase job flexibility and efforts by health care providers to better accommodate people with inflexible jobs could improve access, utilization, and equity.

MeSH terms

  • Employment
  • Family Characteristics
  • Health Services Accessibility
  • Humans
  • Salaries and Fringe Benefits*
  • Sick Leave*