Expanded Family and Medical Leave

  • Date: Jan 01 2000
  • Policy Number: 20001

Key Words: Abortion

The American Public Health Association,

Recognizing that major life events such as illness of oneself or an immediate family member, pregnancy, birth of a child,1 or death in a family constitute a significant source of individual stress affecting the workplace and that in all, 47% of the US. labor force has some type of dependent care responsibility;2 and Recognizing that previous APHA policy recognizes the importance of public health measures to improve the health of the elderly,3 those with chronic diseases, or catastrophic acute and chronic health care needs, as well as increased services for mothers and children and low-income populations; and.

Recognizing that the U.S. Family and Medical Leave Act (FMLA) of 1993, requires employers with 50 or more employees to provide unpaid leave for up to 12 weeks, but unlike every other industrialized country, shifts much of the economic burden to the worker;8 and that only 55% of workers in the US are covered by the FMLA, leaving 41 million workers uncovered, while most other industrialized countries mandate paid maternity leave, offer more than the 12 weeks accorded US. mothers, and provide such leave for all, not just those working for companies with 50 or more employees;9 for example a survey of parental leave policies in 16 European countries and Canada found that those countries averaged 68 weeks of leave, more than one full year, of which 33 weeks were paid,10 and a 1998 United Nations study found that the United States is one of only six countries out of 152 surveyed that did not have paid maternity leave;11and

Recognizing that initial opposition to the FMLA, primarily from the business community, based on concern about high costs to employers 12 has proven to be groundless as numerous studies have demonstrated that turnover costs are significantly higher than temporary replacement;13 family leaves can lead to increased worker contentment, higher productivity,14,15 and better public relations;16and the Commission on Leave’s Employer Study 17 found that only 10% of employers surveyed reported increased costs from implementing the FMLA; and countries that U.S. businesses often consider as competitors such as Germany and Japan implemented paid parental leaves years ago;18,19and

Recognizing that paid leaves would cost more than existing unpaid leaves but that these and other employee benefits serve basic human needs, essential for families and society and have always met with resistance from the corporate sector and that limits on overtime, minimum wage and occupational safety and health standards are just some examples of laws that many take for granted now but had to be won over the opposition of employers; and

Recognizing that parent-infant bonding is essential to child development,20-22 and that other studies report high levels of physical, emotional, and financial stress from workers taking care of new babies, sick children, and elderly and dis-abled adults while continuing at their paid jobs;20,21;and

Realizing that millions of Americans cannot afford to take the unpaid leave provided by the FMLA and that eighty-three percent of US women responding to the recent AFL-CIO working women poll rate laws to expand the FMLA 23 and provide paid leave as important legislative priorities; and

Realizing that, while the FMLA does not require wage replacement, 47% of employees tak-ing leave receive full pay and 20% collect partial pay during their leave with the money coming from sick pay benefits, vacation time, or disability insurance.17

Realizing that workers most likely to receive wage replacement under FMLA are Caucasian, salaried, highly educated, unionized, and have higher household incomes; that the employees least likely to collect wage replacement are those in the youngest or oldest age groups with low levels of income and/or education and who are Latino/a;17,24 and that nearly one in ten FMLA users is forced onto public assistance during unpaid leaves; and

Realizing that estimates of the US Department of Labor Studies paid leaves for new babies in California would cost about $768 million and, for the United States as a whole, between $5 and $10 billion per year, are small when one considers the most recent annual military budget;26 therefore,

The American Public Health Association urges Congress of the United States to,

  1. Expand the Family and Medical Leave Act to include paid family- or medical-related leaves, such as those provided by most other industrialized countries;27,28 and
  2. Give qualified support to President Clinton’s plan to allow states to use surplus unemployment insurance for paid parental leaves as a first step toward federal provision of paid leaves; acknowledging that paid parental leaves should not be paid from funds intended for workers’ unemployment benefits, but instead, by employers or through general taxes and that people need paid family and medical leaves for reasons other than having or adopting a new baby; and
  3. Provide paid family and medical leaves to all workers, who work for companies with 20 or more employees, not just those who work for a company with 50 or more employees; and
  4. Expand the FMLA definition of “immediate family” to include an employee’s spouse, child, parent, or any other primary care giver. 


  1. Hyde JS, Klein MH, Essex MJ, Clark R. Maternity leave and women’s mental health. Psy-chology of Women Quarterly. 1995;19:257-285.
  2. American Association of Retired Persons (AARP) and the Travelers Foundation, A National Survey of Caregivers: Final Report. Washington, DC: AARP, 1988; U.S. House of Representatives, Select Committee on Aging, Exploding the Myth: Caregiving in America. Committee publication 99-611. Washington, DC: U.S.GPO, 1987.
  3. APHA Policy Statement 8201: Health Issues of Older Women. APHA Policy Statements; 1948– present, cumulative. Washington DC: American Public Health Association; current volume.
  4. APHA Policy Statement 5602: Federal Assistance to Programs to Improve the Health of Older Persons. APHA Policy Statements; 1948— present, cumulative. Washington DC: American Public Health Association; current volume.
  5. APHA Policy Statement 8731PP: Toward a Comprehensive National Policy on Catastrophic Acute and Long Term Health Care. APHA Policy Statements; 1948—present, cumulative. Washington DC: American Public Health Association; current volume.
  6. APHA Policy Statement 5817: Federal Grants-in-Aid for Maternal and Child Health and Crippled Children’s Services and Child Welfare. APHA Policy Statements; 1948—present, cumu-lative. Washington DC: American Public Health Association; current volume.
  7. APHA Policy Statement 9611: Linkage of Medical Services for Low-Income Populations with Mental Health, Substance Abuse and Other Supportive Services. APHA Policy Statements; 1948—present, cumulative. Washington DC: American Public Health Association; current vol-ume.
  8. Grosswald B, Scharlach AE. Employee experiences with family and medical leave: a case study. Community, Work & Family. 1999; 2:187- 203.
  9. Scharlach AE, Grosswald B. The Family and Medical Leave Act of 1993. Social Service Review. 1997;71:335-359.
  10. Ruhm CJ, Teague JL, Parental Leave Policies in Europe and North America, Greensboro, NC: University of North Carolina, Department of Economics, 1993.
  11. Olson, E. U.N. surveys paid leave for mothers: U.S. among nations without a policy. New York Times: A5.
  12. Scharlach AE, Grosswald B. The Family and Medical Leave Act of 1993. Social Service Review. 1997;71:337-338.
  13. Phillips JD, Reisman B. Turnover and return on investment models for family leave. Parental Leave and Productivity: Current Re-search. Friedman DE, Galinsky E, Plowden V, New York, NY: Families and Work Institute, 1992;33-53.
  14. National Council for Jewish Women, Accommodating pregnancy in the workplace. New York, NY: National Council for Jewish Women; 1987.
  15. Scharlach AE, Stanger JK. Mandated fam-ily and medial leave: Boon or bane? Compen-sation and Benefits Management. 1995;1(3):1-9.
  16. Ibid.
  17. Commission on Leave. A workable bal-ance: Report to Congress on Family and Medical Leave policies. Washington, DC: Commission on Leave; 1996;102-130.
  18. Ferber MA, O’Farrell B with Allen LR (eds). Work and Family: Policies for a Changing Work Force. Washington, DC: National Academy Press; 1991; 161-162.
  19. Jankanish MB. Conditions of work digest: Maternity and work. International Labor Or-ganization, Geneva. 1994;13:326-327, 241-242.
  20. Belsky J. Consequences of child care for children’s development: A deconstructionist view. Child Care in the 1990s: Trends and Conse-March quences. Booth A (ed.). Hillsdale, NJ: Erlbaum: 1992;83-93
  21. Belsky J, Rovine M. Nonmaternal care in the first year of life and security of infant-parent attachment. Child Development. 1988;59:157- 167.
  22. Vandell DL, Corasiniti MA. Child care and family. New Directions for Child Development. 1990;49:23-88
  23. Scharlach AE, Boyd SL. Caregiving and employment: Results of an employee survey. Gerontologist. 1989; 29: 382-387.
  24. Emlen AC, Koren PE, Louise D. Child and elder care: Final report of an employee survey at the Sisters of Providence. Portland, OR: Portland State University; 1988.
  25. AFL-CIO. Working women say...: Findings from the Ask a Working Women 2000 Survey. Washington, DC: AFL-CIO; 2000; 10.
  26. Scharlach AE, Grosswald B. The Family and Medical Leave Act of 1993. Social Service Review. 1997;71:335-359.
  27. Ibid.
  28. Institute for Women’s Policy Research, 1995. Providing Paid Family Leave: Establishing the cost of expanding California’s disability insur-ance program. Washington, DC.

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