TUESDAY, July 27, 2021 (HealthDay News) — The 1993 U.S. Family and Medical Leave Act (FMLA) requirements disproportionately exclude women and Black, indigenous, and multiracial workers, according to a study published online July 26 in Health Affairs.

Noting that the United States has no national paid sick leave policy, Jody Heymann, M.D., Ph.D., from the University of California Los Angeles, and colleagues determined the extent to which specific FMLA features produce gaps and disparities in leave access using a nationally representative survey. Comparative policy data from 193 countries were used to analyze whether these policy features are prevalent globally or whether there are common alternatives.

The researchers found that women were disproportionately excluded in the FMLA minimum hours requirement, while the tenure requirement disproportionately excluded Blacks, indigenous, and multiracial workers. Greater exclusion is faced by Latinx workers due to employer size. None of the 94 percent of countries that provide permanent sick leave broadly restrict leave based on employer size, and 93 percent cover part-time workers with no minimum hour requirement.

“Even the unpaid leave available through the FMLA is conditioned on eligibility criteria that lead to widespread exclusion and often worsen disparities in access,” the authors write. “These exclusions have severe consequences for the spread of both COVID-19 and seasonal illnesses like the flu, and threaten health for those with other conditions.”

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