Optimal durations of paid family and medical leave to support health
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OBJECTIVE: We assessed the impact of paid family and medical leave durations on the health outcomes of employees and their families. Using previous literature and relevant studies, we aimed to formulate evidence-based recommendations for the duration of paid family and medical leave that would promote optimal health outcomes. METHODS: PubMed was utilized to identify relevant literature. The concept of paid leave was organized into four main categories: maternity leave, parental leave, personal medical leave, and leave for children’s health needs. Literature searching, data abstraction, and analyses were performed. Weekly discussions with the Medical Decision Points team were also conducted to finalize article selection, organization, and data analysis. RESULTS: Maternal mental health and breastfeeding continuation were positively associated with maternity (i.e., maternal disability) leave durations of 12 to 16 weeks and longer. Infant morbidity and mortality, vaccination uptake rate, breastfeeding continuation all improved with up to six months of parental (i.e., parent bonding) leave. There was limited evidence regarding personal medical leave and leave for children’s health needs. Typical durations of hospitalization, recovery, work and school absence were analyzed to formulate appropriate paid leave durations. CONCLUSION: Evidence suggests that the 12 weeks of unpaid leave offered by the Family and Medical Leave Act (FMLA) is inadequate in providing employees and their families with health sustaining benefits. We recommend at least four months of paid maternity leave and six months of paid parental leave for each new child. We also recommend up to six months of paid personal medical leave for each serious illness and at least six weeks (for up to six months) of paid family leave for each child’s serious illness, with substantial flexibility to account for both acute illness requiring sustained care and recovery periods requiring more intermittent care.