The Impact of Parental and Medical Leave Policies on Socioeconomic and Health Outcomes in OECD Countries: A Systematic Review of the Empirical Literature

Abstract

Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being. Context Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. Methods We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. Findings We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. Conclusions There is substantial quasi‐experimental evidence to support expansions in the duration of job‐protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job‐protected paid leave or lack a national paid leave entitlement altogether.

Work and Family in the Second Decade of the 21st Century

“…Our understanding of the effects of state provision of paid leave relies primarily on data from outside the United States because the United States is the only Organization for Economic Co‐operation and Development (OECD) country without a national paid parental leave policy (although some states have limited paid leave policies). A review of the impact of parental and medical leave policies in OECD countries concluded that paid parental leave improves women's economic outcomes (i.e., increases employment rates, job retention, wages), reduces infant mortality, and helps parents address competing demands of work and family (Nandi et al, ). As paid leave rolls out state by state in the United States, recent studies have captured the effects of this natural experiment on families.…”

“…International research suggests a potential tipping point, where leaves for 6 to 12 months may have negative effects on women's labor force commitment (Gangl & Ziefle, ). Although the benefits of paid leave are positive, studies of unpaid leave, offered through the Family and Medical Leave Act, show it has little effect on women's economic participation (Nandi et al, ). Moreover, Rossin () suggested that unpaid leave may actually increase disparities because it only benefits those mothers who can afford to take it (Milkman & Applebaum, ).…”

Association of increased duration of legislated paid maternity leave with childhood diarrhoea prevalence in low-income and middle-income countries: difference-in-differences analysis

“…Despite extensive research on preventive and therapeutic interventions, the evidence for informing specific national social policy strategies to lower childhood diarrhoea prevalence through these mechanisms remains limited 4 13 16. Extending the duration of legislated paid maternity leave has been associated with lower infant mortality in a sample of 18 Organisation for Economic Co-operation and Development countries17–20 and a sample of 20 LMICs 21. In addition, more generous paid maternity leave policies were associated with increased breastfeeding practices22–27 and vaccination uptake 28 29.…”

Paternity leave: A systematic review of studies in education and psychology from 1990-2019

“…According to Rostgaard (2002, p. 344), by offering gender equality, paternal leave policies can encourage better relationships between children and fathers; therefore, advancing children's well-being outcomes. Furthermore, father leave policies can help mothers to return to their job and lead them to participate in the labour market; as a result of that, gender inequalities in labour force participation might be lessened (Nandi et al, 2018;Dearing, 2016). Based on Bratberg and Naz's (2014, p. 508) findings, there is also a relationship between fathers' use of paternity leave and the reduced use of mothers' sickness absence, leading to a change in the employers' notions about hiring women.…”