Although childcare and paid leave are increasingly in the news and on people’s minds, the United States does not ensure paid leave for new parents. Federal law demands only that employers provide up to 12 weeks of unpaid time off for new parents – and only a little more than half of all workers are eligible for this benefit.
In recent years, a number of states have moved to offer more. A new study, published today in the American Journal of Preventive Medicine, looks at two states that were early adopters of partially paid parental leave: California (since 2004) and New Jersey (since 2009). The study explores whether these policies reduce stress for new parents and if they show any benefits to the child’s mental health at age two. Prior studies have focused just on a single state or were conducted in other countries where leave policies are more generous and have been in effect longer.
“We wanted to contribute robust evidence of how these policies might benefit parents and young kids,” said lead author Amanda Irish, a PhD candidate in epidemiology.
As part of a natural experiment, the paper compared measures of mental health in the two states in the years before the paid leave policies took effect to the same measures in the years immediately afterward. Other states that did not pass paid leave policies were considered the control group. Because the policies went into effect at different times and the states have different demographics, including two states makes a more robust case that changes when each policy went into effect were not caused by the unique features of just one state or time period.
Irish and her co-authors, who included UCSF faculty Justin White, PhD, and Rita Hamad, MD, PhD, found that parents’ mental health did in fact improve following paid time off. The parents’ stress scores fell by 25% compared with the period prior to the leave policy. Both mothers and fathers benefited from the policy. The study did not document any overall effect on the tots’ mental health, which was reported by their parents in a widely used behavioral questionnaire.
The researchers also looked at differences in how the policies affected parents of different race/ethnicity, income, age and marital status. Unmarried parents benefitted more than married parents, which makes sense given their larger care responsibilities. Troublingly, low-income parents saw a much smaller benefit than middle-income parents, and Black parents saw a much smaller benefit than their white counterparts.
At the same time, the health data the researchers used reveals only who was eligible for paid parental leave – who had a child and was employed – not who actually received it. So it may be that the improvements among those who actually received the benefit were higher than what the study was able to show. Leave benefits require significant paperwork to access and only reimburse a fraction of the parent’s salary, so it may be that those in low-pay jobs and/or facing other challenges of systemic racism less frequently received the benefits for which they were eligible.
“Policies that provide more generous and longer leave may be important to improve health equity for those families that can’t afford to take time off if it’s only partially paid,” Hamad noted.
The findings on children’s mental health were more mixed. Overall, the scores remained unchanged for children aged 2-3 whose parents may have received paid parental leave. But Black children and children in high-income families actually experienced worsening mental health after the policies went into place. Because time-limited partly paid leave encourages parents to go back to work, it may be that these kids were placed in lower-quality childcare.
“It could be that there really is no overall effect on children's behavioral health for this age group, but it's also possible the survey failed to capture aspects of behavioral health that might have been affected by paid parental leave,” Irish explained.
In the decade plus since California and New Jersey passed their policies, several more states have followed suit, some with more generous benefits. These provides further opportunity to evaluate the short- and long-term effects of paid parental leave.