New York state's paid family leave policy was associated with reduced acute-care visits for infants with respiratory tract infections, including respiratory syncytial virus (RSV), according to a study yesterday in JAMA Pediatrics.
Respiratory tract infections, including RSV, are the leading cause of hospitalization for newborns in the first 2 months of life: Hospitalizations for lower respiratory tract infection among infants 2 months or younger are 4.5 times as high as among 6- to 11-month-olds (17.9 vs 3.9 per 1,000, respectively).
New York enacted a paid family leave law in 2018, which provided 8 weeks of paid leave for parents with an infant 12 months or younger, or to residents who needed to provide care for an ill family member.
"Young infants commonly acquire respiratory tract infections in the daycare setting. Out-of-home care has consistently been associated with 2- to 3-times higher risk of infection compared with in-home care," the authors wrote.
Medical encounters dropped 18%, RSV 27%
To assess if the law, which enabled parents to stay home with infants, was tied to fewer emergency department visits or hospitalizations for infants with respiratory tract infections, researchers compared acute-care encounters for such infections in infants 8 weeks or younger in New York.
They compared those rates to data in four New England control states (Maine, Massachusetts, New Hampshire, Vermont) from October 2015 through February 2020. The control states had no paid leave policies in place during the study period.
In total, the authors noted 52,943 acute-care encounters (hospitalization or emergency department visits) in infants 8 weeks or younger for respiratory tract infection, of which 63% were paid for by Medicaid, and 30% were hospitalizations with a median length of stay of 2 days.
Before the paid family leave act went into effect, all states saw similar seasonal patterns of respiratory virus hospitalizations for infants.
The observed hospitalization rates in New York after the introduction of paid family leave were significantly lower than predicted, the authors found, with cumulative counts of acute care encounters for respiratory tract infections 18% lower (95% confidence interval [CI], −20% to −16%).
There were 15,726 acute care encounters for RSV bronchiolitis seen in the study, with visits 27% lower (95% CI, −31% to −24%) in New York after the paid leave law was enacted.
13 states have paid leave
"Our findings suggest that US state-paid family leave policies can protect young infants from serious respiratory tract infections,” the authors concluded.
US state-paid family leave policies can protect young infants from serious respiratory tract infections
In a commentary on the study Justin White, PhD, from Boston University School of Public Health, and Rita Hamad, MD, PhD, with the Department of Social and Behavioral Sciences at Harvard, said the study offers more evidence of the public health benefit of paid family leave.
"As the body of evidence grows, it strengthens the case for adopting a national paid family leave policy, which could significantly improve public health outcomes and provide economic stability for more families across the country," they wrote.
As of 2024, 13 states and Washington, DC, have implemented a mandatory paid family leave policy.
