STATE MANDATED PAID SICK LEAVE: HOW POLICY AWARENESS, WORKPLACE FLEXIBILITY, AND COMFORT SHAPE PREVENTATIVE CARE USE

Drawing on original survey data from workers in Arizona and Michigan, two states that enacted paid sick leave through ballot initiatives, this dissertation examines whether and how access to paid sick leave (PSL) translates to preventative care use. Across multiple empirical chapters, this dissertation focuses on the mechanisms through which PSL may influence preventative care by examining whether workers are aware that paid leave can be used for preventative care, whether access to PSL or other workplace arrangements facilitates preventive care use, and how workplace norms and individual comfort with using the policy shape employees’ decisions to use leave for preventative care. The findings reveal gaps in policy knowledge, uneven access to workplace arrangements, and differences in comfort using leave, all of which contribute to unequal use of preventative care. Together, these results demonstrate that policy access alone is insufficient to ensure that the policy is able to be used as intended. Instead, the effectiveness of PSL depends on how policies are implemented, communicated, and embedded within workplace environments, highlighting the importance of administrative enforcement and workplace culture in shaping whether worker rights are realized.