March 2018 | Issue Brief Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey Women now comprise nearly half of the nation’s workers, and 70% of mothers with children under age 18 are in the labor force. The U.S. Census Bureau reports that median earnings for women are only 81% of men’s earnings, a gap that has persisted for several years. Policy makers across the political spectrum have forwarded proposals to shore up economic security for working families. Much of the national discussion has focused on policies related to income, such as minimum wage, tax credits, salary transparency, job training, and the wage gap, all of which are important issues for women. For many working women, economic security also encompasses health issues, including workplace benefits such as insurance coverage, paid sick leave, and paid family leave. It is also related to women’s roles as mothers and the primary managers of their children’s health care. This brief presents data on employer benefits and women’s roles in caring for families’ health from the 2017 Kaiser Women’s Health Survey, a nationally representative survey of women and men ages 18 to 64, conducted in the summer and fall of 2017. WORKPLACE BENEFITS So called “fringe benefits” such as Figure 1 paid leave and health insurance help Rates for workplace benefits are similar between women employees meet their personal and and men Does your employer offer you: family health care needs while also Women Men fulfilling their work responsibilities. About two-thirds of working women 65% 63% 69% 69% 65% 61% report that their employer offers them paid sick leave (65%), paid 47% 44% 44% vacation (69%) and a retirement plan 38% (65%), while almost half are offered paid maternity leave (44%) and paid family leave (47%). Men report receiving those same benefits in similar rates (Figure 1). Paid Sick Leave Paid Vacation A Retirement Plan Paid Maternity/ Paid Family Leave Paternity Leave Benefits, however, are not equally NOTE: Among women and men ages 18-64 who were employed. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey and 2017 Kaiser Men’s Health Survey. available to all workers. Low-income women, women who are employed part-time, and women who live in rural areas are less likely to be offered these benefits. The disparity in workplace benefits is particularly stark between full and part-time workers (Figure 2). Among women part-time Figure 2 workers, 33% report they were Part-time workers and low-income women are less likely to offered paid sick leave compared to be offered “fringe benefits” by their employers 75% of full-time workers, 21% were Part Time Full-Time <200% FPL ≥200%FPL offered paid family leave (55% full- time workers), and 19% were offered 75% 72% paid maternity leave (52% full-time workers). Half of low-income women 50%* 55% 53% 52% 48% reported they were offered paid sick leave, and about one in three 33%* 33%* 35%* reported they were offered paid 21%* 19%* family leave and paid maternity leave. Only about a third of women living in rural areas reported their Paid Sick Leave Paid Family Leave Paid Maternity Leave employer offered paid family leave NOTE: Among women ages 18-64 employed full-time or part-time. The Federal Poverty Level (FPL) was $20,420 for a family of three in 2017. *Indicates a and maternity leave compared to statistically significant difference from Full Time and ≥200% FPL; p<.05 SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey. roughly half of women living in urban areas (see Appendix Table 1). PARENTAL ROLES FOR CHILDREN’S HEALTH In most households, women are the Figure 3 managers of their families’ health Mothers considerably more likely to manage children’s care needs, as illustrated clearly in health than fathers Figure 3. Among mothers, about Share of mothers and fathers reporting who usually: Respondent Spouse/partner/child's other parent Joint responsibility Other three-quarters report that they are Mothers the ones who usually take charge of Make decisions about selecting children's doctor 79% 3% 16% 2% health care responsibilities such as Takes children for doctor's appointments 77% 5% 15% 3% choosing their children’s provider Assures children receive doctor recommended care 77% 2% 19% 1% (79%), taking them to appointments Take care of sick child* 40% 4% 34% 21% (77%), and following through with Fathers recommended care (77%), compared Make decisions about selecting children's doctor 22% 40% 34% 3% to approximately a fifth of fathers Takes children for doctor's appointments 24% 37% 34% 3% who report they take care of these Assures children receive doctor recommended care 19% 33% 43% 4% tasks. These rates have not changed Take care of sick child* 10% 28% 45% 15% significantly over the past decade. NOTE: Among women and men ages 18-64 who have children under age 18 in household. There are some variations between *For “take care of sick child:” data are among women and men ages 18-64 who have children under age 18 in household and are employed outside the home; on this indicator, respondent indicates that respondent must miss work; Other includes other people can take care of child, child can stay home alone, or respondent can work from home. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey and 2017 Kaiser Men’s Health Survey. groups of women by marital status and education level (Appendix Table 2). This pattern has not changed since the Kaiser Women’s Health Survey was first conducted in 2001. Mothers and fathers differ somewhat on their assessment of their involvement in children’s health care. While fathers are more likely to report that their partners take care of their children’s health needs than themselves, they are also more likely than mothers to report that it is a joint responsibility. Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey 2 IMPACT OF CHILDREN’S HEALTH NEEDS ON WORKING PARENTS This gender difference extends to working parents as well. Four in ten working mothers (40%) say they must take time off work and stay home when their children are sick, four times the share of men who say this is the case (10%). Over one-third of both mothers and fathers say they share responsibility for these tasks. Caring for children’s health has Figure 4 tangible economic consequences, Many working mothers do not get paid when they take time especially for women. Among the off to care for sick children mothers who must miss work when Working mothers’ options when When women must miss work to care child is sick and has to stay home: for sick children: their children are sick, 56% are not Spouse/ paid for that time off (Figure 4), up Partner/ Child's Father Misses Work Other significantly from 45% in 2004. 4% 6% Are Paid Considering that nearly one-fifth of Can Call 44% Someone Else children miss more than a week due 15% to illness or injury, this is a relatively Must Miss Work 40% common occurrence with potentially Share w/Spouse/ Do Not Get Paid negative economic implications for Partner Equally 56% 33% working mothers. Mothers in part-time jobs are more likely to report they have to miss NOTE: Among women ages 18-64 employed full-time or part-time, who have children younger than 18. “Other “ includes child can stay home alone, or mother can work from home. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey. work when their child is sick (51%) compared to about a third (36%) of their full-time counterparts. Low-income mothers who must miss work when their child is sick are also far more likely to lose pay (73%) compared to higher income mothers (47%). Additionally, there is a large disparity in workplace benefits, with offer rates of paid sick leave and paid vacation significantly lower among mothers who are low-income or part-time employees (Table 1). Table 1: Employer Benefits and Family Health Does your employer offer you: When your child is sick do you: Lose pay when you Paid sick leave Paid family leave Have to miss work miss work Mothers <200% FPL (Low income) 56%* 40%* 43% 73%* Mothers ≥200% FPL (Higher Income) 70% 54% 38% 47% Mothers Full-Time Employment 76% 58% 36% 49% Mothers Part-Time Employment 34%* 22%* 51%* n/a NOTES: Among women ages 18-64 who have children under 18. The Federal Poverty Level (FPL) was $20,420 for a family of three in 2017. Some estimates are “n/a” because point estimates do not meet the minimum standards for statistical reliability *Indicates a statistically significant difference from >200% FPL and Full Time; p<.05. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey. Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey 3 CONCLUSION The landmark Family and Medical Leave Act (FMLA) has been in place for more than 20 years, and gives eligible employees up to 12 weeks of unpaid leave to care for seriously ill family members, the arrival of a child, and job protection when an employee returns from family or medical leave. However, many working women simply cannot afford to take extended leave without pay. While there is no national paid leave policy, five states and DC have enacted laws offering eligible employees partial paid family leave. In addition to paid family leave, several cities across the nation as well as nine states and DC, require some level of paid sick days, which enables women to take time off without losing pay when they or their children get a minor illness and need to stay home for short periods. Women have always been the primary caregivers for their family’s health needs, be it for their children, parents, or other family members. The Kaiser Women’s Health Survey finds that there has been relatively little change over time in the share of women employees who receive workplace benefits, such as paid leave, retirement plans, and paid sick days. For many women, missing work when they or their children have a cold or upset stomach has a cost. The price is especially high for low-income working mothers, who have fewer financial resources, and often limited workplace benefits. This brief was prepared by Ivette Gomez, Usha Ranji, and Alina Salganicoff of the Kaiser Family Foundation. The authors would like to thank Anthony Damico, an independent consultant, for his assistance with survey analysis. Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey 4 Appendix Table 1: Employer Benefits Does your employer offer you: Paid Family Paid Maternity A Retirement Paid Sick Leave Paid Vacation Leave Leave Plan All women 18-64 65% 47% 44% 69% 65% White 66% 47% 42% 71% 68% Black 68% 54% 58%* 73% 72% Latina 66% 45% 42% 61%* 50%* Private Insurance 73% 54% 50% 77% 73% Medicaid 40%* 18%* 27%* 38%* 34%* Uninsured 44%* 26%* 22%* 51%* 38%* <200% FPL 50%* 33%* 35%* 55%* 47%* ≥200% FPL 72% 53% 48% 75% 72% Full-Time Employment 75% 55% 52% 80% 74% Part-Time Employment 33%* 21%* 19%* 31%* 32%* <High School 41% 17% 14% 44% 20% High School Graduate 56% 37%* 40%* 62%* 56%* Some College 67%* 51%* 44%* 74%* 69%* College Graduate 71%* 53%* 51%* 72%* 71%* Urban 68% 51%* 48%* 72%* 65% Suburban 65% 48%* 47%* 70% 67% Rural 60% 37% 29% 61% 58% Fair/Poor Health 60% 46% 39% 62% 47%* Good/ Excellent Health 66% 47% 45% 70% 67% Women with children <18 65% 49% 46% 66% 62% Women without children <18 67% 53% 54% 72% 68% NOTES: Among women ages 18-64 employed full time or part time. The Federal Poverty Level (FPL) was $20,420 for a family of three in 2017. *Indicates a statistically significant difference from White, Private Insurance, >200% FPL, Full Time, <High School, Rural, and Good/Excellent; p<.05. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey. Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey 5 Appendix Table 2: Family Health Mothers who responded that they usually: Make decisions Make sure their Take children to Must miss work about selecting their children get the care doctor’s when their children children’s doctor doctor recommends appointments are ill^ All women 18-64 79% 77% 77% 40% White 83% 79% 77% 43% Black 78% 85% 81% 38% Latina 74% 71% 75% 43% Married 75% 72% 73% 37% Divorced 90%* 90%* 89%* n/a Never Married 89%* 90%* 87%* n/a <200% FPL 79% 79% 79% 43% ≥200% FPL 81% 76% 76% 38% Full-Time Employment 83% 76% 70% 36% Part-Time Employment 81% 81% 84%* 51%* Not Employed 71%* 75% 81%* - <High School 67%* 70%* 75% n/a High School Graduate 74%* 75%* 72% 37% Some College 86% 85% 82% 44% College Graduate 80% 74%* 76% 35% Urban 80% 80% 78% 41% Suburban 76%* 76% 76% 43% Rural 87% 75% 75% 31% Fair/Poor Health 73% 78% 75% n/a Good/ Excellent Health 80% 77% 77% 38% NOTES: Among women with children under the age of 18. ^Among women with children under 18 and who reported they were employed. The Federal Poverty Level (FPL) was $20,420 for a family of three in 2017. Some estimates are “n/a” because they do not meet the minimum standards for statistical reliability. *Indicates a statistically significant difference from Married, Full-Time employment, Some College, and Rural , p<.05. SOURCE: Kaiser Family Foundation, 2017 Kaiser Women’s Health Survey. The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400 Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270 www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/KaiserFamFound Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.