Skip to main content
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2010 Mar 1;101(Suppl 1):S9–S15. doi: 10.1007/BF03403840

Paid Health and Family Leave: The Canadian Experience in the Global Context

S Jody Heymann 1,, Megan Gerecke 1, Martine Chaussard 1
PMCID: PMC6974079  PMID: 20629441

Abstract

Objectives

Two thirds of Canadian adults participate in the workforce. Their health and that of their families can be markedly affected by the availability of paid sick leave, paid leave to care for family members’ health and paid parental leave.

Methods

We gathered data from all Canadian provinces and territories on these essential leave policies and compared Canadian policies with data collected on 186 United Nations (UN) countries.

Results

While Canada pays sickness benefits for 15 weeks for serious illnesses, globally at least 90 countries provide benefits for at least 26 weeks or until recovery. Moreover, within Canada only Saskatchewan and Quebec guarantee job protection if sick leave lasts over 12 days.

Results

The federal government guarantees Canadian workers six weeks of paid leave to provide care or support to gravely ill family members. Only 39 countries guarantee such leave with pay. Most, but not all, provinces guarantee workers’ job protection during compassionate care leave.

Results

Eligibility for job protection during parental leave varies across the country from having no restrictions to requiring at least one year of service.

Conclusion

Compared with Canada, many countries offer a longer duration of paid sick leave for employees and replace a higher percentage of wages lost. Internationally, Canada performs well in having policies that guarantee paid leave to care for dependants with serious illnesses, but it lags behind in the provision of paid leave to address the health needs of children or family members’ with non-life-threatening conditions. Finally, while paid parental leave is of adequate duration, the wage replacement rate lowers its accessibility to families with limited means.

Key words: Sick leave, family leave, parental leave, public policy, comparative study, provincial government

Footnotes

Acknowledgements: We are indebted to Alison Earle and Jeff Hayes for their immense contributions to the development of the globally comparative data. This article also benefited greatly from the superb editorial and staff skills of Melanie Benard and Kristen McNeill.

Conflict of Interest: None to declare.

References

  • 1.Statistics Canada. The Daily. 2010. Labour force characteristics by age and sex. [Google Scholar]
  • 2.Statistics Canada. The Canadian Labour Market at a Glance. 2007. [Google Scholar]
  • 3.Canadian Caregiver Coalition. Caregiver Facts. 2008. [Google Scholar]
  • 4.Health Canada. National Profile of Family Caregivers in Canada–2002. 2008. [Google Scholar]
  • 5.Gilleski DB. A dynamic stochastic model of medical care use and work absence. Econometrica. 1998;66:1–45. doi: 10.2307/2998539. [DOI] [Google Scholar]
  • 6.Aronsson G, Gustafsson K, Dallner M. Sick but yet at work: An empirical study of sickness and presenteeism. J Epidemiol Community Health. 2000;54:502–9. doi: 10.1136/jech.54.7.502. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Grinyer A, Singleton V. Sickness absence as risk-taking behaviour: A study of organizational and cultural factors in the public sector. Health Risk Soc. 2000;2:7–21. doi: 10.1080/136985700111413. [DOI] [Google Scholar]
  • 8.Johannsson G. Work-life balance: The case of Sweden in the 1990s. Soc Sci Inform. 2002;41:303–17. doi: 10.1177/0539018402041002007. [DOI] [Google Scholar]
  • 9.Murphy B, Schofield H, Nankervis J, Bloch S, Herman H, Singh B. Women with multiple roles: The emotional impact of caring for ageing parents. Ageing Soc. 1997;17:277–91. doi: 10.1017/S0144686X97006429. [DOI] [Google Scholar]
  • 10.Joshi H, Paci P, Waldfogel J. The wages of motherhood: Better or worse? Cambridge J Econ. 1999;23:543–64. doi: 10.1093/cje/23.5.543. [DOI] [Google Scholar]
  • 11.National Alliance for CaregivingAmerican Association of Retired People. Caregiving in the U.S. 2004. [Google Scholar]
  • 12.Heymann J. The Widening Gap: Why America’s Working Families are in Jeopardy and What Can Be Done about It. New York: Basic Books; 2000. [Google Scholar]
  • 13.Earle A, Ayanian JZ, Heymann SJ. What predicts women’s ability to return to work after newly diagnosed coronary heart disease: Findings on the importance of paid leave. J Womens Health. 2006;15(4):430–41. doi: 10.1089/jwh.2006.15.430. [DOI] [PubMed] [Google Scholar]
  • 14.Skatun JD. Take some days off, why don’t you? Endogenous sick leave and pay. J Health Econ. 2003;22(3):379–402. doi: 10.1016/S0167-6296(02)00102-9. [DOI] [PubMed] [Google Scholar]
  • 15.Lovell V. No Time to Be Sick: Why Everyone Suffers When Workers Don’t Have Paid Sick Leave. Washington, D.C.: Institute for Women’s Policy Research; 2004. [Google Scholar]
  • 16.Centers for Disease ControlPrevention. Key Facts about Influenza and the Influenza Vaccine. 2006. [Google Scholar]
  • 17.Centers for Disease ControlPrevention. Good Health Habits for Preventing the Flu. 2006. [Google Scholar]
  • 18.Goetzel RZ, Long SR, Ozminkowski RJ, Hawkins K, Wang S, Lynch W. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. J Occup Environ Med. 2004;46(4):398–412. doi: 10.1097/01.jom.0000121151.40413.bd. [DOI] [PubMed] [Google Scholar]
  • 19.Chatterji M, Tilley CJ. Sickness, absenteeism, presenteeism, and sick pay. Oxford Econ Papers. 2002;54:669–87. doi: 10.1093/oep/54.4.669. [DOI] [Google Scholar]
  • 20.Li JH, Birkhead GS, Strogatz DS, Coles FB. Impact of institution size, staffing patterns, and infection control practices on communicable disease outbreaks in New York State nursing homes. Am J Epidemiol. 1996;143(10):1042–49. doi: 10.1093/oxfordjournals.aje.a008668. [DOI] [PubMed] [Google Scholar]
  • 21.Robertson J. Young Children in Hospital. London, England: Tavistock; 1970. [Google Scholar]
  • 22.Van der Schyff G. The role of parents during their child’s hospitalization. Aust Nurs J. 1979;8:57–61. [PubMed] [Google Scholar]
  • 23.Mahaffy P. The effects of hospitalization on children admitted for tonsillec-tomy and adenoidectomy. Nurs Res. 1965;14:12–19. doi: 10.1097/00006199-196501410-00006. [DOI] [PubMed] [Google Scholar]
  • 24.Palmer SJ. Care of sick children by parents: A meaningful role. J Adv Nurs. 1993;18:185. doi: 10.1046/j.1365-2648.1993.18020185.x. [DOI] [PubMed] [Google Scholar]
  • 25.Taylor M, O’Connor P. Resident parents and shorter hospital stay. Arch Dis Child. 1989;64(2):274–76. doi: 10.1136/adc.64.2.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Heymann SJ, Vo PH, Bergstrom CA. Child care providers’ experiences caring for sick children: Implications for public policy. Early Child Dev Care. 2002;172(1):1–8. doi: 10.1080/03004430210881. [DOI] [Google Scholar]
  • 27.Heymann SJ, Toomey S, Furstenberg F. Working parents: What factors are involved in their ability to take time off from work when their children are sick? Arch Pediatr Adolesc Med. 1999;153(8):870–74. doi: 10.1001/archpedi.153.8.870. [DOI] [PubMed] [Google Scholar]
  • 28.Loda FA, Glezen WP, Clyde WA. Respiratory disease in group day care. Pediatrics. 1972;49:428–37. [PubMed] [Google Scholar]
  • 29.Sullivan P, Woodward WE, Pickering LK, Dupont HL. Longitudinal study of occurrence of diarrheal disease in day care centres. Am J Public Health. 1984;74:987. doi: 10.2105/AJPH.74.9.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Dahl IL, Grufman M, Hellberg C, Krabbe M. Absenteeism because of illness at daycare centers and in three-family systems. Acta Paediatr Scand. 1991;80:436. doi: 10.1111/j.1651-2227.1991.tb11879.x. [DOI] [PubMed] [Google Scholar]
  • 31.Mottonen M, Uhari M. Absences for sickness among children in day care. Acta Paediatr. 1992;81:929. doi: 10.1111/j.1651-2227.1992.tb12138.x. [DOI] [PubMed] [Google Scholar]
  • 32.Strangert K. Respiratory illness in preschool children with different forms of day care. Pediatrics. 1976;57:191. [PubMed] [Google Scholar]
  • 33.Doyle AB. Incidence of illness in early group and family day care. Pediatrics. 1976;58:607. [PubMed] [Google Scholar]
  • 34.Bennet SJ. Relationships among selected antecedent variables and coping effectiveness in postmyocardial infarction patients. Res Nurs Health. 1993;16:131–39. doi: 10.1002/nur.4770160208. [DOI] [PubMed] [Google Scholar]
  • 35.Gorkin L, Schron EB, Brooks MM, Wiklund I, Kellen J, Verter J, et al. Psychosocial predictors of mortality in the Cardiac Arrhythmia Suppression Trial-1 (CAST-1) Am J Cardiol. 1993;71:263–67. doi: 10.1016/0002-9149(93)90788-E. [DOI] [PubMed] [Google Scholar]
  • 36.Tsouna-Hadjis E, Vemmos KN, Zakopoulos N, Stamatelopoulos S. First-stroke recovery process: The role of family support. Arch Phys Med Rehabil. 2000;81:881–87. doi: 10.1053/apmr.2000.4435. [DOI] [PubMed] [Google Scholar]
  • 37.Seeman TE. Health promoting effects of friends and family on health outcomes in older adults. Am J Health Promot. 2000;14:362–70. doi: 10.4278/0890-1171-14.6.362. [DOI] [PubMed] [Google Scholar]
  • 38.Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57:245–54. doi: 10.1097/00006842-199505000-00006. [DOI] [PubMed] [Google Scholar]
  • 39.Ruhm CJ. Parental leave and child health. J Health Econ. 2000;19(6):931–60. doi: 10.1016/S0167-6296(00)00047-3. [DOI] [PubMed] [Google Scholar]
  • 40.Avery ME. A 50-year overview of perinatal medicine. Early Hum Dev. 1992;29(1–3):43–50. doi: 10.1016/0378-3782(92)90056-M. [DOI] [PubMed] [Google Scholar]
  • 41.Crouch M, Manderson L. The social life of bonding theory. Soc Sci Med. 1995;41(6):837–44. doi: 10.1016/0277-9536(94)00401-E. [DOI] [PubMed] [Google Scholar]
  • 42.Anisfeld E, Lipper E. Early contact, social support, and mother-infant bonding. Pediatrics. 1983;72(1):79–83. [PubMed] [Google Scholar]
  • 43.Johnson CK, Gilbert MD, Herdt GH. Implications for adult roles from differential styles of mother-infant bonding: An ethological study. J Nerv Ment Dis. 1979;167(1):29–37. doi: 10.1097/00005053-197901000-00004. [DOI] [PubMed] [Google Scholar]
  • 44.Lamb ME. Early contact and maternal-infant bonding: One decade later. Pediatrics. 1982;70(5):763–68. [PubMed] [Google Scholar]
  • 45.Mertin PG. Maternal-infant attachment: A developmental perspective. Aust N Z J Obstet Gynaecol. 1986;26(4):280–83. doi: 10.1111/j.1479-828X.1986.tb01588.x. [DOI] [PubMed] [Google Scholar]
  • 46.Henry JP, Wang S. Effects of early stress on adult affiliative behavior. Psychoneuroendocrinol. 1998;23(8):863–75. doi: 10.1016/S0306-4530(98)00058-4. [DOI] [PubMed] [Google Scholar]
  • 47.Nettelbladt P. Father/son relationship during the preschool years. An inte-grative review with special reference to recent Swedish findings. Acta Psychi-atr Scand. 1983;68(6):399–407. doi: 10.1111/j.1600-0447.1983.tb00947.x. [DOI] [PubMed] [Google Scholar]
  • 48.Taubenheim AM. Paternal-infant bonding in the first-time father. J Obstet Gynecol Neonatal Nurs. 1981;10(4):261–64. doi: 10.1111/j.1552-6909.1981.tb00856.x. [DOI] [PubMed] [Google Scholar]
  • 49.Feldman R, Sussman AL, Zigler E. Parental leave and work adaptation at the transition to parenthood: Individual, marital and social correlates. Appl Dev Psychol. 2004;25:459–79. doi: 10.1016/j.appdev.2004.06.004. [DOI] [Google Scholar]
  • 50.Coutrona CE, Troutman BR. Social support, infant temperament and parenting self-efficacy: A mediational model of post-partum depression. Child Dev. 1986;57:1507–18. doi: 10.2307/1130428. [DOI] [PubMed] [Google Scholar]
  • 51.Brandth B, Kvande E. Flexible work and flexible fathers. Work Employ Soc. 2004;15(2):251–67. doi: 10.1177/09500170122118940. [DOI] [Google Scholar]
  • 52.Leon-Cava N, Lutter C, Ross J, Luann M. Quantifying the Benefits of Breastfeeding: A Summary of the Evidence. Washington DC: Pan American Health Organization (PAHO); 2002. [Google Scholar]
  • 53.Ip S, Chung M, Raman G, Chew P, Magula M, Devine D, et al. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Prepared for: Agency for Healthcare Research and Quality. 2007. [PMC free article] [PubMed] [Google Scholar]
  • 54.Cattaneo A, Yngve A, Koletzko B, Guzman LR. Protection, promotion and support of breast-feeding in Europe: Current situation. Public Health Nutr. 2005;8(1):39–46. doi: 10.1079/PHN2004660. [DOI] [PubMed] [Google Scholar]
  • 55.Bates CJ, Prentice A. Breast milk as a source of vitamins, essential minerals and trace elements. Pharmacol Ther. 1994;62(1–2):193–220. doi: 10.1016/0163-7258(94)90011-6. [DOI] [PubMed] [Google Scholar]
  • 56.Habicht JP, DaVanzo J, Butz WP. Does breastfeeding really save lives, or are apparent benefits due to biases? Am J Epidemiol. 1986;123(2):279–90. doi: 10.1093/oxfordjournals.aje.a114236. [DOI] [PubMed] [Google Scholar]
  • 57.Hobcraft JN, McDonald JW, Rutstein SO. Demographic determinants of infant and early child mortality: A comparative analysis. Popul Stud (Camb) 1985;39(3):363–85. doi: 10.1080/0032472031000141576. [DOI] [Google Scholar]
  • 58.Jason JM, Nieburg P, Marks JS. Mortality and infectious disease associated with infant-feeding practices in developing countries. Pediatrics. 1984;74(4Pt2):702–27. [PubMed] [Google Scholar]
  • 59.Feachem RG, Koblinsky MA. Interventions for the control of diarrhoeal diseases among young children: Promotion of breast-feeding. Bull World Health Organ. 1984;62(2):271–91. [PMC free article] [PubMed] [Google Scholar]
  • 60.Dewey K, Heinig M, Nommsen-Rivers L. Differences in morbidity between breastfed and formula-fed infants. Part 1. J Pediatr. 1995;126(5):696–702. doi: 10.1016/S0022-3476(95)70395-0. [DOI] [PubMed] [Google Scholar]
  • 61.Howie P, Forsyth J, Ogston S, Clark A, Florey C. Protective effect of breast feeding against infection. BMJ. 1990;300(6716):11–16. doi: 10.1136/bmj.300.6716.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 62.Lepage P, Munyakazi C, Hennart P. Breastfeeding and hospital mortality in children in Rwanda. Lancet. 1982;1(8268):403. doi: 10.1016/S0140-6736(82)91437-4. [DOI] [PubMed] [Google Scholar]
  • 63.Cerqueriro M, Murtagh P, Halac A, Avila M, Weissenbacher M. Epidemiolog-ic risk factors for children with acute lower respiratory tract infection in Buenos Aires, Argentina: A matched case-control study. Rev Infect Dis. 1990;8(12Suppl):S1021–28. doi: 10.1093/clinids/12.Supplement_8.S1021. [DOI] [PubMed] [Google Scholar]
  • 64.Watkins CJ, Leeder SR, Corkhill RT. The relationship between breast and bottle feeding and respiratory illness in the first year of life. J Epidemiol Community Health. 1979;33(3):180–82. doi: 10.1136/jech.33.3.180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 65.Wright A, Holberg C, Martinez F, Morgan W, Taussig L. Breast feeding and lower respiratory tract illness in the first year of life. BMJ. 1989;299(6705):946–49. doi: 10.1136/bmj.299.6705.946. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Aniansson G, Alm B, Andersson B, Hakansson A, Larsson P, Nylen O, et al. A prospective cohort study on breast-feeding and otitis media in Swedish infants. Pediatr Infect Dis J. 1994;13(3):183–88. doi: 10.1097/00006454-199403000-00003. [DOI] [PubMed] [Google Scholar]
  • 67.Duncan B, Ey J, Holberg C, Wright A, Martinez F, Taussig L. Exclusive breastfeeding for at least 4 months protects against otitis media. Pediatrics. 1993;91(5):867–72. [PubMed] [Google Scholar]
  • 68.Arnold C, Makintube S, Istre G. Daycare attendance and other risk factors for invasive Haemophilus influenzae type B disease. Am J Epidemiol. 1993;138(5):333–40. doi: 10.1093/oxfordjournals.aje.a116863. [DOI] [PubMed] [Google Scholar]
  • 69.Gdalevich M, Mimouni D, David M, Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood: A systematic review and meta-analysis of prospective studies. J Am Acad Dermatol. 2001;45(4):487–647. doi: 10.1067/mjd.2001.114741. [DOI] [PubMed] [Google Scholar]
  • 70.Anderson JW, Johnstone BM, Remley DT B-f d A m-analysis. Am J Clin Nutr. 1999;70(4):525–35. doi: 10.1093/ajcn/70.4.525. [DOI] [PubMed] [Google Scholar]
  • 71.Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The association between duration of breastfeeding and adult intelligence. JAMA. 2002;287(18):2365–71. doi: 10.1001/jama.287.18.2365. [DOI] [PubMed] [Google Scholar]
  • 72.McGill Institute for HealthSocial Policy. Raising the Global Floor: Adult Labour. A WoRLD Legal Rights Database. 2009. [Google Scholar]
  • 73.Heymann J, Earle A. Raising the Global Floor: Dismantling the Myth That We Can’t Afford Good Working Conditions For Everyone. Stanford: Stanford University Press; 2010. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES