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A newly released report offers the most detailed look yet at earned sick leave laws in the 75 largest U.S. cities — and how those laws have changed between July 2022 and June 2024.
The data, published by CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, with the Center for Public Health Law Research at the Temple University Beasley School of Law, show not just where earned sick leave exists, but how strong — or absent — those protections are.
Patchwork of Protections and Preemptions Across U.S. Cities
As of June 1, 2024, only 36 of the largest U.S. cities have laws on the books guaranteeing workers earned sick leave. Meanwhile, 37 cities are explicitly prohibited from creating such laws by their state governments — up from 33 in 2022.
That increase signals a rising trend of preemption, where state laws override or prevent local governments from enacting worker protections like sick leave.
Earned sick leave laws help reduce the spread of illness, protect low-wage and frontline workers, and allow families to care for each other without risking their income.
According to Katrina Forrest, JD, executive director of CityHealth, earned sick leave is “about fairness and health,” especially for low-income workers and people of color who are least likely to have paid time off.
“No one should have to choose between earning a paycheck and caring for themselves or a loved one,” Forrest said. “Ensuring that all workers have time to recover when they’re sick protects low-income workers and people of color who are least likely to have access to this benefit. These data provide an in-depth look at how cities and states are structuring these policies, providing a clearer view of where progress is happening and where more work is needed.”
As companies and policymakers navigate evolving workforce expectations, access to earned sick leave is emerging as a key factor in employee well-being, retention, and equitable work practices — making it a critical piece of the future of work conversation.
