Kewei (Sylvia) Shi
Paid Sick Leave and Cancer Care among Working-age Adults
Abstract
Cancer incidence among adults under 65 is increasing, placing growing pressure on individuals balancing treatment and employment. Paid sick leave (PSL) policies are designed to protect workers’ time for medical care, yet access remains limited and unequal. Nearly 30% of U.S. employees lack PSL, with the greatest gaps among part-time, low-wage, and minority workers. This project evaluates PSL as a structural policy intervention to improve access, timeliness, and outcomes of cancer care among working-age adults. Leveraging variation in PSL mandates from 2004-2023, Aims 1 and 2 estimate the impact of PSL on time to treatment initiation, adherence, and survival using national cancer registry data. Aim 3 extends these findings through microsimulation to project the population-level and equity impacts of nationwide PSL expansion. This study will generate the first comprehensive evidence on how labor protections affect cancer outcomes, informing policies to advance equitable cancer care.
I am honored to receive the PhRMA Foundation’s fellowship. This support fuels my research on how systemic policy interventions shape health outcomes to improve access to care, reduce financial burden, and achieve better patient outcomes.
