As primary care providers in the safety net, we frequently witness patients making difficult decisions in balancing their health needs with economic survival in an unforgiving environment. Insufficient job protections and a lack of paid sick days are an often under-recognized factor that adversely affect the health of many of our patients.
We are seeing in real time how the lack of job protection and paid sick days, especially during this public health crisis of COVID-19, is devastating individuals and their families. Our patients often sacrifice their health because they are so worried about losing their jobs. Many patients are unable to get the support they need because their family members have to go to work or they risk losing their jobs.
One of our patients is an elderly woman with multiple severe medical problems who is lovingly cared for by her adult children. Due to her medical illness and early dementia, she required full-time care; however, her children made the difficult decision to leave her alone for long periods during the day because they had to go to work to afford rent and other bills.
One day, the patient developed shortness of breath due to an asthma exacerbation. If her son had been home, he could have given her medication to prevent her breathing from getting worse. Fortunately, she was able to call 911, and the paramedics transported her to the emergency department for a 16-hour visit that might have been prevented if she had help at home.
Another patient was recently diagnosed with schizophrenia and has had trouble accessing mental health care because of clinic closures due to COVID-19. The patient’s paranoia caused him to be so worried about contracting COVID-19 that he started bathing in bleach and washing his hands and face so vigorously that they started to bleed.
His mother was his primary caretaker and had to continue to work due to concerns about losing her job as a contract employee. Because the patient remained at risk due to minimal supervision during the day, he was ultimately hospitalized because he was a danger to himself. His mother is worried about how she will care for him after his discharge from the hospital since he would likely need to be independent as she continues to work to support them both financially.
These are just two patient stories of many that we have witnessed in our clinical practice, and we are disheartened by the impossible choices our patients have to make on a daily basis due to policies that have broad influence on the health and well-being of individuals.
We urge our state lawmakers to support the bill AB 3216 and Governor Newsom’s Paid Family Leave trailer bill because these proposals would improve job protections and paid leave and increase paid sick days for the people of California. These protections and provisions are particularly important in these uncertain times, especially for the most vulnerable members of our community.
We believe that expanded job protections and paid sick days provide a compassionate way for our neighbors to focus on the health and well-being of themselves and their families without sacrificing their economic stability. We must not force them into impossible circumstances. Rather, we must help these individuals maintain their health.
Ask your legislators to support expanded job protections, paid leave, and increased paid sick days by going to https://action.aclu.org/ca-support-paid-family-leave
This article was written by Sharad Jain, MD and Melody Tran-Reina, MD—primary care physicians at the Sacramento County Health Center and published by The California Work & Family Coalition.
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