Background: Cardiovascular Disease (CVD) is the leading cause of death in the United States and may be prevented through improved working conditions. The United States is one of the few high-income nations that does not guarantee paid sick leave (PSL) at the federal level. Our objective was to examine the relationship between state-level PSL policies and CVD mortality. Methods: We used quasi-experimental event study methods to examine the relationship between implementing a mandatory PSL policy for all employees at the state-level and county-level CVD mortality rates using National Center for Health Statistics data among working-age adults aged 15 to 64 over time from 2008 to 2019. During this time, 11 states implemented PSL policies. We examined the annual CVD mortality rates (2008-2019) in 1054 counties from all 50 states and Washington D.C., accounting for approximately 88% of the United States population in this analysis. Results: We found that in the Northeastern region of the United States, there were drops in the CVD mortality rate for persons ages 15-64 for all years after PSL was implemented, ranging from 7.1 fewer deaths per 100,000 persons (?=-7.1, 95% CI = -9.7, -4.4) seven years post-treatment to 2.7 fewer deaths two years post-treatment (?=-2.7, 95% CI= -5.1, -0.3). Conclusion: Our results support the use of state-level PSL policies to reduce county-level CVD mortality rates, especially in the Northeastern United States.

The authors have declared no competing interest.

No external funding was received

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