Financial, Emotional Costs of Taking a Sick Day Rising Amid the Pandemic

As the COVID-19 pandemic upended the work-life balance for the US workforce nationwide, a national survey conducted by OnePoll on behalf of MDLIVE sought to examine the emotional and financial costs associated with taking a sick day in 2020.

“The factors directly or indirectly related to the pandemic that are driving the rise in stress and anxiety are well documented, and the body of research continues to grow,” said Cynthia Zelis, MD, chief medical officer of MDLIVE, in an email exchange with The American Journal of Managed Care^®. “Stress is also being driven by concerns over the well-being of the country, ongoing worry over issues including health care, sociocultural issues, and environmental concerns.”

As the first online survey to report in 2021 on the emotional and financial implications of taking a sick day in 2020, “Worried Sick: US Workers and the Burden of Sick Day Stress,” polled 2000 employed US workers in January of this year on several aspects related to the following:

• Price of taking a sick day
• Reason for taking sick leave
• Stress associated with taking sick leave
• Additional concerns of taking sick leave

On average, the survey found that 42% of US working adults were more stressed or anxious in the past year, which caused them to take a sick day to care for themselves or someone else, than in years past, with sick day stress more prominent in remote workers than in-person workers. Moreover, 55% of respondents reported that they were more likely to take a sick day in 2020 for mental health reasons than in previous years, with men noted to be more likely to cite stress and anxiety than women in needing to take time from work.

"The sick day experience, meant to enable workers to set aside their worries to focus on rest and recovery from illness, has for many people morphed into full-blown stress and anxiety due to the changing dynamics and blurred lines between work, home, and family," said Zelis.

These blurred lines between work, home, and family were further spotlighted in the study as US workers reported that the most stressful part of taking a sick day is having to help their children with schoolwork (24%). This burden coincided with another workload stressor, as 22% of workers felt compelled to keep up with their work.

Nearly half of workers also said that their boss or employer expects them to continue to work in some form when taking a sick day.

The financial impact of taking sick leave added to these stressors as 45% of respondents said that taking a sick day cost them more over the past year than in years prior to 2020. Specifically, the average estimated cost of taking a sick day was $277 in lost income and out-of-pocket expenses, including doctor visits ($63), childcare costs ($53), and lost income ($60).

With an increase of more than 500% in behavioral health visits for MDLIVE, Zelis highlighted that these trends in stress and anxiety are driving a massive need for, and adoption of, behavioral health services via telehealth as consumers seek access to care to deal with what she describes as a secondary epidemic.

So, what can employers do to address intensifying behavioral health concerns?

Zelis says that one of the most fundamental things that employers can do to support the mental health and wellness of their employees, regardless of whether they are working remote or in person, is to ensure they have access to behavioral health services, are aware of how they can access that care, and can access it conveniently when they need it.

As more than 1 in 5 workers (23%) reported in the study being concerned about infection risk at the doctor’s office when considering taking a sick day in 2020, greater availability of telehealth services may assist in avoiding a potential deferral in care for employers. Notably, Zelis said that a previous study conducted in mid-2020 found that over half of respondents intend to use telehealth for specialist care, including behavioral health.

“There is very clearly a need and a demand, and employers can play an important part in answering that need and demand,” concluded Zelis.