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A primer on access to and use of paid family leave

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The United States is still the only advanced country in the world without a federal paid leave policy. In the absence of such a policy, some workers currently access paid leave through benefit plans provided by employers or through social insurance programs offered by a handful of states. A key question for future policy discussions is the extent to which American workers are already accessing paid leave through employer-provided plans, and what additional needs might be met by state or federal policies.

Administrative data on access to and use of paid leave offered by states is difficult to access and not nationally representative, so we cannot derive estimates on all workers’ access to paid family and medical leave from this data (although researchers have found administrative data from California and New Jersey useful for studying the long-term effects of program participation).

Sarah Nzau

Former Senior Research Assistant - Center on Children and Families

Katherine Guyot

Former Research Analyst - Center on Children and Families

One of the most cited estimates on workers’ access to paid leave is that only 19% of U.S. employees have access to paid family leave through an employer. This comes from the benefits portion of the National Compensation Survey produced by the Bureau of Labor Statistics (BLS). Some critics argue that this number is too low, since surveys of employees suggest around half can take paid time off for family reasons, even in the absence of a formal benefit plan.

Below, we look at key differences between three surveys that provided new data on access to and use of paid leave in 2019.

Defining paid family and medical leave

Workers may have access to leave for various purposes, such as vacation, personal days, or general paid time off. We focus on paid family and medical leave, which refer specifically to paid time away from work to address personal illness, to care for a new child, or to care for an ill family member.

Table 1: Defining Paid Family and Medical Leave

Type of Leave Purpose of Leave
Parental Includes both maternity and paternity leave and guarantees employees the ability to take a leave of absence to care for and bond with a new child (including biological, adopted, or foster children).
Family care Enables workers to take time off to care for an ill or aging family member. Qualifying family members can vary, but often include children, spouses, and parents.
Medical Provides workers with time off to care for their own disability or serious illness such as cancer that requires weeks (or months) to recuperate.
Sick Sick leave is usually defined as leave for routine preventative and medical care or a short bout of illness, such as the flu that requires days—but not months—to recuperate.

Describing the surveys

Two of the most common sources of data on access to paid leave are the benefits portion of the National Compensation Survey and the Access to and Use of Leave Module of the American Time Use Survey (both produced by BLS), which released new data on leave benefits in 2019. In the next section, we discuss key differences in how these surveys measure leave access.

In addition to looking at access, the American Time Use Survey also measures take-up of leave benefits and provides insight into the reasons workers do not always use leave benefits that are available to them. We compare this to data from the American Family Survey, a fairly new household survey that released data on the use of leave benefits in 2019.

The three surveys we focus on are summarized below.[1]

  1. The National Compensation Survey is an establishment survey that collects data on employer-sponsored benefits, including paid leave. Since NCS data is collected directly from employers, it provides more detailed and accurate information on official employer leave policies. NCS data is updated annually.
  2. The Access to and Use of Leave module of the American Time Use Survey (ATUS) is a survey of wage and salary workers about access to and use of paid and unpaid leave at their main job. The leave module was first introduced in 2011, and questions about leave were not asked again until 2017-2018.
  3. Since 2015, the American Family Survey (AFS) has been measuring attitudes and practices surrounding marriage and families. In 2019, the survey collected data about respondents’ experiences with using family leave.

Table 2: Summary of three surveys on paid leave

Survey Measures access to or use of leave Years available Sample for most recent survey period Represented workers Timeframe for use of leave benefits
NCS – Benefits Access to leave benefits Annually starting in 2010 (earlier years available in Employee Benefits Survey) 11,477 establishments (employer-based survey) Civilian workers employed in private industry or state/local government (not self-employed) N/A
ATUS Leave Module Access to and use of leave benefits 2011 and 2017-18 10,071 individuals (household survey) Wage and salary workers (not self-employed) ages 15+ Previous week
AFS Use of leave benefits (family leave only) 2019 3,000 individuals (household survey) Individuals ages 18+ who worked in last five years Previous five years

 What can we learn from these surveys?

A cursory look at the data on access to paid leave would suggest a serious contradiction: According to estimates from the NCS, just one in five workers has access to paid family leave (here defined as a combination of parental and family care leave), but according to the ATUS, about half of all workers over the age of 14 can access parental or family care leave. Among those who actually take parental or family care leave, at least half report being paid, according to a combination of estimates from the ATUS and AFS. Reconciling these numbers requires an understanding of precisely what each survey is measuring.

The tables below present some basic estimates on access to paid leave benefits (from the NCS and ATUS) and use of paid leave (from the ATUS and AFS).

Table 3: Percentage of wage and salary workers with access to paid family or medical leave


Type of Leave


Workers with access to paid leave

Parental 19% (Paid parental and family care leave are combined in this survey.) 50%
Family Care 51%
Sick 76% 62% (This survey does not distinguish between sick and medical leave.)
Medical 40% (short-term disability)

Source: BLS, Employee Benefits in the United States, March 2019, Table 31; and authors’ calculations using ATUS.

Table 4: ATUS—Among workers who took leave during the previous week, percentage who were paid



Main reason for taking leave, among those who took any leave last week




Type of leave used (paid or unpaid)

Paid leave only Unpaid leave only Paid and unpaid leave Total
Parental Not reported (too few cases)
Family Care (Illness or medical care of another family member) 52% 42% 6% 100%
Sick or medical 61% 37% 2% 100%

Source: BLS, Access to and Use of Leave—2017-2018 Data from the American Time Use Survey, Table 6

Table 5: AFS—Among workers who took at least one week of leave during the last five years, percentage who were paid



Reason for taking leave

(at least one week of leave taken in the last five years)


Did employer offer pay during the leave period?

Yes (Paid leave) No (Unpaid leave) Don’t know Total
Parental 66% 29% 5% 100%
Family Care
Care of spouse or partner 53% 46% 1% 100%
Care of child 47% 45% 8% 100%
Care of elderly parents 46% 53% 1% 100%
Care of extended family member 44% 56% 0 100%
Care of close friend or neighbor 33% 67% 0 100%
Sick or medical Not reported

Source: Authors’ calculations using AFS data.

Explaining differences in access and utilization rates of leave across surveys

1. Access versus utilization of paid leave.

Workers who have access to paid family or medical leave benefits may not take leave when it is needed for a number of reasons. For instance, the benefit amount may be less than their normal earnings and thus insufficient to meet their financial needs during the leave period, or workers may fear losing their jobs or facing other penalties if they take time off. It is important, then, to assess both whether paid leave is available to workers (access), and whether workers use paid leave when it is needed (take-up). We may also be interested in the percentage of current leave-takers who are paid for their time off (see Tables 4 and 5 above).

The NCS provides detailed information on the leave benefits available to employees but does not report on individual employees’ use of leave benefits. The AFS only provides data on leave take-up as reported by workers.

The leave module of the ATUS provides data on both self-reported access to and take-up of paid leave, and is thus useful for comparing the population of current leave-takers to the overall workforce. For instance, Table 3 above shows that 51% of ATUS respondents report that they could take paid leave to care for a family member. Among ATUS respondents who actually took family care leave in the week before the interview, 52% reported that they were paid, and 6% used a combination of paid and unpaid leave (Table 4).

We might expect that workers with access to paid leave would be disproportionately likely to take leave, with the result that most of the leave taken would be paid. Instead, it appears that nearly half of those who take time off to care for a seriously ill family member in the average week are unpaid. As we will see below, many of those who are paid are probably using a leave benefit that is not specifically designed for family care.

2. Employer-based versus household (employee-based) surveys.

The NCS is an establishment survey (collected from employers), whereas the ATUS and AFS are household surveys (collected from employees). Employers are a more accurate source of information about formal benefit plans; workers may not be aware of all of the benefits available to them through their employers. In the ATUS, fully 7% of workers report that they do not know if they would be able to take leave in the event of the birth or adoption of a child.[2]

Different sources of information lead to what is probably the most important distinction between measures of access in the NCS and ATUS: the NCS reports the percentage of workers whose employers offer specific types of paid leave plans, while the ATUS reports the percentage of workers who could (or think they could) take paid leave for certain purposes.

Specifically, a leave benefit will only be classified as paid family leave in the NCS if it is distinct from any sick leave, vacation, personal leave, and short-term disability leave that is available to an employee. (Paid family leave in the NCS includes both parental and family care leave.) So, if an employer offers short-term disability leave that can be used as parental leave, the NCS would not count this as a family leave benefit. As a result, the NCS estimate of access to family leave is fairly low, at just 19% (Table 3). This reflects the percentage of workers who have access to a specific employer-provided family leave benefit.

By contrast, the ATUS asks workers if they can take paid leave to care for a new child or ill family member, regardless of whether this is the defined purpose of the leave benefit. Workers who are not covered by a formal family or medical leave benefit may be able to access time off for these purposes using other forms of leave such as general paid time off, vacation days, or informal arrangements with employers. About half of ATUS respondents report that they can take paid parental or family care leave. Some of these respondents may live in states such as California where leave is provided through social insurance programs. Such non-employer-provided leave benefits will not be captured in the NCS.

3. Occupations versus individuals as the unit of observation.

The NCS provides information at the establishment-occupation level. That is public-use version of the NCS provides information about the benefits available to certain positions within each surveyed establishment but not about the individual employees in those positions. One implication of this is that when we look at gaps in access to leave benefits between high- and low-wage workers, wages are assigned based on the average wage for the occupation rather individuals’ own wages (see Figure 1 below). This also prevents us from narrowing our focus to certain age groups in the NCS, as we do for the ATUS in certain figures below.

Another implication is that it is theoretically possible for a single person to be represented more than once in the NCS if they work for more than one surveyed establishment-occupation category. However, since only about 5% of workers hold more than one job at any given time, multiple jobholding is unlikely to be an important factor here. Additionally, we may be more interested in access to leave at the job level than at the person level. ATUS respondents report their ability to access paid leave at their “main” jobs, so leave benefits at any of the respondent’s other jobs are not included in ATUS estimates. The AFS does not specify whether respondents should consider main or secondary jobs.

4. Time period over which leave is taken.

The ATUS asks respondents to report any leave taken in the previous week. (Respondents also report if there was a time in the previous month when they needed leave but did not take it.) Such a short reporting period may make sense for, say, short-term sick leave, since this is the most commonly used leave type (5% of workers report taking time off for their own illness in an average week). It makes less sense for parental or longer-term medical leave, which are used only rarely. For example, too few ATUS respondents report being on parental leave in any given week to meet the BLS’s reporting standards, so official BLS tables do not report whether individuals on parental leave were paid or unpaid.

The upside of the ATUS approach is that respondents can likely recall whether they took leave the previous week. The AFS, by contrast, asks respondents whether they took family leave of at least one week at any time in the past five years, which will be more difficult for respondents to remember accurately.

The longer recall period in the AFS does help to capture forms of leave that are taken more rarely, such as parental leave. About 22% of AFS respondents reported that they had taken some form of family leave in the past five years, with parental leave (especially maternity leave) being the most common, followed by care of a spouse and care of non-newborn children. This may be surprising given that parental leave is less common than family care leave in the ATUS, but the AFS restriction to leave periods of at least a full week is likely important here.

Despite these differences, the percentage of leave-takers who report being paid for family care leave is similar in the ATUS (58%, if we include those paid for part of the time) and AFS (53%). This varies widely between high- and low-wage workers, as we will see below.

Disparities in access to and use of paid family leave

Survey data on leave benefits reveal stark disparities in access to paid leave across the wage distribution. Here, we present a few estimates on access to and use of paid leave by wage quartile,[3] with a particular focus on family leave. To be consistent across surveys, we define family leave as parental or family care leave (i.e. respondents who have access to only one or the other will be counted as having access to family leave).

  1. Access to paid family leave is still rare among low-wage workers, according to both the NCS and ATUS. Workers in the highest quartile are 2 to 3 times as likely as workers in the lowest quartile to have access to either paid parental leave or paid family care leave. Many companies have announced new or expanded paid leave policies, but paid leave is mainly concentrated among high-wage workers.

2. Data from ATUS and AFS show that workers toward the top of the wage or family income distribution are more likely to take leave, and are more likely to be paid when they do take leave. The ATUS numbers below reflect the percentage of prime-age workers in each wage quartile who took any kind of paid or unpaid leave during an average week; the AFS numbers reflect the percentage of workers over the age of 18 in each family income quartile who reported taking at least one week of paid or unpaid family leave in the previous five years. In both cases, a majority of lower-wage leave-takers received no pay while on leave, since they have a lower likelihood of accessing paid leave in the first place.

  1. In addition to being stratified by income, access to paid leave also depends on whether employees work part-time or full-time. Fewer than half of part-time workers in any wage quartile report that they can take paid family leave in the ATUS. Full-time workers in the bottom wage quartile have the same level of access to paid family leave as part-time workers in the top two wage quartiles (44%). Research shows that gender differences in access to paid leave are entirely explained by the fact that women are more likely to work in part-time jobs.

  1. Workers may not be able to take time off from work when they need to for different reasons, including fear of job loss or being unable to afford the loss in income during the leave period. The chart below shows reported reasons for not taking leave among respondents who said that there was some time in the previous month when they needed leave but did not take it.

Among respondents who did not take leave when they needed it, 21% said they could not afford to take leave or feared job loss or other negative employment consequences. Almost half of these respondents (9% of 21%) were in the bottom wage quartile. Workers in the bottom quartile were also more likely to report that their leave request was denied or that they could not find someone to cover their shift, whereas workers toward the top of the wage distribution tended to report that they had too much work to take leave.


The data sources we have explored above allow us to answer different questions about access to and use of paid family and medical leave. For instance, while NCS data tell us that very few workers have access to formal paid family leave benefits through the employers, ATUS data suggest that many appear to be using other leave benefits or informal arrangements to cover their time off. One common thread throughout these data sources is that the ability to take paid family or medical leave is far from universal and is highly unequal. Low-wage workers are less likely to have access to paid leave and tend to take unpaid leave at higher rates than other groups, though they take less leave overall. Understanding the data on current access to and use of employer-provided paid leave benefits is particularly important as policymakers at both the state and federal levels become increasingly interested in paid leave policy.


[1] This is far from an exhaustive list of data sources on paid leave benefits. We focus on a selection of surveys to illustrate key measurement differences that are applicable to a variety of similar data sources. For a description of several other data sources, see this report from the Washington Center for Equitable Growth.


[2] This combines the 1% of workers who do not know if they have access to any form of paid leave and the 6% of workers who report that they have access to some form of paid leave but do not know if they have access to paid parental leave.


[3] We mentioned above that the NCS divides workers into wage quartiles according to the average wage of their occupation. The ATUS provides earnings and employment information for individual respondents, which allows us to calculate wage quartiles for the figures below. We limit the ATUS sample to prime-age workers between the ages of 25 and 54, so our ATUS wage quartiles are not exactly comparable to NCS wage quartiles, which are not age-limited. The AFS provides information only on individuals’ family income ranges, so we group workers into family income categories rather than wage quartiles. This means, for example, that some low-wage who have higher-earning family members will be included in high-income categories. Additionally, a respondent’s current family income may differ from their income at the time leave was taken.

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