Over the last 20 months, getting sick has been a scary and, at times, confusing reality. Especially in the South, where Covid-19 vaccination efforts have plateaued at about 50%.

And yet, getting paid sick days from an employer is more difficult in the South than anywhere else in the country. And it’s particularly bad if you’re a low-income worker, according to a recently released report by the Bureau of Labor Statistics.

According to the report, 67% of private sector workers in the East South Central region of the country have access to paid sick leave, the lowest in the nation, compared to nearly 95% in the Pacific region and 85% in New England.

The East South Central area includes Alabama, Mississippi, Kentucky, and Tennessee. The West South Central region, which includes Louisiana, Texas and Arkansas, offers 69% of workers paid sick leave. The South Atlantic region is at 73%.  

All three regions are among the lowest to offer the benefit in the country.

“Workers shouldn’t have to decide between staying home from work to care for themselves or their dependents and paying rent or putting food on the table,” wrote Elise Gould, senior economist at the Economic Policy Institute, a Washington D.C.-based independent, nonprofit think tank that researches the impact of economic trends and policies on working people in the United States. 

“But that is the situation our policymakers have put workers in. Meaningful paid sick leave legislation is incredibly important for low-wage workers and their families and important to reduce the spread of illness. At the same time, access to paid sick days has positive benefits to employers as it reduces employee turnover with no impact on employment.”

In addition, nonunion workers, who are most present in the South, are also less likely to get paid sick days compared to union workers, according to the new report.

The highest number of low wage workers in the country are in the South, concentrated around South Carolina, Alabama, Louisiana, Mississippi, and Virginia, according to different Bureau of Labor Statistics report from 2020.

Low-wage is considered when hourly paid workers earn at or below the federal minimum wage of $7.25 an hour.

“The highest wage workers (top 10%) are nearly three times as likely to have access to paid sick leave as the lowest paid workers (bottom 10%),” wrote Gould in the report. “Whereas 95% of the highest wage workers had access to paid sick days, only 33% of the lowest paid workers are able to earn paid sick days.”

What can local governments do about this? 

Some cities and towns have tried to ensure sick leave is fair for all, but nearly every Southern state government eroded those rights over the last 20 years, according to the Economic Policy Institute.

Those laws prevent cities and towns from enacting ordinances that would ordinarily protect workers’ rights, including increasing the minimum wage, allowing fair scheduling, prevailing wage, paid leave and legislation around gig economy workers.

Most of the states noted enacted these restrictive laws in 2013 onwards. 

Tennessee has the most restrictive, while Virginia has the most flexible state laws around workers rights.

Fourteen states have laws protecting workers rights, as have a further 19 cities and four counties, according to the National Partnership for Women and Families, a nationwide group advocating for women’s health, reproductive rights and economic justice.