Research

My research agenda focuses on the impacts of work-family policies on the employment, economic security, and health of work families. My dissertation and current working papers consider the impacts of state-level paid sick leave policies, while my broader work includes research on the impact of New York’s Paid Family Leave Act on small businesses and women who recently gave birth. While at the NYC Department of Health and Mental Hygiene, my research spanned health policy, maternal and infant health, and communicable diseases.

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Slopen, M. (2023). The impact of paid sick leave mandates on women’s health. Social Science & Medicine, 115839. https://doi.org/10.1016/j.socscimed.2023.115839

The United States does not have a national program to provide job-protected paid leave to workers when they or a family member are ill or need medical care. Many workers receive paid sick leave through their employers, however women, particularly parents, those without a college degree, and Latinas are less likely than their counterparts to receive employer-provided paid sick leave (PSL). To address the shortfall in PSL coverage, several states and localities have passed laws mandating employers to provide PSL. I examine the impacts of three recent state-level paid sick leave policies on women’s self-reported health using data from the Behavior Risk Factor Surveillance System. Using static and event-study difference-in-differences models, I find that PSL mandates decreased the proportion of women reporting fair or poor health by an average of 2.4 percentage points and reduced the number of days women reported their physical and mental health was not good by 0.68 days and 0.43 days in the past 30 days respectively. Effects were concentrated among parents, women without college degrees, and women of color. This study demonstrates that despite being a low-intensity policy, PSL improves women’s health and well-being. Mandating workplace policies may be a leverage point to address health and employment inequalities.

Bartel A., Rossin-Slater M., Ruhm C., Slopen M., Waldfogel J. Support for Paid Family Leave among Small and Medium Employers Increases during the COVID-19 Pandemic. Socius. January 2021. doi:10.1177/23780231211061959. [NBER working paper #29486]

The United States is one of the few countries that does not guarantee paid family leave (PFL) to workers. Proposals for PFL legislation are often met with opposition from employer organizations, which fear disruptions to business, especially among small employers. But there are limited data on employers’ views. The authors surveyed firms with 10 to 99 employees in New York and New Jersey on their attitudes toward PFL programs before and during the coronavirus disease 2019 (COVID-19) pandemic. There was high support for state PFL programs in 2019 that rose substantially over the course of the pandemic: by the fall of 2020, almost 70 percent of firms were supportive. Increases in support were larger among firms that had employees using PFL, suggesting that experience with PFL led to employers becoming more supportive. Thus, concerns about negative impacts on small employers should not impede efforts to expand PFL at the state or federal level.

Slopen, M. Type and Lengths of Family Leave Among New York City Women: Exploring the Composition of Paid and Unpaid Leave. Maternal and Child Health Journal 24, no. 4 (2020): 514-523.

Paid family leave (PFL) is an important protective policy mechanism to support the health of mothers and children and the economic security of families This paper explores the links of employment and demographic characteristics on leave type and lengths of overall, paid, and unpaid leave in a large city in the United States. Using a sample of 601 women who worked during pregnancy from the 2016 New York City Work and Family Leave Survey, multinomial and linear regression models were used to assess disparities in the type and length of leave taking. Women eligible for the Family and Medical Leave Act (FMLA) have higher relative likelihood to take only paid leave (RRR = 6.588, p < 0.01). While Black women utilized 3.739 weeks of leave more than white women overall, holding all else constant (p < 0.1), this additional leave is composed of 4.739 more weeks of unpaid leave (p < 0.05). Shortened leave taking by women with less than a college degree is driven by fewer weeks of paid leave (p < 0.01). Using unique data from a survey of recent mothers in New York City, this study provides deeper understanding of disparities in the composition of leave. This study adds to the literature by identifying disparities in leave composition that are masked in consideration of total lengths of leave for Black women and those not eligible for FMLA protections. Given the consequences of short leave taking and reliance on unpaid leave, examination of leave composition is required to identify and address disparities.

Lipkind, HS., M. Slopen, MR. Pfeiffer, and KH. McVeigh. School-age outcomes of late preterm infants in New York City. American Journal of Obstetrics and Gynecology 206, no. 3 (2012): 222-e1.

This study compares school-age outcomes among preterm (PT) (32 0/7-<34 weeks), late PT (LP) (34 0/7-<37 weeks), and full-term (FT) infants to assess cognitive sequelae of LP births. We obtained linked birth and educational data for all nonanomalous singleton infants born 1994 through 1998 in New York City who had a third-grade standardized test score (n = 215,138). Children delivered LP and PT had 30% and 50% higher adjusted odds of needing special education than those delivered FT (adjusted odds ratio, 1.34; 95% confidence interval, 1.29–1.40; and adjusted odds ratio, 1.53; 95% confidence interval, 1.30–1.69). They also had lower adjusted math and English scores than those delivered FT (math: 7% and 10% of SD, respectively; English: 4% and 6% of SD). A linear association between gestational age and test scores was seen through 39 weeks’ gestation. There is a significant risk of developmental differences in PT and LP infants compared with FT infants.

Curry, AE., MR. Pfeiffer, M. Slopen, and KH. McVeigh. Rates of early intervention referral and significant developmental delay, by birthweight and gestational age. Maternal and Child Health Journal 16, no. 5 (2012): 989-996

Though correlated, birthweight (BW) and gestational age (GA) have independent effects on cognitive and neurological outcomes. Jurisdictions vary in their inclusion of these two characteristics in their list of established conditions for automatic eligibility for Early Intervention (EI) services, which may lead them to miss important high-risk groups. We evaluated the relationship between BW–GA combinations and both EI referral rates and risk of EI-diagnosed significant developmental delay in a population of New York City (NYC) births. We linked birth certificates of children born in NYC to resident mothers during 1999–2001 and surviving the first 28 days of life (n = 339,522) to EI administrative data. We calculated EI referral rates for various BW–GA categories, and used a logistic model to directly estimate the predicted risk of delay. EI referral rates of over 50% were observed in children born <1,250 g and those born <30 weeks and 1,250–1,499 g. Additionally, more than one in two children born either less than 1,250 g or <30 weeks and 1,250–1,499 g were predicted to be diagnosed with a developmental delay, compared with almost one-tenth among those born >2,500 g and 39+ weeks. A BW threshold of <1,250 g would identify children with the highest risk of delay; GA as an additional criterion would prevent overlooking high-risk children born <30 weeks but at higher birthweights. Physicians should monitor children with high-risk birth characteristics and refer them, if appropriate, for formal evaluation. EI programs may use these findings to guide determination of automatic eligibility criteria.

Slopen, M.., MC. Mosquera, S. Balter, BD. Kerker, MA. Marx, MR. Pfeiffer, A. Fine et al. Patients hospitalized with 2009 pandemic influenza A (H1N1)-New York City, May 2009. Morbidity and Mortality Weekly Report 58, no. 51/52 (2009): 1436-1440.

The first cases of 2009 pandemic influenza A (H1N1) in New York City occurred in April 2009, raising many questions about how best to contain the epidemic. To rapidly assess the severity of influenza illness and identify persons at highest risk for severe infection, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) reviewed the medical charts of the first 99 patients with laboratory confirmed H1N1 admitted to any NYC hospital. The purpose of the review was to characterize the demographics of the first hospitalized patients, identify associated underlying medical conditions, describe the course and severity of disease, and examine the use of antiviral medications. This report summarizes the findings of this analysis. Approximately 60% of admitted patients were aged <;18 years. The most commonly documented underlying condition was asthma, observed among 50% of patients aged <18 years and 46% of adult patients. Multiple underlying conditions were observed in 17% of patients (12% of children, 24% of adults). Patients treated with oseltamivir within 2 days of symptom onset had shorter median hospitalizations than those who did not (2 days versus 3 days [p = 0.03]). The findings of this assessment were used to inform immediate outbreak response measures in New York City. During such outbreaks, public education campaigns should encourage patients at high risk of severe illness to seek treatment promptly after symptom onset and should emphasize the importance of early antiviral therapy for patients with underlying risk conditions.