The cashier is counting out your change, but right before she hands you 83 cents and sends you on your merry way, she lets out a big sneeze. “Gross,” you think. “Why didn’t she just stay at home?” You gingerly take your coins, and douse yourself in hand sanitizer the second you get to the car. There’s no way you can afford to get sick this week.

For many people, riding out a cold on the couch with a mug of steaming tea simply isn’t an option – especially if you have children and a job that doesn’t let you take time off. For the millions of workers without access to paid sick leave, they simply can’t afford to stay at home – even if it means putting their coworkers and customers at risk.

In the United States – the only industrialized country that does not require employers to provide paid sick leave – 40 percent of workers in the private sector must go to work even if they are sick, or go without pay if they stay at home. Without paid time off, these workers are not only suffering through an illness while at work, they’re creating a public health problem.

In 2009, the year of the swine flu pandemic, public health experts estimate that seven million individuals contracted the H1N1 virus from contagious employees who went to work, resulting in 1,500 more deaths than would have otherwise occurred. Many of these illnesses and deaths might have been prevented if more employees had access to paid sick leave, giving them the option to stay at home and recuperate without fear of financial repercussions.

Because paid sick leave in the United States is typically viewed as a perk, not as a basic part of employment compensation, it’s not surprising that fewer low wage employees have access to paid sick leave. Only 29 percent in the bottom fourth of workers receive paid sick leave. Hispanic and American Indian workers are also less likely to have paid sick days than other workers. 

But paid sick leave is more than a perk. It’s a way to help the general public from getting sick, and unfortunately, many low-wage positions are at a greater risk of spreading diseases. Less than one-fifth of workers in the food service industry have paid sick leave, and nearly two-thirds of restaurant employees admit to having prepared or served food while under the weather. It’s enough to make you think twice about eating out until spring comes again.

For parents, a lack of paid sick leave presents an additional problem. While some workers may be able to afford taking a few unpaid days off in order to nurse a cold, workers with children must choose between taking care of themselves, or budgeting that time for when their child is truly ill. Parents who can’t afford to do both are often stuck going to work while they’re sick, potentially spreading contagious diseases to coworkers and the public.

Children of employees without paid sick time suffer as well – if their parent can’t even afford to take unpaid time off to care for them, they can be sent to school while ill.

If employers were required to provide employees with paid sick time, mothers would stand to benefit the most. Forty percent of mothers in a National Health Interview Survey said they were solely responsible for staying home from work when a child is sick, compared to only three percent of fathers.

With women earning less than men, a family might be foregoing less money when a mother stays home. Unfortunately, employers also justify paying women less because they are more likely to take time off to take care of kids, trapping women in a can’t win situation. Paid sick leave for all employees could help even the playing field, and help all parents take care of their family’s physical health and financial needs.

Critics of paid sick leave point to the financial cost for businesses, worrying that it would cause undue strain. But while the costs of the programs are moderate, the benefits are pronounced. An analysis of Connecticut’s paid sick leave law showed an average weekly cost per worker of $6.87. Employers, meanwhile, see an increase in productivity and reduced turnover by providing compensated time off.

Going to work with the sniffles might not seem like a big deal, especially if you need the money more than you need a day to rest. But when millions of workers do the same, disease spreads more rapidly. Cities that require employers to provide paid sick leave for their workers, like Washington D.C., Seattle, and New York, have fewer cases of the flu. Not only do the workers benefit from paid leave, anyone who would have come into contact with them benefits as well.

More and more employers, states, and cities are recognizing the importance of paid sick leave to their employees, their employees’ families, and to the public as a whole. For parents, paid sick leave can offer not only improved financial stability, but also better health for the entire family.