Dive Brief:

• A 1% increase in the employment rate correlates with a 19% increase in the number of flu-related doctor's visits, meaning that in a strong economy, the public health community should plan for an above-normal increase in flu incidences, according to a study by researchers at Ball State University. The analysis examined the relationship between employment levels and the spread of the influenza virus. Researchers used state-level data on flu prevalence available from the Centers for Disease Control and information on the employment rate calculated from the U.S. Bureau of Labor Statistics (BLS).
• Researchers found the strongest correlation in the retail and healthcare sectors, both industries with high levels of interpersonal contact. Two sectors with the lowest levels of personal contact — construction and manufacturing — were not associated with statistically significant changes in the prevalence of the flu.
• The results indicated that employment in service industries is a "particularly strong mechanism for flu spread," researchers said. They added that if the economy continues to shift to more service-oriented employment, there is greater potential for the flu to spread.

Dive Insight:

In the midst of a strong job economy, the 2018 and 2019 flu seasons were predicted to be tough on employers. Challenger, Gray & Christmas estimated that the 2018 flu season would cost employers $9 billion in lost productivity, and the 2019 season would cost employers $17 billion. The New York Times reported that the 2017/2018 flu season was the worst in 10 years.

The Ball State researchers suggested that to combat lost productivity caused by employees infected with the flu, employers should consider more generous sick-day policies, especially during flu season. Workers need 10 or more paid sick leave days to raise the odds significantly that they'll take time out for preventive healthcare, according to researchers in a joint study by Florida Atlantic University and Cleveland State University.

BLS found that, as of March 2018, workers in the private industry received an average of seven sick days a year at one, five or ten years of service, and eight sick days a year at 20 years of service. However, only 71% of workers in private industry had paid sick leave benefits. 

Given the high risks of flu within the healthcare industry, more than 800 health care organizations have mandated flu vaccines, according to the Influenza Action Coalition. But even for healthcare providers, requiring flu shots can be a risky proposition. The EEOC has adopted a tough enforcement stance on the policies, taking the position that employers may have to grant exemptions for a number of reasons, including religion and disability.