Attendance Points Systems Drive Sickness Presenteeism in US Firms

Nearly half of hourly service-sector workers operate under attendance points systems that penalize absences, a new study reveals. Despite the availability of paid sick leave, the looming threat of disciplinary action or dismissal forces many employees to report to work while ill, undermining public health and workplace productivity.

Researchers from Harvard Kennedy School, UC Berkeley, Stony Brook, and Wayne State University analyzed data from over 3,000 hourly workers across 63 large US firms. The findings, published in the June 2026 issue of Health Affairs, demonstrate that fear of demerits consistently outweighs the protections afforded by paid leave policies. When employees accumulate points for lateness or unplanned absences, the professional risk of staying home becomes too high, regardless of their health status.

This phenomenon, known as presenteeism, carries significant costs. Working while unwell not only prolongs individual recovery times but also accelerates the transmission of illness among teams. The study suggests that current corporate attendance frameworks actively conflict with modern wellbeing initiatives. For businesses aiming to foster a healthy environment, the researchers argue that merely offering sick leave is insufficient if punitive attendance metrics remain in place. To mitigate these risks, organizations must align their disciplinary policies with the reality of employee health needs rather than prioritizing rigid staffing levels.