Surveys consistently show that work-life conflict in the United States is epidemic. The problem is due not only to the presence of mothers in the workforce but also to the increase in conflicting demands placed on fathers. According to the Families and Work Institute, a New York-based research group, men now report more work-family conflict than women, and while the percentage of women reporting some or a lot of work-family conflict has remained more or less stable over the past few decades, the percentage of men with such conflicts rose from 35 percent in 1977 to 60 percent in 2008.

Work hours have risen, at least for those in the middle and upper-middle class. Between 1977 and 2002, dual-earner married couples with children saw their combined working hours shoot up by an average of ten hours a week, from eighty-one to ninety-one. By 2005, fully one-third of U.S. employees reported feeling chronically overworked. Today, adults employed full time in the United States work an average of forty-seven hours per week, with nearly 40 percent of full-time workers reporting that they work at least fifty hours a week.

Low-wage and hourly workers face a different set of time pressures. They routinely encounter highly unpredictable scheduling practices with last-minute work assignments, impromptu cancellations of work shifts without pay, or the chaos of being “on call,” committed to working shifts for which they might or might not be needed.

All of this—combined with increasing pressures for more time-consuming and intensive parenting than was the norm for previous generations—contributes to an overwhelming sense of overload and lack of control. In November 2012, nearly three-quarters of respondents polled by the National Partnership for Women & Families said that they, their neighbors, and their friends experienced hardship in balancing high and often inflexible work demands with the equally high yet unpredictable responsibility of caring for family members at least somewhat often, and nearly 40 percent said they experienced such conflict “all the time” or “very often.” University of Minnesota sociologist Erin L. Kelly and her co-authors found that approximately 70 percent of Americans now report “some interference between work and non-work.”

The troublesome level of stress weighing on parents from work-family conflict is generally considered a private matter—a personal problem of the sort best addressed by yoga, relaxation exercises, or going out to coffee with friends. And yet a considerable body of research now indicates that, in fact, it should be considered a public health issue. Work-family conflict has been linked to mental and physical health problems, including the risk of heart disease, high blood pressure, poor sleep, depression, obesity, and addictive behaviors such as smoking and excessive alcohol consumption. It has also been associated with lower satisfaction with family, marriage, work, and life, generally.

The consequences for our economic growth and prosperity are alarming. Work-family conflict impairs worker productivity, commitment, and engagement, and increases turnover and absenteeism. Women in particular, who still disproportionately serve as the primary caregivers in their families even as they’ve increasingly become sole or co-breadwinners, are all too often pushed out of the workforce by the inflexible demands of their jobs or forced to consider less remunerative work that upends or destroys promising career tracks. If women can’t work, earn, and spend to the full extent of their capabilities, then our national economic health suffers as a direct result of crimped or collapsing individual family budgets, lowered tax revenues, and lost productivity.

The health of our economy, then, as well as that of our families, will depend on finding ways to relieve destructive work-family conflict. But to do so we must directly confront the roots of this American epidemic, which are nestled in public policy decisions extending back over two generations. The face of the U.S. workforce and the shape of the American family have vastly changed over the past four decades, chiefly due to the movement of women into the paid workforce. In 1967, only roughly 28 percent of mothers were breadwinners or co-breadwinners, responsible for at least 25 percent of their family income. Today, 63 percent of all mothers make that essential contribution to their families’ economic situation. And there’s no going back. With income stagnant for all but the most wealthy over the past thirty years, and with incomes falling for low-income workers and many in the middle class, women’s earnings are absolutely essential for most families to make ends meet.

Yet despite this massive alteration in the landscape of home and work, our policies and expectations for employees haven’t much changed from the days of homemaker moms and sole-provider dads. The United States is the only industrialized nation that does not guarantee working mothers paid time off to care for a new child, and the only developed country that doesn’t guarantee paid sick leave. What nationally mandated leave we have—provided by the Family and Medical Leave Act of 1993—is unpaid, with qualification restrictions so onerous that 40 percent of all American workers are excluded from coverage. Forty-three percent of all adult workers lack a single paid sick day. And 44 percent of working Americans are unable to arrange their work schedules to meet their responsibilities at home.

This lack of access to workplace flexibility and support, particularly among middle- and low-income earners, means that most parents are fully exposed to the stressors that make work-family conflict most toxic—“high demand and low control,” as Rosalind B. King, program scientist for the Work, Family, Health, and Well-Being Initiative at the National Institute of Child Health and Human Development, puts it. “Changing working conditions is the best prevention strategy for the dilemmas faced by working families,” says King.

Recent studies seeking to measure the role of family-friendly workplace interventions in reducing work-family conflict and stress bear this out. In 2011, Erin Kelly, a sociologist at the University of Minnesota, and her colleagues published findings from a study of employees at Best Buy’s corporate headquarters who were involved in a program to change their office culture so that they were rewarded for results rather than face time. These employees, Kelly found, reported getting more sleep and having more energy, a greater sense of control over their schedules, and less work-family stress. The human resource executives at the company who designed the program also reported large reductions in voluntary employee turnover and substantially increased productivity. Dozens of other companies have since adopted Best Buy’s model.

Then there’s research by Maureen Perry-Jenkins, a professor of psychology at the University of Massachusetts Amherst, who shows that having the ability to take time off for a doctor’s appointment without fear of job or income loss led to less depression in mothers a year after their child’s birth. Stable hours and consistent pay and benefits, Perry-Jenkins also finds, appeared to be protective of mothers’ mental health, whereas the instability from ever-changing work schedules led to a lack of control, which was related to poorer mental health outcomes. Indeed, the mere perception of workplace support enhanced mothers’ mental health, says Perry-Jenkins. The effects held for fathers, too. Perceptions of greater child care support were linked to less depression in fathers, and mothers’ longer maternity leaves were linked to less anxiety in fathers over time.

Most of the published studies to date on the effects of workplace flexibility focus on voluntary employer-provided initiatives, which sadly are the only type of work-family policies available for most workers in the United States. The problem with relying upon such measures is, first, that they depend on the will and whims of chief executives—as Best Buy employees found, in early 2013, when a new CEO, Hubert Joly, did away with the popular practice—and, second, that they are least likely to be provided to the people who need them the most: low-income and hourly workers. More than 90 percent of high-wage employees report that their employers allow them to earn paid time off or to change their schedule if they have an urgent family issue. Less than half of private-sector workers in the bottom 25 percent of earners, however, can change their schedules under such circumstances, and only about half of middle-income workers have the right to these sorts of schedule changes.

The pattern holds steady for access to paid parental leave and paid sick days as well: 66 percent of high-wage workers have access to paid parental leave, compared with 11 percent of those who earn the lowest wages. Almost 80 percent of the highest-paid workers have access to earned sick time, but only 15 percent of the lowest-paid workers have the right to take paid time off if they or a family member get sick.

With implementation of family-friendly policies across the business landscape uneven, at best, the main way to truly alleviate toxic work-family stress for all working parents in the United States is through the universal protections of public policy, with provisions to ensure that employers cannot declare their workers “contract employees” who are exempt from workplace flexibility rules. Fortunately, the landscape for such measures has never been better.

Thirteen cities, among them Washington, D.C., New York City, Jersey City, Seattle, and, most recently, Patterson, New Jersey, now guarantee workers paid sick days, as do two states, Connecticut and California. In the past year, Rhode Island passed paid family leave legislation, joining California, New Jersey, and Washington State; advocates now have eyes on New York, Massachusetts, and Oregon to enact similar legislation. Vermont and San Francisco passed laws granting workers the right to request flexible work arrangements and predictable scheduling. In June, President Obama issued a memo that granted all federal employees the right to request flexible work arrangements.

National paid family leave—a policy idea that not so long ago was considered a pie-in-the-sky impossibility—is now poised to become a campaign issue in the 2016 presidential election. From an economic policy perspective, this public conversation could not be more timely. Between 1990 and 2010, our country fell from having the sixth-highest rate of female participation in the workforce among the twenty-two developed nation members of the Organisation for Economic Co-operation and Development to seventeenth on the list—a decline that economists Francine D. Blau and Lawrence M. Kahn at Cornell University suggest may be due to our lack of federal work-family policy.

To waste women’s resources is foolhardy. The Congressional Budget Office predicted last year that the flattening-out of women’s workforce participation will play a notable role in slowing down U.S. economic growth over the next decade. And the economists Heather Boushey, Eileen Appelbaum, and John Schmitt have calculated that, if women’s employment hadn’t risen the way it did from 1979 to 2012, our gross domestic product would have been roughly 11 percent lower at the end of that period.

For too many decades, children of professional working mothers were considered the victims of their mothers’ ambitions. Now, with the overwhelming majority of families dependent on women’s economic contributions—and our economy and future economic well-being on the line as well—it’s time for policymakers to consider that the best interests of children, their parents, society, and the economy are fully aligned. We know now that families’ mental, physical, and economic health depends not just on the presence but on the quality of parents’ work as well—how much control they have, and how much stress they bring home at the end of the day. In addition, relieving stress at home results in more productive employees in the workplace. American parents are overloaded to a breaking point. That’s a public health and economic risk we as a nation simply cannot afford.

Return to “American Life: An Investor’s Guide.”

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Judith Warner

Judith Warner is a senior fellow at the Center for American Progress and a contributing writer for the New York Times Magazine.