The lack of paid sick days affects all working people who are forced to ignore sore throats and runny noses for fear of being fired, but it disproportionately affects women. Concentrated in industries like care-giving and food service, and most likely to have to stay home if a child is ill, women also risk the most economically when forced to take an unplanned and unpaid sick day.
Now a campaign in New York City to introduce paid sick days, led by working women and a coalition of labor and community groups, is gaining ground and could help spur similar movements already in the works in other states and nationally. A majority of the New York City Council is on board - 36 of 50 council members support the law that would secure sick days for more than 1.2 million workers.
But the main gatekeeper to the legislation being brought to the floor - Christine Quinn, the City Council speaker - argues that the bill could raise business costs in tough economic times.
In response, advocates are putting pressure on the politician, who wants to be the city's first female and openly gay mayor, by telling her that women's votes will not be easy to get if she does not support legislation that helps working women.
"Quinn is assuming women voters will support her. She is also assuming that women won't know that she's been blocking the paid sick days legislation that they and their families need," said Elana Levin, a feminist activist in New York City working to pass the bill.
"Our job is to make sure women know that when their health and livelihoods are on the line, Quinn is instead siding with her corporate donors. But it's not too late for the speaker to do the right thing for herself and for all women."
Half of working moms, who themselves make up half of the female workforce, take the primary caring responsibilities when their child is sick, according to 2003 figures from the Kaiser Foundation. Over half lose pay when they take this time off, a figure that is likely to have only been exacerbated during the continuing recession.
It hurts children - 28 percent of parents of children with asthma have had to miss at least one medical appointment because they could not get time off work, according to the Institute for Women's Policy Research.
And for many female activists in the Women for Paid Sick Days Campaign, it's an issue of equality as much as of economic security.
"I knew women could never be equal inside or outside the home until we addressed these issues," said Ellen Bravo with the Family Values @ Work Consortium. "When my two sons were young, I worked for the phone company and was told when I was hired that I couldn't be sick for five years."
Nationally, an estimated 44 million workers in the private sector don't get paid sick days, meaning that if they have a contagious illness, they still head into work.
The New York City bill, known as the Paid Sick Days Act, would establish a minimum floor for earning paid sick days, from five to nine sick days per year depending on the size of the business. In a nod to the small-business lobby, mom-and-pop shops would allow workers to earn five days of unpaid sick time without fear of losing their jobs.
Many of the women leaders have a strong background in helping women in other arenas, as well. Ai-jen Poo worked with immigrant women to get the Domestic Workers' Bill of Rights passed, the sex-ed activist Shelby Knox and former president of the National Partnership for Women and Families Judith Lichtman are all working on the campaign for paid sick days. In addition, feminist icon Gloria Steinem is also a public face in support of the bill.
There is a precedent in place for the New York City bill - San Francisco passed a paid sick leave ordinance in 2007, and a recent report found that the ordinance was "overwhelmingly positive for workers, business and the public."
"Paid sick days is already a national movement, as evidenced most recently by victories in Seattle and Connecticut in 2011," said Vicki Shabo with the National Partnership for Women and Families.
Washington DC, Connecticut, New Jersey and Milwaukee have also adopted paid sick leave ordinances, though Milwaukee's was halted by Gov. Scott Walker.
Shabo said that there were vibrant campaigns in Orange County and Miami, Florida; Portland, Oregon, Philadelphia and Massachusetts.
"A win in New York City would add even more momentum to a diverse and growing nationwide campaign," said Shabo, "which is ultimately what everybody is working towards."