First author and year Crisis Country Participants
(N; ages)
Study Design Key findings
Andersson 1992[@38579] Measles epidemic Mexico 1211 children<5 Mixed Methods
  • Monetary cost and loss of household reserve capital
  • Average loss of 18.8 workdays per case of measles
  • Local pharmacies reported increased cost of drugs
  • Families often sold livestock to pay for medical care
  • Families with measles in household:
  • 70% incurred financial loss
Borse 2011[@38564] H1N1 USA 554 households with elementary school children Cross-sectional
  • 83% did not lose time at work
  • The probability of losing work for a household with only one working parent is 9%
  • When both parents are employed, the probability of losing work is 42%
CDC 2008[@38544] Influenza Kentucky 480 children
School district A = low SES (327)
School district B = higher SES (145)
Mixed Methods
  • 29.1% had an adult that had to miss work
  • 15.7% have lost pay
  • 10% children in school district A (lower SES) relied more on school meal plans
  • 14.9% had the option to work from home
  • 39.8% had a "non-working" member
Chen 2011[@38578] H1N1 Taiwan 232 parents/caretakers of children ages 6-13 Cross-sectional
  • 27% reported workplace absenteeism
  • 18% reported wage loss
  • 23% felt moderately inconvenienced by school closure 
  • 73% supported the school closure 
Chow 2013[@38570] Pandemic influenza (general) Australia 23 parents of children aged 6 months – 3 years Qualitative
  • Many nominated impact on work as one of the largest daily life disturbances
  • Work absenteeism increased and pay decreased
  • Impact on employee-employer relationship
Cui 2020[@38510] COVID-19 China 33 hospitals Cross-sectional
  • Parent job loss adds stress on family
Effler 2010[@38521] H1N1 Australia 223 parents of school children during school closure Cross-sectional
  • 45% reported taking >1 day off work for childcare (1-5 days, median 3 days)
  • 35% had to arrange childcare
  • 10% cared for themselves at home
Epson 2015[@38538] Epidemic ILI (general) USA - Colorado 35 households (representing 67 students) Cross-sectional
  • 80% reported closure not challenging 
  • 20% reported challenges 
  • 14% reported that ≥1 day missed work 
  • 9% reported lost pay
  • 63% did not anticipate challenges to school closure; 6 of 8 who anticipated challenges indicated all the adults in the household worked out of the home
Esposito 2011[@38580] H1N1 Italy 389 children < 15 Mixed methods
  • No major effect # of days missed:
  • 08/09 seasonal H3N2: mothers lost 5.9 fathers lost 3.4, siblings missed 3.9 days of school
  •  09/10 pandemic H1N1 missed days: mothers lost 5.9, fathers lost 3.3 and siblings missed 4.1
Gift 2010[@38565] H1N1 USA - Pennsylvania 214 households (269 students) Cross-sectional
  • 69% reported zero missed workdays, of the remaining
  • ~ 40% missed 5 workdays during school closures
  • School closure > week may result in more missed work
  • Older siblings can reduce missed work
Johnson 2008[@38542] Influenza B North Carolina 220 households (438 adults, 355 school aged children) Cross-sectional
  • 54% employed outside the home
  • 18% were able to work from home
  • 18% of adults stayed home due to school closures (all employed at schools)
  • 76% had a form of childcare
  • 10%, special childcare arrangements due to school closures
  • 3% spent >1 day overnight for childcare
  • 1% spent extra money on childcare
Kavanagh 2012[@38582] H1N1 Victoria, Australia 133 households of employed parents, 33 schools (school aged children) Cross-sectional
  • 52% of parents took time of work to care for quarantined children
  • 42% (without leave) vs. 58% (leave), P=0.08 took time off work
  • 73% pay loss without leave vs. 21%, with leave P<0.001
  • of those who lost pay, 42% experienced further financial consequences
Miller 2010[@38566] H1N1 N/A 63 parent responses for 176 grade 5-8 students; 188 student responses for 240 grade 9-12 students Cross-sectional
  • 20%, nanny/babysitter for childcare
  • 30% had caregivers stay home from work to care for them ≥ 1 day a week
  • 9% in upper school reported caregivers staying home from work to care for them