We’re hearing a lot these days about how difficult it is to find enough workers. But the discussion often overlooks a related problem: understaffing caused by employees who are too sick to clock in.

It’s a bit of a stealth challenge, but the drivers behind it are hardly a mystery. As a new report shows, low-income employees — or those with annual family incomes of less than $35,000 — are far more likely to forego available health insurance. And that is where trouble often begins, before it gets worse.

Why would anyone take a pass on health coverage? Well, because hurdles such as high deductibles, coinsurance and drug costs can render insurance unaffordable, notes the report from the Integrated Benefits Institute.

“When employees can’t afford the care they need, health problems can spiral out of control,” said Brian Gifford, research director at Integrated Benefits Institute and the study’s lead author.

He noted, for example, that if conditions get so bad that employees need to go to the emergency department, then there is a high risk of absences during recovery time.

“In that case, the employer loses the contributions of the employee, co-workers have to pick up the slack, and the employee loses some or all of their earnings. Everyone loses,” he said.

So what’s a senior living operator to do?

“We recognize that employers face practical limits on what they can accomplish on behalf of lower-income workers,” he admitted.

But he added that relatively small fixes can make a big difference. For example, enrolling workers in low-deductible health plans, providing prescription coverage and offering flexible health spending accounts can reduce lost workdays by more than 8%.

That may not sound like much. But it can make a big difference. Especially to the person who might have to perform a sick colleague’s duties for a while.