Health effects of downsizing survival and job loss in Norway

Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed

BACKGROUND

The evidence is insufficient regarding the association between organizational downsizing and employee mental health. Our aim was to analyze trajectories of prescribed sedatives and anxiolytics with a sufficiently long follow-up time to capture anticipation, implementation and adaption to a downsizing event among stayers, changers and those who become unemployed compared to unexposed employees.

METHOD

Residents in Sweden aged 20-54 years in 2007, with stable employment between 2004 and 2007, were followed between 2005 and 2013 (n = 2,305,795). Employment at a workplace with staff reductions ≥18% between two subsequent years in 2007-2011 (n = 915,461) indicated exposure to, and timing of, downsizing. The unexposed (n = 1,390,334) were randomized into four corresponding sub-cohorts. With generalized estimating equations, we calculated the odds ratios (OR) of purchasing prescribed anxiolytics or sedatives within nine 12-month periods, from four years before to four years after downsizing. In order to investigate whether the groups changed their probability of purchases over time, odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated contrasting the prevalence of purchases during the first and the last 12-month period within four time periods for each exposure group.

RESULTS

The odds of purchasing psychotropic drugs increased more for changers (sedatives OR 1.08, 95% CI 1.05-1.11) and unemployed (anxiolytics OR 1.08, 95% CI 1.03-1.14), compared to unexposed before downsizing, while for stayers purchases increased more than for unexposed during and after downsizing. Among those without previous sickness absence, stayers increased their purchases of psychotropic drugs from the year before the event up to four years after the event.

CONCLUSION

This study indicates that being exposed to downsizing is associated with increased use of sedatives and anxiolytics, before the event among those who leave, but especially thereafter for employees who stay in the organization.

The impact of precarious jobs on mental health: a gender-sensitive literature review

PURPOSE

The aim of this study is to analyse the extent to which research and knowledge production on a key occupational health issue-the impact of precarious employment on health-incorporates, and is sensitive to, a gender perspective.

METHODS

A systematic literature review was carried out to identify studies that analysed the relationship between precarious employment and mental health in the period January 2010-May 2018 through. A minimum of two independent reviewers assessed each article for quality and eligibility. A checklist was used to determine whether the articles included in the review incorporated a gender perspective.

RESULTS

The search retrieved 1522 papers, of which 54 (corresponding to 53 studies) met the inclusion criteria. Of these 54 papers, 22 (40.7%) stratified the analyses by sex. Only 5.4% of the total of articles both stratified by sex and considered variables of household composition and marital status, while only 33.3% incorporated an intersectional perspective. None considered the distribution of domestic work and only a quarter (25.9%) approached the study and interpreted the results in terms of gender.

CONCLUSION

Too few studies researching paid work and health include a gender perspective. This omission necessarily implies a biased interpretation of the reality of precarious employment and its impact on health.

Labor market exit around retirement age in Sweden and trajectories of psychotropic drugs in a context of downsizing

Background

A maintained psychological wellbeing is important in order to continue working longer and remain active into older age. However, little is known about impact of different organizational factors, such as downsizing, on the mental health of older workers exiting the labor market. The aim in this study was to investigate trajectories of purchases of psychotropic drugs in relation to labor market exit later in life in a context with and without downsizing.

Method

People living in Sweden, born 1941–1951, exiting paid work via unemployment, sickness absence/disability pension, or old-age pension were followed from 2005 to 2013 regarding purchases of psychotropic drugs. Individuals employed at a workplace closing down or downsizing with ≥18% between two subsequent years were compared to employees exiting from workplaces without downsizing or workplace closure. Generalized estimating equations was applied to derive trajectories of annual prevalence of purchased antidepressants, sedatives and anxiolytics from 4 years before to 4 years after a labour market exit.

Results

During the period around the exit, old-age retirees experiencing a downsizing/workplace closure did not decrease their purchases of sedatives (OR 1.01 95% CI 0.95–1.07) while the unexposed decreased their purchases during this period (OR 0.95 95% CI 0.92–0.98). Similar differences concerning sedatives and antidepressants between exposed and unexposed were seen for those exiting via sickness absence or disability pension. Furthermore, a significant difference in purchases of anxiolytics was observed between those exposed to downsizing (OR 1.10 95% CI 0.97–1.24) and the unexposed (OR 0.98 95% CI 0.91–1.06) exiting via old-age retirement during the time before the exit.

Conclusion

Downsizing or workplace closure, although weakly, was associated with higher prevalence of psychotropic drugs certain years around the labor market exit. The results support the idea that involuntary labor market exit in mature adulthood may negatively affect the development of mental health.

Organizational change and the risk of sickness absence: a longitudinal multilevel analysis of organizational unit-level change in hospitals

BACKGROUND

Organizational change is often associated with reduced employee health and increased sickness absence. However, most studies in the field accentuate major organizational change and often do not distinguish between and compare types of change. The aim of this study was to examine the different relationships between six unit-level changes (upsizing, downsizing, merger, spin-off, outsourcing and insourcing) and sickness absence among hospital employees.

METHODS

The study population included employees working in a large Norwegian hospital (n = 26,252). Data on unit-level changes and employee sickness absence were retrieved from objective hospital registers for the period January 2011 to December 2016. The odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee were estimated in a longitudinal multilevel random effects logistic regression model.

RESULTS

Unit-level organizational change was associated with both increasing and decreasing odds of short-term sickness absence compared to stability, but the direction depended on the type and stages of change. The odds of long-term sickness absence significantly decreased in relation to unit-level upsizing and unit-level outsourcing.

CONCLUSIONS

The results from this study suggested that certain types of change, such as unit-level downsizing, may produce greater strain and concerns among employees, possibly contributing to an increased risk of sickness absence at certain stages of the change. By contrast, changes such as unit-level insourcing and unit-level upsizing were related to decreased odds of sickness absence, possibly due to positive change characteristics.

The impact of employment protection on health: Evidence from fixed-term contract workers in South Korea

In this paper, we examine the impact of increased employment protection on the self-rated health of workers. We utilize the recent labor reform in South Korea which sharply increased the employment protection level of fixed-term contract workers meeting certain criteria. By applying a difference-in-differences framework to longitudinal data, we explore the causal impact of employment protection. We find that subjective health and perceived job security improved with increased statutory employment protection. Further analysis suggests that the improvement in subjective health is less likely to be driven by improvement in working conditions or health related behaviors.

Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed

BACKGROUND

The evidence is insufficient regarding the association between organizational downsizing and employee mental health. Our aim was to analyze trajectories of prescribed sedatives and anxiolytics with a sufficiently long follow-up time to capture anticipation, implementation and adaption to a downsizing event among stayers, changers and those who become unemployed compared to unexposed employees.

METHOD

Swedish residents aged 20-54 years in 2007, with stable employment between 2004 and 2007, were followed between 2005 and 2013 (n = 2,305,795). Employment at a workplace with staff reductions ≥18% between two subsequent years in 2007-2011 (n = 915,461) indicated exposure to, and timing of, downsizing. The unexposed (n = 1,390,334) were randomized into four corresponding sub-cohorts. With generalized estimating equations, we calculated the odds ratios (OR) of purchasing prescribed anxiolytics or sedatives within nine 12-month periods, from four years before to four years after downsizing. In order to investigate whether the groups changed their probability of purchases over time, odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated contrasting the prevalence of purchases during the first and the last 12-month period within four time periods for each exposure group.

RESULTS

The odds of purchasing anxiolytics increased more for stayers (OR 1.03, 95% CI 1.01-1.06) and unemployed (OR 1.08, 95% CI 1.03-1.14) compared to unexposed before downsizing, and purchases continued to increase after downsizing for stayers. Among those without previous sickness absence, stayers increased their purchases of anxiolytics from the year before the event up to four years after the event. Trajectories for sedatives were similar but less pronounced.

CONCLUSION

This study indicates that being exposed to downsizing is associated with increased use of sedatives and anxiolytics, especially before the event, if the employee stays in the organization or becomes unemployed.

Risk of psychological ill health and methods of organisational downsizing: a cross-sectional survey in four European countries

BACKGROUND

The manner in which organizational downsizing is implemented can make a substantial difference as to whether the exposed workers will suffer from psychological ill health. Surprisingly, little research has directly investigated this issue. We examined the likelihood of psychological ill health associated with strategic and reactive downsizing.

METHODS

A cross-sectional survey included 1456 respondents from France, Sweden, Hungary and the United Kingdom: 681 employees in stable workplaces (reference group) and 775 workers from downsized companies. Reactive downsizing was exemplified by the exposures to compulsory redundancies of medium to large scale resulting in job loss or surviving a layoff while staying employed in downsized organizations. The workforce exposed to strategic downsizing was represented by surplus employees who were internally redeployed and supported through their career change process within a policy context of "no compulsory redundancy". Symptoms of anxiety, depression and emotional exhaustion were assessed in telephone interviews with brief subscales from Hospital Anxiety Scale (HADS-A), Hopkins Symptom Checklist (SCL-CD₆) and Maslach Burnout Inventory (MBI-GS). Data were analyzed using logistic regression.

RESULTS

We observed no increased risk of psychological ill health in the case of strategic downsizing. The number of significant associations with psychological ill health was the largest for the large-scale reactive downsizing: surviving a layoff was consistently associated with all three outcome measures; returning to work after the job loss experience was related to anxiety and depression, while persons still unemployed at interview had elevated odds of anxiety. After reactive medium-scale downsizing, unemployment at interview was the only exposure associated with anxiety and depression.

CONCLUSIONS

The manner in which organizational downsizing is implemented can be important for the psychological wellbeing of workers. If downsizing is unavoidable, it should be achieved strategically. Greater attention is needed to employment and health policies supporting the workers after reactive downsizing.

Exploring work-related attributions of sickness absence during organizational change

Purpose

The purpose of this paper is to review the literature on the relationship between organizational change and sickness absence and to map and describe the prevailing “trends” in the field. In particular, the paper focuses on the indirect links between change and sickness absence and identifies knowledge gaps and novel research opportunities.

Design/methodology/approach

A scoping review was conducted seeking to generate a wide-ranging overview of relevant studies. To this end, research articles were collected through different sources of landmark articles, bibliographies and databases.

Findings

The association between organizational change and sickness absence is often explained by adverse changes in work characteristics. Such potential mediation or moderation effects, however, are rarely statistically tested. Including such variables in the analyses may represent an important avenue for future research. Additionally, earlier studies have mainly emphasized organization-wide episodic changes. Recently, however, researchers have focused on smaller and frequently implemented changes. Accordingly, the field of organizational change and occupational health may advance by incorporating greater diversity of change type.

Originality/value

The paper demonstrates that attention to the potential health effects of organizational change will remain important as the field of workplace health management proceeds. Research needs to develop beyond attributions of the relationship between change and sickness absence and focus more on statistical testing of linking variables. The unique contribution of this review is therefore that it identifies knowledge gaps and novel avenues for prospective research.

Purchases of Prescription Antidepressants in the Swedish Population in Relation to Major Workplace Downsizing

Organizational downsizing may be a risk factor for morbidity among both the displaced and those who remain in work. However, the knowledge is limited regarding its impact on clinically relevant mental health problems. Our objective was to investigate purchases of prescription antidepressants across 5 years in relation to workplace downsizing. We studied all Swedish residents 2004 throughout 2010, 22-54 years old in 2006, gainfully employed, and with a stable labor market position up to 2006. People primarily employed at a workplace with ≥18% staff reduction were considered exposed to major downsizing (in 2006-2007, 2007-2008, or 2008-2009). We applied repeated measures regression analyses through generalized estimating equations, calculating odds of any purchase of prescription antidepressants (inferred from the prescribed drug register) within five 12-month periods from 2 years before to 2 years after the period of major downsizing and compared the trends for newly exposed (n = 632,500) and unexposed (n = 1,021,759) to major downsizing. The odds of purchasing prescription antidepressants for exposed increased more than for nonexposed, mainly peridownsizing (1 year before to 1 year after), and postdownsizing (1 year after to 2 years after) for survivors (odds ratio 1.24 vs. 1.14 peridownsizing and 1.12 vs. 1.00 postdownsizing) and those changing workplace (odds ratio 1.22 vs. 1.14 peridownsizing and 1.10 vs. 1.00 postdownsizing) with no previous sickness absence or disability pension (≥7% more than unexposed peri- and postdownsizing). This large-scale study indicates that downsizing is associated with a slight increase in the odds of purchasing prescription antidepressants among people without previous sickness absence or disability pension.

Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience

BACKGROUND

The unemployed more often suffer from depression than the employed. We examined whether mental health deterioration occurs already before unemployment implicating health selection, or whether it mostly occurs after becoming exposed to the experience rendering causal explanations more likely.

METHODS

We used nationally representative Finnish register data to examine changes in depressive morbidity as measured by antidepressant medication in 1995-2009 over four years before and since a new onset of unemployment (N = 28 000) at the age of 30-60 compared to the employed (N = 124 136). We examined separately those who became continuously long-term unemployed, intermittently unemployed and unemployed with eventual re-employment in the second, third or fourth year since the year of onset. Annual repeated measurements were analysed using generalised estimation equations.

RESULTS

Among the employed antidepressant medication increased slowly but steadily over the study period and it was mainly at a lower level than among the unemployed. In the four years leading to unemployment there was excess increase in medication that was generally stronger among those with longer duration of the eventual unemployment experience. During unemployment medication decreased in all groups except among the intermittently unemployed. By the first year of re-employment antidepressant medication reached a level similar to that among the employed and afterwards followed no consistent trend.

CONCLUSIONS

The associations of unemployment and re-employment with depressive morbidity appear to be largely driven by health selection. The question of potential causal associations remains unresolved for intermittent unemployment in particular.

Health, work and working conditions: a review of the European economic literature

Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29 %) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific "flexicurity" (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health.

Unemployment and initiation of psychotropic medication: a case-crossover study of 2 348 552 Norwegian employees

OBJECTIVES

The study investigated initiation of psychotropic medication in relation to unemployment in the months before, during and after job loss, to detect the period of greatest risk.

METHODS

The Norwegian working population in 2004 (N=2 348 552) was observed from 2005 to 2010 through administrative registries linked to the Norwegian Prescription Database. A case-crossover design was used to analyse within-person relative risk of incident purchases of prescribed psychotropic drugs in relation to timing of unemployment. Control periods were defined 12, 24 and 36 months before the drug purchase. Supplementary analyses were performed on medication for cardiovascular disease, diabetes, obesity, thyroid disorder, pain and musculoskeletal conditions.

RESULTS

Purchases of all psychotropic drugs increased 1-3 months before job loss. Antidepressants had the highest estimate in the month before job loss (OR 2.68, 95% CIs 2.39 to 3.01), followed by hypnotics/sedatives (OR 2.21, 95% CI 1.97 to 2.48), anxiolytics (OR 2.18, 95% CI 1.91 to 2.48) and antipsychotics (OR 2.09, 95% CI 1.76 to 2.48). Rises were greatest in men. Risk of starting psychotropic medication remained raised during a spell of unemployment, but returned to close-to-baseline levels following re-employment. Drugs used to treat somatic and pain conditions showed similar trends but with weaker associations.

CONCLUSIONS

Concerns about impending unemployment may influence mental health several months prior to job loss, especially around the time of notification. The clinical implications of this might be a strengthening of preventive health initiatives early in the unemployment process.

Mitigating Physiological Responses to Layoff Threat: An Experimental Test of the Efficacy of Two Coping Interventions

The purpose of the current study was to assess real-time physiological reactions to the threat of layoffs and to determine whether the use of an emotion-focused vs. problem-focused coping intervention would be more efficacious in attenuating these physiological reactions. A 2 (coping intervention) × 4 (within-subjects time points) mixed experimental design was used to test the hypotheses. Eighty-four undergraduates participated in this laboratory experiment during which their galvanic skin response (GSR) and heart rate (HR) were continuously monitored. Analyses indicate that individuals instructed to utilize an emotion-focused coping strategy experienced a significantly greater decline in their GSR compared to those utilizing the problem-focused coping method. Results suggest organizations conducting layoffs might focus first on dealing with the emotional aftermath of downsizing before focusing on problem-solving tasks, such as resume writing and other traditional outplacement activities.

Poor quality in the reporting and use of statistical methods in public health - the case of unemployment and health

BACKGROUND

It has previously been reported that many research articles fail to fulfill important criteria for statistical analyses, but, to date, these reports have not focused on public health problems. The aim of this study was to investigate the quality of reporting and use of statistical methods in articles analyzing the effect of unemployment on health.

METHODS

Forty-one articles were identified and evaluated in terms of how they addressed 12 specified criteria.

RESULTS

For most of these criteria, the majority of articles were inadequate. These criteria were conformity with a linear gradient (100 % of the articles), validation of the statistical model (100 %), collinearity of independent variables (97 %), fitting procedure (93 %), goodness of fit test (78 %), selection of variables (68 % for the candidate model; 88 % for the final model), and interactions between independent variables (66 %). Fewer, but still alarmingly many articles, failed to fulfill the criteria coefficients presented in statistical models (48 %), coding of variables (34 %) and discussion of methodological concerns (24 %). There was a lack of explicit reporting of statistical significance/confidence intervals; 34 % of the articles only presented p-values as being above or below the significance level, and 42 % did not present confidence intervals. Events per variable was the only criterion met at an undoubtedly acceptable level (2.5 %).

CONCLUSIONS

There were critical methodological shortcomings in the reviewed studies. It is difficult to obtain unbiased estimates, but there clearly needs to be some improvement in the quality of documentation on the use and performance of statistical methods. A suggestion here is that journals not only demand that articles fulfill the criteria within the STROBE statement, but that they include additional criteria to decrease the risk of incorrect conclusions being drawn.

Depressive symptoms as a cause and effect of job loss in men and women: evidence in the context of organisational downsizing from the Swedish Longitudinal Occupational Survey of Health

BACKGROUND

Few studies have examined depression as both a cause and effect of unemployment, but no prior work investigated these relationships in the context of organisational downsizing. We explored whether the exposure to downsizing is associated with subsequent depression (social causation), and whether pre-existing depression increases the risk of being laid off when organisations downsize (health selection).

METHODS

Two successive waves of the nationally representative Swedish Longitudinal Occupational Survey of Health represented the baseline (2008) and follow-up (2010) of this study. Analyses included 196 workers who lost their jobs through downsizing, 1462 layoff survivors remaining in downsized organisations and 1845 employees of non-downsized workplaces. The main outcomes were: (1) Depressive symptoms at follow-up, assessed with a brief subscale from the Symptom Checklist 90, categorised by severity levels ("major depression", "less severe symptoms" and "no depression") and analysed in relation to earlier downsizing exposure; (2) Job loss in persons with downsizing in relation to earlier depressive symptoms. The associations were assessed by means of multinomial logistic regression.

RESULTS

Job loss consistently predicted subsequent major depression among men and women, with a somewhat greater effect size in men. Surviving a layoff was significantly associated with subsequent major depression in women but not in men. Women with major depression have increased risks of exclusion from employment when organisations downsize, whereas job loss in men was not significantly influenced by their health.

CONCLUSIONS

The evidence from this study suggests that the relative importance of social causation and health selection varies by gender in the context of organisational downsizing. Strategies for handling depression among employees should be sensitive to gender-specific risks during layoffs. Policies preventing social exclusion can be important for female workers at higher risk of depression.

Misery loves company? A meta-regression examining aggregate unemployment rates and the unemployment-mortality association

PURPOSE

Individual-level unemployment has been consistently linked to poor health and higher mortality, but some scholars have suggested that the negative effect of job loss may be lower during times and in places where aggregate unemployment rates are high. We review three logics associated with this moderation hypothesis: health selection, social isolation, and unemployment stigma. We then test whether aggregate unemployment rates moderate the individual-level association between unemployment and all-cause mortality.

METHODS

We use six meta-regression models (each using a different measure of the aggregate unemployment rate) based on 62 relative all-cause mortality risk estimates from 36 studies (from 15 nations).

RESULTS

We find that the magnitude of the individual-level unemployment-mortality association is approximately the same during periods of high and low aggregate-level unemployment. Model coefficients (exponentiated) were 1.01 for the crude unemployment rate (P = .27), 0.94 for the change in unemployment rate from the previous year (P = .46), 1.01 for the deviation of the unemployment rate from the 5-year running average (P = .87), 1.01 for the deviation of the unemployment rate from the 10-year running average (P = .73), 1.01 for the deviation of the unemployment rate from the overall average (measured as a continuous variable; P = .61), and showed no variation across unemployment levels when the deviation of the unemployment rate from the overall average was measured categorically. Heterogeneity between studies was significant (P < .001), supporting the use of the random effects model.

CONCLUSIONS

We found no strong evidence to suggest that unemployment experiences change when macroeconomic conditions change. Efforts to ameliorate the negative social and economic consequences of unemployment should continue to focus on the individual and should be maintained regardless of periodic changes in macroeconomic conditions.

How does unemployment affect self-assessed health? A systematic review focusing on subgroup effects

BACKGROUND

Almost all studies on the effect on health from unemployment have concluded that unemployment is bad for your health. However, only a few review articles have dealt with this relation in recent years, and none of them have focused on the analysis of subgroups such as age, gender, and marital status. The objective of our article is to review how unemployment relates to self-assessed health with a focus on its effect on subgroups.

METHODS

A search was performed in Web of Science to find articles that measured the effect on health from unemployment. The selection of articles was limited to those written in English, consisting of original data, and published in 2003 or later. Our definition of health was restricted to self-assessed health. Mortality- and morbidity-related measurements were therefore not included in our analysis. For the 41 articles included, information about health measurements, employment status definitions, other factors included in the statistical analysis, study design (including study population), and statistical method were collected with the aim of analysing the results on both the population and factor level.

RESULTS

Most of the studies in our review showed a negative effect on health from unemployment on a population basis. Results at the factor levels were most common for gender (25 articles), age (11 articles), geographic location (8 articles), and education level (5 articles). The analysis showed that there was a health effect for gender, age, education level, household income, and geographic location. However, this effect differed between studies and no clear pattern on who benefits or suffers more among these groups could be determined. The result instead seemed to depend on the study context. The only clear patterns of association found were for socioeconomic status (manual workers suffer more), reason for unemployment (being unemployed due to health reasons is worse), and social network (a strong network is beneficial).

CONCLUSIONS

Unemployment affects groups of individuals differently. We believe that a greater effort should be spent on specific groups of individuals, such as men or women, instead of the population as a whole when analysing the effect of unemployment on health.

Organizational downsizing and depressive symptoms in the European recession: the experience of workers in France, Hungary, Sweden and the United kingdom

Background

Organizational downsizing has become highly common during the global recession of the late 2000s with severe repercussions on employment. We examine whether the severity of the downsizing process is associated with a greater likelihood of depressive symptoms among displaced workers, internally redeployed workers and lay-off survivors.

Methods

A cross-sectional survey involving telephone interviews was carried out in France, Hungary, Sweden and the United Kingdom. The study analyzes data from 758 workers affected by medium- and large-scale downsizing, using multiple logistic regression.

Main Results

Both unemployment and surviving layoffs were significantly associated with depressive symptoms, as compared to reemployment, but the perceived procedural justice of a socially responsible downsizing process considerably mitigated the odds of symptoms. Perception of high versus low justice was assessed along several downsizing dimensions. In the overall sample, chances to have depressive symptoms were significantly reduced if respondents perceived the process as transparent and understandable, fair and unbiased, well planned and democratic; if they trusted the employer’s veracity and agreed with the necessity for downsizing. The burden of symptoms was significantly greater if the process was perceived to be chaotic. We further tested whether perceived justice differently affects the likelihood of depressive symptoms among distinct groups of workers. Findings were that the odds of symptoms largely followed the same patterns of effects across all groups of workers. Redeploying and supporting surplus employees through the career change process–rather than forcing them to become unemployed–makes a substantial difference as to whether they will suffer from depressive symptoms.

Conclusions

While depressive symptoms affect both unemployed and survivors, a just and socially responsible downsizing process is important for the emotional health of workers.

Effects of occupational role conflict and emotional demands on subsequent psychological distress: a 3-year follow-up study of the general working population in Norway

OBJECTIVE

To examine the impact of occupational role conflict and emotional demands on subsequent psychological distress.

METHODS

A randomly drawn cohort from the general Norwegian working-age population was followed up for 3 years (n = 12,550; response rate = 67%). Eligible respondents were in paid work during the reference week in 2006 and 2009 or temporarily absent from such work (n = 6,745; response rate = 68%).

RESULTS

In the fully adjusted model, both high role conflict (odds ratios = 1.53; 95% CI = 1.15 to 2.03) and high emotional demands (odds ratios = 1.38; 95% CI = 1.13 to 1.69) were significant predictors of psychological distress. Additional significant predictors were low job control, bullying/harassment, and job insecurity (P < 0.05).

CONCLUSIONS

Considering all of the evaluated work-related factors, role conflict and emotional demands contributed the most to the population risk of developing psychological distress.