Human costs of organizational downsizing: comparing health trends between leavers and stayers

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.

Psychosocial work environment as a dynamic network: a multi-wave cohort study

While characteristics of psychosocial work environment have traditionally been studied separately, we propose an alternative approach that treats psychosocial factors as interacting elements in networks where they all potentially affect each other. In this network analysis, we used data from a prospective occupational cohort including 10,892 participants (85% women; mean age 47 years) and repeated measurements of seven psychosocial work characteristics (job demands, job control, job uncertainty, team climate, effort-reward imbalance, procedural justice and interactional justice) assessed in 2000, 2004, 2008 and 2012. Results from multilevel longitudinal vector autoregressive models indicated that job demands as well as interactional and procedural justice were most broadly associated with the subsequent perceptions of the work-related psychosocial factors (high out-Strength), suggesting these factors might be potentially efficient targets of workplace interventions. The results also suggest that modifying almost any of the studied psychosocial factors might be relevant to subsequent perceptions of effort-reward imbalance and interactional justice at the workplace.

COVID-19-induced layoff, survivors' COVID-19-related stress and performance in hospitality industry: The moderating role of social support

The COVID-19 pandemic has hit the hospitality industry hard globally, resulting in millions of employees being laid off. Drawing upon the conservation of resources theory, this study aims to empirically examine how and when COVID-19-induced layoff influences employees' in-role and extra-role performance in the hospitality industry. We tested this model by using field data collected from 302 employees and their supervisors in China across two waves. Results revealed that COVID-19-induced layoff increases survivors' COVID-19-related stress, which in turn leads to decreased in-role and extra-role performance. The strength of these indirect effects is mitigated by perceived family support against COVID-19. Unexpectedly, perceived organizational support against COVID-19 intensifies these indirect effects. The theoretical and practical implications of this study are further discussed.

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.

The Effect of Organizational Changes on the Psychosocial Work Environment: Changes in Psychological and Social Working Conditions Following Organizational Changes

Purpose: The present study aimed to clarify the prospective effects of various types and frequencies of organizational changes on aspects in the psychosocial work environment. Methods: The study had a prospective, full-panel, repeated measures design. Data were collected by self-administered, online questionnaires, with a 2-year interval between measurement occasions. Five types of organizational change were assessed - company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. The effects of change on eleven, specific work factors were measured utilizing QPS Nordic. At baseline, 12652 employees participated, while 8965 responded at follow-up. Generalized estimating equations were utilized to estimate the effects of change taking place within the last 12 months or more than 24 months prior. Results: Cross-sectional analyses, i.e., changes occurring within the last 12 months, showed all 11 work factors to be statistically significantly associated with the organizational changes restructuring, downsizing, and partial closure (coefficients ranging -0.28 to 0.04). In the prospective analyses, i.e., the effects of change taking place more than 24 months prior, associations were no longer significant for a number of work factors, although all types of organizational change remained significantly associated with at least three work factors (coefficients ranging -0.14 to 0.05). Following repeated organizational changes, statistically significant associations were shown for all 11 work factors (coefficients ranging from 0.39 to -0.04). Conclusion: Following both separate and repeated organizational change, various psychological and social work factors were altered, with the most pronounced effects following repeated change. These results suggest the implementing organizational change, especially repeated change, may have an adverse effect on various parts of the psychosocial work environment. The negative effects of a company's psychosocial working conditions may contribute to the adverse health effects often observed following such changes and help explain why many change initiatives fail to reach its intended results.

Implantação do Programa Seguro-Emprego e saúde dos trabalhadores na indústria automobilística

RESUMO O objetivo do artigo foi analisar a implantação do Programa Seguro-Emprego (PSE) em relação à saúde dos trabalhadores nas montadoras de autoveículos do ABC. A metodologia incluiu pesquisa documental em acordos coletivos de trabalho, legislação, documentos de entidades sindicais e empresariais. Em 2015, o PSE foi lançado pelo governo como resposta à crise econômica, permitindo redução de até 30% da jornada de trabalho e de salário. Apesar dos questionamentos de grupos sindicais e da resistência operária nas montadoras, a maioria do sindicalismo apoiou a implantação do Programa. Os resultados da pesquisa apontaram o PSE como parte de um novo ciclo de expansão e transformações produtivas na indústria automobilística, ampliando e aprofundando a intensificação do trabalho como forma de geração do desgaste operário. O PSE participa da estratégia empresarial para manter o emprego mais produtivo, selecionando os operários que se manterão no emprego e excluindo trabalhadores considerados de ‘baixo desempenho’ e os ‘compatíveis’ (com redução da capacidade laboral). A inclusão do Programa na reforma trabalhista torna-o alternativa permanente para utilização pelas empresas. Portanto, trata-se de tema relevante para as pesquisas e ações em saúde coletiva e saúde do trabalhador.

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.

Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees

Objectives

We investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees.

Methods

The study population comprised employees from the Capital Region of Denmark (n=14 388). Data on reorganisation at the work-unit level (merger, demerger, relocation, change of management, employee layoff or budget cut) between July and December 2013 were obtained via surveys distributed to the managers of each work unit. Individual-level data on work-unit exit, total and long-term sickness absence (≥29 days) in 2014 were obtained from company registries. For exposure to any, each type or number of reorganisations (1, 2 or ≥3), the HRs and 95% CIs for subsequent work-unit exit were estimated by Cox regression, and the risk for total and long-term sickness absence were estimated by zero-inflated Poisson regression.

Results

Reorganisation was associated with subsequent work-unit exit (HR 1.10, 95% CI 1.01 to 1.19) in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes (HR 1.52, 95% CI 1.30 to 1.79), merger (HR 1.29, 95% CI 1.12 to 1.49), demerger (HR 1.41, 95% CI 1.16 to 1.71) or change of management (HR 1.24, 95% CI 1.11 to 1.38). Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence (OR 1.15, 95% CI 1.00 to 1.33), which was particularly important for merger (OR 1.31, 95% CI 1.00 to 1.72) and employee layoff (OR 1.31, 95% CI 1.08 to 1.59).

Conclusions

Specific types of reorganisation seem to have a dual impact on subsequent work-unit exit and sickness absence in the year after change.

Restructuring of a Textile Manufacturing Company and Workers' Health

Organizational restructuring is associated with greater mortality and morbidity of the workers affected by it. We examined the quality of workers' health at a textile manufacturing company after restructuring, comparing three groups of workers: workers who remained (survivors), workers who lost their jobs and later found new jobs (the reemployed), and unemployed workers. A total of 1046 workers participated in a telephonic survey. The data were processed using SPSS and the R package version 1.2 of prLogistic. The differences between groups were calculated using the chi-square test and adjusted prevalence ratios. The comparison between the three groups shows significantly poorer mental health of the unemployed, who more often than survivors and the reemployed reported depression, as well as significant differences in elevated blood pressure, cholesterol level, and cardiac disorders. The reemployed, who were nonetheless in better health compared to the unemployed, reported poor mental health or depression more often in comparison to survivors. Higher morbidity of the unemployed and reemployed could be influenced by numerous factors associated with restructuring.

Are Employees More Mobilized After Job Mobility?

The antecedents of voluntary employee turnover are well studied, but little is known about the consequences or outcomes of this voluntary job mobility. We address this gap through a survey study of 121 banking employees who have changed their employer in the last 3 years. We hypothesized that job change, whether self-initiated or imposed, may improve organizational commitment, work engagement, and well-being. These positive effects are expected when the job change is perceived as professionally and personally beneficial. Regression analyses revealed that employer change that is perceived as successful, whether voluntary or not, predicts an increase in general well-being, work engagement, and, to a lesser extent, affective organizational commitment. These results suggest that employer change may help employees to be more mobilized in their new work. Misconceptions about highly mobile employees and advantages of job change for both employees and organizations are discussed.

The 2008-2009 Great Recession and employment outcomes among older workers

This study examined whether economic changes related to the 2008-2009 Recession were associated with employment status and job quality indicators among older workers in Europe and Israel. Data were derived from 4917 respondents (16,090 observations both before and after the recession) from 13 countries who participated in the Survey of Health, Ageing and Retirement in Europe. Annual data on gross domestic product (GDP) per capita, life expectancy, and quarterly unemployment rates were assigned to employment assessments from 2004 to 2013. Using difference-in-differences models, we assessed the recession's implications on individual employment outcomes, while isolating cyclical variation within countries and individual changes over time. Among older workers, decreases in GDP were associated with an increase in the likelihood of being unemployed and a decrease in the likelihood of being retired. An increasing country-level unemployment rate had a significant effect on aspects of job quality: lower prospects for job advancement, lower job security, and higher job satisfaction. Economic recessions are thus negatively associated with employment outcomes for older workers. However, malleable policy-related factors such as longer tenure and improved general health can limit the negative employment and job quality outcomes following a recession.

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.

The Effects of Job Insecurity on Health Care Utilization: Findings from a Panel of U.S. Workers

OBJECTIVE

To examine the impacts of job insecurity during the recession of 2007-2009 on health care utilization among a panel of U.S. employees.

DATA SOURCES/STUDY SETTING

Linked administrative and claims datasets on a panel of continuously employed, continuously insured individuals at a large multisite manufacturing firm that experienced widespread layoffs (N = 9,486).

STUDY DESIGN

We employed segmented regressions to examine temporal discontinuities in utilization during 2006-2012. To assess the effects of job insecurity, we compared individuals at high- and low-layoff plants. Because the dataset includes multiple observations for each individual, we included individual-level fixed effects.

PRINCIPAL FINDINGS

We found discontinuous increases in outpatient (3.5 visits/month/10,000 individuals, p = .002) and emergency (0.4 visits/month/10,000 individuals, p = .05) utilization in the panel of all employees. Compared with individuals at low-layoff plants, individuals at high-layoff plants decreased outpatient utilization (-4.0 visits/month/10,000 individuals, p = .008), suggesting foregone preventive care, with a marginally significant increase in emergency utilization (0.4 visits/month/10,000 individuals, p = .08).

CONCLUSIONS

These results suggest changes in health care utilization and potentially adverse impacts on employee health in response to job insecurity during the latest recession. This study contributes to our understanding of the impacts of economic crises on the health of the U.S. working population.

Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland

At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services.

Cooper C, Ivy J. Leaveism and public sector reform: will the practice continue?

Purpose

– The purpose of this paper is to examine and report how the construct of “Well-being” is being recognised within the public services. Using research conducted in a northern provincial police force in the UK the paper explores the issues that may contribute to sickness absence, presenteeism and leaveism; a recently described manifestation of workload overload. As sweeping public sector reform results in reduced workforce and potentially static demand, the question asked here is, “how do organisations adapt to the shifting landscape and retain employee engagement in the workplace?”

Design/methodology/approach

– The study used A Short Stress Evaluation Tool to assess the risk of stress in the workforce. The questionnaire employed an online self-administered survey and collected data from 155 respondents on stress perceptions, health, attitude towards the organisation, job satisfaction and commitment to the organisation.

Findings

– Sickness absence figures receive detailed attention when it comes to managing employees, but they may not represent a reliable picture. In this study one-third of respondents indicated that they had taken leave when they had actually been ill or injured; leaveism. The concept of leaveism does not currently appear within sickness absence reporting mechanisms, and the authors would suggest that the omission of this concept leaves a lacuna in current thinking that may have significant impact on both individual and organisational performance.

Research limitations/implications

– This research clearly shows that the issue of leaveism is a valid concept and has potentially far-reaching consequences. This study has only touched on the first (of three) of the leaveism behaviours and is conducted solely in a policing environment (although non-warranted employees are included in the research cohort). Further research could include attempts to quantify elements two and three of leaveism, and explore to what extent these may impact on organisations undergoing public sector reform.

Practical implications

– Previous studies have highlighted the negative health effects on “stayers” in public sector downsizing exercises. This in turn raises the question of just how these “survivors” cope with the new regime; with potentially more work and less pay. The authors ask what behaviour cuts of this magnitude will eventually drive when the dust settles? As a consequence could the authors see an end to the practice of leaveism? In which case the authors could make the assumption that (in its first form) it may convert to sickness absenteeism? With a third of people surveyed conceding to the practice, this has far-reaching consequences. In comparison to presenteeism, which has no overt costs, this scenario presents an entirely different fiscal proposition.

Originality/value

– Leaveism, a recently described and under researched phenomenon, is a hidden source of potential abstractions from the workplace, and could impact enormously on organisational effectiveness. The motivation for the practice is unclear, and could be a manifestation of loyalty, enjoyment or duty. It could also be construed as a reaction to fear of job loss, redundancy or down grade. Whatever the underlying reason this study clearly illustrates the potentially harmful consequences to (public sector) organisations.

[Changes in the nature of work]

"Dynamic", "complexity", and "diversity" are terms that best describe the challenges in the workplace resulting from the changing nature of work. These changes should conform to the criteria of human-related work design. However, the number of pensions for reduced earning capacity and the number of unfit for work days caused by psychic disorders are rising. Affective disorders, including depression, are the largest group. Depression represents a long-term consequence of work demands. Empirical results confirm a significant relationship between depression and the objective existing as well as the subjective perceived workload conditions. Burn-out as a further long-term consequence depends inter alia on the design of the physical work demands, the environmental conditions, the psychosocial conditions, and the transparency of the decision and information processes in a company. Additionally, empirical results show that the short-term consequences of work demands, i.e., fatigue, satiation, and monotony correlate with the burn-out components of exhaustion and alienation from work. Furthermore, using restructuring as an example, it is demonstrated that the changes in work that accompany modifications in the working world also have other health-related consequences.

Psychosocial risks: is risk management strategic enough in business and policy making?

BACKGROUND

In times of continuous change and volatile markets, organizations are increasingly characterized by downsizing, work intensification, and resource rationalization. This has resulted in diversification, and the emergence of new risks within the field of occupational health and safety, with an important impact. This paper focuses on one such type of risk in the modern workplace-psychosocial risks. The current study aimed to explore stakeholder perspectives, regarding the extent to which psychosocial risks are incorporated into strategic risk management practices, at both the business and policy level.

METHODS

Semi-structured interviews were conducted with 14 professionals, representing employer, expert, policy maker, and trade union stakeholder perspectives.

RESULTS

It was found that the majority of organizations do not sufficiently, if at all, understand and incorporate psychosocial risks into strategic decision making, whereby the key barrier related to practical difficulties of not knowing how to manage psychosocial risks adequately.

CONCLUSION

The study found that there is a need to close the gap between policy and practice on a number of levels. Future recommendations comprise a policy framework and infrastructure underpinned by educational initiatives, partnerships, and networks to drive a shift in attitudes toward recognizing the duality of the concept of risk (including both potential negative and positive outcomes) and moving beyond simple regulatory compliance.

Health consequences of the 'Great Recession' on the employed: evidence from an industrial cohort in aluminum manufacturing

While the negative effects of unemployment have been well studied, the consequences of layoffs and downsizing for those who remain employed are less well understood. This study uses human resources and health claims data from a large multi-site fully insured aluminum company to explore the health consequences of downsizing on the remaining workforce. We exploit the variation in the timing and intensity of layoff to categorize 30 plants as high or low layoff plants. Next, we select a stably employed cohort of workers with history of health insurance going back to 2006 to 1) describe the selection process into layoff and 2) explore the association between the severity of plant level layoffs and the incidence of four chronic conditions in the remaining workforce. We examine four health outcomes: incident hypertension, diabetes, asthma/COPD and depression for a cohort of approximately 13,000 employees. Results suggest that there was an increased risk of developing hypertension for all workers and an increased risk of developing diabetes for salaried workers that remain at the plants with the highest level of layoffs. The hypertension results were robust to a several specification tests. In addition, the study design selected only healthy workers, therefore our estimates are likely to be a lower bound and suggest that adverse health consequences of the 2007-2009 recession may have affected a broader proportion of the population than previously expected.

Effects of (un)employment on young couples' health and life satisfaction

This study investigated effects of employed and unemployed job status on health outcomes with questionnaires in 50 young couples. Analysis of variance revealed higher pessimism, higher stress levels, and lower life satisfaction in couples in which one partner was unemployed. These couples also exhibited more health risk behaviours compared to couples in which both partners were working. The dyadic analysis of data, using an actor-partner interdependence model, demonstrated strong actor and partner effects for male partner's job status. Being unemployed was significantly associated not only with male partner's life satisfaction but also with the life satisfaction of his female partner. In addition, male partner's pessimism was identified as a significant variable which mediates between male partner's job status and female partner's life satisfaction. The study highlights the relevance of the accomplishment of tasks in the domains of work and partnership during young adulthood and it emphasises the gender specific importance.

The importance of work conditions and health for voluntary job mobility: a two-year follow-up

Background

Changing jobs is part of modern working life. Within occupational health, job mobility has mainly been studied in terms of employees’ intentions to leave their jobs. In contrast to actual turnover, turnover intentions are not definite and only reflect the probability that an individual will change job. The aim of this study was to determine what work conditions predict voluntary job mobility and to examine if good health or burnout predicts voluntary job mobility.

Methods

The study was based on questionnaire data from 792 civil servants. The data were analysed using logistic regressions.

Results

Low variety and high autonomy were associated with increased voluntary job mobility. However, the associations between health and voluntary job mobility did not reach significance. Possible explanations for the null results may be that the population was homogeneous, and that the instruments for measuring global health are too coarse for a healthy, working population.

Conclusions

Voluntary job mobility may be predicted by high autonomy and low variety. The former may reflect that individuals with high autonomy have stronger career development motives; the latter may reflect the fact that low variety leads to job dissatisfaction. In contrast to our results on job content, global health measurements are not strong predictors of voluntary job mobility. This may be because good health affects job mobility through several offsetting channels, involving the resources and ability to seek a new job. Future work should use more detailed measurements of health or examine other work settings so that we may learn more about which of the offsetting effects of health dominate in different contexts.

Enterprise restructuring and the health of employees: a cohort study

OBJECTIVE

To examine the influence of enterprise restructuring on general health and emotional exhaustion, and to investigate which factors explain the relation between restructuring and these outcomes.

METHODS

Longitudinal data of the Netherlands Working Conditions Cohort Study were used. At baseline and after 12 months, 9076 employees filled out a questionnaire. Logistic regression analysis was applied.

RESULTS

Prolonged exposure to restructuring increased the likelihood of poor general health, and its influence was partly explained by job insecurity. Emotional exhaustion was more likely among employees that experienced prolonged exposure to restructuring or restructuring during the past year. Job insecurity explained the influence of prolonged restructuring, together with job demands and supervisor's support.

CONCLUSIONS

Prolonged exposure to restructuring adversely affects general health and emotional exhaustion in employees, and its influence seems to be explained by job insecurity.

Unemployment and disability pension--an 18-year follow-up study of a 40-year-old population in a Norwegian county

Background

This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics.

Methods

A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance.

Results

In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%.

Conclusions

Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence.

Is mobility in the labor market a solution to sustainable return to work for some sick listed persons?

AIM

The study aims to identify characteristics associated with long-term expectations of professional stability or mobility among recently sick-listed workers, and to study whether expectations of professional mobility and turnover intentions were associated with duration of sick leave.

METHODS

A cross-sectional study was performed on baseline measures in a prospective cohort study of patients who were granted sick leave due to musculoskeletal (MSD) or mental (MD) disorders. A total of 1,375 individuals fulfilled the inclusion criteria. A baseline questionnaire was sent by mail within 3 weeks of their first day of certified medical sickness; 962 individuals responded (70%). The main diagnosis was MSD in 595 (62%) individuals and MD in 367 (38%).

RESULTS

Expectations of ability to remain in the present profession in 2 years was associated with better health and health-related resources, younger age, higher education, and better effort-reward balance. Effort-reward imbalance, MD, high burnout scores, and better educational and occupational position were associated with turnover intentions. Low expectations of ability to remain in the present profession defined two vulnerable groups with regard to RTW, those with no turnover intentions were older, had lower personal resources, more often had MSD, and slower RTW rate. Those with turnover intentions had a clear effort-reward imbalance and high burnout scores.

CONCLUSIONS

The results of this explorative study underline the importance of differentiating RTW-interventions based on knowledge about the sick-listed person's resources in relation to the labor market and the work place, and their expectations of future employment and employability.

Contribution of the psychosocial work environment to psychological distress among health care professionals before and during a major organizational change

The aim of this study was to investigate the relationships between 4 dimensions of the psychosocial work environment (psychological demands, decision latitude, social support, and effort-reward) among health care professionals as well as their psychological distress during a reorganization process. A correlational descriptive design was used for this quantitative study. A total of 159 health care professionals completed the questionnaire at T1, and 141 at T2. First, before the work reorganization, effort-reward imbalance was the sole variable of the psychological work environment that significantly predicted psychological distress. Second, the high overall level of psychological distress increased during the process of organizational change (from T1 to T2). Finally, effort-reward imbalance, high psychological demands, and low decision latitude were all significant predictors of psychological distress at T2, during the organizational change. In conclusion, to reduce the expected negative outcomes of restructuring on health care practitioners, managers could increase the number of opportunities for rewards, carefully explain the demands, and clarify the tasks to be performed by each of the employees to reduce their psychological burden and increase their perceptions of autonomy.

Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review

This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research.

Mitigating on-call symptoms through organizational justice and job control: a cross-sectional study among Finnish anesthesiologists

BACKGROUND

On-call duty has been shown to be associated with health problems among physicians. However, it cannot be abolished, as patient safety has to be assured. Thus, we need to find factors that could mitigate the negative health effects of on-call duty.

METHODS

The cross-sectional questionnaire of the buffering effects of organizational justice, job control, and social support on on-call stress symptoms was sent to all working Finnish anesthesiologists (n=550).

RESULTS

The response rate was 60% (n=328, 53% men). High organizational justice, job control, and social support were associated with a low number of symptoms while on call or the day after in crude analysis and when adjusted for age, gender, and place of work. Only the association between justice and symptoms was robust to additional adjustments for on-call burden and self-rated health. In the interaction analysis among those being on call at the hospital, we found that the higher the levels of job control or organizational justice, the lower the number of symptoms.

CONCLUSIONS

Job control and organizational justice successfully mitigated stress symptoms among those who had on-call hospital duties. It would be worth enhancing decision-making procedures, interpersonal treatment, and job control routines when aiming to prevent on-call stress and related symptoms.

Overstretched and Unreciprocated Commitment: Reviewing Research on the Occupational Health and Safety Effects of Downsizing and Job Insecurity

Over the past two decades, a leading business practice has been often-repeated rounds of downsizing and restructuring (also referred to as reorganization, re-engineering, and a host of other euphemistic terms) by large private and public sector employers. Frequently associated with other practices such as outsourcing, privatization, and the increased use of temporary workers, downsizing/restructuring has increased the level of job insecurity among workers as well as leading to changes in work processes (including work intensification and multi-tasking) and management behavior. How has downsizing/restructuring and increased job insecurity affected the occupational health, safety, and well-being of workers, and what measures have employers, unions, and governments taken to address any adverse effects? The authors reviewed international studies of the occupational health and safety (OHS) effects of downsizing/restructuring and increased job insecurity undertaken over the past 20 years. After imposing quality filters, they obtained 86 studies. Analysis revealed that 73 (85%) of the studies found poorer OHS outcomes (using a range of measures). Studies were examined to see whether they provided clues as to the reasons for negative outcomes.

Demand, control and social climate as predictors of emotional exhaustion symptoms in working Swedish men and women

AIMS

Most studies on burnout have been cross-sectional and focused on specific occupations. In the present study we prospectively investigated the association between demands, control, support and conflicts as well as downsizing and emotional exhaustion in men and women derived from a representative sample of the working population in Sweden.

METHODS

The study comprised working men (1,511) and women (1,493), who participated in the Swedish Work Environment Survey (SWES) in 2003 and had no physical exhaustion and prior sick leave at baseline. These participants were followed up in 2006 as part of the Swedish Longitudinal Occupational Survey of Health (SLOSH). Demands, decision authority, support from fellow workers and superiors, conflicts with fellow workers and superiors, and downsizing were utilized as predictors and the Maslach Burnout Inventory subscale of emotional exhaustion as the outcome in multiple logistic regression analyses.

RESULTS

High demands were a highly significant predictor of symptoms of emotional exhaustion (>/=75th percentile). Downsizing and lack of support from superiors were also independent predictors for men as well as lack of support from fellow workers and low decision authority for women.

CONCLUSIONS

This study indicates that high demands, low decision authority, lack of support at work and downsizing could be important predictors of emotional exhaustion symptoms among working men and women.

Organisational restructuring/downsizing, OHS regulation and worker health and wellbeing

A growing body of international evidence indicates that downsizing and related forms of organisational restructuring are having profound adverse effects on worker safety, health and wellbeing. In particular, evidence links downsizing to poorer mental health outcomes, including bullying and other forms of occupational violence. In Australia federal, state and territory occupational health and safety (OHS) legislation imposes obligations on employers who make changes to the workplace or work processes to identify hazards, undertake risk assessment, consult with employee representatives and take appropriate steps to manage any significant hazards that are identified, including psychosocial hazards. This study shows that while Australian regulators are aware of the problems posed by downsizing they have made only modest efforts to pursue compliance with legislative duties, producing some guidance material that refers to restructuring and workloads and launching a small number of prosecutions. At the same time, there is an increased willingness to address staffing levels and other impacts of downsizing (like working in isolation). Employer and union responses were also examined. The article concludes by identifying a number of initiatives that would enable regulators, unions and employers to address the problems posed by downsizing more effectively.

Factors associated with a positive attitude towards change among employees during the early phase of a downsizing process

Most research on organizational changes in working life, including downsizing, focuses on the negative attitudes and negative consequences of the change. The aim of this study was to evaluate if the employee's previous learning experience and characteristics of the working environment were associated with positive attitudes towards organizational change. The 467 employees (73.5% males) working in a global oil company in the early phases of a downsizing process were asked to answer a questionnaire with demographic variables, perception of the working environment, and attitude to change (93% response rate). Corporate social responsibility (CSR), involvement and participation, team leadership and team effectiveness were important factors related to positive attitudes towards organizational change. Non-leaders and older employees were positive to change. We conclude that employees' perceptions of their psychosocial working environment, in particular the CSR, were highly related to their attitude to organizational change.

Getting the big picture in community science: methods that capture context

Community science has a rich tradition of using theories and research designs that are consistent with its core value of contextualism. However, a survey of empirical articles published in the American Journal of Community Psychology shows that community scientists utilize a narrow range of statistical tools that are not well suited to assess contextual data. Multilevel modeling, geographic information systems (GIS), social network analysis, and cluster analysis are recommended as useful tools to address contextual questions in community science. An argument for increased methodological consilience is presented, where community scientists are encouraged to adopt statistical methodology that is capable of modeling a greater proportion of the data than is typical with traditional methods.

Job characteristics and the subjective oral health of Australian workers

The way in which work is structured and organised is associated with the health and well-being of workers.

OBJECTIVES

To examine the associations between hours worked, job security, skill maintenance and work and home interference and subjective oral health; and to compare findings for different occupational groups.

METHODS

Data were collected in 1999 from a random stratified sample of households in all Australian States and Territories using a telephone interview and a questionnaire survey. Subjective oral health was evaluated with the short form Oral Health Impact Profile (OHIP-14), which assesses the adverse impact of oral conditions on quality of life.

RESULTS

Data were obtained for 2,347 dentate adults in the workforce. In the 12 months preceding the survey, 51.9% had experienced oral pain and 31.0% reported psychological discomfort from dental problems. Males, young adults, Australian-born workers, and those in upper-white collar occupations reported lower mean OHIP-14 scores (ANOVA p < 0.001). Having controlled for the effects sex, age, country of birth and socioeconomic factors in a linear multiple regression analysis, hours worked, skill maintenance and work and home interference were significantly associated with OHIP-14 scores for all workers. While part-time work was associated with higher OHIP-14 among upper white-collar workers, working >40 hours a week was associated with higher OHIP-14 scores for other workers.

CONCLUSIONS

Aspects of the work environment are associated with the subjective oral health of workers. Because these contexts are subject to only limited control by individual workers, their influence is a public health issue.

Economy and job contract as contexts of sickness absence practices: revisiting locality and habitus

This study revisits two Finnish local governments-Raisio and Nokia-that in an earlier study showed different sickness absence rates in the early 1990s. The locality difference was interpreted sociologically, within a framework inspired by Bourdieu's theory of social field, habitus and practice. The same framework is applied in the present study, starting out from the hypothesis that a constant historical and cultural locality context tends to reproduce prevailing sickness absence practices. The hypothesis was tested by extending the context beyond the locality to the macroeconomic fluctuations that occurred during the 1990s and to the type of employment contract. In both localities a 30% rise was observed in levels of sickness absence from 1991-1993 to 1997-2000. At the beginning of the 1990s the absence rate among permanent employees was 1.86 times higher in Nokia than in Raisio; at the end of the decade the corresponding rate ratio was 1.88. The absence rates were significantly lower among fixed-term employees than permanent employees, but the locality difference was seen in their case, too. Both results support the hypothesis. In spite of major changes taking place in the national economy, the differences between the two towns' sickness absence rates persisted, which in this particular case probably reflects the persisting working-class character of Nokia and middle-class character of Raisio. The theory also applies to the difference between permanent and fixed-term employees: the peripheral power position of the latter on work related social fields leads to the observed practices, i.e. to the relatively low absence rate. The results of our revisit give reason to recapitulate and elaborate upon our theoretical interpretation with a view to deepening our understanding of the social origins of sickness absence practices in the post-industrial workplace, which is characterised by increasing atypical employment and growing job insecurity.