Despite the amount of privatizations around the world in recent decades, only limited research attention has been paid to how privatization affects the employees. The effects are likely to vary depending on the individual's position in the organization. The aim of this study was to investigate how employees' work‐related attitudes and strain changed after privatization of a Swedish acute care hospital, and to analyze whether the effects of privatization differed between employees at various hierarchic levels. Questionnaire data collected at a hospital 1 year before and 2 years after privatization, as well as at a hospital which remained a public administration unit, suggest only limited effects of privatization on a general level, but that employees at various hierarchic levels may be affected differently. While employees at a high level (physicians) and low level (assistant nurses) reported only marginal differences over time in work attitudes and strain, also in comparison with their colleagues at the comparison hospital, work attitudes of employees at the intermediate level (registered nurses) decreased after privatization. These results emphasize the importance of taking hierarchic level into account when a privatization is implemented and analyzed.

The results indicate that organisational change affects employees' health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.

Work and family are sources of both satisfaction and conflicting demands. A challenge is to identify individuals at risk for conflict and factors that potentially reduce conflict. This study investigated how gender and socioeconomic status (SES) were associated with work–family interference (WFI) and family–work interference (FWI) and how control at work and at home related to WFI and FWI. Data from 1991–1993 and 1997–1999 of the Whitehall II study of British civil servants, including 3484 (827 women and 2657 men) employees in three SES-levels, were analysed. Women reported a higher risk for WFI and FWI. High SES employees reported higher WFI. Less control at home increased risks for WFI and FWI as did low control at work but only for WFI. This suggests that high SES women are especially at risk for conflict and that aspects from the spheres of both work and home should be considered in further research and practice.

A number of studies have found that control over work conditions and hours is positively related to mental health. Still, potential positive and negative effects of work flexibility remain to be fully explored. On the one hand, higher work flexibility might provide better opportunities for recovery. On the other hand, especially mothers may use flexibility to meet household and family demands. Here, we investigated the association between parent's work flexibility, rated relative to their partner, and emotional exhaustion in interaction with gender. Additionally, gender differences in time use were investigated. Cross-sectional analyses based on responses of employed parents to the 2012 wave of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were conducted (N = 2,911). Generalized linear models with gamma distribution and a log-link function were used to investigate associations between relative work-flexibility (lower, equal, or higher as compared to partner), gender, and emotional exhaustion. After control for potential confounders, we found that having lower work flexibility than the partner was associated with higher levels of emotional exhaustion as compared to those with higher relative work flexibility. Also, being a mother was associated with higher levels of emotional exhaustion, independent of possible confounders. An interaction effect between low relative work flexibility and gender was found in relation to emotional exhaustion. Regarding time use, clear differences between mothers' and fathers' were found. However, few indications were found that relative work flexibility influenced time use. Mothers spent more time on household chores as compared to fathers, while fathers reported longer working hours. Fathers spent more time on relaxation compared with mothers. To conclude, our results indicate that lower relative work flexibility is detrimental for mental health both for mothers and fathers. However, while gender seems to have a pronounced effect on time use, relative work flexibility seems to have less influence on how time is used. Generally, mothers tend to spend more time on unpaid work while fathers spend longer hours on paid work and report more time for relaxation.

Perceiving a pay system as just has been suggested to be a precondition for individualized pay to have a motivating effect for employees. Supervisors' enacted justice is central for understanding the effects that pay setting can have on employee attitudes and behavior. Yet, enacted justice has received little research attention, in regard to both organizational justice and pay-related topics. This study examines the effects of employees' perceived pay justice and supervisors' enacted justice, as well as the degree of congruence, on employees' work-related attitudes and behaviors. Questionnaire data from employees (N = 566) matched with data from their pay-setting supervisors (N = 208), employed in a Swedish manufacturing company, were analyzed. Results of polynomial regression with response surface analysis show that employees' perceptions of pay justice were important for their work-related attitudes and behaviors and that supervisor-employee congruence regarding pay justice was positively related to employees' attitudes and behavior, particularly when the ratings concerned high levels of justice. The results not only highlight the importance of developing a pay system that is perceived as just by employees but also emphasize the importance of reaching a congruence between supervisors' and employees' perceptions of high fairness, as this has positive implications for employees' attitudes and behaviors.

Political liberalization and increased public costs have placed new demands on the Swedish public sector. Two ways of meeting these novel requirements have been to corporatize and privatize organizations. With these two organizational changes, however, comes a risk of increased insecurity and higher demands on employees; the ability to handle these changes is likely dependent on their social status within an organization. The general aim of the thesis is to contribute to the understanding of how corporatization and privatization might affect employees' work climate, work attitudes and ill-health. Special importance is placed on whether outcomes may differ depending on the employees' social status in the form of hierarchic level and gender. Questionnaire data from Swedish acute care hospitals were used in three empirical studies. Study I showed that physicians at corporatized and privatized hospitals reported more positive experiences of their work climate compared with physicians at a public administration hospital. Study II showed that privatization had more negative ramifications for a middle hierarchic level (i.e., registered nurses) who reported deterioration of work attitudes, while there were no major consequences for employees at high (physicians) or low (assistant nurses) hierarchic levels. Study III found that although the work situation for women and men physicians were somewhat comparable (i.e., the same occupation, the same organization), all of the differences that remained between the genders were to the detriment of women. The results of this thesis suggest that corporatizations and privatizations do not necessarily imply negative consequence for employees. However, the consequences appear to differ between groups with different social status. Employees whose immediate work situation is affected but who do not have sufficient resources to handle the requirements associated with an organizational change may perceive the most negative consequences.

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