Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study

Abstract

Objective To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased sickness absence and mortality among employees. Design Prospective cohort study over 7.5 years of employees grouped into categories on the basis of reductions of personnel in their occupation and workplace: no downsizing ( < 8% reduction), minor downsizing (8-18%), and major downsizing ( > 18%). Setting Four towns in Finland. Participants 5909 male and 16 521 female municipal employees, aged 19-62 years, who kept their jobs. Main outcome measures Annual sickness absence rate based on employers' records before and after downsizing by employment contract; all cause and cause specific mortality obtained from the national mortality register. Results Major downsizing was associated with an increase in sickness absence (P for trend < 0.001) in permanent employees but not in temporary employees. The extent of downsizing was also associated with cardiovascular deaths (P for trend < 0.01) but not with deaths from other causes. Cardiovascular mortality was 2.0 (95% confidence interval 1.0 to 3.9) times higher after major downsizing than after no downsizing. Splitting the follow up period into two halves showed a 5.1 (1.4 to 19.3) times increase in cardiovascular mortality for major downsizing during the first four years after downsizing. The corresponding hazard ratio was 1.4 (0.6 to 3.1) during the second half of follow up. Conclusion Organisational downsizing may increase sickness absence and the risk of death from cardiovascular disease in employees who keep their jobs.

Precarious Employment and Health: Analysis of the Comprehensive National Survey in Japan

“…All of these factors suggest a greater likelihood of developing mental disorders 2, 14-16, 19, 20, 33) . Although mental disorders require medical treatment and rest, reports indicate that fewer precarious workers take sick leave compared with permanent workers 2,18) . This suggests that precarious workers may not disclose their illness for fear of losing their jobs, and this precludes early detection and treatment of mental disorders.…”

“…During the last decade, the influence of unstable employment contracts on health has been a subject of research, but primarily in Western nations. Researchers have found that precarious workers tend to have higher mortality rates 12,13) , poorer mental status [14][15][16] , more work-related injuries 17) , and fewer sick-leave days than permanent workers 18) . However, results are not always consistent across countries, partly because each nation has its own classifications of the labor environment and non-regular employment.…”

Prediction of long-term absence due to sickness in employees: development and validation of a multifactorial risk score in two cohort studies

“…Both studies are described in detail elsewhere (20)(21)(22). Briefly, the FPS study population was employees in the municipal service of 10 Finnish towns and 21 public hospitals with survey data collected from employees at work during 2000-2002 or 2004.…”

Work stress in the etiology of coronary heart disease—a meta-analysis

“…One example of such changes is organizational downsizing, a proxy measure for increases in job strain and effort-reward imbalance among those who keep their jobs (75). In a recent study, downsizing was associated with an increased risk of CVD mortality among such employees, and the greatest excess risk was found in the years immediately following the personnel reductions (76). This time-dependent effect pattern supports a causal, rather than a confounded, association between downsizing and CVD mortality, but further research is needed for confirmation.…”