Downsizing, role demands, and job stress

The Relationship Between Financial Stressors, Chronic Pain, and High-Impact Chronic Pain: Findings From the 2019 National Health Interview Survey

OBJECTIVES

Public health interventions to prevent financial stressors and reduce chronic pain and high-impact chronic pain (HICP) are important to potentially improve the health of the US population. The objectives of our study were to provide an update on the prevalence of chronic pain and HICP and to examine relationships between financial stressors and pain.

METHODS

We used data from a cross-sectional sample of adults aged ≥18 years (n = 31 997) collected by the 2019 National Health Interview Survey. We constructed bivariate and multivariate models to examine chronic pain and HICP in relation to financial worries, employment with wages, income, sociodemographic characteristics, number of chronic health conditions, and body mass index.

RESULTS

In fully adjusted multivariate regression models, having no employment with wages was strongly associated with increased risk for chronic pain (adjusted odds ratio [aOR] = 1.3; 95% CI, 1.2-1.5) and HICP (aOR = 1.6; 95% CI, 1.4-1.9). Worries about paying medical bills was associated with chronic pain (aOR = 1.1; 95% CI, 1.0-1.2) and HICP (aOR = 1.1; 95% CI, 1.0-1.3). Being unable to pay medical bills was associated with chronic pain (aOR = 2.1; 95% CI, 1.9-2.3) and HICP (aOR = 2.3; 95% CI, 2.0-2.6). Compared with having more income, having less income relative to the federal poverty level was associated with increased risk for chronic pain and HICP.

CONCLUSIONS

We found a strong relationship between financial worries, employment for wages, income, and self-reported chronic pain and HICP independent of poor physical health and body mass index. Interventions to reduce chronic pain and HICP should address economic instability and financial stressors.

Changes of depression and job stress in workers after merger without downsizing

Background

Since the 1980s, restructuring, which includes downsizing, closures, mergers, and privatization, has expanded worldwide, and various studies have investigated its effect on health. However, previous studies have mainly focused on restructuring accompanied by massive lay-offs, and the effect of a merger on workers’ health is still controversial. This study aims to investigate changes in worker depression and job stress after a merger without downsizing, which is unusual in Korea.

Methods

Repeated surveys were done in April 2014, April 2015, and April 2016 involving the participation of 209 subjects. Participants were divided into two groups, which were comprised of blue-collar workers (104) and white-collar workers (105). Sociodemographic characteristics, including age, education level, job tenure, gender, marital status, smoking status, and alcohol consumption, were measured via a survey. To determine the level of depression, the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) was employed, and to investigate job stress, the Korean Occupational Stress Scale-Short Form (KOSS-SF) was used. For statistical analyses, Pearson’s chi-square test, the Student’s t-test, and repeated measure analysis of variance (ANOVA) were performed.

Results

The results showed that depression (CES-D, F[2, 400] = 0.466, p = 0.628) was changed but without significance and job stress (KOSS-SF, F[1.899, 379.831] = 3.192, p = 0.045) were significantly different. The between-group difference in the CES-D score between the blue- and white-collar workers by survey administration time was not statistically significant (F = 0.316, p = 0.574). The interaction between the survey time and occupational group was also not statistically significant (F = 0.967, p = 0.381). The between-group difference in the KOSS-SF total score was not statistically significant (F = 1.132, p = 0.289), and the interaction between the survey administration time and occupational group was also not significant (F = 0.817, p = 0.437). In the job stress subgroup analyses Job insecurity and Lack of reward showed a significant difference by survey administration time.

Conclusion

This study showed that a merger without massive downsizing can cause negative health effects such as an changes in depression and increase in job stress. To improve the health of workers, both the immediate negative effects on health, and the long-term effects or their resolution over time should be considered prior to the merger.

Mental ability and psychological work performance in Chinese workers

This study was to explore the relationship among mental ability, occupational stress, and psychological work performance in Chinese workers, and to identify relevant modifiers of mental ability and psychological work performance. Psychological Stress Intensity (PSI), psychological work performance, and mental ability (Mental Function Index, MFI) were determined among 485 Chinese workers (aged 33 to 62 yr, 65% of men) with varied work occupations. Occupational Stress Questionnaire (OSQ) and mental ability with 3 tests (including immediate memory, digit span, and cipher decoding) were used. The relationship between mental ability and psychological work performance was analyzed with multiple linear regression approach. PSI, MFI, or psychological work performance were significantly different among different work types and educational level groups (p<0.01). Multiple linear regression analysis showed that MFI was significantly related to gender, age, educational level, and work type. Higher MFI and lower PSI predicted a better psychological work performance, even after adjusted for gender, age, educational level, and work type. The study suggests that occupational stress and low mental ability are important predictors for poor psychological work performance, which is modified by both gender and educational level.

Downsizing and social cohesion: the case of downsizing survivors

Organizational downsizing was a pervasive feature of the U.S. economy during the 1980s and 1990s. A long-standing public health literature recognizes that unemployment and job loss may adversely affect health, but there has been little attention to date on the impact of downsizing upon those who survive job cuts and continue to work in downsized firms. Drawing on research with survivors of downsizing carried out by the U.S. Department of Energy, this article identifies a variety of social and psychological consequences of downsizing that fundamentally destabilize the work environment and work experience for remaining employees. Evidence from this research suggests that the work climate of the post-downsizing environment is laden with suspicion and conflict, and that survivors show feelings of demoralization, sadness, anxiety, and disorientation. A critical factor influencing these responses, we argue, is not downsizing - which is the exposure faced by those who lose their jobs - but the loss of social cohesion that downsizing ultimately represents to survivors. We conclude that addressing the trauma of downsizing for survivors will require providing employees with more genuine opportunities to participate in workplace governance.

Effects of job insecurity from a workplace closure threat on fatigue and psychological distress

The aim of this study was to prospectively investigate the effect of potential workplace closure, an externally attributed form of job insecurity, on fatigue and psychological distress. In April 1999, the minister responsible announced that a governmental agency would close down one of its two locations. Baseline data from the employees were available before the closure announcement (n = 574) because they were enrolled in the Maastricht Cohort Study on "Fatigue at Work." In the closure group, the relative risk for becoming a psychological distress case was 1.61 (95% confidence interval [CI] = 1.27-2.05) during 13 months after the closure threat. Within the closure group, a difference in relative risk for psychological distress was observed between employees who self reported an increase in job insecurity (relative risk = 1.85; 95% CI = 1.41-2.42) and employees who did not report an increase in job insecurity (relative risk 1.14; 95% CI = 0.58-2.24)

The interface between health sector reform and human resources in health

The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms.The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways - reacting to transformations, supporting, blocking and distorting the proposed ways of action.This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them.

Relationships of alcohol use, stress, avoidance coping, and other factors with mental health in a highly educated workforce

PURPOSE

The relationships of drinking, stress, life satisfaction, coping style, and antidepressant use to mental health were examined in a highly educated workforce.

DESIGN

This study used a one-time mail-out, mail-back cross-sectional survey design to examine the relationships of mental health with three kinds of stress (life events, work stress, home stress); two kinds of life satisfaction (work and home); use of avoidance coping; and antidepressant use.

SETTING

This study was conducted at a large worksite in northern California in which the workforce was comprised of predominantly highly educated employees.

SUBJECTS

Questionnaires were mailed to a random sample of 10% of 8567 employees, and 504 were completed and returned by participants (59%). Complete data were provided by 460 participants (53%).

MEASURES

Respondents completed the Mental Health Index, the Alcohol Use Disorders Identification Test (AUDIT), and measures of coping style, work and home stress and satisfaction, stressful life events, and antidepressant use.

RESULTS

Mean Mental Health Index scores were at the 32nd percentile of the U.S. population-based norms, with low percentile values associated with worse mental health. Using multiple regression analysis, the factors examined in this study were significantly related to Mental Health Index scores as the dependent variable [F(16, 443) = 27.41, p < .001, adjusted overall R2 = .48]. Poor mental health scores were significantly related to the following: age (p < .05); screening positively for current harmful or hazardous drinking (p < .05); having high levels of stress at work (p < .05) or home (p < .01); experiencing dissatisfaction with work (p < .001) or home life (p = .01); engaging in avoidance coping (p < .001); and using antidepressants (p < .001). Employees currently using antidepressants had significantly more outpatient medical and mental health visits, indicating higher health costs. Furthermore, mental health status was also significantly related to the interactions between several pairs of these variables: education and gender, age and job stress, home satisfaction and work stress, home satisfaction and avoidance coping, and home satisfaction and use of antidepressants.

CONCLUSION

Mental health status was poorer on average in a highly educated workforce compared with general U.S. norms. Most of the factors that were found to be associated with poorer mental health were ones that are potentially modifiable, such as experiencing more stress and less satisfaction in work and home life and engaging in current hazardous or harmful drinking. The findings that mental health is worse among individual employees who exhibit combinations of these factors suggest that we need to better understand possible effects of these factors in the context of one another. As interpretation of these results may be limited by the single worksite that participated in this study, future research should re-examine these relationships in other worksites varying from this one in geography and demographic characteristics.

The global expansion of precarious employment, work disorganization, and consequences for occupational health: a review of recent research

In this review of a range of studies on the health and safety effects of precarious employment in industrialized societies published since 1984, the authors examine the overall findings and methodological issues and identify areas in need of further research. Of the 93 published journal articles and monographs/book chapters reviewed, 76 studies found precarious employment was associated with a deterioration in occupational health and safety (OHS) in terms of injury rates, disease risk, hazard exposures, or worker (and manager) knowledge of OHS and regulatory responsibilities. Of the more than 25 studies each on outsourcing and organizational restructuring/downsizing, well over 90 percent find a negative association with OHS. The evidence is fairly persuasive for temporary workers, with 14 of 24 studies finding a negative association with OHS. The evidence is less strong for small business, and a handful of studies on part-time workers found no clear association with negative OHS outcomes (in some cases the reverse). Further research is needed to more clearly link health effects to particular business practices and neoliberal policies and to explore the regulatory implications of the growth of precarious employment. The authors suggest some ways to conceptualize the association between precarious employment and occupational health.