Health effects of
job insecurity

An article titled "The Effects of Past and Anticipated Future Downsizing on Survivor Well-Being" (Kalimo, Taris & Schaufelt, 2003) in the April 2003 issue of the Journal of Occupational Health Psychology intrigued me, because it purported to be about a "study [that] deals with the health effects of various types of downsizing-related reorganizations." Unfortunately, that article didn't really address health effects, per se, although it reflects the interest in recent years on how surviving a layoff affects workers who remain on the job (see Ferrara-Love, 1998; Grunberg, Moore & Greenberg, 2001; and Grunberg, Anderson-Connolly &, Greenberg, 2000).

We all know about the repeated reports of the deleterious effects of stress on the immune system. So it doesn't surprise me that several writers and editors I know in the Silicon Valley and San Francisco Bay areas of northern California, who have been unemployed for a year or more after being laid off from jobs or contracts, are sick of the recession. Literally. Many of the men, in particular, seem to always catch the latest cold or flu, get sicker from it, and have a harder, longer time recovering than most. Perhaps its sex or sex roles, choice of occupation or temperament that are the significant variables or at least factors?

Merely out of curiosity, I searched MEDLINE for job insecurity and health or illness and for layoff and health (all restricted to English and human) for research results reported during just the past three years (2000-2003), when the U.S. economy has steadily worsened. A recently reported study affirmed that my colleagues' experiences aren't uncommon:

“A cross-sectional relationship between job insecurity and common infections or health complaints was found," [even when] corrected for health behavior, the presence of a long-standing illness, and work-related demands.” (See Mohren, Swaen, van Amelsvoort, Borm& Galama, 2003.)

A comment in an undated WHO Regional Office for Europe report based on a five-year project begun in 1997 suggests that my writer and editor acquaintances' chronic illnesses could, indeed, be related to their choice of careers, as well as living in a region particularly hard-hit by the recession: "The real determinants of health are not only one’s genetic make-up and lifestyles, but also working conditions, education, environment, social support and living conditions."

However, the results from nearly a dozen more studies were surprising. (Caveat: Since I have to pay $15 each to retrieve most full articles, I read only the abstracts where noted in the list of references. Also, I make no claims that this is a journal-quality review.)

Studies don't show what you might expect

Even though one would expect different levels of physical and psychological distress between those who have actually lost their jobs and those who fear being laid off or fired, the previously mentioned WHO report of a project in Denmark flatly states in the first sentence that "Job insecurity harms health even more than unemployment."

Grunberg, Moore and Greenberg (2001) noted that, "Having any kind of personal contact with layoffs is found to be associated with less job security, more symptoms of poor health, depression, and eating changes as compared with having no layoff contact. Being laid off and rehired is associated with more work-related injuries and illnesses and missed work days due to such events than is receiving a 'warn' notice, indirect contact (i.e., friends or coworkers laid off), or no contact with layoffs."

Most of the studies have shown surprisingly few health consequences of job insecurity, with conclusions similar to these:

“[Two studies] examined changes in psychosocial work characteristics (job strain model) and health-related behaviors as potential explanations of the job insecurity-health relationship in a longitudinal cohort of white-collar British civil servants. Job insecurity arising from anticipation of change was associated with a modest increase in self-reported morbidity, whereas chronic job insecurity was associated with some adverse physiological changes. Anticipation of change and chronic job insecurity were associated with adverse changes in other psychosocial work characteristics, but few changes were significant and consistent across both exposure groups. Changes in health-related behaviors associated with either exposure were slight." (Ferrie, Shipley, Marmot, Martikainen, Stansfeld & Smith, 2001)

In citing a series of studies, Ferrie (Ferrie, 2001) offers one clue to why things aren't worse than we might expect during the current disastrous economy: "There is robust evidence of sleep disturbance before redundancy [layoff], but not, to judge from a [1997] study in Finland, in time of economic recession." Perhaps everybody sleeps easier when we're all going through the same thing together.

Even some detrimental effects observed are inconsistent:

Job insecurity responses are pretty much the same between men and women and in older workers (Armstrong-Stassen, 2001).

Some studies say blue-collar workers are more likely to be affected, but others contradict that (at least if one assumes that white-collar workers are better educated):

• "...job insecurity has detrimental consequences for employees' job attitudes, organizational attitudes, health, and, to some extent, their behavioral relationship with the organization. Moderator analyses suggest that these relationships may be underestimated in studies relying on single-item measures of job insecurity and that the behavioral consequences of insecurity are more detrimental among manual, as compared with nonmanual, workers. (Sverke, Hellgren & Naswall, 2002)
• "...in a longitudinal cohort of white-collar British civil servants. Job insecurity arising from anticipation of change was associated with a modest increase in self-reported morbidity, whereas chronic job insecurity was associated with some adverse physiological changes. Anticipation of change and chronic job insecurity were associated with adverse changes in other psychosocial work characteristics, but few changes were significant and consistent across both exposure groups. (Ferrie et al., 2001)
• "The results show that the psychosocial stress induced by job insecurity (fear of unemployment) has a negative effect on these health indicators. Fear of unemployment had a stronger unfavorable effect on health for highly educated employees than for the less educated." (Domenighetti, D'Avanzo & Bisig, 2000)
• When a large manufacturer cut 27% of its workforce, sick days increased among managers and professional staff, but decreased in the lower ranks (Grunberg et al., 2000).

Although people studied so far who fear losing their jobs don't seem to be drinking more, according to self-reports (McDonough, 2000), some admit to smoking more (Kivimaki, Vahtera, Pentti & Ferrie, 2000 and Ferrie, Shipley, Stansfeld & Marmot, 2002).

Predictably, families are affected by a member's job insecurity, too (Kivimaki et al., 2000).

A few studies have looked at the effects of job insecurity on blood pressure. According to a recent one (Ferrie et al., 2002): "Those exposed to chronic job insecurity had the highest self reported morbidity. Changes in the physiological measures were limited to an increase in blood pressure among women who lost job security and a decrease in body mass index among women reporting chronic job insecurity."

But the results of a study more than a decade ago seem to be holding true more often: "We found no increase in overall blood pressure level, and no effect of anticipation of job loss on 1989 blood pressure when controlling for 1986 blood pressure level, age, body mass index, work hours, and other demographic variables. On the other hand, employment in a department sold to another employer on the day of screening, as well as employment in a clerical job title, were both associated with significant increases in diastolic blood pressure of about 5 mm Hg." (Schnall et al., 1992)

Other noteworthy findings:

"Results indicate that employees who report high perceptions of job insecurity exhibit decreased safety motivation and compliance, which in turn are related to higher levels of workplace injuries and accidents." (Probst and Brubaker, 2001)

"...job insecurity, defined as a combination of organisational or personal vulnerability, was significantly related to only two antecedent variables, i.e., neuroticism and job characteristics. Further regression analyses indicated that job insecurity was a statistically significant moderator but only between one consequence, i.e., intention to quit, and the job characteristics variable." (Tivendell and Bourbonnais, 2001)

"Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part." (Kivimaki, Vahtera, Ferrie, Hemingway & Pentti, 2001)

Limitations of previous studies

Nearly all of the studies have focused only on psychological rather than physical factors or manifestations of psychological distress (other than a few on blood pressure), and far more studies have been done in Europe than the U.S. Most have involved academic populations or government workers, which is skewed because government employees usually enjoy and expect more security than those in the private sector.

Jane E. Ferrie, PhD, at the Department of Epidemiology and Public Health, University of College London Medical School, has done more research than anyone else on this topic, and her literature review titled "Is Job Insecurity Harmful to Health?" (Ferrie, 2001) is a good place to start if you want to explore the problem further. As she says in that article, the studies so far have necessarily been limited in their broader relevance because there are inherent difficulties in conducting the research. She writes: "...organizations undergoing major restructuring are not keen to have uncertainties exacerbated by researchers."

Later, she adds: "Unequivocal evidence of a causal association between job insecurity and health would require studies comprising a longitudinal design, with baseline data from a period of secure employment for the subject group and a well-matched control group that remained in secure employment. Opportunities for ideal studies are therefore rare."

Research opportunities

Although there's obviously a connection between psychological and some physical reactions to job insecurity, there's also obviously a need for further research into the consequences for employees, their families and their employers. Many of those still lucky enough to have jobs are now doing the work that was previously done by two or even three people. They are often sick and continually exhausted, but often continue to go to work even when they're clearly sick, out of fear of losing their jobs (Ferrie, 2001).

"In addition to effects on individuals, the wider impact of job insecurity on the family and on society requires further investigation," says Ferrie (Ferrie, 2001).... Although some work has been done on the spill-over effects of these changes on the family, evidence remains sparse. Finally, the financial and societal costs of job insecurity have just begun to be considered and documented. In a policy context of increasing concern for cost and cost-effectiveness, attempts should be made to measure the full costs of the flexible labour market."

Several of these studies reported that continually worrying about losing one's job results in lower morale; decreased loyalty, trust, productivity and creativity; and higher injury rates (Armstrong-Stassen, 2001; Grunberg et al., 2000; Probst 2001). Mohren (2003) and his colleagues concluded that “An increase in common infections or health complaints has a substantial impact on employee well-being and may result in economic consequences for the company.”

Significant health effects or not, convince corporations that chronic job insecurity among their employees hurts their profits, and maybe a few — in enlightened self-interest — will allow researchers to determine the true extent and impact of the problem, then do something to change the present treatment of people as commodities. One can dream.

References