Work disability following major organisational change: the Whitehall II study.
ABSTRACT BACKGROUND: Privatisation and private sector practices have been increasingly applied to the public sector in many industrialised countries. Over the same period, long-term work disability has risen substantially. We examined whether a major organisational change--the transfer of public sector work to executive agencies run on private sector lines--was associated with an increased risk of work disability. METHODS: The study uses self-reported data from the prospective Whitehall II cohort study. Associations between transfer to an executive agency assessed at baseline (1991-1994) and work disability ascertained over a period of approximately 8 years at three follow-up surveys (1995-1996, 1997-1999 and 2001) were examined using Cox proportional hazard models. RESULTS: In age- and sex-adjusted models, risk of work disability was higher among the 1263 employees who were transferred to an executive agency (HR 1.90, 95% CI 1.46 to 2.48) compared with the 3419 employees whose job was not transferred. These findings were robust to additional adjustment for physical and mental health and health behaviours at baseline. CONCLUSIONS: Increased work disability was observed among employees exposed to the transfer of public sector work to executive agencies run on private sector lines. This may highlight an unintentional cost for employees, employers and society.
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ABSTRACT: BACKGROUND: Changes in employment conditions in the global economy over the past 30 years have led to increased job insecurity and other work organization hazards. These hazards may play a role in creating and sustaining occupational health disparities by socioeconomic position, gender, race, ethnicity, and immigration status. METHODS: A conceptual model was developed to guide the review of 103 relevant articles or chapters on the role of work organization and occupational health disparities identified through a comprehensive search conducted by NIOSH. A second review was conducted of employment and workplace policies and programs designed to reduce the health and safety risks due to job insecurity and other work organization hazards. RESULTS: There is consistent evidence that workers in lower socioeconomic or social class positions are exposed to greater job insecurity and other work organization hazards than workers in higher socioeconomic positions. Likewise, racial and ethnic minorities and immigrants are exposed to greater job insecurity. Limited research examining the effects of interventions targeting work organization hazards on disparities has been conducted; nonetheless, intervention strategies are available and evidence suggests they are effective. CONCLUSIONS: Job insecurity and work organization hazards play a role in creating and sustaining occupational health disparities. Employment and workplace policies and programs have the potential to reduce these hazards, and to reduce disparities. Am. J. Ind. Med. © 2012 Wiley Periodicals, Inc.American Journal of Industrial Medicine 05/2014; 57(5). DOI:10.1002/ajim.22126 · 1.59 Impact Factor
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ABSTRACT: 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. 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. 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%. 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.BMC Public Health 02/2012; 12:148. DOI:10.1186/1471-2458-12-148 · 2.32 Impact Factor
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ABSTRACT: In this study, we examined the connection between organizational changes and employees own evaluations of their work ability. In early 2010, we asked employees (n = 2429) working in the Finnish social services and health care industry to identify all the organizational changes that had occurred at their workplaces over the previous two years, and to evaluate their own work ability and whether different statements related to the elements of work ability were true or false at the time of the survey. For our method of analysis, we used logistical regression analysis. In models adjusted for gender, age, marital status, professional education and managerial position, the respondents who had encountered organizational changes were at a higher risk of feeling that their work ability had decreased (OR = 1.49) than the respondents whose workplaces had not been affected by changes. Those respondents who had encountered organizational changes were also at a higher risk of feeling that several elements related to work ability had deteriorated. The risk of having decreased self-evaluated work ability was in turn higher among the respondents who stated they could not understand the changes than among those respondents who understood the changes (OR = 1.99). This was also the case among respondents who felt that their opportunities to be involved in the changes had been poor in comparison to those who felt that they had had good opportunities to be involved in the process (OR = 2.16). Our findings suggest that the organizational changes in social and health care may entail, especially when poorly executed, costs to which little attention has been paid until now. When implementing organizational changes, it is vital to ensure that the employees understand why the changes are being made, and that they are given the opportunity to take part in the implementation of these changes.International Journal of Occupational Medicine and Environmental Health 03/2012; 25(2):151-65. DOI:10.2478/S13382-012-0014-x · 1.09 Impact Factor