Background Relatively few studies have examined the effects of layoffs on remaining workers, although the effects of layoffs and downsizing events may extend beyond those employees who lose their jobs.
Methods We examined the effects of layoffs on mental healthcare utilisation and injury risk among workers at 30 US plants between 2003 and 2013. We defined layoffs as reductions in the hourly workforce of 20% or more at each plant. Using a difference-in-differences approach, we compared the change in outcomes during layoffs versus the same 3-month period 1 year previously, accounting for secular trends with control plants.
Results Our study population included 15 502 workers and 7 layoff events between 2003 and 2013. Layoffs were associated with only minor decreases in injuries (−0.006, 95% CI −0.013 to 0.001). The probability of outpatient visits related to mental health increased by 1% during layoffs (0.010, 95% CI 0.003 to 0.017), and the probability of mental health-related prescriptions increased by 1.4% (0.014, 95% CI −0.0006 to 0.027). Among women, the increase in outpatient visits was more pronounced (0.017, 95% CI 0.003 to 0.031). Increased prescription utilisation appeared attributable primarily to opioid use (0.016, 95% CI 0.005 to 0.027).
Conclusion Our results indicate an association between layoffs and remaining workers’ mental health and safety, although changes mental healthcare utilisation may reflect both changes in underlying mental health and changes in care-seeking. Future research on concordance of service utilisation and underlying health may yield valuable insight into the experiences employed workers in the wake of layoffs.
- mental health
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Contributors HE conceptualised and designed the study, performed the statistical analysis, interpreted results and drafted the manuscript. EB-M conceptualised and designed the study and interpreted the results. DR, SM and EAE contributed to the study design, interpretation of the data and analysis and critically revised the manuscript. MRC was responsible for data acquisition, contributed to the study design, interpretation of the data and analysis and critically revised the manuscript.
Funding HE was funded by National Institute on Mental Health grant F31-MH112246; EAE was funded by the National Institute on Occupational Health and Safety grant R01-OH009939; MRC and DR were funded by the National Institute on Aging grant R01-AG026291.
Disclaimer The conclusions expressed are solely those of the authors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.