RT Journal Article
SR Electronic
T1 Layoffs and the mental health and safety of remaining workers: a difference-in-differences analysis of the US aluminium industry
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 1094
OP 1100
DO 10.1136/jech-2018-211774
VO 73
IS 12
A1 Holly Elser
A1 Eli Ben-Michael
A1 David Rehkopf
A1 Sepideh Modrek
A1 Ellen A Eisen
A1 Mark R Cullen
YR 2019
UL http://jech.bmj.com/content/73/12/1094.abstract
AB 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.