Johan Høy Jensen.

Health and well-being after organizational change

Investigating the impact of organizational change and psychosocial work environment on employee health and well-being.

Purpose: Organizational changes at the workplace are frequently executed to meet increasing demands for cost-efficient productivity and service. Present epidemiological evidence suggests that organizational changes have adverse effects on psychosocial work environment, sickness absence, and stress-related physical and mental illness. The aim of this PhD project conducted by Johan Høy Jensen in the period December 2015 to November 2018 is to examine these adverse effects further.

Methods: The project uses data from work-environment surveys, TrivselOp, distributed to all employees in the Capital Region of Denmark in 2011 (N=35,894; response rate: 81%) and 2014 (N=37,720; response rate: 84%) measuring job strain, perceived stress, and social capital (“workplace togetherness”) among other factors. Data on various organizational work-unit changes in the period 2009-2013 were obtained via two waves of surveys distributed to the managers (response rates: 59% and 69%). Data on health outcomes are retrieved from local and national registries. For anonymization reasons, all analyses are performed in Statistics Denmark.

Results: We found a 1.87-fold increased risk of low work-unit social capital (i.e., the 25% lowest) associated with the work-unit manager’s report of low job control (vs high job control: 95% CI 1.31-2.68). There were trends of the same relation when the managers reported high perceived stress (vs low perceived stress: OR 1.40, 95% CI 0.98-1.99), low social support (vs high social support: OR 1.37, 95% CI 0.97-1.92) or high job demands (vs low job demands: OR 1.26, 95% CI 0.88-1.79). Moreover, we found that exposure to work-unit merger or employee layoff were associated with total effects of 37% and 19% higher risks for long-term sickness absence (>29 days) in the following 9 months relative to employees unexposed to any change (natural direct effects: OR 1.33, 95% CI 1.12-1.58 and OR 1.15, 95% CI 1.01-1.30, respectively). These total effects were not mediated substantially via social capital (natural indirect effects: OR 1.04, 95% CI 1.02-1.06 and OR 1.04, 95% CI 1.03-1.05, respectively). This is supported by longitudinal findings of relatively small decreases of 1.7 and 1.6 scores on a 0-100 social capital scale from 2011 to 2014 due to work-unit merger or employee layoff, respectively, in employees occupied through this period. Finally, we found 23-37% higher rates of voluntary early retirement (“efterløn”) among senior employees in a 2-year period after exposure to change of management (HR 1.37, 95% CI 1.13-1.66), work-unit merger (HR 1.23, 95% CI 1.01-1.49) or relocation (HR 1.25, 95% CI 1.01-1.54) from 2009-2011.

Conclusions: The present findings suggest that common types of organizational change and a poor psychosocial work environment are related to poor health and well-being outcomes among the employees.


Johan Høy Jensena, Line Leonhardt Laursena,b, Søren Grove Vejlstrupa,c, Nina Breinegaarda,d, Esben Meulengracht Flachsa, Theis Langed,e, Janne Skakonc, Naja Hulvej Rodb, Jens Peter Bondea

a Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Denmark. b Department of Public Health, University of Copenhagen, Denmark. c Department of Psychology, University of Copenhagen, Denmark. d Department of Biostatistics, University of Copenhagen, Denmark. e The Center for Statistical Science, Peking University, China.

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