O3E.4 Layoffs and the mental health and safety of remaining workers: a quasi-experimental study of the U.S. aluminum industry

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 utilization and injury risk among workers at 30 U.S. 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 three-month period one year previously, accounting for secular trends with control plants. Results Our study population included 15 502 workers and seven layoff events between 2003 and 2012. Layoffs were associated with decreases in reported injuries (−0.006, 95% CI −0.013, 0.001), and increased probability of outpatient visits (0.010, 95% CI 0.003, 0.017) and prescriptions (0.014, 95% CI −0.0006, 0.027) for mental health. Among men, injury risk decreased more substantially (−0.010, 95% CI −0.018,–0.001) and among women the increase in outpatient visits was more pronounced (0.017, 95% CI 0.003, 0.031). Most notably, the observed increase in prescription utilization appeared attributable primarily to increased frequency of opioid prescriptions (0.016 95% CI 0.005–0.027). Conclusion Our results indicate an association between layoffs and remaining workers’ mental health and safety. However, decreased injury may reflect changes in reporting practices, and changes mental healthcare utilization may reflect changes in care-seeking. Future research on concordance of service utilization and underlying health and safety may yield valuable insight into the experiences employed workers in the wake of layoffs.