The process of company downsizing needs to be considered in the framework of economic change, which occurs at the macro-level (whole societies) and at the micro-level (single organizations). We will first develop a conceptual frame in which to integrate a relatively heterogeneous body of empirical evidence. A selective review of study results on the health effects of downsizing among survivors follows in the next two sections. The first section concerns the health consequences for the remaining workforce and the more distant stressful conditions related to marked changes in employment. The second section analyzes the more proximal stressful conditions of restructuring at the micro-level of single organizations, with an emphasis on workers’ short-term and long-term health. Finally, some challenges for future research are identified and the policy implications of current knowledge discussed.

Theoretical background

Probably the most important link between economic change and adverse health is the notion of threat. Threat arises from a sudden or recurrent interruption of habitual living and working conditions – the individual’s established coping patterns are powerless to meet an undesirable challenge. Threat may fuel insecurity about one’s sense of mastery or even result in loss of control, with its associated negative consequences. This then may provoke sustained activation of the body’s innate stress axes and eventually trigger a variety of physical and mental disorders (Weiner, 1991; McEwen, 1998).