THE HEALTH-EFFECTS OF MAJOR ORGANIZATIONAL-CHANGE AND JOB INSECURITY

Since August 1988 an increasing proportion of the executive functions of government in the United Kingdom have been devolved to executive ag encies. Transfer to an executive agency involves a period of uncertain ty during which the options of elimination or transfer to the private sector are considered, followed by a marked change in management style and further periods of uncertainty when the agency's function is reco nsidered for transfer to the private sector. This paper examines the e ffects of this major organisational change and consequent job insecuri ty on the health status of a cohort of 7419 white-collar civil servant s by comparing groups either exposed to or anticipating exposure to th is stressor, with controls experiencing no change. Compared with contr ols, men both already working in and anticipating transfer to an execu tive agency experienced significant increases in hearth self-rated as ''average or worse'', longstanding illness, adverse sleep patterns, me an number of symptoms in the fortnight before questionnaire completion , and minor psychiatric morbidity. Significant relative increases in b ody mass index were seen in both exposure groups while exposure to age ncy status was also associated with significant relative increases in blood pressure. Health-related behaviours, where they differed between exposure and control groups, tended to favour those in the exposure g roups. Compared with controls, women in both exposure groups reported small increases in most self-reported morbidity measures and most clin ical measurements, accompanied by slight beneficial changes in some he arth-related behaviours and small adverse changes in others. Significa nt relative increases were seen in mean number of symptoms, and ischae mia among women anticipating exposure and in body mass index among tho se exposed to agency status. Policy makers should be aware of the wide r consequences of job insecurity when considering the efficiency of ch anges in employment policy. (C) 1998 Elsevier Science Ltd. All rights reserved.