Justice at work and health: The impact of organizational changes and uncertainty over time

Organizational justice regards subjective evaluations of the organisation in terms of the fairness of formal decision-making in the organization (procedural justice), the perceived fairness of decision outcomes (distributive justice), and the treatment of employees by supervisors (interactional justice). A number of studies of mostly cross-sectional design have shown that organizational justice relates to ill-health. However, longitudinal studies with repeated measures of both predictors and outcomes are few. In our project we studied the impact of justice at work on health over time under conditions of uncertainty (e.g. job insecurity and organizational change) and employability. The specific research questions concerned 1) long-term exposure, e.g., is the risk for long-term sickness absence the higher the longer an employee is exposed to unfair treatment at work?, 2) effects of exposure change, e.g., do changes in justice at work relate to changes health outcomes?, and 3) effects of job related uncertainty factors, e.g., how is the justice-health link affected by conditions of uncertainty? The data used within the project came mainly from the Swedish longitudinal Survey of Health (SLOSH) study (see also www.slosh.se), a unique approximately representative cohort study. Both outcomes and exposures are measured at multiple waves. In a number of scientific articles we investigated the research questions outlined above.

The project started in August 2014 and developed as planned, with the exception of some changes in the composition of the research team. As all data was available from the start of the project, we were able to focus on data analyses right from the beginning. The three main findings of the project can be summarized as follows. (1) We could show that experienced organizational justice associates to health over time. (2) Health impacts on the experienced organizational justice over time. (3) The association between organizational justice and health is in some cases, but not all, moderated by job insecurity.

More detailed, we found an association between procedural justice and self-rated health over time. Also, self-rated health improved at any given point in time as procedural justice increased relative to initial procedural justice, i.e., health and procedural justice developed together. In another study we studied whether bidirectional relationships between procedural justice perceptions and health, measured in terms of self-rated health, depressive symptoms, and sickness absence, can be explained by two different mediation mechanisms. Significant lagged effects from procedural justice to health were found for models predicting depressive symptoms and sickness absence. However, mental preoccupation with work was not found to mediate the longitudinal relationship between procedural justice perceptions and indicators of health. Further, significant lagged effects from health indicators to procedural justice were found for models involving self-rated health, depressive symptoms and sickness absence. Here, social support mediated the longitudinal relationships between all three health indicators and procedural justice. In yet another study, we found that a decrease in perceived procedural justice over time was associated with greater receipt of anti-depressants compared to people with stable high perceptions of procedural justice, although this association was rather weak. Further, we investigated the association between interpersonal and informational justice at work with long and frequent sickness absence respectively, under conditions of job insecurity. We found informational and interpersonal justice to associate with risk of long and frequent sickness absence independently of job insecurity and demographic variables. Contrary to expectations, we found no interaction between justice and job insecurity, which however might be explained by the low levels of experienced job insecurity in the study population. This assumption is partly supported by another study, in which we analysed if procedural justice can explain associations between job insecurity and different health outcomes. In this study we found that among temporary employed procedural justice did not moderate the association between job insecurity and health. However, among permanent employed we found that job insecurity mattered in two ways: first, job insecurity changes were associated with changes in procedural justice, and in turn, health outcomes. Second, the effect was stronger among permanent workers who seldom experience job insecurity. We also studied distributive justice in terms of effort-reward imbalance. Using four recurrent measurements covering six years we identified four diverging patterns of effort-reward development: a low imbalance trajectory, a U-shaped imbalance trajectory, an inverted U-shaped trajectory and an increasing imbalance trajectory. Less favourable trajectories were related to less favourable health outcomes.

There are several noteworthy features about this project which adds to the research landscape around organizational justice and health. One of them is that this project allowed to investigate a broad range of research questions subsequently, and develop a research theme. It created a cluster of leading research on justice and health at Stockholm University and the Stress Research Institute. Another aspect is that very little systematic research has been done on justice and health. While in previous research justice has been related to work outcomes, more studies have since then suggested that justice perceptions also are an important predictor for health. Yet, very little attention had been payed to which specific health aspect was studied using which method and what time interval was considered. Many studies on justice and health stem from Finland, and the UK, based on two large-scale panel studies. The here described project helped us to put ourselves and Slosh onto the map of researching justice and health. As presented above, we were able to investigate the justice – health relationship considering a variation of health outcomes with various complex analytical procedures.

In agreement with international research our project could show that different aspects of organizational justice are associated to ill-health. Ill-health in turn is closely connected to labour force participation and withdrawal from the labour force. Only few studies have investigated the association between organizational justice and labour force participation. In a new, Forte funded project (dnr 2017-00259), we will examine longitudinal associations between organizational injustice and (1) turnover intentions, involuntary retention, and plans to retire, and (2) reduced work hours, change of employer or work group, and early retirement. Further, the project aims to explore whether impaired health mediates and moderates the potential links between organizational injustice and withdrawal intention and behaviour.

The project has been conducted in close collaboration to Dr Constanze Eib from the Norwich Business School, University of East Anglia, UK. We also collaborated with researchers from Canada (University of Calgary). Results from the project has been presented at a large number of international conferences (e.g., a small group meeting of the European Association of Work and Organizational Psychology (EAWOP) 2015, and the European Academy of Occupational Health Psychology Association conference (EAOHP) 2016) and workshops (e.g., ProWorkNet 2015, Stockholm Stress Center, 2015). Within the frame of a scientific symposium at the EAWOP in Dublin 2017, we were able to present several of studies related to this project. Results have also been presented at group meetings and internal seminars. A short description of the study and its related results will be made public at the Stress Research Institute’s website (http://www.idear-net.net/slosh/deltagare/resultat). All articles within this projects has been (or will be) published with Open Access. The project gathered a lot of interest from international media, e.g., Economic Times, Financial Express, Business Standard, the HR Magazine.