title: Changes in occupational mental and physical health and health symptoms during the economic recession.
abstract: BACKGROUND
  In 2008, many Western countries faced a great economic recession, the result of which was increased unemployment and reduced public expenditure.
  
  
  OBJECTIVE
  This article focuses on changes in the self-reported mental and physical health and health symptoms of the remaining employees of Icelandic municipalities who worked within the educational system and the care service during the economic recession. We examine gender differences in health and differences between downsized workplaces and workplaces where no downsizing occurred and differences between workplaces with heavy workload and light workload.
  
  
  METHODS
  The study is based on a balanced panel online survey and focus groups.
  
  
  RESULTS
  The main finding is that both the mental and physical health of employees deteriorated year by year between 2010, 2011 and 2013 in all workplaces although the downsized workplaces and workplaces with heavy workloads fared worse. At the same time, public expenditure on the health care system was reduced.
  
  
  CONCLUSIONS
  We hope that our results encourage further studies in the field and that they will be taken into account when dealing with prevention and rehabilitation initiatives.
authors.affiliation: School of Business and Science, University of Akureyri, Akureyri, Iceland.
authors.forename: Hjördís
authors.initials: H
authors.lastname: Sigursteinsdóttir
authors.affiliation: Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
authors.forename: Gudbjörg Linda
authors.initials: GL
authors.lastname: Rafnsdóttir
authors.affiliation: Social Science Research Institute, University of Iceland, Reykjavik, Iceland.
authors.forename: Gudbjörg Andrea
authors.initials: GA
authors.lastname: Jónsdóttir
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data; D057172:Economic Recession; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D020415:Personnel Downsizing / Q000523:psychology / Q000706:statistics & numerical data; D000070777:School Teachers / Q000706:statistics & numerical data; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D016526:Workload
keywords: Downsizing; health symptoms; mixed method; self-reported health; workload