It is a well-known fact that workplace restructuring has undesirable effects on the psychosocial work
environment, health, and sick leave, but no attention has been given to the health effects of work
environments characterized by restructuring, a multicultural staff, and a strong socioeconomic occupational
hierarchy. In this casestudy, we examine a large Norwegian hospital in which all of these
features are present. Through in-depth interviews with employees and their managers we investigate
the healthiness of the restructuring process, and the consequences of the restructuring process on the
work environment, subjective health, and sick leave. Results show that immigrant workers received less
information, had higher level of frustration and less control over work, and experienced a decrease in
well-being, autonomy, and social support. Immigrant worker vulnerability, that is, the handicap of poor
understanding of the Norwegian language and a lack of understanding of general and local organizational
norms and practices in the Norwegian workplace, is an important explanation. Immigrant workers
with a poor Norwegian language understanding are even worse off. We conclude that a strong
occupational hierarchy within the hospital exerts an overall influence on the position of low/unskilled
employees in the restructuring process as well as their perception of and involvement in it.
Author Biographies
Heidi Enehaug, Work Research Institute, Oslo and Akershus University College of Applied
Sciences
Senior Researcher
Svenn-Erik Mamelund, Work Research Institute, Oslo and Akershus University College of Applied
Sciences