Introduction and overview of the article Human resource is an important capital for an organization; however, during organization change, employee downsizing may be an essential strategy for an organization’s survival. Employee downsizing may not involve laying off staff, but can be done through freezing of hiring. However, hiring freeze, also known as attrition, does not always result in staff reduction; instead, it may cause staff imbalances especially considering that there is no replacement of retiring employees [1] . Employee downsizing is defined as planned reduction of the workforce by either laying off, early retirement or failing to replace retired staff and does not include termination due to poor performance [2] . This strategy is used by organization to cut back the cost of operating. In addition, downsizing is done to reduce managerial layers, hence speed up decision-making process, to increase productivity and increase core competencies, and outsource peripheral duties. There are various criteria that management uses when choosing the employees to downsize – productivity, age, competency of employee and health or fitness of the employees. Generally, managers indicate that they use performance appraisals and evaluating skills of employee when selecting employees for downsizing [3] . Downsizing can produce adverse consequences to employees and the employer. Generally, employee motivation on those left behind is largely affected, which can be translated to low productivity. Besides, the organization can lose valuable staff due to voluntary retirement that may be difficult and expensive to replace. In the event downsizing is unavoidable, management should ensure that the process is done at the appropriate time, proper selection criterion is used, while sufficient communication and secrecy is maintained to avoid negative effects [4] . In another perspective, both the leaving and staying employees may be affected health wise. Therefore, this research evaluates the effects of downsizing on the health of leavers and those staying in an organization. This article evaluates the health of employees in municipal before downsizing and after downsizing. Consequently, the article tests the hypothesis that employees with health problems before downsizing in an organization are the target of layoffs, while the health of leavers after downsizing is dependent of reemployment. In support of first hypothesis, many researches indicate that, organization may consider the health of an employee during downsizing. Generally, various researchers suggest that loss of job due to downsizing considerately affect the health of employees. Theme and article summary The theme of this article is health trends of employees before and after downsizing. It explores the links of health problem with being targeted for layoff and the consequences of being laid off on individuals’ health. The research was based on two hypotheses – selection and consequence hypothesis. The selection hypothesis suggests that employees with health problems are a target of being made redundant while consequence hypothesis indicated that downsizing increased the risks of health problems. Leavers w