At the request of City of Cincinnati employees, the Cincinnati Health Department (CHD) Health Impact Assessment (HIA) Committee studied the health impacts experienced by workers impacted directly and indirectly from the layoff or the bumping process. When a senior union member's position is eliminated, s/he can 'bump' a junior employee out his position. The following are 5 employee groups that the project studied: terminated, bumped, layoff survivors, supervisors, and the employees who have to tell someone that they are being bumped or losing a job. The HIA team reviewed literature concerning layoffs and downsizing and the mental health impacts and work environment impacts on employees and survivors of the layoff process. Job insecurity leads to worse job attitudes, and adverse health outcomes including depression, increased alcohol consumption and increase in work injuries (Moore, Grunberg, Anderson-Connolly, & Greenberg, 2003). The report contains mitigation recommendations based on best practices for different employee groups affected by layoff and bumping.