Rebecca Bentley

Exploring the Bi-directional Relationship between Health and Housing in Australia

Publisher: Informa UK Limited

Date: 11-10-2013

DOI: 10.1080/08111146.2013.831759

The impact of social housing on mental health: longitudinal analyses using marginal structural models and machine learning-generated weights

Publisher: Oxford University Press (OUP)

Date: 26-06-2018

DOI: 10.1093/IJE/DYY116

Abstract: Social housing may provide an affordable and secure residential environment, but has also been associated with stigma, poor housing conditions and locational disadvantage. We examined the cumulative effect of additional years, and tenure security (number of transitions in/out), of social housing on mental health in a large cohort of lower-income Australians. We analysed a longitudinal panel survey that annually collected information on tenure and health from 2001 to 2013. To address the time-varying effect of previous health on social housing occupancy, we used marginal structural models. Stabilized inverse probabilities of treatment weights were generated using ensemble learning to improve prediction. To address remaining residual imbalance across covariates, double adjustment was made by additionally including baseline covariates in models. Mental health was measured using the Mental Health Short-Form summary measure of the SF-36 (MH), and psychological distress was measured using the Kessler Psychological Distress Scale (K10). People who had continuous exposure to social housing had worse mental health on average than people continuously occupying other tenures. The worst mental health outcomes, however, were observed for people who made multiple transitions. Mental health deteriorated and psychological distress increased with number of transitions: MH -1.04 [95% confidence interval (CI) -2.16 0.09) and K10 0.56 (95% CI 0.12 1.00). Estimates are in the order of 6% (MH) and 9% (K10) of one standard deviation for each measure. The more transitions people made in/out of social housing, the greater the impact on mental health and psychological distress, supporting the case for provision of more stable forms of social housing.

Social Housing exit points, outcomes and future pathways: An administrative data analysis

Publisher: Australian Housing and Urban Research Institute (AHURI)

Date: 03-2020

DOI: 10.18408/AHURI-3119901

Associations of public transport accessibility with walking, obesity, metabolic syndrome and diabetes

Publisher: Elsevier BV

Date: 06-2016

DOI: 10.1016/J.JTH.2016.01.006

The effect of energy poverty on mental health, cardiovascular disease and respiratory health: a longitudinal analysis

Publisher: Elsevier BV

Date: 06-2023

DOI: 10.1016/J.LANWPC.2023.100734

An Australian geography of unhealthy housing

Publisher: Wiley

Date: 02-2019

DOI: 10.1111/1745-5871.12326

Housing Disadvantage and Poor Mental Health: A Systematic Review

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.AMEPRE.2019.03.018

Abstract: This study reviews collective evidence on the longitudinal impact of housing disadvantage (based on tenure, precarity, and physical characteristics) on mental health. It is focused on temporally ordered studies where exposures preceded outcomes, a key criterion to establishing causal evidence. A systematic review of evidence on housing disadvantage and mental health was performed. The literature search used six electronic databases including MEDLINE (PubMed and Ovid platform), Embase, PsycINFO, Web of Science, SciELO, and Sociological Abstracts. Population-based longitudinal studies where exposure to housing disadvantage (excluding exposure to homelessness) preceded mental health were included. Methodologic quality of selected studies was examined using the Newcastle-Ottawa Quality Assessment Scale. Because of definitional and methodologic heterogeneity among studies, narrative synthesis rather than meta-analysis was used to summarize research findings. Of the 1,804 unique titles identified in the literature search, 12 met the selection criteria for inclusion in the systematic review. Housing disadvantage was measured by overcrowding, mortgage delinquency, housing mobility, housing tenure, subjective perceptions of inadequate housing, eviction, and physical housing conditions. Mental health was measured as depression, psychological impairment, anxiety, allostatic load, mental strain, and psychological health. Study s le sizes ranged from 205 to 16,234 people, and the follow-up period ranged from within 1 year to 34 years. Each study indicated a positive association between housing disadvantage and mental health for at least one housing disadvantage measure and mental health outcome. This systematic review confirms that prior exposure to housing disadvantage may impact mental health later in life.

Housing inequality: a systematic scoping review

Publisher: Informa UK Limited

Date: 12-09-2022

DOI: 10.1080/02673037.2022.2119211

Vulnerability and recovery: Long-term mental and physical health trajectories following climate-related disasters

Publisher: Elsevier BV

Date: 03-2023

DOI: 10.1016/J.SOCSCIMED.2023.115681

Daily Walking among Commuters: A Cross-Sectional Study of Associations with Residential, Work, and Regional Accessibility in Melbourne, Australia (2012–2014)

Publisher: Environmental Health Perspectives

Date: 09-2019

DOI: 10.1289/EHP3395

Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working-aged Australians

Publisher: Elsevier BV

Date: 04-2015

DOI: 10.1016/J.DHJO.2014.08.008

Abstract: People with disabilities are socio-economically disadvantaged and have poorer health than people without disabilities however, little is known about the way in which disadvantage is patterned by gender and type of impairment. 1. To describe whether socio-economic circumstances vary according to type of impairment (sensory and speech, intellectual, physical, psychological and acquired brain injury). 2. To compare levels of socio-economic disadvantage for women and men with the same impairment type. We used a large population-based disability-focused survey of Australians, analyzing data from 33,101 participants aged 25-64. Indicators of socio-economic disadvantage included education, income, employment, housing vulnerability, and multiple disadvantage. Stratified by impairment type, we estimated: the population weighted prevalence of socio-economic disadvantage the relative odds of disadvantage compared to people without disabilities and the relative odds of disadvantage between women and men. With few exceptions, people with disabilities fared worse for every indicator compared to people without disability those with intellectual and psychological impairments and acquired brain injuries were most disadvantaged. While overall women with disabilities were more disadvantaged than men, the magnitude of the relative differences was lower than the same comparisons between women and men without disabilities, and there were few differences between women and men with the same impairment types. Crude comparisons between people with and without disabilities obscure how disadvantage is patterned according to impairment type and gender. The results emphasize the need to unpack how gender and disability intersect to shape socio-economic disadvantage.

Housing at the frontline of the COVID-19 challenge: A commentary on “Rising home values and Covid-19 case rates in Massachusetts”

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.SOCSCIMED.2020.113534

Employment Arrangements and Mental Health in a Cohort of Working Australians: Are Transitions From Permanent to Temporary Employment Associated With Changes in Mental Health?

Publisher: Oxford University Press (OUP)

Date: 28-05-2014

DOI: 10.1093/AJE/KWU093

Abstract: We investigated whether being in temporary employment, as compared with permanent employment, was associated with a difference in Short Form 36 mental health and whether transitions from permanent employment to temporary employment were associated with mental health changes. We used fixed-effects regression in a nationally representative Australian s le with 10 waves of data collection (2001-2010). Interactions by age and sex were tested. Two forms of temporary employment were studied: "casual" (no paid leave entitlements or fixed hours) and "fixed-term contract" (a defined employment period plus paid leave). There were no significant mental health differences between temporary employment and permanent employment in standard fixed-effects analyses and no significant interactions by sex or age. For all age groups combined, there were no significant changes in mental health following transitions from stable permanent employment to temporary employment, but there was a significant interaction with age (P = 0.03) for the stable-permanent-to-casual employment transition, because of a small transition-associated improvement in mental health for workers aged 55-64 years (β = 1.61, 95% confidence interval: 0.34, 2.87 16% of the standard deviation of mental health scores). Our analyses suggest that temporary employment is not harmful to mental health in the Australian context and that it may be beneficial for 55- to 64-year-olds transitioning from stable permanent employment to casual employment.

Precariously placed: housing affordability, quality and satisfaction of Australians with disabilities

Publisher: Informa UK Limited

Date: 22-12-2019

DOI: 10.1080/09687599.2018.1521333

Does gender modify associations between self rated health and the social and economic characteristics of local environments?

Publisher: BMJ

Date: 06-2006

DOI: 10.1136/JECH.2005.043562

Psychosocial working conditions in a representative sample of working Australians 2001-2008: an analysis of changes in inequalities over time.

Publisher: BMJ

Date: 30-05-2013

DOI: 10.1136/OEMED-2012-101171

Abstract: A number of widely prevalent job stressors have been identified as modifiable risk factors for common mental and physical illnesses such as depression and cardiovascular disease, yet there has been relatively little study of population trends in exposure to job stressors over time. The aims of this paper were to assess: (1) overall time trends in job control and security and (2) whether disparities by sex, age, skill level and employment arrangement were changing over time in the Australian working population. Job control and security were measured in eight annual waves (2000-2008) from the Australian nationally-representative Household Income and Labour Dynamics of Australia panel survey (n=13 188 unique in iduals for control and n=13 182 for security). Observed and model-predicted time trends were generated. Models were generated using population-averaged longitudinal linear regression, with year fitted categorically. Changes in disparities over time by sex, age group, skill level and employment arrangement were tested as interactions between each of these stratifying variables and time. While significant disparities persisted for disadvantaged compared with advantaged groups, results suggested that inequalities in job control narrowed among young workers compared with older groups and for casual, fixed-term and self-employed compared with permanent workers. A slight narrowing of disparities over time in job security was noted for gender, age, employment arrangement and occupational skill level. Despite the favourable findings of small reductions in disparities in job control and security, significant cross-sectional disparities persist. Policy and practice intervention to improve psychosocial working conditions for disadvantaged groups could reduce these persisting disparities and associated illness burdens.

Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes

Publisher: Elsevier BV

Date: 09-2010

DOI: 10.1016/J.SOCSCIMED.2010.05.038

Reflection on modern methods: when worlds collide—prediction, machine learning and causal inference

Publisher: Oxford University Press (OUP)

Date: 11-07-2019

DOI: 10.1093/IJE/DYZ132

Abstract: Causal inference requires theory and prior knowledge to structure analyses, and is not usually thought of as an arena for the application of prediction modelling. However, contemporary causal inference methods, premised on counterfactual or potential outcomes approaches, often include processing steps before the final estimation step. The purposes of this paper are: (i) to overview the recent emergence of prediction underpinning steps in contemporary causal inference methods as a useful perspective on contemporary causal inference methods, and (ii) explore the role of machine learning (as one approach to ‘best prediction’) in causal inference. Causal inference methods covered include propensity scores, inverse probability of treatment weights (IPTWs), G computation and targeted maximum likelihood estimation (TMLE). Machine learning has been used more for propensity scores and TMLE, and there is potential for increased use in G computation and estimation of IPTWs.

Housing niches: new directions for housing and urban policy

Publisher: Informa UK Limited

Date: 24-10-2023

DOI: 10.1080/19491247.2023.2254466

Gender Equity and Contraceptive Use in China: An Ecological Analysis

Publisher: Informa UK Limited

Date: 30-11-2011

DOI: 10.1080/03630242.2011.623221

Perceived fairness of pay among people with and without disabilities: a propensity score matched analysis of working Australians

Publisher: Scandinavian Journal of Work, Environment and Health

Date: 17-07-2015

DOI: 10.5271/SJWEH.3515

How much of the effect of disability acquisition on mental health is mediated through employment and income? A causal mediation analysis quantifying interventional indirect effects using data from four waves of an Australian cohort study

Publisher: BMJ

Date: 11-2021

DOI: 10.1136/BMJOPEN-2021-055176

Abstract: There is evidence that disability acquisition causes a decline in mental health, but few studies have examined the causal mechanisms through which the effect operates. This study used a novel approach to mediation analysis to quantify interventional indirect effects (IIEs) through employment and income. We used four waves of longitudinal data (2011–2014) from the Household, Income and Labour Dynamics in Australia Survey, a nationally representative survey of Australian households. Working aged in iduals who acquired a disability (n=233) were compared with those who remained disability-free in all four waves (n=5419). Self-reported mental health was measured using the Mental Health Inventory subscale of the Short Form 36 general health questionnaire, which measures symptoms of depression, anxiety and psychological well-being. We conducted a causal mediation analysis quantifying IIEs of disability acquisition on mental health operating through two distinct mediators: employment status and income. We used multiple imputation with 50 imputed datasets to account for missing data. The total causal effect of disability acquisition on mental health was estimated to be a 4.8-point decline in mental health score (estimated mean difference: −4.8, 95% CI −7.0 to –2.7). The IIE through employment was estimated to be a 0.5-point difference (−0.5, 95% CI −1.0 to 0.0), accounting for 10.6% of the total effect, whereas there was no evidence that income explained any of the effects. This study estimated that disability-related mental health inequalities could be reduced by 10.6% if employment rates were the same for people with disability as those without disability. The results suggest that employment is implicated in the relationship between disability acquisition and mental health and that more research is needed to understand the influence of other aspects of employment and other socioeconomic characteristics.

An Australian rental housing conditions research infrastructure

Publisher: Springer Science and Business Media LLC

Date: 02-02-2022

DOI: 10.1038/S41597-022-01136-5

Abstract: Each year the proportion of Australians who rent their home increases and, for the first time in generations, there are now as many renters as outright homeowners. Researchers and policy makers, however, know very little about housing conditions within Australia’s rental housing sector due to a lack of systematic, reliable data. In 2020, a collaboration of Australian universities commissioned a survey of tenant households to build a data infrastructure on the household and demographic characteristics, housing quality and conditions in the Australian rental sector. This data infrastructure was designed to be national (representative across all Australian States and Territories), and balanced across key population characteristics. The resultant Australian Rental Housing Conditions Dataset (ARHCD) is a publicly available data infrastructure for researchers and policy makers, providing a basis for national and international research.

Is Housing a Health Insult?

Publisher: MDPI AG

Date: 26-05-2017

DOI: 10.3390/IJERPH14060567

Area-Level unemployment and perceived job insecurity: Evidence from a longitudinal survey conducted in the Australian working-age population.

Publisher: Oxford University Press (OUP)

Date: 26-12-2014

DOI: 10.1093/ANNHYG/MET066

Abstract: RESEARCH SIGNIFICANCE: Job insecurity, the subjective in idual anticipation of involuntary job loss, negatively affects employees' health and their engagement. Although the relationship between job insecurity and health has been extensively studied, job insecurity as an 'exposure' has received far less attention, with little known about the upstream determinants of job insecurity in particular. This research sought to identify the relationship between self-rated job insecurity and area-level unemployment using a longitudinal, nationally representative study of Australian households. Mixed-effect multi-level regression models were used to assess the relationship between area-based unemployment rates and self-reported job insecurity using data from a longitudinal, nationally representative survey running since 2001. Interaction terms were included to test the hypotheses that the relationship between area-level unemployment and job insecurity differed between occupational skill-level groups and by employment arrangement. Marginal effects were computed to visually depict differences in job insecurity across areas with different levels of unemployment. Results indicated that areas with the lowest unemployment rates had significantly lower job insecurity (predicted value 2.74 95% confidence interval (CI) 2.71-2.78, P < 0.001) than areas with higher unemployment (predicted value 2.81 95% CI 2.79-2.84, P < 0.001). There was a stronger relationship between area-level unemployment and job insecurity among precariously and fixed-term employed workers than permanent workers. These findings demonstrate the independent influences of prevailing economic conditions, in idual- and job-level factors on job insecurity. Persons working on a casual basis or on a fixed-term contract in areas with higher levels of unemployment are more susceptible to feelings of job insecurity than those working permanently.

Urban Social Housing Pathways: A Linked Administrative Data Analysis

Publisher: Informa UK Limited

Date: 18-11-2021

DOI: 10.1080/08111146.2020.1838894

Time trends in socio-economic inequalities for women and men with disabilities in Australia: evidence of persisting inequalities

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1475-9276-12-73

Prescription rates of the contraceptive implant in Australia 2008-2012: Impact of patient age and area of residence

Publisher: CSIRO Publishing

Date: 2016

DOI: 10.1071/SH15141

Abstract: Background Long-acting reversible contraceptives are an effective means of preventing unwanted pregnancies and associated negative consequences. The Sexual Health and Family Planning Association of Australia has called for efforts to address barriers to the uptake of long-acting reversible contraceptives (LARCs) in Australia, where LARC uptake is thought to be low, though comprehensive data describing use and associated factors is scarce. The aims of this study were to describe patterns of prescriptions for the etonogestrel-releasing subdermal implant (SDI) in Australia, 2008–2012, and associated factors. Methods: Records of prescriptions written through Australia’s Pharmaceutical Benefits Scheme from 2008 to 2012 were obtained, including patient age and geographic location. Direct, age-standardised rates (ASR) of prescriptions were calculated for each year and location, with multivariate analysis used to examine associations between prescription rates and patient age, location and proximity to family planning clinics (FPC) or Aboriginal Medical Services (AMS). Results: ASR of prescriptions rose ~6% per year (OR 1.06, 95%CI: 1.05–1.06) from 13.05 per 1000 (2008) to 15.76 per 1000 (2012 P 0.01). Rates were highest among 15- to 19-year-olds, increasing from 20.81 (2008) to 29.09 per 1000 (2012: P 0.01) and lowest among 45- to 49-year-olds, increasing from 3.37 to 3.73 per 1000 (P 0.01). ASR by location were significantly higher in regional than metropolitan areas. Conclusions:This is the first analysis of SDI prescriptions across all ages and regions of Australia. Uptake of SDI in Australia is increasing but remains low. Significant associations were found between prescription rates and patient age and residence in regional/remote areas.

Sickness Absence and Psychosocial Job Quality: An Analysis From a Longitudinal Survey of Working Australians, 2005–2012

Publisher: Oxford University Press (OUP)

Date: 03-04-2015

DOI: 10.1093/AJE/KWU355

Social capital and health in rural and urban communities in South Australia

Publisher: Elsevier BV

Date: 02-2009

DOI: 10.1111/J.1753-6405.2009.00332.X

Abstract: This paper seeks to compare the relationships between social capital and health for rural and urban residents of South Australia. Using data from a South Australian telephone survey of 2,013 respondents (1,402 urban and 611 rural), separate path analyses for the rural and urban s les were used to compare the relationships between six social capital measures, six demographic variables, and mental and physical health (measured by the SF-12). Higher levels of networks, civic participation and cohesion were reported in rural areas. Education and income were consistently linked with social capital variables for both rural and urban participants, with those on higher incomes and with higher educational achievement having higher levels of social capital. However, there were also differences between the rural and urban groups in some of the other predictors of social capital variables. Mental health was better among rural participants, but there was no significant difference for physical health. Social capital was associated with good mental health for both urban and rural participants, but with physical health only for urban participants. Higher levels of social capital were significantly associated with better mental health for both urban and rural participants, but with better physical health only for urban participants. The study found that social capital and its relationship to health differed for participants in rural and urban areas, and that there were also differences between the areas in associations with socioeconomic variables. Policies aiming to strengthen social capital in order to promote health need to be designed for specific settings and particular communities within these.

Individual and area-level socioeconomic associations with fast food purchasing

Publisher: BMJ

Date: 10-2011

DOI: 10.1136/JECH.2009.099614

Abstract: It has been suggested that those with lower socioeconomic characteristics would be more likely to seek energy-dense food options such as fast food because of cheaper prices however, to date the evidence has been inconsistent. This study examines both in idual- and area-level socioeconomic characteristics and their independent associations with chain-brand fast food purchasing. Data from the 2003 Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) a multilevel study of 2,547 adults from 49 small-areas in Melbourne, Australia, were used. Multilevel multinomial models adjusted for confounders were used to assess associations between in idual socioeconomic position (education, occupation and income) and area socioeconomic characteristics in relation to fast food purchasing from five major fast food chains with outcome categories: never, at least monthly and at least weekly. The study finally assessed whether any potential area-level associations were mediated by fast food access. Increased fast food purchasing was independently associated with lower education, being a blue-collar employee and decreased household income. Results for area-level disadvantage were marginally insignificant after adjustment for in idual-level characteristics, although they were suggestive that living in an area with greater levels of disadvantage increased an in idual's odds of more frequent fast food purchasing. This effect was further attenuated when measures of fast food restaurant access were included in the models. Independent effects of lower in idual-level socioeconomic characteristics and more frequent fast food purchasing for home consumption are demonstrated. Although evidence was suggestive of an independent association with area-level disadvantage this did not reach statistical significance.

Association between housing affordability and mental health: A longitudinal analysis of a nationally representative household survey in Australia

Publisher: Oxford University Press (OUP)

Date: 05-08-2011

DOI: 10.1093/AJE/KWR161

Abstract: Evidence about the mental health consequences of unaffordable housing is limited. The authors investigated whether people whose housing costs were more than 30% of their household income experienced a deterioration in their mental health (using the Short Form 36 Mental Component Summary), over and above other forms of financial stress. They hypothesized that associations would be limited to lower income households as high housing costs would reduce their capacity to purchase other essential nonhousing needs (e.g., food). Using fixed-effects longitudinal regression, the authors analyzed 38,610 responses of 10,047 in iduals aged 25-64 years who participated in the Household, Income, and Labour Dynamics in Australia (HILDA) Survey (2001-2007). Respondents included those who remained in affordable housing over 2 consecutive waves (reference group) or had moved from affordable to unaffordable housing over 2 waves (comparison group). For in iduals living in low-to-moderate income households, entering unaffordable housing was associated with a small decrease in their mental health score independent of changes in equivalized household income or having moved house (mean change = -1.19, 95% confidence interval: -1.97, -0.41). The authors did not find evidence to support an association for higher income households. They found that entering unaffordable housing is detrimental to the mental health of in iduals residing in low-to-moderate income households.

A Longitudinal Analysis of Changes in Job Control and Mental Health

Publisher: Oxford University Press (OUP)

Date: 07-2015

DOI: 10.1093/AJE/KWV046

The urban public realm and adolescent mental health and wellbeing: A systematic review

Publisher: Elsevier BV

Date: 09-2021

DOI: 10.1016/J.SOCSCIMED.2021.114242

Access to alcohol outlets and harmful alcohol consumption: A multi-level study in Melbourne, Australia

Publisher: Wiley

Date: 28-07-2011

DOI: 10.1111/J.1360-0443.2011.03510.X

Abstract: To assess the association between access to off-premises alcohol outlets and harmful alcohol consumption. Multi-level study of 2334 adults aged 18-75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne. Alcohol outlet density was defined as the number of outlets within a 1-km road network of respondents' homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi-level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short-term harm at least weekly and monthly drinking at levels associated with long-term harm and frequency of consumption. Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short-term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22-4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07-3.04). We found no evidence to support an association between proximity and harmful alcohol consumption. The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption.

How are the built environment and household travel characteristics associated with children's active transport in Melbourne, Australia?

Publisher: Elsevier BV

Date: 03-2019

DOI: 10.1016/J.JTH.2019.01.003

Beyond the bicycle: Seeing the context of the gender gap in cycling

Publisher: Elsevier BV

Date: 09-2020

DOI: 10.1016/J.JTH.2020.100871

Recommendations for and compliance with social restrictions during implementation of school closures in the early phase of the influenza A (H1N1) 2009 outbreak in Melbourne, Australia

Publisher: Springer Science and Business Media LLC

Date: 30-09-2011

DOI: 10.1186/1471-2334-11-257

Alcohol and tobacco consumption: What is the role of economic security?

Publisher: Wiley

Date: 28-01-2021

DOI: 10.1111/ADD.15400

Abstract: To better understand the longstanding inequalities concerning alcohol and tobacco use, we aimed to quantify the effect of household economic security on alcohol and tobacco consumption and expenditure. Longitudinal analysis using data from the Household, Income and Labour Dynamics in Australia survey (2001–2018). Australia A nationally representative cohort of 24 134 adults aged 25–64 years (187 378 observations). Tobacco and alcohol use (Yes/No), frequency of use of each per week, household expenditure on each per week, household weekly income (Consumer Price Index [CPI]‐adjusted), employment security (based on conditions of employment) and housing affordability (housing costs relative to household income). At baseline, one‐quarter of the s le used tobacco and 87% used alcohol. Annual increases in household income were associated with the increased use of both tobacco and alcohol for people in households in the lowest 40% of the national income distribution (OR = 1.13, 95% CI = 1.03–1.23 and OR = 1.12, 95% CI = 1.04–1.20, respectively) with no similar income effect observed for higher‐income households. In relation to smoking, the odds of a resident's tobacco use increased when their household was unemployed (OR = 1.32, 95% CI = 1.07–1.62). In relation to alcohol, the odds of use decreased when households were insecurely employed or unemployed, or housing costs were unaffordable (OR = 0.87, 95% CI = 0.77–0.98, OR = 0.66, 95% CI = 0.55–0.80 and OR = 0.84, 95% CI = 0.75–0.93, respectively). This was also reflected in the reduced odds of risky drinking (defined in accordance with Australian guidelines) when housing became unaffordable or households became unemployed (OR = 0.90, 95% CI = 0.81–0.99 OR = 0.82, 95% CI = 0.69–0.98, respectively). In Australia, smoking and drinking appear to exhibit different socio‐behavioural characteristics and household unemployment appears to be a strong determinant of smoking.

Disability acquisition and mental health: an analysis of excess mental health inequalities according to demographic and socioeconomic characteristics using propensity score models with inverse probability of treatment weighting.

Publisher: BMJ

Date: 09-2017

DOI: 10.1136/BMJOPEN-2017-016953

Abstract: There is evidence of a causal relationship between disability acquisition and poor mental health, but the substantial heterogeneity in the magnitude of the effect is poorly understood and may be aetiologically informative. This study aimed to identify demographic and socioeconomic factors that modify the effect of disability acquisition on mental health. The Household, Income and Labour Dynamics in Australia Survey is a nationally representative longitudinal survey of Australian households that has been conducted annually since 2001. Four waves of data were included in this analysis, from 2011 to 2014. In iduals who acquired a disability (n=387) were compared with those who remained disability-free in all four waves (n=7936). Mental health was measured using the mental health subscale of the Short Form 36 (SF-36) general health questionnaire, which measures symptoms of depression, anxiety and psychological well-being. Linear regression models were fitted to estimate the effect of disability acquisition on mental health, testing for effect modification by key demographic and socioeconomic characteristics. To maximise causal inference, we used a propensity score approach with inverse probability of treatment weighting to control for confounding and multiple imputation using chained equations to assess the impact of missing data. On average, disability acquisition was associated with a 5-point decline in mental health score (estimated mean difference: −5.1, 95% CI −7.2 to –3.0). There was strong evidence that income and relationship status modified the effect, with more detrimental effects in the lowest (−12.5, 95% CI −18.5 to –6.5) compared with highest income quintile (−1.1, 95% CI –4.9 to 2.7) and for people not in a relationship (−8.8, 95% CI −12.9 to –4.8) compared with those who were (−3.7, 95% CI −6.1 to –1.4). Our results suggest that the detrimental effect of disability acquisition on mental health is substantially greater for socioeconomic disadvantaged in iduals.

Short-run effects of poverty on asthma, ear infections and health service use: analysis of the Longitudinal Study of Australian Children

Publisher: Oxford University Press (OUP)

Date: 21-04-2021

DOI: 10.1093/IJE/DYAB059

Abstract: Many studies have reported an inferred causal association of income poverty with physical health among children but making causal inference is challenging due to multiple potential sources of systematic error. We quantified the short-run effect of changes in household poverty status on children’s health (asthma and ear infections) and service use (visits to the doctor and parent-reported hospital admissions), using a national longitudinal study of Australian children, with particular attention to potential residual confounding and selection bias due to study attrition. We use four modelling approaches differing in their capacity to reduce residual confounding (generalized linear, random effects (RE), hybrid and fixed effects (FE) regression modelling) to model the effect of income poverty (& % of median income) on health for 10 090 children surveyed every 2nd year since 2004. For each method, we simulate the potential impact of selection bias arising due to attrition related to children’s health status. Of the 10 090 children included, 20% were in families in poverty at survey baseline (2004). Across subsequent years, ∼25% experienced intermittent and & % persistent poverty. No substantial associations between poverty and child physical health and service use were observed in the FE models least prone to residual confounding [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.81–1.10 for wheeze], in contrast to RE models that were positive (consistent with previous studies). Selection bias causing null findings was unlikely. While poverty has deleterious causal effects on children’s socio-behavioural and educational outcomes, we find little evidence of a short-run causal effect of poverty on asthma, ear infections and health service use in Australia.

Cold housing environments: defining the problem for an appropriate policy response

Publisher: Springer Science and Business Media LLC

Date: 29-07-2023

DOI: 10.1057/S41271-023-00431-8

Abstract: Researchers across disciplines are increasing attention to cold housing environments. Public health, environmental and social sciences, architecture, and engineering each define and measure cold housing environments differently. Lack of standardisation hinders our ability to combine evidence, determine prevalence, understand who is most at risk––and to formulate policy responses. We conducted a systematic, cross-disciplinary review of literature to document the measures used. We examined benefits and limitations of each approach and propose a conceptualisation of cold housing: where temperature is too low to support optimal health and wellbeing of inhabitants, measured using one or a combination of economic, ‘objective’, or subjective approaches. More accurate data on home temperatures for all population groups, combined with an understanding of factors leading to cold homes, will enable appropriate policy response to reduce adverse health effects and costs. Policies targeting better building standards and energy subsidies both improve temperature conditions in housing environments.

Young maternal age at first birth and mental health later in life: Does the association vary by birth cohort?

Publisher: Elsevier BV

Date: 05-2016

DOI: 10.1016/J.SOCSCIMED.2016.03.037

Abstract: It is well established that maternal age at childbirth has implications for women's mental health in the short term, however there has been little research regarding longer term implications and whether this association has changed over time. We investigated longer term mental health consequences for young mothers in Australia and contrasted the effects between three birth cohorts. Using thirteen waves of data from 4262 women aged 40 years or above participating in the Household, Income and Labour Dynamics in Australia Survey, we compared the mental health of women who had their first child aged 15-19 years, 20-24 years, and 25 years and older. Mental health was measured using the mental health component summary score of the SF-36. We used random-effects linear regression models to generate estimates of the association between age at first birth and mental health, adjusted for early life socioeconomic characteristics (country of birth, parents' employment status and occupation) and later life socioeconomic characteristics (education, employment, income, housing tenure, relationship status and social support). We examined whether the association changed over time, testing for effect modification across three successive birth cohorts. In models adjusted for early life and later life socioeconomic characteristics, there was strong evidence of an association between teenage births and poor mental health, with mental health scores on average 2.76 to 3.96 points lower for mothers aged younger than 20 years than for mothers aged 25 years and older (Late Baby Boom (born 1936-1945): -3.96, 95% CI -5.38, -2.54 Early Baby Boom (born 1946-1955): -3.01, 95% CI -4.32, -1.69 Lucky Few (born 1956-1965): -2.76, 95% CI -4.34, -1.18), and evidence of an association for mothers aged 20-24 years compared to mothers aged 25 years and older in the most recent birth cohort only (-1.09, 95% CI -2.01, -0.17). There was some indication (though weak) that the association increased in more recent cohorts. This study highlights that young mothers, and particularly teenage mothers, are a vulnerable group at high risk of poor mental health outcomes compared to mothers aged 25 years and above, and there was some suggestion (though weak) that the health disparities increased over time.

Does employment security modify the effect of housing affordability on mental health?

Publisher: Elsevier BV

Date: 12-2016

DOI: 10.1016/J.SSMPH.2016.09.003

Does the effect of disability acquisition on mental health differ by employment characteristics? A longitudinal fixed-effects analysis

Publisher: Springer Science and Business Media LLC

Date: 24-10-2019

DOI: 10.1007/S00127-019-01783-X

Abstract: Longitudinal studies have suggested a causal relationship between disability acquisition and mental health, but there is substantial heterogeneity in the magnitude of the effect. Previous studies have provided evidence that socioeconomic characteristics can buffer the effect but have not examined the role of employment characteristics. We used data from 17 annual waves of the Household, Income and Labour Dynamics in Australia Survey to compare the mental health of working age in iduals before and after disability acquisition, using the Mental Health Inventory, a subscale of the SF-36 health questionnaire. Linear fixed-effects regression models were used to estimate the effect of disability acquisition on mental health. We tested for effect modification by two characteristics of people’s employment prior to disability acquisition: occupational skill level and contract type. Multiple imputation using chained equations was used to handle missing data. Disability acquisition was associated with a substantial decline in mental health score (estimated mean difference: − 4.3, 95% CI − 5.0, − 3.5). There was evidence of effect modification by occupational skill level, with the largest effects seen for those in low-skilled jobs (− 6.1, 95% CI − 7.6, − 4.5), but not for contract type. The findings highlight the need for social and health policies that focus on increasing employment rates, improving the sustainability of employment, and providing employment services and education and training opportunities for people who acquire a disability, particularly for people in low-skilled occupations, to reduce the mental health inequalities experienced by people with disabilities.

Leave entitlements, time off work and the household financial impacts of quarantine compliance during an H1N1 outbreak.

Publisher: Springer Science and Business Media LLC

Date: 20-11-2012

DOI: 10.1186/1471-2334-12-311

Fruit and vegetable purchasing and the relative density of healthy and unhealthy food stores: evidence from an Australian multilevel study.

Publisher: BMJ

Date: 25-10-2013

DOI: 10.1136/JECH-2012-201535

Abstract: Evidence of a relationship between residential retail food environments and diet-related outcomes is inconsistent. One reason for this may be that food environments are typically defined in terms of the absolute number of particular store types in an area, whereas a measure of the relative number of healthy and unhealthy stores may be more appropriate. Using cross-sectional data from the VicLANES study conducted in Melbourne, Australia, multilevel logistic regression analysis was used to estimate the independent associations between absolute measures (numbers of healthy and unhealthy stores) and a relative measure (relative density of healthy stores) of the food environment, and self-reported variety of fruit and vegetable purchasing in local households. Purchasing behaviour was measured as the odds of purchasing above the median level of fruit and vegetables. Compared to households in areas where healthy food stores made up no more than 10% of all healthy and unhealthy stores, households in areas with 10.1-15.0% healthy food stores and >15% healthy stores had increased odds of healthier purchasing (OR=1.48 (95% CI 1.12 to 1.96) and OR=1.45 (95% CI 1.09 to 1.91), respectively). There was less evidence of an association between absolute numbers of healthy or unhealthy stores and fruit and vegetable purchasing. We found strong evidence of healthier fruit and vegetable purchasing in households located in areas where the proportion of food stores that were healthy was greater. Policies aimed at improving the balance between healthy and unhealthy stores within areas may therefore be effective in promoting greater consumption of fruit and vegetables.

Better transport accessibility, better health: a health economic impact assessment study for Melbourne, Australia

Publisher: Springer Science and Business Media LLC

Date: 22-10-2019

DOI: 10.1186/S12966-019-0853-Y

Abstract: Physical inactivity is a global public health problem, partly due to urbanization and increased use of passive modes of transport such as private motor vehicles. Improving accessibility to public transport could be an effective policy for Governments to promote equity and efficiency within transportation systems, increase population levels of physical activity and reduce the negative externalities of motor vehicle use. Quantitative estimates of the health impacts of improvements to public transport accessibility may be useful for resource allocation and priority-setting, however few studies have been published to inform this decision-making. This paper aims to estimate the physical activity, obesity, injury, health and healthcare cost-saving outcomes of scenario-based improvements to public transport accessibility in Melbourne, Australia. Baseline and two hypothetical future scenario estimates of improved public transport accessibility for Melbourne, Australia, were derived using a spatial planning and decision tool designed to simulate accessibility performance (the Spatial Network Analysis for Multimodal Urban Transport Systems (SNAMUTS)). Public transport related physical activity was quantified by strata of age group and sex from Melbourne travel survey data (VISTA survey) and used with the SNAMUTS Composite Index to estimate input data for health impact modelling for the Melbourne population aged 20–74 years. A proportional multi-state, multiple cohort lifetable Markov model quantified the potential health gains and healthcare cost-savings from estimated changes in physical activity, body weight and injuries related to walking to access/egress public transport under two scenarios: (S1) public transport accessibility under current policy directions, and (S2) multi-directional, high-frequency network improvements. Multi-directional, high-frequency improvements to the public transport network (S2) resulted in significantly greater health and economic gains than current policy directions (S1) in relation to physical activity (mean 6.4 more MET minutes/week), body weight (mean 0.05 kg differential), health-adjusted life years gained (absolute difference of 4878 HALYs gained) and healthcare cost-savings (absolute difference of AUD43M), as compared to business as usual under both scenarios ( n = 2,832,241 adults, over the lifecourse). Based on our conservative analyses, improving accessibility to public transport will improve population health by facilitating physical activity and lead to healthcare cost savings compared with business-as-usual. These wider health benefits should be better considered in transport planning and policy decisions.

Housing and health: an updated glossary

Publisher: BMJ

Date: 27-06-2022

DOI: 10.1136/JECH-2022-219085

Abstract: Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman’s early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20 years of development in the field. It defines key concepts currently used in research, policy and practice to describe housing in relation to health and health inequalities. Definitions are organised by three overarching aspects of housing: affordability (including housing affordability stress (HAS) and fuel poverty), suitability (including condition, accessibility and sustainable housing) and security (including precarious housing and homelessness). Each of these inter-related aspects of housing can be either protective of, or detrimental to, health. This glossary broadens our understanding of the relationship between housing and health to further promote interdisciplinarity and strengthen the nexus between these fields.

Housing affordability and residential mobility as drivers of locational inequality

Publisher: Elsevier BV

Date: 07-2016

DOI: 10.1016/J.APGEOG.2016.05.007

Local environments as determinants of walking in Melbourne, Australia

Publisher: Elsevier BV

Date: 06-2010

DOI: 10.1016/J.SOCSCIMED.2010.01.041

Abstract: Structural changes to neighbourhoods that promote walking are likely to benefit everyone in a community and result in long-term improvements in the population's physical activity and health. We consider time spent walking in relation to objectively measured features of people's local environments (functionality, safety, destinations and aesthetics) in Melbourne, Australia. We used multilevel ordered logistic regression analysis to examine variations in time spent walking amongst 2334 residents of 49 small areas (Census Collection Districts - CCDs). Features on each street segment within a 400 m radius of a randomly selected household within each CCD were measured, supplemented by geographic information system data. Models were adjusted for socio-demographic and socio-economic characteristics of in idual and socio-economic characteristics of areas. We found that increasing track length, having paths located closer to roads, fewer buildings with driveways, a greater presence and variety of destinations and views of shops, light industry, offices and/or schools (commercial views) were associated with more time spent walking in local environments in adjusted models. As such, each of the four features of local environments considered (design, safety, destinations and aesthetics) were associated on at least one measure with walking. Characteristics of areas reflecting urbanisation (destinations, commercial views, path location and driveways) were associated with increased time spent walking. This study provides important evidence on how urban design can be utilised to improve physical activity.

Housing affordability and mental health: Does the relationship differ for renters and home purchasers?

Publisher: Elsevier BV

Date: 10-2013

DOI: 10.1016/J.SOCSCIMED.2013.06.023

Abstract: There is increasing evidence of a direct association between unaffordable housing and poor mental health, over and above the effects of general financial hardship. Type of housing tenure may be an important factor in determining how in iduals experience and respond to housing affordability problems. This study investigated whether a relationship exists between unaffordable housing and mental health that differs for home purchasers and private renters among low-income households. Data from 2001 to 2010 of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey were analysed using fixed-effects linear regression to examine change in the SF-36 Mental Component Summary (MCS) score of in iduals aged 25-64 years, associated with changes in housing affordability, testing for an interaction with housing tenure type. After adjusting for age, survey year and household income, among in iduals living in households in the lower 40% of the national income distribution, private renters in unaffordable housing experienced somewhat poorer in mental health than when their housing was affordable (difference in MCS = -1.18 or about 20% of one S.D. of the MCS score 95% CI: -1.95,-0.41 p = 0.003) while home purchasers experienced no difference on average. The statistical evidence for housing tenure modifying the association between unaffordable housing and mental health was moderate (p = 0.058). When alternatives to 40% were considered as income cut-offs for inclusion in the s le, evidence of a difference between renters and home purchasers was stronger amongst households in the lowest 50% of the income distribution (p = 0.020), and between the 30th and 50th percentile (p = 0.045), with renters consistently experiencing a decline in mental health while mean MCS scores of home purchasers did not change. In this study, private renters appeared to be more vulnerable than home purchasers to mental health effects of unaffordable housing. Such a modified effect suggests that tenure-differentiated policy responses to poor housing affordability may be appropriate.

Housing and health: a time for action

Publisher: Informa UK Limited

Date: 03-04-2023

DOI: 10.1080/19491247.2023.2204650

Housing Vulnerability and COVID-19 Outbreaks: When Crises Collide

Publisher: Informa UK Limited

Date: 15-02-2023

DOI: 10.1080/08111146.2022.2028616

Invited Commentary: Harnessing Housing Natural Experiments Is Important, but Beware Differential Misclassification of Difference in Difference: Table 1.

Publisher: Oxford University Press (OUP)

Date: 08-09-2016

DOI: 10.1093/AJE/KWW053

Abstract: In this issue of the Journal, Reeves et al. (Am J Epidemiol. 2016 (6):421-429) present the findings of a natural experiment analyzing the association between reduced housing affordability and mental ill health. Their difference-in-difference analysis of cross-sectional, quarterly population health surveys administered before and after implementation of a policy to reduce Housing Benefit payments in the United Kingdom in April 2011 represents an important way to assess the impact of a national housing policy shift on public health. It is a well-conducted study harnessing a natural experiment and adds to the weight of evidence supporting an association between housing costs and mental health. However, quantitative bias analysis based on the reported findings suggests that a small amount of differential (by unblinded Housing Benefit status) misclassification bias in the outcome may be enough to explain the observed association. Our analysis of possible misclassification bias in the outcome used in the study highlights the need for caution when a difference-in-difference estimate is small, the population is not blinded to its postintervention exposure status, and the outcome measure is subjective and prone to differential (by unblinded exposure or treatment status) misclassification.

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults

Publisher: Elsevier BV

Date: 06-2011

DOI: 10.1111/J.1753-6405.2011.00683.X

Abstract: To examine associations between in idual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. In idual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the in idual and household levels may be an important determinant of alcohol consumption among Australian adults.

The ‘double precarity’ of employment insecurity and unaffordable housing and its impact on mental health

Publisher: Elsevier BV

Date: 03-2019

DOI: 10.1016/J.SOCSCIMED.2019.02.008

Abstract: This paper describes who is most likely to experience household employment insecurity and housing affordability stress - double precarity - and estimates the degree to which housing affordability mediates the effect of employment insecurity on mental health. We use a cohort of 24,201 participants in 2016 Household, Income and Labour Dynamics in Australia survey (6.2 repeated measures on average). We estimate the likelihood of onset of household employment insecurity, housing affordability stress and change in housing costs using longitudinal regression analyses for socio-demographic groups. We assess mediation by estimating how much exposure variable coefficients attenuate with inclusion of a mediator in fixed effects regression models. We also apply causal mediation methods to fixed-effects regression models to better account for exposure-mediator interaction and meet strict model assumptions. If people's households become insecurely employed, there are five times greater odds of them also experiencing housing affordability stress (OR 4.99 95%CI 4.21-5.90). Key cohorts within the population are shown to be especially vulnerable to double precarity - notably single parents (OR 2.91, 95%CI 1.94-4.35) and people who live alone (OR 4.42, 95% CI 3.03-6.45) (compared to couples), and people who are recently separated or orced (OR 2.59, 95%CI 1.81-3.70). Mediation analysis confirms that household employment insecurity has a small, negative effect on mental health (Beta -0.24, 95%CI -0.38-0.11 on a 1 to 100-point scale with 10-point standard deviation). Estimates from casual mediation analyses suggest housing affordability accounts for 20% of the total effect likely concentrated in the lowest and highest strata of income. Employment and housing insecurity represent a form of double precarity for people in households with a single income. When we consider the impact on mental health, we find evidence of a causal relationship between insecure employment onset and mental health, around one fifth of which is mediated by changing housing cost and onset of affordability stress.

Does the presence and mix of destinations influence walking and physical activity?

Publisher: Springer Science and Business Media LLC

Date: 17-09-2015

DOI: 10.1186/S12966-015-0279-0

Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping: A multilevel study in Melbourne, Victoria

Publisher: Cambridge University Press (CUP)

Date: 22-02-2010

DOI: 10.1017/S136898001000385X

Abstract: To describe associations between demographic and in idual and area-level socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping. Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables. Random selection of households from fifty small areas in Melbourne, Australia, in 2003. The main food shoppers in each household ( n 2564). A lack of money was significantly more likely among the young and in households with single adults. Difficultly lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower in idual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficultly lifting and reduced car access. In Melbourne, households with lower in idual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.

Fast food purchasing and access to fast food restaurants: A multilevel analysis of VicLANES

Publisher: Springer Science and Business Media LLC

Date: 2009

DOI: 10.1186/1479-5868-6-28

The Mental Health Effects of Housing Tenure: Causal or Compositional?

Publisher: SAGE Publications

Date: 29-04-2025

DOI: 10.1177/0042098012446992

Abstract: Housing tenure sits at the heart of much academic and policy literature across many post-industrial countries, and, while debate is often centred on promoting tenure choice, surprisingly little is known of the underlying ways that the tenure chosen can affect health. While population characteristics tend to vary between tenure types, this largely reflects the forces of broader social and economic selection into those tenures. This paper examines what identifiable effect tenure has upon the mental health of in iduals, over and above the characteristics of selection. The analysis is based upon 40 828 responses of 10 245 in iduals in the Australian working-age population who participated in the Household, Income and Labour Dynamics in Australia study between 2001 and 2007. It is found that, while mental health varies significantly between tenure types, once tenure population differences are accounted for there is little evidence of an intrinsic relationship between tenure and mental health.

Housing affordability and mental health: an analysis of generational change

Publisher: Informa UK Limited

Date: 15-08-2022

DOI: 10.1080/02673037.2022.2108380

Area disadvantage, individual socio-economic position, and premature cancer mortality in Australia 1998 to 2000: a multilevel analysis.

Publisher: Springer Science and Business Media LLC

Date: 20-11-2007

DOI: 10.1007/S10552-007-9084-7

Housing tenure and affordability and mental health following disability acquisition in adulthood

Publisher: Elsevier BV

Date: 02-2016

DOI: 10.1016/J.SOCSCIMED.2016.01.010

Abstract: Acquiring a disability in adulthood is associated with a reduction in mental health and access to secure and affordable housing is associated with better mental health. We hypothesised that the association between acquisition of disability and mental health is modified by housing tenure and affordability. We used twelve annual waves of data (2001-2012) (1913 participants, 13,037 observations) from the Household, Income and Labour Dynamics in Australia survey. Eligible participants reported at least two consecutive waves of disability preceded by two consecutive waves without disability. Effect measure modification, on the additive scale, was tested in three fixed-effects linear regression models (which remove time-invariant confounding) which included a cross-product term between disability and prior housing circumstances: housing tenure by disability housing affordability by disability and, in a sub-s le (896 participants 5913 observations) with housing costs, tenure/affordability by disability. The outcome was the continuous mental component summary (MCS) of SF-36. Models adjusted for time-varying confounders. There was statistical evidence that prior housing modified the effect of disability acquisition on mental health. Our findings suggested that those in affordable housing had a -1.7 point deterioration in MCS (95% CI -2.1, -1.3) following disability acquisition and those in unaffordable housing had a -4.2 point reduction (95% CI -5.2, -1.4). Among people with housing costs, the largest declines in MCS were for people with unaffordable mortgages (-5.3, 95% CI -8.8, -1.9) and private renters in unaffordable housing (-4.0, 95% CI -6.3, -1.6), compared to a -1.4 reduction (95% CI -2.1, -0.7) for mortgagors in affordable housing. In sum, we used causally-robust fixed-effects regression and showed that deterioration in mental health following disability acquisition is modified by prior housing circumstance with the largest negative associations found for those in unaffordable housing. Future research should test whether providing secure, affordable housing when people acquire a disability prevents deterioration in mental health.

Measuring Housing Affordability: A Longitudinal Approach

Publisher: Informa UK Limited

Date: 21-05-2015

DOI: 10.1080/08111146.2015.1034853

Housing affordability, tenure and mental health in Australia and the United Kingdom: a comparative panel analysis

Publisher: Informa UK Limited

Date: 20-08-2016

DOI: 10.1080/02673037.2015.1070796

Inequalities in socio-economic and health and wellbeing of men with and without disabilities: a cross-sectional analysis of the baseline wave of the Australian Longitudinal Study on Male Health

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3700-Y

Impact of COVID-19 shocks, precarity and mediating resources on the mental health of residents of share housing in Victoria, Australia: an analysis of data from a two-wave survey

Publisher: BMJ

Date: 04-2022

DOI: 10.1136/BMJOPEN-2021-058580

Abstract: COVID-19 lockdown measures have challenged people’s mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as job loss, living cost pressures and changing housing conditions throughout the lockdown period) and double precarity (defined as precarity in housing and employment) on mental health outcomes for members of share households as well as the mediating effects of a range of resources. We conducted a two-wave survey of occupants of share housing in June and October 2020 during a prolonged period of population lockdown. Research design involved fixed effects ordered logit regression models to assess the mental health consequences of baseline precarity and COVID-related shocks. Victoria, Australia. We surveyed 293 occupants of share houses (mean age 34 SD 11.5, 56% female). Members of share houses (where in iduals are unrelated adults and not in a romantic relationship) are more likely to be young, casually employed, visa-holders and low-income. We measured household composition, housing and employment precarity, access to government support, household crowding, social networks and COVID-19 shocks. We used a self-reported measure of mental health. Those exposed to COVID-19 shocks reported a 2.7 times higher odds of mental health deterioration (OR 2.7, 95% CI 1.53 to 4.85). People exposed to double precarity (precarity in both housing and employment) reported 2.4 times higher odds of mental health deterioration (OR 2.4, 95% CI 0.99 to 5.69). Housing inadequacy and lack of access to sufficient government payments explained 14.7% and 7% of the total effect of double precarity on mental health, respectively. Results indicate that residents of group households characterised by pre-existing precarity were vulnerable to negative mental health effects during lockdown. Access to sufficient government payments and adequate housing buffered this negative effect.

Examining associations between area-level spatial measures of housing with selected health and wellbeing behaviours and outcomes in an urban context

Publisher: Elsevier BV

Date: 2017

DOI: 10.1016/J.HEALTHPLACE.2016.11.003

Abstract: Adequate and affordable housing is a major social determinant of health yet no work has attempted to conceptually map and spatially test area-level measures of housing with selected health and wellbeing outcomes. Sourcing data from 7,753 adults from Melbourne, Australia, we tested associations between area-level measures of housing density, tenure, and affordability with in idual-level measures of neighbourhood safety, community satisfaction, and self-rated health. Compared with the reference groups, the odds of: feeling unsafe was higher for residents living in areas with less affordable housing community dissatisfaction was ~30% higher in those living in areas with >36% residential properties assigned as rentals, and was significantly higher in the least affordable areas (OR =1.57). Compared with the reference groups, as dwelling density, proportion of rental properties, and housing unaffordability increased, the odds of reporting poorer self-rated health increased however these associations did not always reach statistical significance. This work highlights the benefits of evidenced-based planning spatial measures to support health and wellbeing.

Neoliberalism, economic restructuring and policy change: Precarious housing and precarious employment in Australia

Publisher: SAGE Publications

Date: 10-07-2019

DOI: 10.1177/0042098015596922

Abstract: Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable in iduals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.

Modelling housing need in Australia to 2025

Publisher: Australian Housing and Urban Research Institute (AHURI)

Date: 02-08-2017

DOI: 10.18408/AHURI-8106901

Socioeconomic position in young adulthood is associated with BMI in Australian families

Publisher: Oxford University Press (OUP)

Date: 19-08-2016

DOI: 10.1093/PUBMED/FDV107

Abstract: Low socioeconomic position (SEP) is associated with increased cardiovascular (CV) disease risk, but the relative importance of SEP in childhood and adulthood, and of changes in SEP between these two life stages, remains unclear. Studies of families may help clarify these issues. We aimed to assess whether SEP in young adulthood, or change in SEP from childhood to young adulthood, was associated with five continuously measured CV risk factors. We used data from 286 adult Australian families from the Victorian Family Heart Study (VFHS), in which some offspring have left home (n = 364) and some remained at home (n = 199). SEP (defined as the Index of Relative Socioeconomic Disadvantage) was matched to addresses. We fitted variance components models to test whether young adult SEP and/or change in SEP was associated with systolic blood pressure, diastolic blood pressure, body mass index (BMI), total cholesterol or high-density lipoprotein cholesterol, after adjustment for parental SEP and within-family correlation. An increase in SEP of 100 SEIFA units from childhood to adulthood was associated with a lower BMI (β = -0.49 kg/m(2), P < 0.01) only. These results suggest that a change in SEP in young adulthood is an important predictor of BMI, independent of childhood SEP.

A Longitudinal Study Examining Changes in Street Connectivity, Land Use, and Density of Dwellings and Walking for Transport in Brisbane, Australia

Publisher: Environmental Health Perspectives

Date: 21-05-2018

DOI: 10.1289/EHP2080

The use of kernel density estimation to examine associations between neighborhood destination intensity and walking and physical activity

Publisher: Public Library of Science (PLoS)

Date: 10-09-2015

DOI: 10.1371/JOURNAL.PONE.0137402

Do material, psychosocial and behavioural factors mediate the relationship between disability acquisition and mental health? A sequential causal mediation analysis.

Publisher: Oxford University Press (OUP)

Date: 29-01-2018

DOI: 10.1093/IJE/DYX277

Abstract: There is evidence of a causal relationship between disability acquisition and poor mental health however, the mechanism by which disability affects mental health is poorly understood. This gap in understanding limits the development of effective interventions to improve the mental health of people with disabilities. We used four waves of data from the Household, Income and Labour Dynamics in Australia Survey (2011-14) to compare self-reported mental health between in iduals who acquired any disability (n=387) and those who remained disability-free (n=7936). We tested three possible pathways from disability acquisition to mental health, examining the effect of material, psychosocial and behavioural mediators. The effect was partitioned into natural direct and indirect effects through the mediators using a sequential causal mediation analysis approach. Multiple imputation using chained equations was used to assess the impact of missing data. Disability acquisition was estimated to cause a five-point decline in mental health [estimated mean difference: -5.3, 95% confidence interval (CI) -6.8, -3.7]. The indirect effect through material factors was estimated to be a 1.7-point difference (-1.7, 95% CI -2.8, -0.6), explaining 32% of the total effect, with a negligible proportion of the effect explained by the addition of psychosocial characteristics (material and psychosocial: -1.7, 95% CI -3.0, -0.5) and a further 5% by behavioural factors (material-psychosocial-behavioural: -2.0, 95% CI -3.4, -0.6). The finding that the effect of disability acquisition on mental health operates predominantly through material rather than psychosocial and behavioural factors has important implications. The results highlight the need for better social protection, including income support, employment and education opportunities, and affordable housing for people who acquire a disability.

The total health gains and cost savings of eradicating cold housing in Australia

Publisher: Elsevier BV

Date: 10-2023

DOI: 10.1016/J.SOCSCIMED.2023.115954

A multilevel study of area socio-economic status and food purchasing behaviour.

Publisher: Cambridge University Press (CUP)

Date: 26-02-2009

DOI: 10.1017/S1368980009004911

Abstract: The present study examined the association between area socio-economic status (SES) and food purchasing behaviour. Data were collected by mail survey (64·2 % response rate). Area SES was indicated by the proportion of households in each area earning less than $AUS 400 per week, and in idual-level socio-economic position was measured using education, occupation and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression analysis examined the association between area SES and food purchase after adjustment for in idual-level demographic (age, sex, household composition) and socio-economic factors. Melbourne city, Australia, 2003. Residents of 2564 households located in fifty small areas. Residents of low-SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt and sugar and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety. In Melbourne, area SES was associated with some food purchasing behaviours independent of in idual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.

Using kernel density estimation to understand the influence of neighbourhood destinations on BMI

Publisher: BMJ

Date: 02-2016

DOI: 10.1136/BMJOPEN-2015-008878

Men's work, Women's work, and mental health: A longitudinal investigation of the relationship between the gender composition of occupations and mental health

Publisher: Elsevier BV

Date: 05-2018

DOI: 10.1016/J.SOCSCIMED.2018.03.020

Abstract: This longitudinal investigation assesses the extent to which the gender composition of an occupation (e.g., the extent to which an occupation is comprised of males versus females) has an impact on mental health. We used 14 annual waves of the Household Income Labour Dynamics in Australia (HILDA) study to construct a measure representing the gender ratio of an occupation. The outcome measure was the Mental Health Inventory (MHI-5). A Mundlak model was used to compare within and between person effects, after controlling for possible confounders. Results suggest that males and females employed in occupations where their own gender was dominant had better mental health than those in gender-neutral occupations (between person effects). However, within-person results suggested that a movement from a gender-neutral to a male or female dominated occupation was associated with both a decline (females) and improvement (males) in mental health. These results highlight the need for more research on gender specific selection into and out of different occupations in order to progress understandings of gender as a social determinant of health in the work context.

Cumulative exposure to poor housing affordability and its association with mental health in men and women

Publisher: BMJ

Date: 11-11-2012

DOI: 10.1136/JECH-2011-200291

Abstract: Poor housing affordability affects around 10% of the Australian population and is increasingly prevalent. The authors tested two hypotheses: that cumulative exposure to housing affordability stress (HAS) is associated with poorer mental health and that effects vary by gender. The authors estimated the relationship between cumulative exposure to HAS and mental health among 15478 participants in an Australian longitudinal survey between 2001 and 2009. In iduals were classified as being in HAS if household income was in the lowest 40% of the national distribution and housing costs exceeded 30% of income. Exposure to HAS ranged from 1 to 8 annual waves. Mental health was measured using the Short Form 36 Mental Component Summary (MCS) score. To test the extent to which any observed associations were explained by compositional factors, random- and fixed-effects models were estimated. In the random-effects models, mental health scores decreased with increasing cumulative exposure to HAS (up until 4+ years). This relationship differed by gender, with a stronger dose-response observed among men. The mean MCS score of men experiencing four to eight waves of housing stress was 2.02 points lower than men not in HAS (95% CI -3.89 to -0.16). In the fixed-effects models, there was no evidence of a cumulative effect of HAS on mental health however, lower MCS was observed after a single year in HAS (β=-0.70, 95% CI -1.02 to -0.37). While average mental health was lower for in iduals with longer exposure to HAS, the mental health effect appears to be due to compositional factors. Furthermore, men and women appear to experience cumulative HAS differently.

Sources, perceived usefulness and understanding of information disseminated to families who entered home quarantine during the H1N1 pandemic in Victoria, Australia: A cross-sectional study

Publisher: Springer Science and Business Media LLC

Date: 04-01-2011

DOI: 10.1186/1471-2334-11-2

Mental Health Following Acquisition of Disability in Adulthood—The Impact of Wealth

Publisher: Public Library of Science (PLoS)

Date: 07-10-2015

DOI: 10.1371/JOURNAL.PONE.0139708

DAGs and the restricted potential outcomes approach are tools, not theories of causation

Publisher: Oxford University Press (OUP)

Date: 27-01-2017

DOI: 10.1093/IJE/DYW228

Do financial hardship and social support mediate the effect of unaffordable housing on mental health?

Publisher: Springer Science and Business Media LLC

Date: 13-09-2019

DOI: 10.1007/S00127-019-01773-Z

Abstract: Unaffordable housing has a negative impact on mental health however, little is known about the causal pathways through which it transmits this effect. We examine the role of financial hardship and social support as mediators of this relationship. We identified households where housing costs changed from affordable to unaffordable across two waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2014-2015). The sequential causal mediation analysis was used to decompose the total effect of unaffordable housing on mental health into the portion attributable to financial hardship and social support [natural indirect effect (NIE)] and the portion not occurring through measured pathways [natural direct effect (NDE)]. Mental health was measured using the Mental Health Inventory (MHI) and Kessler psychological distress (KPD) scale. Baseline covariates included age, sex, household income, financial hardship, social support, marital status and employment status. Bootstrapping with 1000 replications was used to calculate 95% confidence intervals (CIs). Multiple imputations using chained equations were applied to account for missing data. Unaffordable housing led to a change in mean mental health score on the MHI scale (- 1.3, 95% CI: - 2.1, - 0.6) and KPDS scale (0.9, 95% CI: 0.4, 1.4). Financial hardship accounted for 54% of the total effect on MHI scale and 53% on KPD scale. Collectively, financial hardship and social support explained 68% of the total effect on MHI scale and 67% on KPD scale, respectively. In conclusion, the negative mental health effect of unaffordable housing is largely mediated through increased financial hardship.

Australian rental housing standards: institutional shifts to reprioritize the housing–health nexus

Publisher: Informa UK Limited

Date: 06-04-2023

DOI: 10.1080/21681376.2023.2190406

Effect of having a subsequent child on the mental health of women who lost a child in the 2008 Sichuan earthquake: a cross-sectional study

Publisher: WHO Press

Date: 17-03-2014

DOI: 10.2471/BLT.13.124677

Area disadvantage, socioeconomic position and women's contraception use: a multilevel study in the UK.

Publisher: BMJ

Date: 10-2009

DOI: 10.1783/147118909789587277

Income inequality and Neisseria gonorrhoeae notifications in females: A country-level analysis

Publisher: CSIRO Publishing

Date: 2014

DOI: 10.1071/SH13188

Abstract: Background Patterns of population susceptibility to sexually transmissible infections may be influenced by various social determinants of health, however these receive relatively little attention. Income inequality is one such determinant that has been linked to a number of poor health outcomes. The objective of this analysis was to determine whether there is an association between income inequality and Neisseria gonorrhoeae notification rates when measured at the country level. Methods: Gini coefficients, gonorrhoea notification rates among women, per capita gross domestic product and approximate size of female population were obtained for 11 countries of the OECD. Linear regression was used to measure the association between income inequality and gonorrhoea notification rates, using generalised estimation equations (GEE) to control for the non-independence of repeat measures from particular countries. Results: A total of 36 observations from 11 countries were included. Gini coefficients ranged from 0.21 to 0.38 and gonorrhoea notifications from 0.7 to 153 per 100000 females. Significant associations were found between country-level income inequality and gonorrhoea notification rates among women (b = 17.79 (95% CI: 10.64, 24.94, P 0.01). Conclusions: Significant associations were found, highlighting the importance of acknowledging and accounting for social determinants of sexual health and suggesting that further research in this arena may be fruitful.

The levonorgestrel intrauterine device in Australia: Analysis of prescribing data 2008-2012

Publisher: Springer Science and Business Media LLC

Date: 27-11-2018

DOI: 10.1186/S12905-018-0680-3

Does parkland influence walking? The relationship between area of parkland and walking trips in Melbourne, Australia

Publisher: Springer Science and Business Media LLC

Date: 2012

DOI: 10.1186/1479-5868-9-115

Associations between the purchase of healthy and fast foods and restrictions to food access: A cross-sectional study in Melbourne, Australia

Publisher: Cambridge University Press (CUP)

Date: 28-10-2015

DOI: 10.1017/S1368980013002796

Abstract: To examine the associations between financial, physical and transport conditions that may restrict food access (which we define as food security indicators) and the purchase of fast foods and nutritious staples such as bread and milk. Multilevel logistic and multinomial regression analysis of cross-sectional survey data to assess associations between the three indicators of food insecurity and household food shopping adjusted for sociodemographic and socio-economic variables. Random selection of households ( n 3995) from fifty Census Collector Districts in Melbourne, Australia, in 2003. The main food shoppers in each household ( n 2564). After adjustment for confounders, analysis showed that a greater likelihood of purchasing chain-brand fast food on a weekly basis compared with never was associated with running out of money to buy food (OR = 1·59 95 % CI 1·08, 2·34) and reporting difficulties lifting groceries (OR = 1·77 95 % CI 1·23, 2·54). Respondents without regular access to a car to do food shopping were less likely to purchase bread types considered more nutritious than white bread (OR = 0·75 95 % CI 0·59, 0·95) and milk types considered more nutritious than full-cream milk (OR = 0·62 95 % CI 0·47, 0·81). The food insecurity indicators were not associated with the purchasing of fruits, vegetables or non-chain fast food. Householders experiencing financial and physical barriers were more likely to frequently purchase chain fast foods while limited access to a car resulted in a lower likelihood that the nutritious options were purchased for two core food items (bread and milk). Policies and interventions that improve financial access to food and lessen the effect of physical limitations to carrying groceries may reduce the purchasing of fast foods. Further research is required on food sourcing and dietary quality among those with food access restrictions.

The impact of persistent poor housing conditions on mental health: A longitudinal population-based study

Publisher: Elsevier BV

Date: 12-2017

DOI: 10.1016/J.YPMED.2017.09.020

Abstract: Living with housing problems increases the risk of mental ill health. Housing problems tend to persist over time but little is known about the mental health consequences of living with persistent housing problems. We investigated if persistence of poor housing affects mental health over and above the effect of current housing conditions. We used data from 13 annual waves of the British Household Panel Survey (1996 to 2008) (81,745 person/year observations from 16,234 in iduals) and measured the persistence of housing problems by the number of years in the previous four that a household experienced housing problems. OLS regression models and lagged-change regression models were used to estimate the effects of past and current housing conditions on mental health, as measured by the General Health Questionnaire. Interaction terms tested if tenure type modified the impact of persistent poor housing on mental health. In fully adjusted models, mental health worsened as the persistence of housing problems increased. Adjustment for current housing conditions attenuated, but did not explain, the findings. Tenure type moderated the effects of persistent poor housing on mental health, suggesting that those who own their homes outright and those who live in social housing are most negatively affected. Persistence of poor housing was predictive of worse mental health, irrespective of current housing conditions, which added to the weight of evidence that demonstrates that living in poor quality housing for extended periods of time has negative consequences for mental health.

Mapping the riskscape of using privately-owned short-term lets for specialist family violence crisis accommodation

Publisher: Informa UK Limited

Date: 18-11-2023

DOI: 10.1080/19491247.2021.2002658

Employment status and mental health among persons with and without a disability: evidence from an Australian cohort study.

Publisher: BMJ

Date: 22-07-2014

DOI: 10.1136/JECH-2014-204147

University Of Melbourne

Location: Australia

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ARC Future Fellowships - Grant ID: FT150100131

Start Date: 03-2016

End Date: 03-2020

Amount: $812,921.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP190101188

Start Date: 06-2019

End Date: 12-2023

Amount: $485,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP180100035

Start Date: 12-2019

End Date: 12-2024

Amount: $297,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP120100116

Start Date: 06-2012

End Date: 06-2015

Amount: $154,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP150100077

Start Date: 05-2016

End Date: 12-2021

Amount: $677,681.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP140100680

Start Date: 06-2015

End Date: 12-2018

Amount: $225,000.00

Funder: Australian Research Council

Linkage Infrastructure, Equipment And Facilities - Grant ID: LE190100132

Start Date: 06-2019

End Date: 03-2021

Amount: $372,210.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP120102974

Start Date: 2012

End Date: 06-2016

Amount: $162,449.00

Funder: Australian Research Council

Linkage Infrastructure, Equipment And Facilities - Grant ID: LE160100056

Start Date: 06-2016

End Date: 02-2018

Amount: $190,000.00

Funder: Australian Research Council

Linkage Infrastructure, Equipment And Facilities - Grant ID: LE220100040

Start Date: 07-2022

End Date: 06-2025

Amount: $560,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP110200419

Start Date: 06-2012

End Date: 06-2016

Amount: $348,151.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP100200182

Start Date: 09-2011

End Date: 06-2014

Amount: $130,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP100200545

Start Date: 09-2011

End Date: 06-2015

Amount: $204,425.00

Funder: Australian Research Council