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How financial hardship is associated with the onset of mental health problems over time

Abstract

Purpose

Poor mental health has been consistently linked with the experience of financial hardship and poverty. However, the temporal association between these factors must be clarified before hardship alleviation can be considered as an effective mental health promotion and prevention strategy. We examined whether the longitudinal associations between financial hardship and mental health problems are best explained by an individual’s current or prior experience of hardship, or their underlying vulnerability.

Methods

We analysed nine waves (years: 2001–2010) of nationally representative panel data from the Household, Income, and Labour Dynamics in Australia survey (n = 11,134). Two components of financial hardship (deprivation and cash-flow problems) and income poverty were coded into time-varying and time-invariant variables reflecting the contemporaneous experience of hardship (i.e., current), the prior experience of hardship (lagged/12 months), and any experience of hardship during the study period (vulnerability). Multilevel, mixed-effect logistic regression models tested the associations between these measures and mental health.

Results

Respondents who reported deprivation and cash-flow problems had greater risk of mental health problems than those who did not. Individuals vulnerable to hardship had greater risk of mental health problems, even at the times they did not report hardship. However, their risk of mental health problems was greater on occasions when they did experience hardship.

Conclusions

The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.

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Acknowledgments

Kiely is funded by Alzheimer’s Australia Dementia Research Foundation (AADRF) Fellowship #DGP13F00005. Butterworth is funded by Australian Research Council (ARC) Future Fellowship #FT13101444. Olesen and Leach are funded by Australian National Health and Medical Research Council (NHMRC) Early Career Fellowships #1035690 and #1035803, respectively. This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaHCSIA or the Melbourne Institute.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

The HILDA survey was approved by the Human Research Ethics Committee at the University of Melbourne and is therefore in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All respondents gave their informed consent prior to their participation.

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Correspondence to Kim M. Kiely.

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Kiely, K.M., Leach, L.S., Olesen, S.C. et al. How financial hardship is associated with the onset of mental health problems over time. Soc Psychiatry Psychiatr Epidemiol 50, 909–918 (2015). https://doi.org/10.1007/s00127-015-1027-0

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  • DOI: https://doi.org/10.1007/s00127-015-1027-0

Keywords

  • Cohort study
  • Health inequalities
  • Material deprivation
  • Mental health
  • Poverty