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Housing tenure and affordability and mental health following disability acquisition in adulthood
journal contribution
posted on 2016-02-01, 00:00 authored by A M Kavanagh, Z Aitken, E Baker, Tony LaMontagneTony LaMontagne, Allison Milner, R BentleyAcquiring 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-sample (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.
History
Journal
Social science & medicineVolume
151Pagination
225 - 232Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
ISSN
0277-9536eISSN
1873-5347Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2016, ElsevierUsage metrics
Categories
Keywords
disabilitymental healthhousing tenurehousing affordabilitylongitudinal studyfixed-effects regressioneffect measure modificationScience & TechnologySocial SciencesLife Sciences & BiomedicinePublic, Environmental & Occupational HealthSocial Sciences, BiomedicalBiomedical Social SciencesWORKING AUSTRALIANSCAUSAL DIAGRAMSSOCIAL SUPPORTHOMEINEQUALITIESDYNAMICSMISMATCHQUALITYPEOPLEINCOMEEconomics
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