Emma Baker

Association Between Housing Affordability and Mental Health: A Longitudinal Analysis of a Nationally Representative Household Survey in Australia

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 individuals 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 individuals 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 individuals residing in low-to-moderate income households.

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

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 individuals 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 individuals 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 individuals 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 sample, 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.

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

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 individuals, over and above the characteristics of selection. The analysis is based upon 40 828 responses of 10 245 individuals 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.

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

BACKGROUND 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. OBJECTIVES 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

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

Background 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. Methods The authors estimated the relationship between cumulative exposure to HAS and mental health among 15 478 participants in an Australian longitudinal survey between 2001 and 2009. Individuals 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. Results 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). Conclusions While average mental health was lower for individuals 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.

Housing Policy, Housing Assistance and the Wellbeing Dividend: Developing an Evidence Base for Post-GFC Economies

This paper discusses the recent evolution, at a time of turmoil within global financial markets, of Australias housing system and considers the effectiveness of housing assistance responses formulated to assist lo- income Australians. Following the Global Financial Crisis (GFC), housing was recast in the public and political consciousness and received substantial policy attention. In this era of rapidly declining housing affordability as well as threats to the supply of housing finance, the Australian Government renewed its approach to housing assistance. The paper examines housing assistance in Australia and assesses individual outcomes in terms of a ‘wellbeing dividend’. It draws upon on a survey of 1700 low-income households to examine individual outcomes for health and wellbeing across three of Australias major forms of housing assistance. The research clearly shows that while housing assistance makes a positive contribution to wellbeing, not all forms of assistance are equal.

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

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 individuals 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.

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

Abstract This paper contributes insights into the role of tenure in modifying the relationship between housing affordability and health, using a cross-national comparison of similar post-industrial nations—Australia and the United Kingdom—with different tenure structures. The paper utilises longitudinal data from the Household, Income and Labour Dynamics in Australia Survey and British Household Panel Survey to examine change in the mental health of individuals associated with housing becoming unaffordable and considers modification by tenure. We present evidence that the role of tenure in the relationship between housing and health is context dependent and should not be unthinkingly generalised across nations. These findings suggest that the UK housing context offers a greater level of protection to tenants living in unaffordable housing when compared with Australia, and this finds expression in the mental health of the two populations. We conclude that Australian governments could improve the mental health of their economically vulnerable populations through more supportive housing policies.

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

Over the last decade, Australia has experienced ongoing housing affordability decline, and this has been experienced unevenly across the population. Because housing affordability directly affects the type, quality and security of housing that individuals can access, it represents both an important potential source and symptom of disadvantage in Australia. This article examines the nature of the relationship between housing affordability and a central human right—health. It asks two essential questions for Australian policymakers: does poor health predict unaffordable housing? Moreover, does unaffordable housing influence individual health? Analysis was based upon the Household, Income and Labour Dynamics in Australia (HILDA) Survey. We highlight key populations who are most vulnerable to housing affordability problems such as lone parents, their children and older renters, and consider the potential bi-directionality of the pathways between housing affordability and health. We find new, compelling evidence to suggest that such a bi-directional relationship exists between housing affordability and health (especially mental health) in Australia—suggesting that health may influence affordable housing outcomes, while housing affordability may also predict health outcomes. This work opens up new avenues for more causally focused future research in the area.

Housing, place or social networks: what's more important for relocating tenants?

Abstract Urban regeneration is increasingly used by Australian governments as a means of physically upgrading ageing public dwelling stock, but little is known about the social implications of regeneration projects. For public tenants involuntarily relocated for urban regeneration, relocation risks added stress and disruption for an already disadvantaged population. However, it also has the potential to improve residential satisfaction. Moving may provide an opportunity to improve the quality of housing in terms of room size, space and other physical characteristics, the opportunity to live in a better or safer neighbourhood, access to better services and a broadening of social networks. This paper reports on the findings of a research project investigating the comparative influences‐quality of housing, residential environment, and social networks—on residential satisfaction after relocation. Tenants were interviewed before and after relocation from Ferryden Park in South Australia as part of The Parks Urban Regeneration Project, to date Australias largest regeneration project. The study found that in determining the self‐perceived success of relocation, at least for this group of tenants, the quality of the post relocation housing was the most important factor. The implication for planners is that although familial and friendship networks are still important, the quality of post relocation housing is likely to have a greater influence on whether or not tenants are satisfied with moving as part of urban regeneration projects.