Employment status and mental health among persons with and without a disability: evidence from an Australian cohort study (original) (raw)
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BMJ Open
ObjectivesThere 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.Design and settingThe 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.ParticipantsIndividuals who acquired a disability (n=387) were compared with those who remained disability-free in all four waves (n=7936).Primary outcome measureMental 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.Meth...
BMJ Open, 2021
ObjectivesThere 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.Design and settingWe 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.ParticipantsWorking aged individuals who acquired a disability (n=233) were compared with those who remained disability-free in all four waves (n=5419).Primary outcome measureSelf-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.Statistical analysisWe conducted a causal mediation analysis quantifying IIEs of disability acquisi...
Australian and New Zealand Journal of Public Health, 2020
Objective: To assess the effect of the Australian Disability Support Pension (DSP) on the symptomology of depression and anxiety over and above the effects of reporting a disability itself. Methods: We used the Household Income Labour Dynamics in Australia (HILDA) survey from 2004 to 2017. We used fixed effects regression to understand mental health differences (using the Mental Health Inventory-5 [MHI-5]) when a person reported: i) a disability; or ii) a disability and receiving the DSP) compared to when they reported no disability. The models controlled for time-varying changes in the severity of the disability and other time-related confounders. Results: There was a 2.97-point decline (95%CI-3.26 to-2.68) in the MHI-5 when a person reported a disability compared to waves in which they reported no disability and 4.48-point decline (95%CI-5.75 to-3.22) when a person reported both a disability and being on the DSP compared to waves in which they reported neither. Conclusions: Results suggest that accessing and being in receipt of the DSP can impact the mental health of people with disabilities. Implications for public health: Government income support policies should address the unintended adverse consequences in already vulnerable populations.
The Dynamic Effect of Disability on Work and Subjective Wellbeing in Australia
Social Science Research Network, 2016
The Dynamic Effect of Disability on Work and Subjective Wellbeing in Australia * Using longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2001-2013) we examine the relationship between the dynamics of worklimiting disability and employment, hours of work, earnings and life satisfaction. We employ two alternative classifications of the dynamic trajectories of disability and, in doing so, are able to explicitly consider the influence of disability exit in addition to examining onset by chronicity and severity. After controlling for unobserved individual heterogeneity, we find that the positive impact of disability exit is smaller in magnitude and shorter-lived than the negative impact of onset. Further, while individuals are found to recover from a one period disability within three years, there is no sign of adaptation even after ten years for those whose disability is chronic, defined as evident for three or more years post-onset, and severe.
Mental and physical health: re-assessing the relationship with employment propensity
Work, Employment and Society, 2014
There is significant research demonstrating the labour market disadvantage experienced by the disabled community. Yet, relationships between wider ill-health concepts and employment are poorly investigated. This article presents an empirical investigation into the impacts of poor mental and physical health on the propensity to be employed. The results indicate that activity-limiting physical health and accomplishment-limiting mental health issues significantly affect the propensity to be employed. Further investigations reveal the significance of an interacted variable that captures the multiplicative effect of both physical and mental health, illustrating that the combined effect of both health domains can be more influential than separate pathways. Additional empirical analysis highlights gender and ethnicity divides. It is also found that mental health is mostly exogenous to employment propensity. This research provides evidence that mental and physical health related issues can ...
Mental and physical health: reconceptualising the relationship with employment propensity
2012
While there has been significant research demonstrating the labour-market disadvantage experienced by people with mental health and physical disabilities, influential medical concepts of disability continue to shape explanations of such patterns. From this perspective, a higher rate of unemployment for people with health conditions is rational; they are impaired and are inherently less employable. The evidence from this paper challenges such conceptualisations of disability. It adopts a social model of disability and presents an empirical investigation into the impacts of mental and physical health on the propensity to be employed, yet recognises and addresses its distinct limitations in the case of mental health. Our results indicate that activity-limiting physical health and accomplishment-limiting mental health issues significantly affect the propensity to be employed. Further investigations reveal gender and ethnicity divides and that mental health is mostly exogenous to employm...
Unemployment and mental health--who is (not) affected?
The European Journal of Public Health, 2012
19 Schultz AB, Chen CY, Edington DW. The cost and impact of health conditions on presenteeism to employers: a review of the literature. Pharmacoeconomics 2009;27:365-78. 20 Van der Zee K.I, Sanderman R. Het meten van de algemene gezondheidstoestand met de RAND-36. Een handleiding [Measuring general health status with the RAND-36. A manual]. Groningen: NCG, 1993. 21 Beatty JE, Joffe R. An overlooked dimension of diversity: The career effects of chronic illness. Organ Dyn 2006;35:182-95. 22 Klerk MMY. Rapportage gehandicapten 2000:arbeidsmarkt en financie¨le situatie van mensen met beperkingen en/of chronische ziekten [Report of the handicapped 2000:employment and financial situation of people with limitations and/or chronic diseases].
The dynamic effect of disability on work and subjective well-being
Oxford Economic Papers
Using longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2001-2013) we examine the relationship between the dynamics of worklimiting disability and employment, hours of work, earnings and life satisfaction. We employ two alternative classifications of the dynamic trajectories of disability and, in doing so, are able to explicitly consider the influence of disability exit in addition to examining onset by chronicity and severity. After controlling for unobserved individual heterogeneity, we find that the positive impact of disability exit is smaller in magnitude and shorter-lived than the negative impact of onset. Further, while individuals are found to recover from a one period disability within three years, there is no sign of adaptation even after ten years for those whose disability is chronic, defined as evident for three or more years post-onset, and severe.
PLOS ONE
Objectives Across high-income countries, unemployment rates among workers with disabilities are disproportionately high. The aim of this study was to identify characteristics of employment associated with dropping out of work and assess whether these were different for workers with versus without disabilities. Methods Using a longitudinal panel study of working Australians (2001 to 2015), the current study estimated Kaplan-Meier curves and Cox proportional hazard regression models to identify predictors of leaving employment, including psychosocial job quality, employment arrangement, and occupational skill level. Effect modification by disability status of the relationship between employment-related factors and exit from the labour market were assessed by including interaction terms and assessing model fit with a likelihood ratio test. Models were adjusted for a range of socio-demographic and health related factors. Results Compared to those without disability, those with disability had a greater risk of leaving employment (HR 1.26, 95% CI 1.18 to 1.35, p<0.001). Other predictors of exit from work included low-skilled occupation (HR 1.18, 95% CI 1.07 to 1.29, p = 0.001), being in a job with low psychosocial job quality (HR 1.11, 95% CI 1.03 to 1.19, p = 0.007), and casual, labour hire or fixed-term contract employment (HR 1.58, 95% CI 1.48 to 1.69, p<0.001). There was no effect modification by disability status. Conclusions More research is needed to understand the experiences of workers with disabilities who stay in and leave employment.