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

R Bentley,E Baker,A M Kavanagh,K Mason,S V Subramanian

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 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.

Highlights

A Regression coefficients representing the mean change in Short Form 36 (SF-36) score in individuals whose housing became unaffordable compared with those who remained in affordable housing, adjusted for age, having moved residence since last wave, and equivalized disposable household income
The use of fixed-effects regression analysis, allowing us to look at individual change in response to unaffordable housing, negates the bias generated from unmeasured differences between people
A decline in a person’s mental health may cause his/her housing to become unaffordable, perhaps through job loss or a relationship breakdown. If this were to occur between data collection waves of HILDA, we have no way of knowing if change in mental health preceded a change in housing affordability

Summary

Introduction

A Regression coefficients representing the mean change in SF-36 score in individuals whose housing became unaffordable compared with those who remained in affordable housing, adjusted for age, having moved residence since last wave, and equivalized disposable household income. In Australia in 2004, there were 1.1 million low income households in unaffordable housing [50] and, poor housing affordability has a role in both the creation and maintenance of health inequalities. We have used a large and high quality national longitudinal data set, and this has allowed us to model change in mental health predicted by change in housing affordability and to mount stronger causal arguments.

Results

Conclusion