Household , Income And Labour Dynamics In Australia Research Articles

Staying active, staying sharp: the relationship between physical activity and health-related quality of life for people living with cognitive impairment.

Physical inactivity is a major global health concern and has been identified as a risk factor for cognitive impairment. In Australia, the long-term relationship between physical activity and health-related quality of life (HRQoL) in individuals with cognitive impairment remains under researched. This study aims to address this knowledge gap by using data from a population-based longitudinal study. We used data from two waves (wave 12 [2012] and wave 16 [2016]) of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Our final analytic sample consisted of 1,168 person-year observations from 985 unique individuals. To investigate the association between physical activity and HRQoL, we employed random-effects Generalized Least Squares (GLS) model. We found that participants engaging in physical activity, < 1 to 3 times per week, showed significant positive associations with the Physical Component Summary (PCS) score [β = 4.41, Standard Error (SE) = 0.68], Mental Component Summary (MCS) score (β = 2.55, SE = 0.74), and SF-6D utility value (β = 0.05, SE = 0.007) compared to those who did not perform any physical activity. Similarly, participants who engaged in physical activity more than three times per week to every day had notably higher scores in PCS (β = 7.28, SE = 0.82), MCS (β = 4.10, SE = 0.84), and SF-6D utility values (β = 0.07, SE = 0.009). There is clear evidence that performing physical activity is positively associated with improved HRQoL in people with cognitive impairment. Our findings underscore the critical role of public health initiatives, such as health education and community-based programs, in promoting physical activity to enhance the HRQoL of older Australians living with cognitive impairment.

Unraveling the dyadic dynamics: exploring the impact of flexible working arrangements’ availability on satisfaction with work-life flexibility among working parents

Despite ample research on the association between the availability of flexible working arrangements (FWAs) and satisfaction from an individual perspective, little has explored the dyadic correlation between the availability of FWAs and satisfaction with work-life flexibility (WLF) from a couple-level perspective among working parents. Drawing on a linked lives perspective and the work-family border theory, this study contributes to the literature by adopting the longitudinal couple-level dyadic data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey (2001–2021) to examine how couples’ availability of FWAs affects their own and their spouses’ satisfaction with WLF among working parents. The results show that among couples with children, mothers’ availability of FWAs significantly improves their own and their husbands’ satisfaction with WLF. In contrast, fathers’ access to FWAs only improves their own satisfaction with WLF. Moreover, the impact of one’s availability of FWAs on their satisfaction with WLF, as well as the effects of mothers’ availability of FWAs on their husbands’ satisfaction, are more pronounced among formal contract workers. Overall, this study underscores the dyadic association between couples’ FWAs and satisfaction with WLF among working parents, delineating an asymmetric dynamic.

Cognitive impairment and self-reported health outcomes among older adults: Longitudinal evidence from Australia.

Australia's population is ageing, with forecasts indicating that individuals aged 65years and over will account for >20% of the total population by 2066. Ageing is strongly linked with a significant decrease in cognitive capabilities. This study aimed to explore the association between cognitive impairment and four types of health outcomes among older Australians. Data used for this study was collected from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The final analysis consisted of 11,146 person-year observations from 7035 unique individuals from Wave 2012 and Wave 2016, respectively. A longitudinal random-effects generalised least squares, and ordered logistic regression were used to analyse the association between cognitive impairment and health outcomes. The study results suggest that cognitive impairment was negatively associated with general health, mental health, self-assessed health and health satisfaction. Older Australians with cognitive impairment scored lower on general health (β=-2.82, SE=0.56), mental health (β=-2.93, SE=0.53), self-assessed health (β=- 0.75, SE=0.10), and health satisfaction (β=-0.19, SE=0.09) compared to the counterparts without cognitive impairment. The heterogeneous results also showed cognitive impairment was associated with poor health outcomes across age groups. This study found evidence that cognitive impairment is associated with poor health outcomes. To enhance the physical and mental health and well-being of older adults, the community, government and non-government organizations, and other stakeholders should prioritize routine healthcare prevention, targeted interventions, and treatment practices, particularly for individuals with or at risk of cognitive impairment.

Working from Home, COVID-19, and Job Satisfaction.

This article examines the impact of the growth in the incidence of working from home during the COVID-19 pandemic on workers' job satisfaction. Using longitudinal data collected in 2019 and 2021 as part of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, fixed-effects models of job satisfaction are estimated. Changes in the share of total weekly work hours usually worked from home are not found to have any significant association with changes in job satisfaction for men. By contrast, a strong significant positive (but nonlinear) association is found for women, and this relationship is concentrated on women with children. These findings suggest the main benefit of working from home for workers arises from the improved ability to combine work and family responsibilities, something that matters more to women given they continue to shoulder most of the responsibility for house and care work.

Physical activity, and improvement in health-related quality of life among Australian middle-aged and older adults living with type 2 diabetes mellitus.

Physical inactivity is a major global public health concern and a recognized risk factor for type 2 diabetes mellitus (T2DM). However, the relationship between physical activity and health-related quality of life (HRQOL) in people with T2DM using longitudinal data remains underexplored. We aim to identify the improvement in HRQOL associated with physical activity in Australian middle-aged and older adults using population-based longitudinal data. Data for this study were drawn from waves 9, 13, 17, and 21 of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. We constructed an unbalanced panel consisting of2,472 person-year observations from 1,270 unique individuals living with T2DM. We used a random effects Generalized Least Squares (GLS) model to examine the relationship between physical activity and HRQOL in people with T2DM. The regression results showed that physical activity is positively associated with physical component summary (PCS), mental components summary (MCS), and health state utility value (SF-6D). People with T2DM engaging in physical activity less than once or 1 or 2 times per week had a higher mean score for PCS (β = 4.28, 95%CI:3.38, 5.17), MCS (β = 2.36, 95%CI:1.38, 3.34), and SF-6D utility value (β = 0.04, 95%CI:0.03, 0.05) than their counterparts engaged in no physical activity. Similarly, engaging in physical activity three times daily per week had a further elevated mean score for PCS (β = 6.65, 95%CI: 5.72,7.60), MCS (β = 3.75, 95%CI:2.71, 4.79), and SF-6D utility value (β = 0.07, 95%CI: 0.06,0.08). Our results showed that physical activity is positively associated with improved HRQOL among people with T2DM. Public health initiatives should prioritize health education and community programs to promote physical activity across all demographics to enhance HRQOL in people living with T2DM.

Residential mobility responses to home damage caused by floods, cyclones and bushfires in Australia

Recent climate disasters serve as a reminder of the growing—yet overlooked—risk of climate-driven displacement in the Global North. This paper contributes to a nascent literature on disaster-induced mobility in high-income countries by extending the evidence to a new context: Australia. Applying propensity score matching to panel data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we conduct the first causal assessment of the impact of home damage caused by extreme weather events on residential mobility in Australia. Our findings suggest that from 2009 to 2022, an annual average of 1.6% of Australians aged 15 + (or ~ 308,000 people a year) experienced home damage caused by floods, cyclones or bushfires. Such damage increases the probability of changing address within 1 year by 56%, displacing an annual average of 22,261 Australians. Cumulatively, this amounts to ~ 312,000 people displaced by climate-induced home damage between 2009 and 2022. Importantly, this type of climate-induced mobility is not evenly spread across the population. Contrary to findings from the Global South, we find no evidence of “entrapment effects”, except for uninsured homeowners. Instead, our results indicate that over 80% of climate-displaced Australians come from the bottom two income quartiles, with the poorest 3% accounting for 14% of the displaced population. The most disadvantaged Australians thus face a double vulnerability: they are both more likely to sustain home damage from extreme weather events and more likely to be displaced. These findings bear important implications for adaptation strategies and policy responses to natural disasters.

Australian Parental Leave Policy, Employers' Cognitive Bias, and Mothers' Wages: Penalty or Premium?

ABSTRACTThis paper utilizes a natural experiment created by Australia's first national mandate for paid parental leave in 2011, to investigate employer‐side mechanisms in motherhood wage penalties. Drawing on literature on cognitive bias, we hypothesize that maternity leave taking behaviors could trigger employer discrimination. We test this proposition by comparing whether and how four types of leave‐taking behaviors affect the wage prospects of working mothers. Using fixed effect models with lagged dependent variables and nationally representative panel data, the Household Income and Labor Dynamics in Australia (HILDA) for the period 2005–2019, this study reveals that before the mandate, mothers who had to use unpaid leave due to ineligibility for employer‐funded leave suffered pay penalties. After the mandate, mothers who forwent paid leave received pay premiums. Our study contributes to debates about parental leave policy and gender discrimination in the labor market by indicating that employers interpret contrasting leave taking behaviors differently, and reward employees in accordance with what they believe maternity leave behaviors imply about working mothers' conformity to the “ideal worker” norm.

Socioeconomic status and adherence to COVID-19 preventative measures in Australia: A national cohort study.

The uptake of recommended preventative measures is a critical concern for protecting the public against COVID-19 outbreaks and future pandemics. However, it is unclear to what extent COVID-19 preventative measures were followed in Australia. This study aims to determine adherence level to COVID-19 preventative measures in 2021, and whether these were associated with socioeconomic status (SES). This was a national cross-sectional study using data from the Household Income and Labour Dynamics in Australia (HILDA) survey. This study included 15 457 community-dwelling adults (18 years or older) who participated in the 2021 wave of HILDA survey. SES was assessed by the Socio-Economic Index For Areas (SEIFA) score, split into quintiles. Outcomes included self-reported adherence to COVID-19 preventative measures (mask wearing, keeping distance, staying home; sum score range 3-15) and COVID-19 status (yes/no). Linear and logistic regression were used accordingly to assess the association between SES and the sum score of adherence to COVID-19 measures, and COVID-19 vaccination status. Adherence to COVID-19 preventative measures and uptake of COVID-19 vaccine in Australia in 2021 were moderate (between 60% and 70%). Regression models showed higher SES was associated with a slightly higher score of adherence (β = .08, 95% CI = .04-.12) and a higher likelihood of self-reporting receiving COVID-19 vaccination (OR 1.27, 95% CI = 1.23-1.31). SES was positively associated with the level of adherence to COVID-19 preventative measures and the probability of receiving COVID-19 vaccine. The findings of this study highlight the potential benefits of considering SES, particularly its impact on equity and access, when designing an educational program or awareness campaign in times of crisis. SO WHAT?: The findings of this study highlight the importance of considering SES when designing an educational program or an awareness campaign in times of crisis.

Understanding loneliness after widowhood: The role of social isolation, social support, self-efficacy, and health-related factors

BackgroundWidowhood negatively affects trajectories of social isolation and loneliness. Given the inevitability of spousal bereavement for many, further investigation into potential modifiers of bereavement-related loneliness is warranted. AimTo examine the moderating effects of social isolation, social support, sociodemographic, self-efficacy, health, and quality of life factors on changes in loneliness before and after widowhood. MethodsWe analysed 19 waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, comprising 749 widowed and 8,418 married individuals (comparison). Coarsened exact matching weights were applied, controlling for age and time trends. Local polynomial smoothed plots illustrated social health trajectories from three years before to three years after spousal death. All analyses were gender-stratified. ResultsLow social isolation and higher social support did not prevent increased loneliness following widowhood. Men in major cities were less likely to experience reductions in social isolation during bereavement, despite being less socially-isolated at baseline than men in regional/remote areas. The bereavement-loneliness relationship was consistent across all subgroups. For men, this relationship was weakened by older age and being born in a non-English-speaking country, but strengthened by poverty and living in a regional/remote areas. For women, it was weakened by older age, and strengthened by factors such as being born in a non-English-speaking country, poverty, employment or volunteering, and having a long-term mental health condition. ConclusionLoneliness is a common and potentially unavoidable experience during widowhood, highlighting the importance of screening by healthcare workers to improve wellbeing and prevent future mental health issues.

Personality and cardiovascular mortality risk: a multi-cohort analysis in individuals with and without pre-existing cardiovascular disease

AbstractThis study investigated the associations between personality traits of the Five Factor Model and cardiovascular mortality, with a specific focus on whether pre-existing cardiovascular conditions modified these associations. We used data from 43,027 participants across five cohort studies: Health and Retirement Study (HRS); Wisconsin Longitudinal Study (WLS); National Social Life, Health, and Aging Project (NSHAP); Midlife in the United States (MIDUS); Household, Income, and Labour Dynamics in Australia (HILDA) with a mean age 55.9 years and 6493 individuals with pre-existing cardiovascular disease. We conducted meta-analyses examining conscientiousness, emotional stability, agreeableness, openness to experience, and extraversion in relation to mortality due to coronary heart disease and stroke. During a mean follow-up of 12.1 years, 1620 participants died from coronary heart disease and 454 from stroke. Lower conscientiousness was associated with higher mortality risk from both coronary heart disease (hazard ratio per 1SD = 0.82, 95%CI = 0.75–0.90) and stroke (HR = 0.84, CI = 0.72–0.99). Lower emotional stability predicted increased coronary heart disease mortality (HR = 0.91, CI = 0.85–0.97). The association between conscientiousness and cardiovascular mortality did not differ between individuals with or without baseline cardiovascular conditions. In addition, adjustments for health behaviors and other covariates only slightly attenuated this association. Other personality traits were not associated with cardiovascular disease mortality. Our findings highlight the role of low conscientiousness, and to a lesser extent low emotional stability, in the development and progression of fatal cardiovascular disease through pathways that may extend beyond established health behaviors.

Nationally representative estimates of food insecurity during COVID‐19: An investigation of the Food Insecurity Experience Scale in Australia

AbstractThe purpose of this paper was to measure the prevalence of food insecurity (FI) in Australia during the COVID‐19 pandemic using the 8‐item Food Insecurity Experience Scale (FIES). Employing the Household, Income and Labour Dynamics in Australia (HILDA) survey, Rasch models alongside a discrete method were used to investigate the severity of FI and robustness of the 8‐item FIES during 2020–2021. Our results indicate that during 2020–2021, 6.47% of Australians experienced moderate or severe FI and 2.93% experienced severe FI. Validation tests following United Nations guidelines show similar weighted and unweighted results and consistency with the discrete method. Infit and outfit metrics, alongside measures of reliability and residual correlations, were all within the expected range. We conclude that the FIES administered as part of Wave 20 of the HILDA survey was a suitable instrument for measuring the prevalence of FI at a representative population level. Although Australia has been measuring FI for 40 years, it has been characterised by measurement inconsistency, inadequacy and infrequency, resulting in insufficient data for policymaking. Reliable representative population estimates of the extent of FI in Australia provides critical intelligence for an effective policy response.

The impact of COVID-19 and the ERS on superannuation savings in Australia

COVID-19 has had a significant economic impact on Australia, and consequently on the superannuation savings of many individuals. To examine COVID-19’s heterogeneous effects across different industries and demographic groups, the impact on superannuation was assessed for 12 representative cameos using a range of Australian data, including Household, Income and Labour Dynamics in Australia (HILDA), ATO, ABS and APRA sources. The marginal impacts of sudden job loss, investment losses, investment switching and participation in the Early Release of Superannuation (ERS) scheme were each investigated in turn. The cameos highlight that some demographic cohorts faced several compounding challenges. For example, many ERS applicants were already facing financial hardship, were more likely to be younger, and faced a higher risk of unemployment. This highlights that COVID-19 has impacted different cohorts in different ways, depending on age, employment status and industry, and family situation, among other factors. JEL Classification: D14, D15, J26, J32

Revisiting Panel Data Binary Choice Models with Lagged Dependent Variables*

This paper revisits the identification and estimation of a class of semiparametric (distribution-free) panel data binary choice models with lagged dependent variables, exogenous covariates, and entity fixed effects. We provide a novel identification strategy, using an “identification at infinity” argument. In contrast with the celebrated Honoré and Kyriazidou (2000), our method permits time trends of any form and does not suffer from the “curse of dimensionality”. We propose an easily implementable conditional maximum score estimator. The asymptotic properties of the proposed estimator are fully characterized. A small-scale Monte Carlo study demonstrates that our approach performs satisfactorily in finite samples. We illustrate the usefulness of our method by presenting an empirical application to enrollment in private hospital insurance using the Household, Income and Labor Dynamics in Australia (HILDA) Survey data.

The fattening speed: Understanding the impact of internet speed on obesity, and the mediating role of sedentary behaviour

We examine the impact of access to high-speed internet on obesity. Using 14 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and a newly constructed dataset on the rollout and adoption rate of the National Broadband Network (NBN) across Australian postcodes, we find that access to high-speed internet has a positive effect on obesity. Specifically, our preferred instrumental variable estimates, which predict the variation in timing and location of internet access upgrades, suggest that a 1 % increase in the proportion of a postcode that has access to NBN is associated with a 1.573 increase in Body Mass Index and a 6.6 percentage point increase in the probability of being obese. These results are robust to several checks and alternative specifications. We also find that sedentary behaviour and inactivity are mechanisms through which access to high-speed internet transmits to obesity.

Gender Differences in Variability in Intimate Relationship Satisfaction: A Secondary Analysis and Meta-Analysis.

There is a long-standing interest in gender differences in satisfaction in intimate relationships. Whereas prior research has focused on gender differences in central tendency (i.e., means), we conducted two studies - a secondary analysis of data from a probability sample of Australian married couples and a meta-analysis - to examine gender differences in variability (i.e., variances). We hypothesized that compared to males, females would demonstrate greater variability in intimaterelationship satisfaction (i.e., greater female variability hypothesis), particularly at lower levels of relationship satisfaction. Results from a secondary analysis of data from 2,711 married couples in the Household, Income and Labour Dynamics in Australia (HILDA) survey and from a meta-analysis of 20 years of research (k = 171, N = 84,976), including independent samples from 33 countries, indicated that relative to males, females reported greater variability in relationship satisfaction. Obtained effect sizes (female-to-male variance ratios [VRs] of 1.42 for the HILDA sample and 1.19 for the meta-analysis) were larger than proposed cutoffs for meaningful group differences in variability. Analysis of tail ratios (ratios of the relative proportion of females divided by the relative proportion of males in the distributional tail regions) in the HILDA sample indicated that gender differences in variability were greater at lower (versus higher) levels of satisfaction. Findings support the greater female variability hypothesis and suggest that by focusing only on gender differences in means, the existing literature has underestimated gender differences in intimaterelationship satisfaction.

Socio-economic inequalities in health-related quality of life and the contribution of cognitive impairment in Australia: A decomposition analysis

BackgroundThe distributional effects of cognitive impairment on inequalities in health-related quality of life (HRQoL) are not well studied. This relationship has not been studied in any Australian health inequality literature. Therefore, this study aims to examine how cognitive impairment affects the distribution of HRQoL across various socio-economic classes amongst older Australians. MethodsData for this study was collected from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The final analysis consisted of 5,247 and 5,614 unique individuals from wave 2012 and wave 2016, respectively. An ordinary least squares (OLS) regression model was used to investigate the relationship between cognitive impairment and HRQoL. Additionally, the Wagstaff-Doorslaer-Watanabe standard concentration index was used to examine socioeconomic inequality in HRQoL. ResultsThe findings revealed pro-rich inequalities in HRQoL, as indicated by the concentration indices of 0.029 and 0.025 for wave 12 and wave 16, respectively. Additionally, the results showed that mild cognitive impairment accounted for 7.60% and 9.03%, respectively, of pro-rich socioeconomic inequality in HRQoL in 2012 and 2016. ConclusionPeople from lower socioeconomic status (SES) groups tend to have lower HRQoL compared to those from higher SES. This leads to a greater disparity in HRQoL based on SES. Cognitive impairment positively contributed to this inequality in HRQoL. Therefore, it is critical to incorporate cognitive impairment into the design of interventions to reduce socioeconomic inequality in HRQoL.

Locus of control and the long-term effects of parental smoking on mental health

RationaleFew studies take a life course perspective to explain if exposure to second-hand smoke in childhood influences mental health in adulthood. Importantly, no study provides empirical evidence on the pathways through which exposure to second-hand smoke in childhood influences mental health in adulthood. There is also limited evidence on the factors that moderate the relationship between second-hand smoke exposure and mental health. To inform policy, it is important to explore the pathways through which second-hand smoke influences mental health and understand factors that are likely to moderate this relationship. ObjectivesThe objective of this paper is to examine if exposure to parental smoking in childhood influences mental health in adulthood. The study examines general health and smoking status in later life as potential channels and if locus of control (LoC), a personality trait developed in childhood and adolescence, moderates the relationship between exposure to parental smoking in childhood and mental health in adulthood. MethodsUsing 21 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA), the study conducts regression analyses that adjust for the potential effects of confounders and other biases. ResultsThe results show that exposure to parental smoking in childhood is associated with a decline in mental health in later life, and that general health status and smoking status in adulthood are channels through which exposure to parental smoking in childhood influences mental health in adulthood. Specifically, those who are exposed to parental smoking in childhood tend to have poorer general health and a higher probability of being smokers in adulthood, both of which negatively impact mental health. The findings point to the moderating role of LoC, such that being more internal on LoC dampens the negative effects of exposure to parental smoking on mental health. ConclusionThe findings from this study lend support to the need to address the long-term implications of behaviours that are harmful to health. The findings also suggest that LoC has implications for an individual's psychological resilience against the negative effects from exposure to parental smoking in childhood.

Impact of rurality on health care utilization among Australian residents from 2009 to 2021.

In Australia, there is limited research regarding the effect of rurality on health care utilization using longitudinal data. We analyzed data from four annual waves (2009, 2013, 2017, and 2021) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to examine changes in the health care utilization over time among urban and rural residents. Poisson regression models estimated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CIs) for rural versus urban residents, accounting for a range of health-related and sociodemographic characteristics. Health care utilization was measured using four key indicators: visits to family doctor or another general practitioner(GP visits from hereon), hospital admissions, total nights' stay in the hospital, and prescribed medications taken on a regular basis. The aIRR for GP visits among rural versus urban Australian residents increased over time, from 0.89 (95% CI: 0.82 to 0.97) in 2009 to 0.96 (95% CI: 0.89 to 1.04) in 2021 although not consistently increased in a statistically significant manner. While there were no consistent temporal patterns, our analysis found that rural residents experienced higher number of hospital admissions (aIRR, 1.12 to 1.15) and number of nights in the hospital in the last 12 months (aIRR, 1.18 to 1.25) compared to urban residents. Moreover, rurality had little to no effect on the number of prescribed medications taken on a regualar basisin the 12 months preceding the HILDA Surveys in 2013, 2017, and 2021. This study found that GP visits were less frequent among rural residents compared to metropolitan residents in 2009, indicating health care access disparities between rural and urban areas in Australia. However, the differences in GP visits between rural and urban areas were less pronounced from 2013 to 2021.

Changes in Personality Traits Predict Future Self-Control

Abstract: Using longitudinal data from over 14,000 participants in the Household, Income, and Labor Dynamics in Australia (HILDA) survey, this study examined how levels of personality traits and their changes predict future self-control. The Big Five traits were assessed at four points between 2005 and 2017. Self-control was evaluated in 2019. For data analysis, latent growth curve analyses were performed. While the initial levels of extraversion and openness showed negligible predictive effects, conscientiousness, emotional stability, and agreeableness more strongly predicted future self-control. Furthermore, the results showed that increases in conscientiousness, emotional stability, and agreeableness were associated with higher future self-control. These results provide new insights into the relationship between personality traits and self-control by showing the predictive power of initial trait levels and their developmental trajectories.

Quality of life impacts associated with comorbid insomnia and depression in adult population

PurposeHealth-related quality of life (HRQoL) impacts of insomnia and depression (as separated entities) have been well investigated in previous studies. However, little is known about the effect of comorbid insomnia and depression on HRQoL. This study aimed to assess the impacts of insomnia and depression, in combination or alone, on HRQoL in Australian adults.MethodsData used in this study were obtained from the large-scale longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey. Insomnia was defined using key insomnia criteria of DSM-V. Depression was based on validated cut-off points of the Mental Health Inventory-5 (MHI-5) (scores ≤ 62) in the base case analysis. HRQoL expressed as utility scores (ranging from 0 to 1) were measured using the Short-Form 6-Dimension (SF-6D) converted from the SF-36 and valued using an Australian scoring algorithm. Multi-level modelling was applied to assess the effect of insomnia and/or depression on utility scores.ResultsThe study analysed 30,972 observations from 10,324 individuals (age [mean ± SD]: 45.7 ± 16.5, female: 54.6%). The proportion of individuals with insomnia only, depression only, and comorbid insomnia and depression was 11.3%, 11.6%, and 8.2%, respectively. The interaction effect suggested the combined impact of insomnia and depression on health-related quality of life beyond the sum of their individual effects. Marginal mean difference in utility scores for insomnia only, depression only, and the comorbidity relative to no insomnia or depression was -0.058 (SE: 0.003, Cohen’s d: 0.420, small effect), -0.210 (SE: 0.003, Cohen’s d: 1.530, large effect), and -0.291 (SE: 0.004, Cohen’s d: 2.120, large effect), respectively.ConclusionComorbid depression and insomnia appear to have very large quality-of-life impacts. Furthermore, this is the first study that has estimated the magnitude of the impact of comorbid insomnia and depression on utility scores which can be utilised in future clinical or economic studies.