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Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards.

Methods

Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale.

Results

After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95 % CI 1.31–2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95 % CI 1.37–2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95 % CI 1.80–3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95 % CI 2.63–5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95 % CI 1.04–1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95 % CI 1.32–2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty.

Conclusion

To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.

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Notes

  1. This age range was chosen so that included individuals were of adult working age (21–64 years) for each year throughout the study.

  2. Modified Poisson regression analysis is a Poisson regression with a robust error variance, described by Zou [59]. Poisson regression is generally regarded as an appropriate method of analysis for events with a low probability (such as poverty) when respondents are followed over time [59]. However, traditional Poisson regression produces conservative error estimates [60], and the modified methodology described by Zou [59] provides a way of overcoming this.

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Acknowledgments

Funding for this paper came from a National Health and Medical Research Council (NHMRC) Early Career Fellowship.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

As no research was undertaken on human subjects, ethics approval was not required. The data used in this study was approved by the Commonwealth Department of Social Services.

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Authors and Affiliations

  1. Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia

    Emily J. Callander & Deborah J. Schofield

  2. Health Economics, Level 2, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia

    Emily J. Callander & Deborah J. Schofield

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  1. Emily J. Callander
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  2. Deborah J. Schofield
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Correspondence to Emily J. Callander.

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Callander, E.J., Schofield, D.J. Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults. Soc Psychiatry Psychiatr Epidemiol 50, 1547–1556 (2015). https://doi.org/10.1007/s00127-015-1074-6

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