OBJECTIVE: To examine longitudinal associations between mental health and welfare receipt among working-age Australians. METHOD: We analysed 9 years of data from 11,701 respondents (49% men) from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Mental health was assessed by the mental health subscale from the Short Form 36 questionnaire. Linear mixed models were used to examine the longitudinal associations between mental health and income support adjusting for the effects of demographic and socio-economic factors, physical health, lifestyle behaviours and financial stress. Within-person variation in welfare receipt over time was differentiated from between-person propensity to receive welfare payments. Random effect models tested the effects of income support transitions. RESULTS: Socio-demographic and financial variables explained the association between mental health and income support for those receiving student and parenting payments. Overall, recipients of disability, unemployment and mature age payments had poorer mental health regardless of their personal, social and financial circumstances. In addition, those receiving unemployment and disability payments had even poorer mental health at the times that they were receiving income support relative to the times when they were not. The greatest reductions in mental health were associated with transitions to disability payments and parenting payments for single parents. CONCLUSIONS: The poor mental health of welfare recipients may limit their opportunities to gain work and participate in community life. In part, this seems to reflect their adverse social and personal circumstances. However, there remains evidence of a direct link between welfare receipt and poor mental health that could be due to factors such as welfare stigma or other adverse life events coinciding with welfare receipt for those receiving unemployment or disability payments. Understanding these factors is critical to inform the next stage of welfare reform. ; PB was funded by NHMRC fellowship 525410. This paper was funded by the Australian Research Council grant DP120101887 and uses unit record data from the HILDA Survey. The HILDA project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).
BACKGROUND The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. METHODS Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. RESULTS Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. CONCLUSIONS Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies. ; This paper was funded by the Australian Research Council (ARC) grant DP120101887 and uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).
OBJECTIVE: To examine longitudinal associations between mental health and welfare receipt among working-age Australians. METHOD: We analysed 9 years of data from 11,701 respondents (49% men) from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Mental health was assessed by the mental health subscale from the Short Form 36 questionnaire. Linear mixed models were used to examine the longitudinal associations between mental health and income support adjusting for the effects of demographic and socio-economic factors, physical health, lifestyle behaviours and financial stress. Within-person variation in welfare receipt over time was differentiated from between-person propensity to receive welfare payments. Random effect models tested the effects of income support transitions. RESULTS: Socio-demographic and financial variables explained the association between mental health and income support for those receiving student and parenting payments. Overall, recipients of disability, unemployment and mature age payments had poorer mental health regardless of their personal, social and financial circumstances. In addition, those receiving unemployment and disability payments had even poorer mental health at the times that they were receiving income support relative to the times when they were not. The greatest reductions in mental health were associated with transitions to disability payments and parenting payments for single parents. CONCLUSIONS: The poor mental health of welfare recipients may limit their opportunities to gain work and participate in community life. In part, this seems to reflect their adverse social and personal circumstances. However, there remains evidence of a direct link between welfare receipt and poor mental health that could be due to factors such as welfare stigma or other adverse life events coinciding with welfare receipt for those receiving unemployment or disability payments. Understanding these factors is critical to inform the next stage of welfare reform. ; PB was funded by NHMRC fellowship 525410. This paper was funded by the Australian Research Council grant DP120101887 and uses unit record data from the HILDA Survey. The HILDA project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).
BACKGROUND The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. METHODS Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. RESULTS Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. CONCLUSIONS Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies. ; This paper was funded by the Australian Research Council (ARC) grant DP120101887 and uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).
In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 125, S. 105486
Abstract Background National data on dementia prevalence are not always available, yet it may be possible to obtain estimates from large surveys that include dementia screening instruments. In Australia, many of the dementia prevalence estimates are based on European data collected between 15 and 50 years ago. We derived population-based estimates of probable dementia and possible cognitive impairment in Australian studies using the Mini-Mental State Examination (MMSE), and compared these to estimates of dementia prevalence from meta-analyses of European studies. Methods Data sources included a pooled dataset of Australian longitudinal studies (DYNOPTA), and two Australian Bureau of Statistics National Surveys of Mental Health and Wellbeing. National rates of probable dementia (MMSE < 24) and possible cognitive impairment (24-26) were estimated using combined sample weights. Results Estimates of probable dementia were higher in surveys than in meta-analyses for ages 65-84, but were similar at ages 85 and older. Surveys used weights to account for sample bias, but no adjustments were made in meta-analyses. Results from DYNOPTA and meta-analyses had a very similar pattern of increase with age. Contrary to trends from some meta-analyses, rates of probable dementia were not higher among women in the Australian surveys. Lower education was associated with higher prevalence of probable dementia. Data from investigator-led longitudinal studies designed to assess cognitive decline appeared more reliable than government health surveys. Conclusions This study shows that estimates of probable dementia based on MMSE in studies where cognitive decline and dementia are a focus, are a useful adjunct to clinical studies of dementia prevalence. Such information and may be used to inform projections of dementia prevalence and the concomitant burden of disease.
Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes summarize the data by reporting the sample median and one or both of (i) the minimum and maximum values and (ii) the first and third quartiles, but do not report the mean or standard deviation. To include these studies in meta-analysis, several methods have been developed to estimate the sample mean and standard deviation from the reported summary data. A major limitation of these widely used methods is that they assume that the outcome distribution is normal, which is unlikely to be tenable for studies reporting medians. We propose two novel approaches to estimate the sample mean and standard deviation when data are suspected to be non-normal. Our simulation results and empirical assessments show that the proposed methods often perform better than the existing methods when applied to non-normal data. ; anadian Institutes of Health Research (CIHR) KRS-134297 Fonds de recherche du Quebec -Sante (FRQS) Canadian Institutes of Health Research (CIHR) Canadian Institutes of Health Research (CIHR) FRQS Masters Training Awards Vanier Canada Graduate Scholarship FRQS Postdoctoral Training Fellowship Research Institute of the McGill University Health Centre G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University Cumming School of Medicine, University of Calgary Alberta Health Services through the Calgary Health Trust Hotchkiss Brain Institute Senior Health Scholar award from Alberta Innovates Health Solutions Health Research Council of New Zealand Lundbeck International Tehran University of Medical Sciences M-288 Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Washington H133N060033 Baylor College of Medicine H133N060003 University of Michigan System H133N060032 National Health and Medical Research Council of Australia 1002160 Safe Work Australia Australian Research Council FT130101444 European Foundation for Study of Diabetes Chinese Diabetes Society Lilly Foundation Asia Diabetes Foundation Liao Wun Yuk Diabetes Memorial Fund United States National Institute of Mental Health (NIMH) grant 5F30MH096664 United States Department of Health & Human Services National Institutes of Health (NIH) - USA United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Fogarty International Center (FIC) United States Department of Health & Human Services National Institutes of Health (NIH) - USA National Cancer Center United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI) NIH Office of Research for Women's Health through the Fogarty Global Health Fellows Program Consortium 1R25TW00934001 American Recovery and Reinvestment Act United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) R24MH071604 / R34 MH072925/ K02 MH65919 / P30 DK50456 / R24 MH56858 / RO1 MH073687 /RO1-MH069666 / R34MH084673 /R24 MH071604 United States Department of Health & Human Services Centers for Disease Control & Prevention - USA R49 CE002093 St Anne's Community Services, Leeds, UK US National Center for Medical Rehabilitation Research RO1 HD39415 Federal Ministry of Education & Research (BMBF) 01GY1150 United States Department of Health & Human Services National Institutes of Health (NIH) - USA T37 MD001449 / T32 GM07356 Ohio Board of Regents Research and Development Administration Office, University of Macau MYRG2015-00109-FSS Federal Ministry of Education & Research (BMBF) 01 GD 9802/4 ; 01 GD 0101 Federation of German Pension Insurance Institute Federal Ministry of Education & Research (BMBF) Perpetual Trustees Flora and Frank Leith Charitable Trust Jack Brockhoff Foundation Grosvenor Settlement Sunshine Foundation Danks Trust Canadian Institutes of Health Research (CIHR) FRN 83518 Scleroderma Society of Canada Scleroderma Society of Ontario Scleroderma Society of Saskatchewan Sclerodermie Quebec Cure Scleroderma Foundation Inova Diagnostics Inc Euroimmun FRQS Canadian Arthritis Network Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC FRQS Senior Investigator Award National Strategic Reference Framework European Union (EU) Greek Ministry of Education, Lifelong Learning and Religious Affairs (ARISTEIA-ABREVIATE) 1259 Ministry of Health, Labour and Welfare, Japan UK National Institute for Health Research under its Programme Grants for Applied Research Programme RP-PG-0606-1142 Canada Research Chair in Neurological Health Services Research AIHS Population Health Investigator Award National Health and Medical Research Council of Australia 1088313 Netherlands Organization for Health Research and Development 945-03-047 National Health Research Institutes - Taiwan NHRI-EX97-9706PI Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 49086 Reitoria de Pesquisa da Universidade de Sao Paulo 09.1.01689.17.7 Banco Santander 10.1.01232.17.9 Pfizer medical faculty of the University of Heidelberg, Germany 121/2000 Research University Grant Scheme from Universiti Putra Malaysia, Malaysia Postgraduate Research Student Support Accounts of the University of Auckland, New Zealand National Program for Centers of Excellence (PRONEX/FAPERGS/CNPq, Brazil) Pfizer US Pharmaceutical Inc. PQ-CNPq-2 301321/2016-7 Belgian Ministry of Public Health and Social Affairs Pfizer Ministry of Health, Italy UK National Health Service Lothian Neuro-Oncology Endowment Fund Universiti Sains Malaysia United States Department of Health & Human Services United States Health Resources & Service Administration (HRSA) R40MC07840 United States Department of Health & Human Services Agency for Healthcare Research & Quality R36 HS018246 United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Center for Research Resources (NCRR) TL1 RR024135 University of Melbourne Hunter Medical Research Institute Innovatiefonds Zorgverzekeraars Netherlands Organization for Health Research and Development (ZonMw) Mental Health Program 100.003.005 100.002.021 Academic Medical Center/University of Amsterdam Fund for Innovation and Competitiveness of the Chilean Ministry of Economy, Development and Tourism, through the Millennium Scientific Initiative IS130005 US Department of Veteran Affairs US Department of Veteran Affairs United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI) R01 HL079235 American Federation for Ageing Research Robert Wood Johnson Foundation (RWJF) Ischemia Research and Education Foundation