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Cumulative exposure to poor housing affordability and its association with mental health in men and women
  1. Rebecca Bentley1,
  2. Emma Baker2,
  3. Kate Mason1
  1. 1Centre for Women's Health, Gender and Society, Melbourne School of Population Health, The University of Melbourne, Australia
  2. 2Centre for Housing, Urban and Regional Planning, School of Geography, Environment and Population, The University of Adelaide, Australia
  1. Correspondence to Dr Emma Baker, Centre for Housing, Urban and Regional Planning, The University of Adelaide 5005, Australia; emma.baker{at}


Background Poor housing affordability affects around 10% of the Australian population and is increasingly prevalent. The authors tested two hypotheses: that cumulative exposure to housing affordability stress (HAS) is associated with poorer mental health and that effects vary by gender.

Methods The authors estimated the relationship between cumulative exposure to HAS and mental health among 15 478 participants in an Australian longitudinal survey between 2001 and 2009. Individuals were classified as being in HAS if household income was in the lowest 40% of the national distribution and housing costs exceeded 30% of income. Exposure to HAS ranged from 1 to 8 annual waves. Mental health was measured using the Short Form 36 Mental Component Summary (MCS) score. To test the extent to which any observed associations were explained by compositional factors, random- and fixed-effects models were estimated.

Results In the random-effects models, mental health scores decreased with increasing cumulative exposure to HAS (up until 4+ years). This relationship differed by gender, with a stronger dose-response observed among men. The mean MCS score of men experiencing four to eight waves of housing stress was 2.02 points lower than men not in HAS (95% CI −3.89 to −0.16). In the fixed-effects models, there was no evidence of a cumulative effect of HAS on mental health; however, lower MCS was observed after a single year in HAS (β=−0.70, 95% CI −1.02 to −0.37).

Conclusions While average mental health was lower for individuals with longer exposure to HAS, the mental health effect appears to be due to compositional factors. Furthermore, men and women appear to experience cumulative HAS differently.

  • Housing affordability
  • health
  • mental health
  • longitudinal
  • housing
  • longitudinal studies

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  • Disclaimer This paper 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) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaHCSIA or the Melbourne Institute.

  • Funding The work was supported by the National Health and Medical Research Council Capacity Building Grant (The Australian Health Inequities Program) as well as a Key Centre for Women's Health in Society Director's Start-up Grant and a Flinders University Establishment Grant.

  • Competing interests None.

  • Ethics approval The Household, Income and Labour Dynamics in Australia Survey was approved by the Faculty of Business and Economics Human Ethics Advisory Committee at the University of Melbourne.

  • Provenance and peer review Not commissioned; externally peer reviewed.