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Underemployment and its impacts on mental health among those with disabilities: evidence from the HILDA cohort
  1. Allison Milner1,
  2. Tania Louise King1,
  3. Anthony D LaMontagne1,2,
  4. Zoe Aitken1,
  5. Dennis Petrie1,3,
  6. Anne M Kavanagh1
  1. 1 Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Work, Health and Wellbeing Unit, Population Health Research Centre, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
  3. 3 Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Allison Milner, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010, Australia; allison.milner{at}


Background Underemployment (defined as when a person in paid employment works for fewer hours than their desired full working capacity) is increasingly recognised as a component of employment precarity. This paper sought to investigate the effects of underemployment on the mental health of people with disabilities.

Methods Using 14 waves of the Household, Income and Labour Dynamics in Australia survey, we used fixed-effects models to assess whether the presence of a disability modified the association between underemployment and mental health. Both disability and underemployment were assessed as time-varying factors. Measures of effect measure modification were presented on the additive scale.

Results The experience of underemployment was associated with a significantly greater decline in mental health when a person reported a disability (mean difference −1.38, 95% CI −2.20 to −0.57) compared with when they did not report a disability (mean difference −0.49, 95% CI −0.84 to −0.14). The combined effect of being underemployed and having a disability was nearly one point greater than the summed independent risks of having a disability and being underemployed (−0.89, 95% CI −1.75 to –0.03).

Conclusion People with disabilities are more likely to experience underemployment and more likely to have their mental health adversely affected by it. There is a need for more research and policy attention on how to ameliorate the effects of underemployment on the mental health of persons with disabilities.

  • underemployment
  • mental health
  • disabilities
  • employment precarity

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  • Contributors AM designed the study. AM and TLK conducted analysis. ZA provided advice on the analysis. ZA, AMK, DP and ADLM contributed to the interpretation of results. AM wrote the draft with input from all authors. All authors approved the final version of this manuscript and its previous drafts.

  • Funding NHMRC Centre for Research Excellence: Centre of Research Excellence in Disability and Health (APP1116385); ARC Discovery project: Socio-economic and wellbeing outcomes following acquisition of a disability at working age (DP170101434). DP was supported under an ARC Discovery Early Career Award funding scheme (DE150100309).

  • Competing interests None declared.

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

  • Data sharing statement The data are available on application to the Melbourne Institute.