The Longitudinal Relationship Between Financial Hardship and Mental Health

Abstract

Mental disorder continues to be a leading contributor to global disease burden and cause of disability worldwide. Despite significant expansion of treatment services the prevalence of common mental disorders has remained stable for at least thirty years in many high-income developed countries.

Decades of research have consistently demonstrated the risks posed to mental health of socioeconomic disadvantage. However, it is possible that action upon the recommendations of this work has flagged. In turn, the underlying social conditions driving mental illness have potentially remained under-addressed, and the underlying risk to mental health associated with socioeconomic disadvantage has persisted for sizeable portions of the population.

The majority of work assessing the relationship between socioeconomic disadvantage and health outcomes uses relative income poverty lines. However, given the changes that have occurred within the Australian economy since the turn of the century, this approach may not fully capture the extent of disadvantage experienced across the population. Therefore, this body of work seeks to extend the literature, and inform future prevention efforts, by using an outcome-based measure of socioeconomic disadvantage – namely financial hardship – and assessing its longitudinal relationship with mental health.

Within this framework, a systematic review of 94 international, peer-reviewed studies, along with a series of cross-sectional and longitudinal analyses using up to 23 waves of the HILDA Survey from 2001 to 2023, demonstrated a substantial and highly robust association between financial hardship and mental health. The prevalence of financial hardship in Australia between 2001 and 2023 was also examined, along with the temporal precedence between hardship and mental health, the extent to which longitudinal profiles of hardship exist, and the relationship of these profiles with mental health. The implications of these findings are discussed.