@article{ref1,
title="Effects of poverty on mental health in the UK working-age population: causal analyses of the UK Household Longitudinal Study",
journal="International journal of epidemiology",
year="2022",
author="Thomson, Rachel M. and Kopasker, Daniel and Leyland, Alastair and Pearce, Anna and Katikireddi, S. Vittal",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Addressing poverty through taxation or welfare policies is likely important for public mental health; however, few studies assess poverty's effects using causal epidemiology. We estimated the effect of poverty on mental health. <br><br>METHODS: We used data on working-age adults (25-64 years) from nine waves of the UK Household Longitudinal Survey (2009-19; n = 45 497/observations = 202 207 following multiple imputation). We defined poverty as a household equivalized income <60% median, and the outcome likely common mental disorder (CMD) as a General Health Questionnaire-12 score ≥4. We used double-robust marginal structural modelling with inverse probability of treatment weights to generate absolute and relative effects. Supplementary analyses separated transitions into/out of poverty, and stratified by gender, education, and age. We quantified potential impact through population attributable fractions (PAFs) with bootstrapped standard errors. <br><br>RESULTS: Good balance of confounders was achieved between exposure groups, with 45 830 observations (22.65%) reporting poverty. The absolute effect of poverty on CMD prevalence was 2.15% [%-point change; 95% confidence interval (CI) 1.45, 2.84]; prevalence in those unexposed was 20.59% (95% CI 20.29%, 20.88%), and the odds ratio was 1.17 (95% CI 1.12, 1.24). There was a larger absolute effect for transitions into poverty [2.46% (95% CI 1.56, 3.36)] than transitions out of poverty [-1.49% (95% CI -2.46, -0.53)]. Effects were also slightly larger in women than men [2.34% (95% CI 1.41, 3.26) versus 1.73% (95% CI 0.72, 2.74)]. The PAF for moving into poverty was 6.34% (95% CI 4.23, 8.45). <br><br>CONCLUSIONS: PAFs derived from our causal estimates suggest moves into poverty account for just over 6% of the burden of CMD in the UK working-age population, with larger effects in women.<p /> <p>Language: en</p>",
language="en",
issn="0300-5771",
doi="10.1093/ije/dyac226",
url="http://dx.doi.org/10.1093/ije/dyac226"
}