Mental Health Following Acquisition of Disability in Adulthood--The Impact of Wealth

PLoS One. 2015 Oct 7;10(10):e0139708. doi: 10.1371/journal.pone.0139708. eCollection 2015.


Background: Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth.

Methods: We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001-2012) from the Household, Income and Labour Dynamics in Australia survey--a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF-36 as the outcome.

Results: In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5).

Conclusion: The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Australia
  • Cohort Studies
  • Disabled Persons / psychology*
  • Family Characteristics
  • Female
  • Humans
  • Income
  • Longitudinal Studies
  • Male
  • Mental Disorders / economics*
  • Mental Disorders / psychology*
  • Mental Health / economics*
  • Middle Aged
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Work / economics
  • Work / psychology

Grant support

This study was supported by an Australian Research Council Linkage grant (LP100200545) with VicHealth as a funding partner, a postdoctoral research fellowship (to AM) funding (Australian National Health and Medical Research Council Capacity-Victorian Health Promotion Foundation, Melbourne, Victoria, Australia). The HILDA Project was initiated and is funded by the Australian Government Department of Social 334 Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.