abstract: 'Background: The relative importance of income, poverty and unemployment

  status for mental health is unclear, and understanding this has

  implications for income and welfare policy design. We aimed to assess

  the association between changes in these exposures and mental health.

  Methods: We measured effects of three transition exposures between waves

  of the UK Household Longitudinal Study from 2010/11-2019/20 (n=38,697,

  obs=173,859): income decreases/increases, moving in/out of poverty, and

  job losses/gains. The outcome was General Health Questionnaire (GHQ),

  which measures likelihood of common mental disorder (CMD) as a

  continuous (GHQ-36) and binary measure (score =4 = case). We used

  fixed-effects linear and linear probability models to adjust for time

  invariant and time-varying confounders. To investigate effect

  modification, we stratified analyses by age, sex and highest education.

  Results: A 10\% income decrease/increase was associated with a 0.02\%

  increase (95\% CI 0.00, 0.04) and 0.01\% reduction (95\% CI -0.03, 0.02)

  in likelihood of CMD respectively. Effect sizes were larger for moving

  into poverty (+1.8\% {[}0.2, 3.5]), out of poverty (1.8\%, {[}-3.2,

  0.3]), job loss (+15.8\%, {[}13.6, 18.0]) and job gain (11.4\%,

  {[}-14.4, 8.4]). The effect of new poverty was greater for women (+2.3\%

  {[}0.8, 3.9] versus +1.2\% {[}-1.1, 3.5] for men) but the opposite was

  true for job loss (+17.8\% {[}14.4, 21.2] for men versus +13.5\% {[}9.8,

  17.2] for women). There were no clear differences by age, but those with

  least education experienced the largest effects from poverty

  transitions, especially moving out of poverty (2.9\%, {[}-5.7, 0.0]).

  Conclusions: Moving into unemployment was most strongly associated with

  CMD, with poverty also important but income effects generally much

  smaller. Men appear most sensitive to employment transitions, but

  poverty may have larger impacts on women and those with least education.

  As the COVID-19 pandemic recedes, minimising unemployment as well as

  poverty is crucial for population mental health.'
affiliation: 'Katikireddi, SV (Corresponding Author), Univ Glasgow, MRC CSO Social
  \& Publ Hlth Sci Unit, Berkeley Sq,99 Berkeley St, Glasgow G3 7HR, Lanark, Scotland.

  Kromydas, Theocharis; Thomson, Rachel M.; Pulford, Andrew; Green, Michael J.; Katikireddi,
  S. Vittal, Univ Glasgow, MRC CSO Social \& Publ Hlth Sci Unit, Berkeley Sq,99 Berkeley
  St, Glasgow G3 7HR, Lanark, Scotland.

  Pulford, Andrew; Katikireddi, S. Vittal, Publ Hlth Scotland, Edinburgh, Midlothian,
  Scotland.'
article-number: '100909'
author: Kromydas, Theocharis and Thomson, Rachel M. and Pulford, Andrew and Green,
  Michael J. and Katikireddi, S. Vittal
author-email: Vittal.Katikireddi@glasgow.ac.uk
author_list:
- family: Kromydas
  given: Theocharis
- family: Thomson
  given: Rachel M.
- family: Pulford
  given: Andrew
- family: Green
  given: Michael J.
- family: Katikireddi
  given: S. Vittal
da: '2023-09-28'
doi: 10.1016/j.ssmph.2021.100909
earlyaccessdate: SEP 2021
files: []
issn: 2352-8273
journal: SSM-POPULATION HEALTH
keywords: Mental health; Income; Poverty; Employment; Welfare; Health inequalities
keywords-plus: 'DEPRESSIVE SYMPTOMS; INCOME; DISORDERS; WELL; UNEMPLOYMENT; PREVALENCE;

  HAPPINESS; POLICIES; IMPACT; CHILD'
language: English
month: SEP
number-of-cited-references: '52'
orcid-numbers: 'Thomson, Rachel/0000-0002-3060-939X

  Katikireddi, Srinivasa/0000-0001-6593-9092

  Pulford, Andrew/0000-0001-8378-3431

  Green, Michael/0000-0003-3193-2452'
papis_id: 15ac5e0b3a8b5850b9fc5fc5d0cc00ec
ref: Kromydas2021whichis
researcherid-numbers: 'Green, Michael J/E-8370-2012

  '
times-cited: '11'
title: 'Which is most important for mental health: Money, poverty, or paid work? A
  fixed-effects analysis of the UK Household Longitudinal Study'
type: article
unique-id: WOS:000697998100090
usage-count-last-180-days: '0'
usage-count-since-2013: '15'
volume: '15'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2021'