title: Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults.
abstract: OBJECTIVE
  To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards.
  
  
  METHODS
  Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale.
  
  
  RESULTS
  After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty.
  
  
  CONCLUSIONS
  To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia. emily.callander@sydney.edu.au.|Health Economics, Level 2, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. emily.callander@sydney.edu.au.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Callander
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia.|Health Economics, Level 2, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Schofield
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000523:psychology*; D018570:Risk Assessment; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: Income; K10; Longitudinal analysis; Poverty; SF36