The ‘double precarity’ of employment insecurity and unaffordable housing and its impact on mental health
Abstract
This paper describes who is most likely to experience household employment insecurity and housing affordability stress - double precarity - and estimates the degree to which housing affordability mediates the effect of employment insecurity on mental health. We use a cohort of 24,201 participants in 2016 Household, Income and Labour Dynamics in Australia survey (6.2 repeated measures on average). We estimate the likelihood of onset of household employment insecurity, housing affordability stress and change in housing costs using longitudinal regression analyses for socio-demographic groups. We assess mediation by estimating how much exposure variable coefficients attenuate with inclusion of a mediator in fixed effects regression models. We also apply causal mediation methods to fixed-effects regression models to better account for exposure-mediator interaction and meet strict model assumptions. If people's households become insecurely employed, there are five times greater odds of them also experiencing housing affordability stress (OR 4.99 95%CI 4.21-5.90). Key cohorts within the population are shown to be especially vulnerable to double precarity - notably single parents (OR 2.91, 95%CI 1.94-4.35) and people who live alone (OR 4.42, 95% CI 3.03-6.45) (compared to couples), and people who are recently separated or divorced (OR 2.59, 95%CI 1.81-3.70). Mediation analysis confirms that household employment insecurity has a small, negative effect on mental health (Beta -0.24, 95%CI -0.38-0.11 on a 1 to 100-point scale with 10-point standard deviation). Estimates from casual mediation analyses suggest housing affordability accounts for 20% of the total effect; likely concentrated in the lowest and highest strata of income. Employment and housing insecurity represent a form of double precarity for people in households with a single income. When we consider the impact on mental health, we find evidence of a causal relationship between insecure employment onset and mental health, around one fifth of which is mediated by changing housing cost and onset of affordability stress.
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Access to affordable, appropriate housing is becoming increasingly challenging for urban populations facing precarious housing conditions.
“One of these key aspects is access to affordable, appropriate housing, which is becoming increasingly challenging for urban populations facing precarious housing conditions (133-135).”
From Bridging Sectors and Disciplines to Gain a Critical Understanding of the Eco-Social Determinants of Health Inequities: The ESDHI-EU Conference (2025) · cites this paper as [133]
Living in substandard, precarious, or unaffordable housing, as well as homelessness, causes physical and mental health complications, making housing a key determinant of health inequity.
“Living in substandard, precarious, or unaffordable housing, as well as homelessness, causes physical and mental health complications, which is why housing is a key determinant of health inequity (133).”
From Bridging Sectors and Disciplines to Gain a Critical Understanding of the Eco-Social Determinants of Health Inequities: The ESDHI-EU Conference (2025) · cites this paper as [133]
Cites
Causal Relationship Between Stressful Life Events and the Onset of Major Depression
Kendler, K. S., Karkowski, L. M., & Prescott, C. A. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.6.837 · Cited by 2,486 · see citing works
Precarious Employment: Understanding an Emerging Social Determinant of Health
Benach, J., Vives, A., Amable, M., Vanroelen, C., Tarafa, G., & Muntaner, C. (2014) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-032013-182500 · Cited by 1,354 · see citing works
Vancea, M., & Utzet, M. (2017) · Scandinavian Journal of Public Health · doi:10.1177/1403494816679555 · Cited by 193 · see citing works
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New evidence on mental health and housing affordability in cities: A quantile regression approach
Baker, E., Pham, N. T. A., Daniel, L., & Bentley, R. (2020) · Cities · doi:10.1016/j.cities.2019.102455 · Cited by 74 · see citing works
Self-citationGarnham, L., Rolfe, S., Anderson, I., Seaman, P., Godwin, J., & Donaldson, C. (2022) · Journal of Housing and the Built Environment · doi:10.1007/s10901-021-09852-x · Cited by 27 · see citing works
Morrison, J., Tumas, N., Moreno Mattar, O., Gutiérrez-Zamora Navarro, M., Pericas, J. M., Martínez Herrera, E., Cash-Gibson, L., Caroz Armayones, J. M., Ruisoto, P., Zografos, C., et al. (2025) · International Journal of Social Determinants of Health and Health Services · doi:10.1177/27551938251343485 · Cited by 4 · see citing works
- Authors
- Bentley, R., Baker, E., & Aitken, Z.
- Affiliations
- The University of Melbourne (AU)
- The University of Adelaide (AU)
- Corresponding author
- Bentley, Rebecca
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 225
- Pages
- 9-16
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2912541401
- Cited by
- 113
- References
- 3
- Citations by year
- 2026: 21 · 2025: 17 · 2024: 18 · 2023: 18 · 2022: 22 · 2021: 12 · 2020: 3 · 2019: 2
- FWCI
- 13.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Australian Research Council (FT150100131, FT1401100872)
- Australian Government Research Training Program
- National Health and Medical Research Council (1093740)
- Australian Government Department of Families, Housing, Community Services and Indigenous Affairs
- Topics
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Housing Market and Economics
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- job insecurity, mental health, mediation, single parents, living alone, household income, housing costs, causal mediation analysis
- MeSH terms
- Adult, Aged, Australia, Costs and Cost Analysis, Employment, Female, Housing, Humans, Male, Mental Health, Middle Aged, Surveys and Questionnaires, Stress, Psychological, Cohort Studies, Young Adult
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