How much of the effect of disability acquisition on mental health is mediated through employment and income? A causal mediation analysis quantifying interventional indirect effects using data from four waves of an Australian cohort study

Abstract

Objectives There is evidence that disability acquisition causes a decline in mental health, but few studies have examined the causal mechanisms through which the effect operates. This study used a novel approach to mediation analysis to quantify interventional indirect effects (IIEs) through employment and income. Design and setting We used four waves of longitudinal data (2011-2014) from the Household, Income and Labour Dynamics in Australia Survey, a nationally representative survey of Australian households. Participants Working aged individuals who acquired a disability (n=233) were compared with those who remained disability-free in all four waves (n=5419). Primary outcome measure Self-r..