Baby Bump or Baby Slump? COVID-19, Lockdowns, and their Effects on Births in Australia.

This study examines changes in birth rates in Australia during the COVID-19 pandemic and the extent to which such changes were influenced by lockdowns. We use natality data at State and small regional area levels spanning the period from 2011 to 2022. In our empirical approach, we first take advantage of a unique quasi-experimental setting that arose in Victoria, Australia's second most populous State, during the first year of the pandemic. Victoria imposed a 111-day stay-at-home lockdown while other States and Territories enforced milder restrictions on social and economic activities. We then exploit lockdowns that lasted more than three months in Victoria and New South Wales in the second year of the pandemic. Within these quasi-experimental settings, our empirical approach was to first use monthly data at the State-level and estimate birth rate deviations from secular trends for the months affected by COVID-19 policies. We also estimate separate models to examine variations in births across regional areas with different compositions of Indigenous population, unemployment, low-income, and non-English speaking residents. Our findings reveal a nationwide fertility increase in 2021, but Victoria exhibited slower growth, especially in areas with higher unemployment, lower income, and more non-English speaking residents. In 2022, we find evidence of a gradual return of birth rates to pre-pandemic trends, though this is mainly concentrated in the major cities. While the second-year lockdowns had limited impacts, language-diverse areas still mostly experienced lower rates of growth in birth rates.

Quantifying the human impact of Melbourne's 111-day hard lockdown experiment on the adult population.

Lockdown was used worldwide to mitigate the spread of severe acute respiratory syndrome coronavirus 2 and was the cornerstone non-pharmaceutical intervention of zero-COVID strategies. Many previous impact evaluations of lockdowns are unreliable because lockdowns co-occurred with severe coronavirus disease related health and financial insecurities. This was not the case in Melbourne's 111-day lockdown, which left other Australian jurisdictions unaffected. Interrogating nationally representative longitudinal survey data and quasi-experimental variation, and controlling for multiple hypothesis testing, we found that lockdown had some statistically significant, albeit small, impacts on several domains of human life. Women had lower mental health (-0.10 s.d., P = 0.043, 95% confidence interval (CI) = -0.21 to -0) and working hours (-0.13 s.d., P = 0.006, 95% CI = -0.22 to -0.04) but exercised more often (0.28 s.d., P < 0.001, 95% CI = 0.18 to 0.39) and received more government transfers (0.12 s.d., P = 0.048, 95% CI = 0.001 to 0.24). Men felt less part of their community (-0.20 s.d., P < 0.001, 95% CI = -0.30 to -0.10) and reduced working hours (-0.12 s.d., P = 0.004, 95% CI = -0.20 to -0.04). Heterogeneity analyses demonstrated that families with children were driving the negative results. Mothers had lower mental health (-0.27 s.d., P = 0.014, 95% CI = -0.48 to -0.06), despite feeling safer (0.26 s.d., P = 0.008, 95% CI = 0.07 to 0.46). Fathers increased their alcohol consumption (0.35 s.d., P = 0.002, 95% CI = 0.13 to 0.57). Some outcomes worsened with lockdown length for mothers. We discuss potential explanations for why parents were adversely affected by lockdown.

The impact of lockdowns during the COVID-19 pandemic on fertility intentions.

Lockdown edicts during the COVID-19 pandemic have led to concerns about consequences for childbirth plans and decisions. Robust empirical research to either refute or confirm these concerns, however, is lacking. To evaluate the causal impact of lockdowns on fertility, we exploited a large sample of Australians (aged 18-45) from a nationally representative household panel survey and leveraged variation from a unique natural experiment that occurred in Australia in 2020: a lockdown imposed in the state of Victoria, but not elsewhere in Australia. Difference-in-differences models were estimated comparing changes in fertility intentions of persons who resided in Victoria during lockdown, or within four weeks of the lockdown being lifted, and those living elsewhere in Australia. Results revealed a significantly larger decline in reported intentions of having another child among women who lived through the protracted lockdown. The average effect was small, with fertility intentions estimated to fall by between 2.8% and 4.3% of the pre-pandemic mean. This negative effect was, however, more pronounced among those aged over 35 years, the less educated, and those employed on fixed-term contracts. Impacts on men's fertility intentions were generally negligible, but with a notable exception being Indigenous Australians.

Jobless parents, unhealthy children? How past exposure to parental joblessness influences children's future health.

Rationale: Despite a growing body of work investigating the combined effects of maternal and paternal joblessness for children's outcomes, very little is known about the long-term effects of parental joblessness on children's health, and especially health during adulthood. Objective: The primary objective of this study is to directly test whether exposure to parental joblessness during childhood and early adulthood has adverse consequences for health in later years. This study also explores whether family resources, time inputs and family harmony mediate this relationship. Methods: Multilevel generalized structural equation models describing processes influencing child health outcomes in later life are estimated using longitudinal data from 19 waves of the Household, Income and Labour Dynamics in Australia Survey (N = 2875 individuals and 22,942 person-year observations). Results: Parental joblessness, especially when experienced over a protracted period, is found to impose a penalty on children's mental health in later life, which is mostly not mediated by other variables. A significant negative association with general health is also found, but in this case family income and family harmony play a more important mediating role. Conclusion: The results suggest that it is not parental job loss per se that matters, but parents not being able to quickly find alternative employment. It is only children in families where joblessness is protracted and long-lasting who are at serious risk of long-term health problems. In sum, our results imply that the parental outcome that is most important for children's later health, and especially their mental health, is continuous paid employment. Such findings provide support for a jobs-first policy emphasis.

Effect of lockdown on mental health in Australia: evidence from a natural experiment analysing a longitudinal probability sample survey.

BACKGROUND: Many studies have examined population mental health during the COVID-19 pandemic but have been unable to isolate the direct effect of lockdowns. The aim of this study was to examine changes in the mental health of Australians aged 15 years and older during the COVID-19 pandemic using a quasi-experimental design to disentangle the lockdown effect. METHODS: We analysed data from ten annual waves (2011-20) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to identify changes in the mental health of respondents from the pre-COVID-19 period (2011-19) to the COVID-19 period (2020). Difference-in-differences models were used to compare these changes between respondents in the state of Victoria who were exposed to lockdown at the time of the 2020 interviews (treatment group) and respondents living elsewhere in Australia (who were living relatively free of restrictions; control group). The models included state, year (survey wave), and person-specific fixed effects. Mental health was assessed using the five-item Mental Health Inventory (MHI-5), which was included in the self-complete questionnaire administered during the survey. FINDINGS: The analysis sample comprised 151 583 observations obtained from 20 839 individuals from 2011 to 2020. The treatment group included 3568 individuals with a total of 37 578 observations (34 010 in the pre-COVID-19 and 3568 in the COVID-19 period), and the control group included 17 271 individuals with 114 005 observations (102 867 in the pre-COVID-19 and 11 138 in the COVID-19 period). Mean MHI-5 scores did not differ between the treatment group (72·9 points [95% CI 72·8-73·2]) and control group (73·2 points [73·1-73·3]) in the pre-COVID-19 period. In the COVID-19 period, decreased mean scores were seen in both the treatment group (69·6 points [69·0-70·2]) and control group (70·8 points [70·5-71·2]). Difference-in-differences estimation showed a small but statistically significant effect of lockdown on MHI-5 scores, with greater decline for residents of Victoria in 2020 than for those in the rest of Australia (difference -1·4 points [95% CI -1·7 to -1·2]). Stratified analyses showed that this lockdown effect was larger for females (-2·2 points [-2·6 to -1·7]) than for males (-0·6 [-0·8 to -0·5]), and even larger for women in couples with children younger than 15 years (-4·4 points [-5·0 to -3·8]), and for females who lived in flats or apartments (-4·1 points [-5·4 to -2·8]) or semi-detached houses, terraced houses, or townhouses (-4·8 points [-6·4 to -3·2]). INTERPRETATION: The imposition of lockdowns was associated with a modest negative change in overall population mental health. The results suggest that the mental health effects of lockdowns differ by population subgroups and for some might have exaggerated existing inequalities in mental health. Although lockdowns have been an important public health tool in suppressing community transmission of COVID-19, more research is needed into the potential psychosocial impacts of such interventions to inform their future use. FUNDING: US National Institutes of Health.

Intergenerationally penalized? The long-term wage consequences of parental joblessness.

Studies of intergenerational stratification and mobility have long called for investigation of the joint role of mothers and fathers in affecting labor market outcomes of children. However, long-term effects of parental joblessness-where no co-residing parent is employed at a given time-are not well understood. Using longitudinal data (covering 9942 person-year observations from 2281 children) from the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, this study investigates the long-term association between parental joblessness and children's wages during early adulthood. It examines whether these associations are mediated by family income during childhood and adolescence, educational attainment, and subsequent employment inactivity of the child, and whether exposure at earlier ages is associated with more detrimental effects. Multilevel mixed-effects models regressing hourly wages in early adulthood (observed over 2008-2018) on the proportion of time spent living in a household where no parent is employed (observed over 2001-2007) reveal two major findings. First, exposure to parental joblessness during childhood and adolescence is correlated with adverse wage outcomes during early adulthood in addition to previously documented employment penalties, with similar estimates across age groups. Second, mediation analyses indicate that household income, children's educational attainment, and children's own inactivity reduce the magnitude of this wage penalty, but do not completely offset it.

Is casual employment in Australia bad for workers' health?

OBJECTIVES: This paper assessed the impact of working in casual employment, compared with permanent employment, on eight health attributes that make up the 36-Item Short Form (SF-36) Health Survey, separately by sex. The mental health impacts of casual jobs with irregular hours over which the worker reports limited control were also investigated. METHODS: Longitudinal data from the Household, Income and Labour Dynamics in Australia Survey, over the period 2001-2018, were used to investigate the relationship between the eight SF-36 subscales and workers' employment contract type. Individual, household and job characteristic confounders were included in dynamic panel data regression models with correlated random effects. RESULTS: For both men and women, health outcomes for casual workers were no worse than for permanent workers for any of the eight SF-36 health attributes. For some health attributes, scores for casual workers were higher (ie, better) than for permanent workers (role physical: men: ß=1.15, 95% CI 0.09 to 2.20, women: ß=1.79, 95% CI 0.79 to 2.80; bodily pain: women: ß=0.90, 95% CI 0.25 to 1.54; vitality: women: ß=0.65, 95% CI 0.13 to 1.18; social functioning: men: ß=1.00, 95% CI 0.28 to 1.73); role emotional: men: ß=1.81, 95% CI 0.73 to 2.89, women: ß=1.24, 95% CI 0.24 to 2.24). Among women (but not men), mental health and role emotional scores were lower for irregular casual workers than for regular permanent workers but not statistically significantly so. CONCLUSIONS: This study found no evidence that casual employment in Australia is detrimental to self-assessed worker health.

Trends in the Prevalence of Psychological Distress Over Time: Comparing Results From Longitudinal and Repeated Cross-Sectional Surveys.

Background: While there is discussion of increasing rates of mental disorders, epidemiological research finds little evidence of change over time. This research generally compares cross-sectional surveys conducted at different times. Declining response rates to representative surveys may mask increases in mental disorders and psychological distress. Methods: Analysis of data from two large nationally representative surveys: repeated cross-sectional data from the Australian National Health Survey (NHS) series (2001-2017), and longitudinal data (2007-2017) from the Household, Income and Labor Dynamics in Australia (HILDA) Survey. Data from each source was used to generate weighted national estimates of the prevalence of very high psychological distress using the Kessler Psychological Distress scale (K10). Results: Estimates of the prevalence of very high psychological distress from the NHS were stable between 2001 and 2014, with a modest increase in 2017. In contrast, the HILDA Survey data demonstrated an increasing trend over time, with the prevalence of very high distress rising from 4.8% in 2007 to 7.4% in 2017. This increase was present for both men and women, and was evident for younger and middle aged adults but not those aged 65 years or older. Sensitivity analyses showed that this increase was notable in the upper end of the K10 distribution. Conclusions: Using household panel data breaks the nexus between declining survey participation rates and time, and suggests the prevalence of very high psychological distress is increasing. The study identifies potential challenges in estimating trends in population mental health using repeated cross-sectional survey data.

Psychological distress and sickness absence: Within- versus between-individual analysis.

BACKGROUND: Uncertainty remains whether associations for psychological distress and sickness absence (SA) observed between and within individuals differ, and whether age, gender and work-related factors moderate these associations. METHODS: We analyzed SA records of 41,184 participants of the Finnish Public Sector study with repeated survey data between 2000 and 2016 (119,024 observations). Psychological distress was measured by the General Health Questionnaire (GHQ-12), while data on SA days were from the employers' registers. We used a hybrid regression estimation approach adjusting for time-variant confounders-age, marital status, occupational class, body mass index, job contract type, months worked in the follow-up year, job demand, job control, and workplace social capital-and time-invariant gender (for between-individual analysis). RESULTS: Higher levels of psychological distress were consistently associated with SA, both within- and between-individuals. The within-individual association (incidence rate ratio (IRR) 1.68, 95% CI 1.61-1.75 for SA at high distress), however, was substantially smaller than the between-individual association (IRR 2.53, 95% CI 2.39-2.69). High levels of psychological distress had slightly stronger within-individual associations with SA among older (>45 years) than younger employees, lower than higher occupational class, and among men than women. None of the assessed work unit related factors (e.g. job demand, job control) were consistent moderators. LIMITATIONS: These findings may not be generalizable to other working sectors or cultures with different SA policies or study populations that are male dominated. CONCLUSIONS: Focus on within-individual variation over time provides more accurate estimates of the contribution of mental health to subsequent sickness absence.

Parental joblessness and the moderating role of a university degree on the school-to-work transition in Australia and the United States.

Does parental joblessness delay young adults' school-to-work transitions? If so, can a university degree moderate this relationship? We examine these questions using a representative sample of young adults who lived with their parents prior to entering the labor market in Australia (N = 2152) and the U.S. (N = 811) during the period 2001-2015. Results from Cox proportional hazards models demonstrate that parental joblessness (the proportion of time spent living in a household where no parent was employed) is associated with slower school-to-work transitions in both the U.S. and Australia. University degree attainment mitigates much of this negative relationship in Australia, suggesting that parental joblessness is most harmful for Australians who leave school before earning a university degree. There is no evidence for a similar interaction in the U.S., suggesting that the relationship between education, parental joblessness, and the school-to-work transition may depend on contextual factors such as the welfare regime.

Sexual identity, same-same relationships, and health dynamics: New evidence from Australia.

Prior research has found that opposite-sex marital and cohabiting relationships are associated with improvements in health. However, studies examining the health dynamics of same-sex relationships are sparser because few nationally representative longitudinal datasets collect information on adults' sexual identity. Using newly available data on sexual minorities from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we estimate the effects of Lesbian/Gay/Bisexual (LGB) identification and same-sex relationships on health dynamics. We document two key findings. First, sexual minorities in Australia are more likely to engage in risky health behaviors and report worse health than their heterosexual counterparts. Second, after exploiting the longitudinal nature of the HILDA and accounting for selection into relationships using the dynamic panel approach of Kohn and Averett (2014), we find that while opposite-sex partnerships are associated with a 3 to 7 percentage-point decline in risky health behaviors and improved physical and mental health, the health benefits of same-sex relationships are weaker, particularly for men.

Sickness absence and mental health: evidence from a nationally representative longitudinal survey.

OBJECTIVES: Previous studies have consistently reported evidence of large significant associations between measures of psychological health and sickness absence. Some of this association, however, may be confounded by relevant covariates that have not been controlled. By using data with repeated observations from the same individuals, this study aimed to quantify the bias due to unobserved characteristics that are time invariant. METHODS: Longitudinal data from the Household, Income, and Labour Dynamics in Australia (HILDA) Survey were used to estimate negative binomial regression models of the number of annual paid sickness absence days. Observations spanning the period 2005-2012, and covering all employed persons aged 15-64 years, were used (56 348 observations from 13 622 individuals). RESULTS: Significant associations between the number of paid sickness absence days taken each year and scores on the mental health subscale of the SF-36 (MHI-5) were found. Inclusion of correlated random effects (which effectively control for unobserved person-specific factors that do not vary over time), however, resulted in a marked decline in the magnitude of this association. For persons with severe depressive symptoms (MHI-5 ≤52), the estimated incidence rate ratios were in the range 1.13-1.14 for men and 1.10-1.12 for women. CONCLUSIONS: Poor mental health is a risk factor affecting work attendance, but the magnitude of this effect, at least in a country where the rate of sickness absence is relatively low, is modest.

Long working hours and physical activity.

BACKGROUND: It is widely believed that persons employed in jobs demanding long working hours are at greater risk of physical inactivity than other workers, primarily because they have less leisure time available to undertake physical activity. The aim of this study was to test this hypothesis using prospective data obtained from a nationally representative sample of employed persons. METHODS: Longitudinal data from the Household, Income and Labour Dynamics in Australia Survey (93,367 observations from 17,893 individuals) were used to estimate conditional fixed effects logistic regression models of the likelihood of moderate or vigorous physical exercise for at least 30 min, at least four times a week. RESULTS: No significant associations between long working hours and the incidence of healthy levels of physical activity were uncovered once other exogenous influences on activity levels were controlled for. The odds of men or women who usually work 60 or more hours per week exercising at healthy levels were 6% and 11% less, respectively, than those of comparable persons working a more standard 35-40 h/week; however, neither estimate was significantly different from 0 at 95% CI. CONCLUSIONS: The findings suggest that there is no trade-off between long working hours and physical activity in Australia. It is argued that these findings are broadly consistent with previous research studies from Anglo-Saxon countries (where long working hours are pervasive) that employed large nationally representative samples.

What's the good of education on our overall quality of life? A simultaneous equation model of education and life satisfaction for Australia.

Many economists and educators favour public support for education on the premise that education improves the overall quality of life of citizens. However, little is known about the different pathways through which education shapes people's satisfaction with life overall. One reason for this is because previous studies have traditionally analysed the effect of education on life satisfaction using single-equation models that ignore interrelationships between different theoretical explanatory variables. In order to advance our understanding of how education may be related to overall quality of life, the current study estimates a structural equation model using nationally representative data for Australia to obtain the direct and indirect associations between education and life satisfaction through five different adult outcomes: income, employment, marriage, children, and health. Although we find the estimated direct (or net) effect of education on life satisfaction to be negative and statistically significant in Australia, the total indirect effect is positive, sizeable and statistically significant for both men and women. This implies that misleading conclusions regarding the influence of education on life satisfaction might be obtained if only single-equation models were used in the analysis.

Life satisfaction and sexual minorities: Evidence from Australia and the United Kingdom.

Very little is known about how the differential treatment of sexual minorities could influence subjective reports of overall well-being. This paper seeks to fill this gap. Data from two large surveys that provide nationally representative samples for two different countries -Australia and the UK - are used to estimate a simultaneous equations model of life satisfaction. The model allows for self-reported sexual identity to influence a measure of life satisfaction both directly and indirectly through seven different channels: (i) income; (ii) employment; (iii) health (iv) marriage and de facto relationships; (v) children; (vi) friendship networks; and (vii) education. Lesbian, gay and bisexual persons are found to be significantly less satisfied with their lives than otherwise comparable heterosexual persons. In both countries this is the result of a combination of direct and indirect effects.

The Symbol Digit Modalities Test: Normative data from a large nationally representative sample of Australians.

Data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey were used to calculate weighted norms for the written version of the Symbol Digits Modalities Test (SDMT) by gender, 5-year age groups and four levels of educational attainment. The sample comprised 14,456 Australians (47% male; age range 15-100), of whom 25% reported a tertiary qualification, 30% reported a technical qualification (diploma or trade certificate), 16% reported completing Year 12 (final year of high school), and 29% reported their highest level of educational attainment to be Year 11 or below. Participants were excluded if they reported physical or neurological conditions that limited performance. Age, gender, and education were all significantly associated with SDMT performance, as was poor health, and cultural background. The reported norms are of greater scope and precision than previously available and have utility in a range of clinical and research settings. Indeed, normative data for the SDMT that are representative of a national population have not previously been published.

Working time and cigarette smoking: evidence from Australia and the United Kingdom.

Cigarette smoking is a risk factor in a range of serious diseases, including cardiovascular disease, cancer, stroke and type II diabetes. Theory suggests that working long hours will increase smoking propensities among workers. Consequently there is a significant body of evidence on the relationship between working time and smoking. Results, however, are inconsistent and therefore inconclusive. This paper provides new evidence on how working time affects smoking behaviour using nationally representative panel data from Australia (from 2002 to 2011) and the United Kingdom (from 1992 to 2011). We exploit the panel design of the surveys to look at within-person changes in smoking behaviour over time as working time changes. In contrast to most previous studies, this means we control for time invariant aspects of personality and genetic inheritance that may affect both smoking propensities and choice of working hours. We find that working long hours tends to increase the chances that former smokers will relapse, reduce the chances that smokers will quit and increase cigarette consumption among regular smokers, and that these effects tend to become more pronounced for workers who usually work very long hours (50 or more hours a week) compared to those who work moderately long hours (40-49 h a week).

Associations between body mass index and health-related quality of life among Australian adults.

OBJECTIVES: To assess the relationship between body mass index (BMI) and health-related quality of life (HQoL), as measured by the Short Form Health Survey (SF-36) within a sample with broad population coverage. SUBJECTS AND METHODS: Survey data incorporating the SF-36 questionnaire, height and weight were obtained from a nationally representative sample of 9,771 Australians aged 21 or older (4,649 men and 5,122 women). Linear multiple regression methods were employed to estimate the magnitude of association between BMI classes and HQoL variables, adjusting for disability and other covariates. RESULTS: Less than 1% of men and just 3.5% of women were classified as underweight while 52.2% of women and 65.9% of men were classified as overweight or obese. For all SF-36 health dimensions, people with BMI scores in the healthy range reported, on average, higher health-related HQoL scores than underweight and obese people, and HQoL scores decreased with the degree of obesity. Although overweight and obesity were associated with decreasing levels of both physical and emotional well-being, the deterioration in health status was significantly more evident in the physical than in the mental, social or emotional dimensions. CONCLUSIONS: Low and high BMIs were associated with decreasing levels of both physical and emotional well-being, but the deterioration in health status was more consistent in the physical than in other dimensions.

The effects of household joblessness on mental health.

It is widely assumed that the economic and social costs that unemployment gives rise to must be exacerbated where joblessness is concentrated within families. This hypothesis is tested in this paper. Specifically, data from the first five waves of the Household, Income and Labour Dynamics in Australia Survey (HILDA), a nationally representative household panel survey administered in Australia, are used to test whether jobless individuals score worse on a measure of mental health when they live in households with other jobless people. Consistent with previous research, unemployment is found to be associated with lower levels of mental health. No evidence, however, can be found for any additional disadvantage to the unemployed stemming from living in a jobless household.