Longitudinal trends and associations between housing and health among migrants in Australia: evidence from the Building a New Life in Australia study (2013—2023)

Abstract

BACKGROUND: Housing insecurity is a fundamental social determinant of migrant health. While the relationship between housing and health outcomes is well-documented, there is a paucity of longitudinal data examining this association among humanitarian migrants. Accordingly, we aimed to assess i) longitudinal trends in housing insecurity, psychological distress, post-traumatic stress disorder (PTSD), and self-rated health and ii) the longitudinal associations between housing insecurity and mental and physical health outcomes among humanitarian migrants over the period 2013/14 to 2023. METHODS: Data were drawn from the Building a New Life in Australia Longitudinal Study (n = 6978) with repeated measures over six data waves from 2013/14 to 2023. Generalised Estimating Equations with logistic regression were used to test the association between housing insecurity and psychological distress, PTSD and self-rated health, adjusting for potential confounders and time-varying covariates. The adjusted odds ratios (AOR) and the 95% confidence interval were reported to determine the relationship between health and housing insecurity. A p-value < 0.05 was determined statistically significant. RESULTS: We found that the prevalence of housing insecurity decreased significantly, from 73.3% in Wave 1 (2013/14) to 39.7% in Wave 6 (2023). In contrast, psychological distress showed an alternating trend, increasing slightly from 17.2% in Wave 1 to 22.7% in Wave 6. Similarly, PTSD followed a fluctuating trend, decreasing from 34.12% in Wave 1 to 31.3% in Wave 6; self-rated health remained fairly consistent over time. After adjustment, housing insecurity was significantly related to increased odds for psychological distress (AOR = 1.66; 95% CI: 1.43, 1.93), PTSD (AOR = 1.41; 95% CI: 1.24, 1.60), and poor self-rated health (AOR = 1.42; 95% CI: 1.22, 1.66). CONCLUSION: While housing insecurity declined over time, our study presents strong evidence of the longitudinal associations between housing insecurity and (psychological distress, PTSD, and self-rated health) among humanitarian migrants. Addressing housing insecurity through targeted public health and housing policies may improve health outcomes for humanitarian migrants. These findings offer essential information for policymakers by demonstrating that housing insecurity is significantly associated with poorer mental and physical health outcomes among humanitarian migrants.