Background Universal Credit, a welfare benefit reform in the UK, began to replace six existing benefit schemes in April, 2013, starting with the income-based Job Seekers Allowance. We aimed to determine the effects on mental health of the introduction of Universal Credit.Methods In this longitudinal controlled study, we linked 197 111 observations from 52 187 individuals of working age (16-64 years) in England, Wales, and Scotland who participated in the Understanding Society UK Longitudinal Household Panel Study between 2009 and 2018 with administrative data on the month when Universal Credit was introduced into the area in which each respondent lived. We included participants who had data on employment status, local authority area of residence, psychological distress, and confounding variables. We excluded individuals from Northern Ireland and people out of work with a disability. We used difference-in-differences analysis of this nationally representative, longitudinal, household survey and separated respondents into two groups: unemployed people who were eligible for Universal Credit (intervention group) and people who were not unemployed and therefore would not have generally been eligible for Universal Credit (comparison group). Using the phased roll-out of Universal Credit, we compared the change in psychological distress (self-reported via General Health Questionnaire-12) between the intervention group and the comparison group over time as the reform was introduced in the area in which each respondent lived. We defined clinically significant psychological distress as a score of greater than 3 on the General Health Questionnaire-12. We tested whether there were differential effects across subgroups (age, sex, and education). Findings The prevalence of psychological distress increased in the intervention group by 6•57 percentage points (95% CI 1•69-11•42) after the introduction of Universal Credit relative to the comparison group, after accounting for potential confounders. We estimate that between April 29, 2013, and Dec 31, 2018, an additional 63 674 (95% CI 10 042-117 307) unemployed people will have experienced levels of psychological distress that are clinically significant due to the introduction of Universal Credit; 21 760 of these individuals might reach the diagnostic threshold for depression.Interpretation Our findings suggest that the introduction of Universal Credit led to an increase in psychological distress, a measure of mental health difficulties, among those affected by the policy. Future changes to government welfare systems should be evaluated not only on a fiscal basis but on their potential to affect health and wellbeing.

Studies demonstrate a negative association between community ethnic diversity and indicators of social cohesion (especially attitudes towards neighbours and the community), suggesting diversity causes a decline in social cohesion. However, to date, the evidence for this claim is based solely on cross-sectional research. This article performs the first longitudinal test of the impact of diversity, applying fixed-effects modelling methods to three waves of panel data from the British Household Panel Survey, spanning a period of 18 years. Using an indicator of affective attachment, the findings suggest that changes in community diversity do lead to changes in attitudes towards the community. However, this effect differs by whether the change in diversity stems from a community increasing in diversity around individuals who do not move (stayers) or individuals moving into more or less diverse communities (movers). Increasing diversity undermines attitudes among stayers. Individuals who move from a diverse to a homogeneous community report improved attitudes. However, there is no effect among individuals who move from a homogeneous to a diverse community. This article provides strong evidence that the effect of community diversity is likely causal, but that prior preferences for/against out-group neighbours may condition diversity's impact. It also demonstrates that multiple causal processes are in operation at the individual-level, occurring among both stayers and movers, which collectively contribute to the emergence of average cross-sectional differences in attitudes between communities. Unique insights into the causal impact of community disadvantage also emerge.

Inter-ethnic contact has long been held as a key means of ameliorating possible inter-group tensions and facilitating the integration of increasing immigrant populations into society. However, our understanding of the role of contact in this relationship may be limited due to the omission of contact-valence; that is, whether contact is experienced positively or negatively. This paper integrates the concept of contact-valence into the question of how increasing community diversity affects attitudes towards immigrants via inter-group contact, across Europe. We posit the existence of dual, mediating pathways of both positive and negative inter-group contact. Applying generalized structural equation models to data from the 2014 European Social Survey, we find that living in more diverse communities increases the frequency of positive inter-group contact but also negative inter-group contact. While the former is positively associated with inter-group attitudes the latter is negatively associated. Testing demonstrates that diversity exerts countervailing positive and negative indirect-effects on attitudes towards immigrants via processes of inter-group contact. Furthermore, while the net-effect of diversity on attitudes via contact is positive, attitudes amongst those experiencing more frequent negative contact become progressively worse. Increasing diversity therefore leads to a polarisation in attitudes towards immigration as a result of, and not due to a lack of, inter-group contact.

BackgroundIn most developed countries, governments are implementing policies encouraging older persons to work past 65 years to reduce the burden on societies related to disability benefits and pension payments. Despite this push to extend working lives, we know little about who already works past this age and any inequalities that may exist. Our study investigates the employment rates of those aged 65–75 years of age by educational level, health status and sex in Canada (CAN), Denmark (DK), Sweden (SE) and the United Kingdom (UK). Secondly, we aim to relate findings on employment rates to prevailing policies in the different countries, to increase the understanding on how to further extend working lives.MethodsWe used nationally representative cross-sectional survey data from the 2012–2013 Canadian Community Health Survey, 2013/14 Survey of Health, Ageing and Retirement in Europe for Denmark and Sweden and the 2013 English Longitudinal Study of Ageing to examine employment rates for those aged 65–75 years by sex, educational level and health status (having limiting longstanding illness (LLI) or not).ResultsEmployment rates decline by age, but we see a linear decline in CAN and the UK compared to an initial decline then a plateau of employment rates from 66 to 68 years in DK and SE. Employment rates among persons aged 65–75 years were lower in the UK than in CAN, DK and SE. Among women, employment rates were highest in SE. Women with low education and a LLI had considerably lower employment rates than men with low education and a LLI (employment rates for men ranged from 27% to 12% compared with employment rates for women which ranged from 12% to 0%).ConclusionsOur results suggest that educational level, sex and health all play a role in extending working lives. The variation in employment rates between the four countries implies that policies do matter, but that social differentials show that policies cannot be ‘one size fits all’. Policy-makers must consider different groups (i.e. low-educated women with a LLI) when designing policies to extend working lives.

Background Keeping older workers in employment is critical for societies facing the challenge of an ageing population. This study examined the association between types of health conditions and differentials in the probability of employment by level of education among men and women between 60-69 years of age in Canada, Denmark, Sweden and England. Methods Data were drawn from the Canadian Community Health Survey, Survey of Health, Ageing and Retirement in Europe and English Longitudinal Study of Ageing. We combined country data, applied logistic regression, adjusted for educational level, and stratified the analysis by sex to calculate the odds ratio (OR) of employment (>15 hours work per week) for persons with physical health conditions, mental health conditions (depression) and physical-mental health comorbidity.

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