David W. Johnston

National public health awareness campaigns that emphasize peer-to-peer support are increasingly adopted, but evidence on the effects of peer-based programs at scale remains limited. Using quasi-experimental methods, we examine whether the prominent nationwide “R U OK? Day” campaign affects short-term mental health outcomes in Australia. Leveraging survey and administrative data, we find R U OK? Day leads to a 4% of a standard deviation increase in self-reported mental wellbeing, with the effect particularly pronounced among middle-aged males who experience a 9% of a standard deviation increase. We find no detectable effects on mental health care utilization, and we detect no statistically significant changes in suicide-related deaths in the short run, though the mortality outcomes are rare and power is limited. Our results underscore that peer-based campaigns can improve mental wellbeing, especially for high-risk groups, and point to a distinction between short-run psychological responses and outcomes that require behavioural follow-through.

Abused and neglected children are at extreme risk of school dropout, poor health, and destructive behaviours, yet evidence on interventions that prevent maltreatment and its harms is limited. We use a South Australian education reform to examine whether extending the school-leaving age from 16 to 17 improves maltreatment-related outcomes. Using administrative records and regression-discontinuity techniques, we find that the reform reduced first-time cases of maltreatment reported to Child Protection Services (CPS). Among adolescents with past CPS involvement, it also reduced emergency healthcare utilisation. Our findings suggest school attendance can improve child safety, with an incapacitation effect as the likely mechanism.

For people experiencing mental health problems, timely access to high‐quality healthcare is imperative for improving outcomes. However, limited availability of services, high out‐of‐pocket costs, insufficient health literacy and stigmatizing attitudes may mean people do not receive the necessary treatment. We analyze Australian longitudinal data to document the extent and predictors of horizontal inequity in mental healthcare use among people with a newly developed mild or moderate mental disorder. Importantly, we compare people with similar health, residing in the same area, thus controlling for differences in healthcare needs and availability of services. Results suggest that mental healthcare use is not significantly associated with household income or financial hardship. In contrast, we find significant inequities by educational attainment, with university graduates around 50% more likely to receive mental healthcare than high‐school dropouts. These findings are robust across subsamples and alternative modeling approaches, including panel data models with individual fixed‐effects. Additional explorations of the education gradient suggest a potential pathway through mental health‐specific knowledge and attitudes.

After major adversity, some people rely on their religious faith and networks for comfort, support, and material goods and services. Consistent with this behavior are findings that adversity has a positive causal effect on the importance of religion in people's lives. Using a large high‐frequency US dataset, we estimate the causal effects of natural disasters on stated religious importance and attendance at religious services. Effects are identified by comparing changes in outcomes over time within counties affected by a natural disaster with changes over time in other counties from the same state. We find that most estimates are near‐zero in magnitude; for the full sample, for subgroups defined by religious affiliation, demographics, and income, and for different disaster types. However, significant negative effects are found immediately postdisaster, suggesting a short‐term crowding‐out effect in which recovery activities limit time for worship. This explanation is supported by a finding that people are less “well rested” in the first weeks postdisaster.

Non‐communicable diseases (NCDs) disproportionately affect people in low‐ and middle‐income countries (LMICs), yet context‐specific evidence on policies that impact NCD risk factors is lacking. We estimate the impact of a massive Indonesian primary school expansion program in the 1970s on NCD risk factors in later life using data from two surveys with very large sample sizes. We find that in non‐Java regions of Indonesia, the program led to significant increases in the likelihood of overweight and high waist circumference among women, but not among men. The increase for women can be partly explained by increased consumption of high‐calorie packaged and take‐away meals. We find no meaningful impacts on high blood pressure for either sex. Despite the increase in body weight, the program had a negligible impact on diabetes and cardiovascular disease diagnosis. It led to an improvement in women's self‐reported health outcomes in their early‐40s, but these benefits largely disappeared once they reached their mid‐40s.