Class conflict and public health

Wage theft and life expectancy inequities in the United States: A simulation study

Abstract Wage theft – employers not paying workers their legally entitled wages and benefits – costs workers billions of dollars annually. We tested whether preventing wage theft could increase U.S. life expectancy and decrease inequities therein. We obtained nationally representative estimates of the 2001–2014 association between income and expected age at death for 40-year-olds (40 plus life expectancy at age 40) compiled from tax and Social Security Administration records, and estimates of the burden of wage theft from several sources, including estimates regarding minimum-wage violations (not paying workers the minimum wage) developed from Current Population Survey data.

Structural sexism and Women’s alcohol use in the United States, 1988–2016

Abstract Background Women’s alcohol consumption and binge drinking have increased concurrent with socio-economic gains and may be related to structural sexism. Methods We examined associations between structural sexism (state-level sex inequality in political/economic status), and alcohol outcomes among women in Monitoring the Future (N = 20,859) from 1988 to 2016 (ages 27–45 in 2016). We controlled for state and individual confounders and tested three mediators: depressive symptoms, restrictive alcohol norms, and college completion.

The politics of depression: Diverging trends in internalizing symptoms among US adolescents by political beliefs

Abstract Adolescent internalizing symptoms (e.g. depressive affect) have increased over the past decade in the US, particularly among girls. The reasons for these increases are unclear. We hypothesize that increasing exposure to politicized events has contributed to these trends in adolescent internalizing symptoms, and that effects may be differential by political beliefs and sociodemographic characteristics. We analyzed nationally-representative data from 2005 to 2018 Monitoring the Future annual cross-sectional samples of 12th-grade students (N ​= ​86,138).

Free agents or cogs in the machine? Classed, gendered, and racialized inequities in hazardous working conditions

Abstract Introduction: Few epidemiologic studies have used relational social class measures based on control over productive assets and others' labor to analyze inequities in health-affecting working conditions. Moreover, these studies have often neglected the gendered and racialized dimensions of class relations, dimensions which are essential to understanding population patterns of health inequities. Our study fills these gaps. Methods: Using data from the 2002–2018 U.S. General Social Survey, we assigned respondents to the worker, manager, petit bourgeois, or capitalist classes based on their supervisory authority and self-employment status.

US trends in binge drinking by gender, occupation, prestige, and work structure among adults in the midlife, 2006–2018

Abstract Background Rates of binge drinking have nearly doubled among US women ages 30–49 since 2006. Employment influences alcohol use and varies by the prestige and structure (e.g., authority, autonomy, expertise) of one’s occupation. Methods We examined trends in binge drinking among adults ages 30–49 in the labor force in 2006–2018 National Health Interview Surveys (N = 108,981) by occupation, work prestige (General Social Survey’s occupational prestige score), work structure (occupational authority, autonomy, automation, expertise), and gender.

Moral Calculations: Pandemic Coverage Obscures Individual Risk and Social Harm • Protean Magazine

The United States has largely failed in its response to the coronavirus pandemic. Unlike other countries that have eliminated community transmission or suppressed it to low levels, US officials have allowed high levels of the virus to circulate and tolerated the subsequent mass death that has accompanied such a lax public health approach. In addition to needless, preventable sickness and death, another consequence of this state failure has been to shift the moral burden of pandemic decisionmaking onto individuals.

The Disciplining Effect of Mass Incarceration on Labor Organization

Abstract Previous research has described the criminal justice system as a “labor market institution.” In recent years, however, research on the relationship between the criminal justice system and the labor market has focused primarily on the negative impact of criminal justice involvement on an individual’s ability to find work postrelease. This article explores how workers’ exposure to the criminal justice system is related to labor organization—a labor market institution through which workers in the United States have secured benefits for themselves and that, structurally, has mitigated income inequality.

Relational Social Class, Self-Rated Health, and Mortality in the United States

Abstract Applying a relational class theory based on property ownership, authority, and credentials/skill, we analyzed the relationship between class, self-rated health (SRH), and mortality using the 1972–2016 General Social Survey. In a simple measure of class, we assigned respondents to worker, manager, petty bourgeois, or capitalist classes. In a complex measure, we subdivided workers (less-skilled/more-skilled), managers (low/high), and capitalists (small/large). Next, we estimated trends in class structure.

“The Serpent of Their Agonies”: Exploitation As Structural Determinant of Mental Illness

Abstract Background: Social stratification is a well-documented determinant of mental health. Traditional measures of stratification (e.g., socioeconomic status) reduce dynamic social processes to individual attributes downstream of mechanisms that generate stratification. In this study, we measure one process theorized to generate and reproduce social stratification—economic exploitation—and explore its association with mental health. Methods: Data are from the 1983 to 2017 waves of the Panel Study of Income Dynamics, a nationally representative cohort study (base- line N = 3059).

Mental Illness, Drinking, and the Social Division and Structure of Labor in the United States: 2003-2015

Abstract BACKGROUND: We draw on a relational theoretical perspective to investigate how the social division and structure of labor are associated with serious and moderate mental illness and binge and heavy drinking. METHODS: The Panel Study of Income Dynamics and the Occupational Information Network were linked to explore how occupation, the productivity-to-pay gap, unemployment, the gendered division of domestic labor, and factor-analytic and theory-derived dimensions of work are related to mental illness and drinking outcomes.

Social Sequencing to Determine Patterns in Health and Work-Family Trajectories for U.S. Women, 1968-2013

Abstract Background: Women’s social roles (partnership, parenthood, and worker status) are associated with health, with more roles being associated with lower mortality rates. Few studies have examined social roles using a lifecourse perspective to understand how changing role dynamics affect health over time. Sequence analysis is one analytic technique for examining social trajectories. Methods: Work-family trajectories were determined using social sequence analysis. We estimated mortality using age-standardized mortality rates and Poisson regression and examined the impact of personal income as a mediator.

Unequal Depression for Equal Work? How the Wage Gap Explains Gendered Disparities in Mood Disorders

Abstract Mood disorders, such as depression and anxiety, are more prevalent among women than men. This disparity may be partially due to the effects of structural gender discrimination in the work force, which acts to perpetuate gender differences in opportunities and resources and may manifest as the gender wage gap. We sought to quantify and operationalize the wage gap in order to explain the gender disparity in depression and anxiety disorders, using data from a 2001-2002 US nationally representative survey of 22,581 working adults ages 30-65.

Anxious? Depressed? You Might Be Suffering from Capitalism: Contradictory Class Locations and the Prevalence of Depression and Anxiety in the USA

Abstract Despite a well-established social gradient for many mental disorders, there is evidence that individuals near the middle of the social hierarchy suffer higher rates of depression and anxiety than those at the top or bottom. Although prevailing indicators of socioeconomic status (SES) cannot detect or easily explain such patterns, relational theories of social class, which emphasise political-economic processes and dimensions of power, might. We test whether the relational construct of contradictory class location, which embodies aspects of both ownership and labour, can explain this nonlinear pattern.

Two Decades of Neo-Marxist Class Analysis and Health Inequalities: A Critical Reconstruction

Abstract Most population health researchers conceptualize social class as a set of attributes and material conditions of life of individuals. The empiricist tradition of ‘class as an individual attribute’ equates class to an ‘observation’, precluding the investigation of unobservable social mechanisms. Another consequence of this view of social class is that it cannot be conceptualized, measured, or intervened upon at the meso- or macro levels, being reduced to a personal attribute.

Social Class and Mental Health: Testing Exploitation as a Relational Determinant of Depression

Abstract This study tests whether social class exploitation operates as a relational mechanism that generates mental health inequalities in the nursing home industry. We ask, does social class exploitation (i.e., the acquisition of economic benefits from the labor of those who are dominated) have a systematic and predictable impact on depression among nursing assistants? Using cross-sectional data from 868 nursing assistants employed in 50 nursing homes in three U.

Class Conflict and Public Health

How does capitalism make us anxious and depressed? Our work explores how the social division and structure of labor influences population mental health. We draw on social theory to better operationalize social factors as dynamic relational processes rather than individual attributes.

Social epidemiology’s traditional measures of socioeconomic status, like income and education, are the downstream outcomes of dynamic social processes, and do not shed light on the mechanisms generating social stratification in the first place. Our work looks upstream to such mechanisms, specifically economic exploitation and domination.

Our research finds that unconcealed exploitation (not being paid for productive hours) is associated with mental illness; that people in contradictory class locations suffer higher rates of depression and anxiety; and that occupations with lower autonomy, authority, and expertise, and higher automation, are associated with mental illness and substance use.