title: 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. Data on full-time workers from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 21859) show that occupants of contradictory class locations have higher prevalence and odds of depression and anxiety than occupants of non-contradictory class locations. These findings suggest that the effects of class relations on depression and anxiety extend beyond those of SES, pointing to under-studied mechanisms in social epidemiology, for example, domination and exploitation.
authors.affiliation: Department of Epidemiology, Columbia University, USA.
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Prins
authors.affiliation: Department of Epidemiology, Columbia University, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bates
authors.affiliation: Department of Epidemiology, Columbia University, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.affiliation: Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, and Department of Psychiatry, University of Toronto.
authors.forename: Carles
authors.initials: C
authors.lastname: Muntaner
mesh_terms: D000328:Adult; D001007:Anxiety; D030861:Capitalism; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations; D015995:Prevalence; D012923:Social Class; D064890:Social Determinants of Health; D012962:Sociology, Medical; D014481:United States
keywords: epidemiology; mental health and illness; social class; social determinants of health