Social class and mental health: testing exploitation as a relational determinant of depression.
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.S. states, we measure social class exploitation as "ownership type" (private for-profit, private not-for-profit, and public) and "managerial domination" (labor relations violations, perceptions of labor-management conflict). Depression is assessed using the original and revised versions of the Center for Epidemiologic Studies Depression Scale (CES-D and CESD-R). Using two-level logistic regressions, we find that private for-profit ownership and higher managerial domination are predictive of depression among nursing assistants even after adjustment for potential confounders and mediators. Our findings confirm the theoretical and empirical value of applying a social class approach to understanding how mental health inequalities are generated through exploitative mechanisms. Ownership type and managerial domination appear to affect depression through social relations that generate mental health inequalities through the process of acquiring profits, controlling production, supervising and monitoring labor, and enforcing disciplinary sanctions.
['Muntaner|Carles|C|', 'Ng|Edwin|E|', 'Prins|Seth J|SJ|', 'Bones-Rocha|Katia|K|', 'Espelt|Albert|A|', 'Chung|Haejoo|H|']
D000328:Adult D003430:Cross-Sectional Studies D003863:Depression D004777:Environment D005260:Female D006707:Homes for the Aged D006801:Humans D008297:Male D008603:Mental Health D008875:Middle Aged D009728:Nursing Assistants D009735:Nursing Homes D016272:Occupational Health D010067:Ownership D012923:Social Class D064890:Social Determinants of Health D012959:Socioeconomic Factors D013315:Stress, Psychological D014481:United States
mental health exploitation depression nursing assistant work organization