Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA

Assigning Responsibility for Depression and Diabetes: Frame Building Factors in Health Coverage

Although frame building is a crucial part of framing in health communication, it is much less understood than media frames or their effects on audiences (i.e. frame setting). To address this research gap, we analyzed the individual, organizational, and external factors of influence contributing to the media's portrayal of responsibility for two major health issues: depression and diabetes. To identify relevant factors, we conducted 23 semi-structured interviews with German journalists who regularly report on these health issues. Our findings indicate that the way in which media coverage portrays responsibilities in depression and diabetes is affected by a variety of factors. These include individual (journalist role perception, journalistic routines, academic background and personal experiences with depression, diabetes-related knowledge, and personal values and beliefs), organizational (editorial lines, space limits, time limitations and payment, and newsroom structures), and external (health news sources, audience interest, newsworthiness, and social norms) factors. Notably, there are differences between depression and diabetes coverage - especially regarding individual factors - confirming that frame building, similar to framing in general, should be examined with regard to specific issues. Nevertheless, some factors that seem important across different topics could be identified.

Multilayer perceptron modeling for social dysfunction prediction based on general health factors in an Iranian women sample

In the year 2022, this research conducted an in-person study involving 780 single or widowed women, aged between 20 and 70, falling within the bottom three economic deciles and possessing varying levels of education. All participants held educational qualifications below a high school diploma and were beneficiaries of charitable financial support in Khorasan province, Iran. The study aimed to investigate the predictive factors of social dysfunction in this specific demographic. Data collection spanned a 12-month period throughout 2022, with participants completing the GHQ-28 questionnaire during their visits to the charity office. Clinical in-person interviews were also conducted to gather comprehensive data. Data analysis was carried out using IBM SPSS version 27. The research employed a Multilayer Perceptron (MLP) neural network model, considering an extensive set of input factors and covariates. These factors included cognitive functioning, anxiety, depression, age, and education levels. The MLP model exhibited robust performance, achieving high overall accuracy and sensitivity in identifying cases of high social dysfunction. The findings emphasized the significance of cognitive functioning, anxiety, and depression as pivotal predictors of social dysfunction within this specific demographic, while education and age displayed relatively lower importance. The normalized importance scores provided a relative measure of each covariate's impact on the model's predictions. These results furnish valuable insights for the development of targeted interventions and evidence-based policies aimed at addressing social dysfunction and promoting societal well-being among economically disadvantaged, single or widowed women. Notably, the research underscores the potential of MLP modeling in social science research and suggests avenues for further research and refinement to enhance the model's predictive accuracy, particularly for cases of low social dysfunction.

Tribute to Barbara Ehrenreich: Fighting for Labor Through Critical Research Journalism

This is a short commentary to accompany the article "Hospital Workers: Class Conflicts in the Making" by Barbara Ehrenreich and John H. Ehrenreich. The article was originally published in the International Journal of Health Services in 1975. We are revisiting it in the current issue of the International Journal of Social Determinants of Health and Health Services due to its continued relevance and significance in the twenty-first Century.

Depressive and anxiety symptoms in first generation college students

Objectives: Depression and anxiety contribute to the burden of disease among college students. The current study determined if depressive and anxiety symptoms were more prevalent in first generation students and if social and emotional support moderated this relationship. Methods: Depressive and anxiety symptoms were measured in 432 U.S. college students via an online survey. Single items determined student generation status and available social support. The CES-D10 and GAD-7 measured depression and anxiety, respectively. Structural equation modeling was used to identify significant effects. Results: First generation status was associated with increased cognitive-emotional (p = 0.036) and somatic (p = 0.013) anxiety symptoms, but not depression. High social and emotional support appeared to suppress somatic anxiety symptoms experienced by first generation students (p = 0.004). Conclusions: Greater anxiety symptoms in first generation students may be due to increased general and acculturative stress, although more research is needed. Large national surveys of college students should consider adding a question about first generation status.

Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research

In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research.

Dead Labor: Mortality Inequities by Class, Gender, and Race/Ethnicity in the United States, 1986-2019

Objectives. To estimate social class inequities in US mortality using a relational measure based on power over productive property and workers' labor. Methods. We used nationally representative 1986-2018 National Health Interview Survey data with mortality follow-up through December 31, 2019 (n = 911 850). First, using business-ownership, occupational, and employment-status data, we classified respondents as incorporated business owners (IBOs), unincorporated business owners (UBOs), managers, workers, or not in the labor force (NLFs). Next, using inverse-probability-weighted survival curves, we estimated class mortality inequities overall, after subdividing workers by employment status and occupation, and by period, gender, race/ethnicity, and education. Results. UBOs, workers, and NLFs had, respectively, 6.3 (95% confidence interval [CI] = -8.1, -4.6), 6.6 (95% CI = -8.1, -5.0), and 19.4 (95% CI = -21.0, -17.7) per 100 lower 34-year survival rates than IBOs. Mortality risk was especially high for unemployed, blue-collar, and service workers. Inequities increased over time and were greater among male, racially minoritized, and less-educated respondents. Conclusions. We estimated considerable mortality inequities by class, gender, and race/ethnicity. We also estimated that class mortality inequities are increasing, threatening population health. Public Health Implications. Addressing class inequities likely requires structural, worker-empowering interventions. (Am J Public Health. 2023;113(6):637-646. https://doi.org/10.2105/AJPH.2023.307227).

The social determinants of ideal cardiovascular health: A global systematic review

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.

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

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. Next, we estimated class, class-by-gender, and class-by-race inequities in compensation/safety, the labor process, control, and conflict, using Poisson models. We also estimated gender-by-race inequities among workers.

RESULTS

We identified substantial class inequities, with worse conditions for workers, which is the largest class within genders and racialized groups, but also disproportionately consists of women and people of color (POC), particularly women of color (WOC). For example, relative to workers, capitalists were less likely to report that safety is not a priority (prevalence ratio [PR]: 0.41, 95% confidence interval [CI]: 0.21, 0.82), repetitive tasks (PR: 0.36, 95% CI: 0.21, 0.61), and lacking freedom (PR: 0.11, 95% CI: 0.05, 0.24). We also identified inequities among workers, with women and POC, particularly WOC, reporting worse conditions than white male workers, especially greater discrimination/harassment (WOC PR: 1.70, 95% CI: 1.36, 2.13).

CONCLUSION

We identified substantial inequities in working conditions across intersecting classes, genders, and racialized groups. These inequities threaten workers' health, particularly among women and POC.

The courage to teach with compassion: Enriching classroom designs and practices to foster responsiveness to suffering

Recognizing the prevalence of suffering among management teachers and students, we raise the importance of compassion as central to the practice of management teaching. To aid in understanding how suffering and compassion arise in management teaching, we call upon a theoretical view of their rhizomatic structure, which conveys the widespread, complex, and largely unspoken spreading of suffering and corresponding need for compassion in the work of management teaching. To meet this suffering with compassion, we propose two clusters of practices central to teaching that lend themselves to helping management teachers see possibilities for more skillfully intertwining suffering and compassion. The first focuses on how management teachers can design the context for teaching in ways that make compassion more likely, focusing specifically on roles and networks. The second draws upon Honneth’s recognitional infrastructure to focus on how teachers can approach the relational practice of teaching with emphasis on enriching human recognition of suffering. We conclude with a caution about overly simplistic approaches and overly individualized views of compassion in the work of management teaching. We call for systemic approaches to action that will enrich our imaginations as we approach management teaching and its role in our collective responsiveness to suffering.

The benefits of a historical-dialectical ontology to critical mental health promotion research

In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued dominance of linear and individually oriented theories within predominantly quantitative research approaches and the underdevelopment of ontological and theoretical perspectives that capture complexity; second, the inconsistent use of measures of socio-economic status and health with a lack of attention to taken for granted assumptions; and third, the continued focus on measuring MH challenges to the neglect of exploring the meaning of MH in a positive sense. We extend recommendations within the PHIR literature by sharing our application of a historical-dialectical ontological perspective within a process of social praxis with diverse Canadian young people with varying degrees of access to socio-economic resources. Young people were engaged to explore the relations among socio-economic processes, young people's MH and implications for mental HP. We argue that this ontological perspective can support the development of structurally oriented critical qualitative research approaches in PHIR.

Correlates of Mental Health Symptoms Among US Adults During COVID-19, March-April 2020

OBJECTIVES

An understanding of mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic is critical to ensure that health policies adequately address the mental health needs of people in the United States. The objective of this study was to examine mental health symptoms among US adults in an early stage of the COVID-19 pandemic.

METHODS

We conducted a cross-sectional study in late March 2020 with a national sample of 963 US adults using an online research platform. Participants self-reported state of residence, psychosocial characteristics, and levels of anxiety, depression, anger, cognitive function, and fatigue in the context of COVID-19 using validated patient-reported outcomes scales in the Patient-Reported Outcome Measurement Information System measures. We used analysis of variance and multivariate linear regression to evaluate correlates of mental health symptoms.

RESULTS

Overall, participants reported high levels of anxiety (mean [SD], 57.2 [9.3]) and depression (mean [SD], 54.2 [9.5]). Levels of anger, anxiety, cognitive function, depression, and fatigue were significantly higher among the Millennial Generation and Generation X (vs Baby Boomers), those with not enough or enough (vs more than enough) financial resources, females vs males), those with self-reported disability (vs no self-reported disability), and those with inadequate (vs adequate) health literacy. In adjusted models, being in Generation X and the Millennial Generation (vs Baby Boomer), having not enough or enough vs more than enough) financial resources, and having inadequate (vs adequate) health literacy were most strongly correlated with worse mental health symptoms.

CONCLUSIONS

Results suggest that mental health symptoms during the early stages of the COVID-19 pandemic were prevalent nationally, regardless of state of residence and especially among young, psychosocially vulnerable groups.

Linking work, occupational identity and burnout: the case of managers

Purpose

Based on identity theory, identity represents a set of meanings individuals hold for themselves based on their role in the society. Hence, they often engage in the process of verifying their role, seeking for the compatibility between these meanings and those perceived in a specific lived situation. If this compatibility is not perceived, this is likely to generate negative emotions. that could compromise their mental health. This paper examines the contribution of a weak verification of role identity in the explanation of managers ‘burnout. It aims at integrating identity theory into occupational stress research by analysing the proposition that a low level of verification of a salient role-identity will be associated with a high level of burnout. Hence, we consider identity salience as a moderating variable.

Design/methodology/approach

Cross-sectional data of 314 Canadian managers employed in 56 Quebec firms. Multilevel regression analyses were performed to analyse the data.

Findings

Low levels of verification of some standards of managers' role identity, mainly work demands and recognition which encompasses (monetary and non-monetary recognition, career prospects and job security) are significantly associated with managers' burnout. Furthermore, as predicted, results show that identity salience plays a moderating role on the relation between a weak verification of some standards of managers' role identity and burnout, mainly work demands, superior support and recognition.

Originality/value

This study proposes a relatively unexplored approach for the study of managers' burnout. It broadens the scope of research on workplace mental health issues, by the integration of the identity theory.

Under capital's thumb: longitudinal associations between relational social class and health

BACKGROUND

We used a relational social-class measure based on property ownership and managerial authority to analyse the longitudinal relationships between class, self-rated health (SRH) and mental illness. To our knowledge, this is the first study using a relational social-class measure to evaluate these relationships longitudinally.

METHODS

Using Panel Study of Income Dynamics data from 1984 to 2017, we first assigned respondents aged 25-64 to the not in the labour force (NILF), worker, manager, petit bourgeois (PB) or capitalist classes based on business ownership, managerial authority and employment status. Next, using Cox models, we estimated the confounder-adjusted associations between 2-year-lagged class and incidence of poor/fair SRH and serious mental illness. We also tested whether the associations varied by gender, whether they persisted after more-fully adjusting for traditional socioeconomic-status measures (education and income) and how they changed temporally.

RESULTS

We identified large inequities in poor/fair SRH. NILFs had the greatest hazard, followed by workers, PBs, managers and capitalists. We also identified large inequities in serious mental illness; NILFs and workers had the greatest hazard, while capitalists had the lowest. Class inequities in both outcomes lessened but remained considerable after confounder and socioeconomic-status adjustment, and we found some evidence that the class-SRH relationship varied by gender, as being NILF was more harmful among men than women. Additionally, class inequities in the outcomes decreased somewhat over time.

CONCLUSION

We identified substantial class inequities in SRH and mental illness. Our findings demonstrate the importance of using relational social-class measures to deepen understanding of health inequities' root causes.

Student trauma experiences, library instruction and existence under the 45th

Purpose

By historicizing the broader system of education contextualized under the 45th presidential administration, this paper aims to provide a nuanced discussion regarding the condition of information literacy and librarianship as capitalist institutions in service to the state. In response, tools to oppose systemic racism and minimize harm in the classroom as well as recommendations for change and resistance are addressed.

Design/methodology/approach

The paper focuses on historical analysis of libraries as institutions within larger educational systems and draws heavily on critical theories as a method of critique.

Findings

This paper demonstrates that the 45th presidential administration is a logical progression of neoliberalism and institutionalized discrimination, which has had adverse effects on the health and safety of (primarily marginalized) students, library workers and library practice, but that critical reflection and information seeking on part of librarians may provide solutions.

Practical implications

This paper can be used as a guide for librarians seeking to contextualize the educational environment and apply a critical praxis to information literacy programs.

Social implications

The reflection presented in this paper can aid in expanding awareness in LIS surrounding issues of equity and justice, and impart urgency and need for institutional change.

Originality/value

Given the lack of diversity in library and information science, this paper provides critical interventions for information literacy practice. The authors’ unique practical and theoretical backgrounds allow for nuanced discussion and pedagogical creation which directly impacts and addresses key issues of justice and equity in the classroom.

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

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. Finally, after gender-stratification, we estimated the relationships between class, SRH, and mortality and, in sensitivity analyses, tested for class-by-race interaction. Class structure changed little over time, with workers constituting over half the population each decade. Concerning SRH, for the simple measure, managers, petty bourgeoisie, and capitalists reported better health than workers. For the complex measure, patterns were similar, although skilled workers reported better health than less-skilled workers, low managers, and petty bourgeoisie. Concerning mortality, for the simple measure, inequities were small among women; among men, only capitalists’ hazard was lower than workers’ hazard. For the complex measure, across genders, the hazards of less-skilled workers and petty bourgeoisie were highest, while skilled workers’ hazard resembled that of managers and capitalists. Finally, we found some evidence that the relationship between class and mortality varied by race, although the estimates were imprecise.

Anxiety and contradictory class position in the hierarchy of Brazilian firefighters

BACKGROUND

Workers holding intermediate hierarchical positions in an institution may have a higher risk of occupational stress-related, ill health. This study examined the prevalence rates and odds ratios (ORs) of anxiety disorders among a hierarchical group of firefighters.

METHODS

This cross-sectional study samples firefighters from Minas Gerais, Brazil, who answered a structured questionnaire in 2011 (survey completion rate = 89.5%). The outcome of interest was a medical diagnosis of anxiety disorder. Bivariate and multivariate analyses were conducted among five hierarchical occupational positions: privates (lowest position), corporals, sergeants (intermediate position), sub lieutenants, and officers (highest position).

RESULTS

Overall, 8.4% of the sample reported an anxiety disorder, with the highest rate observed among intermediate workers (sergeants = 14.2%), followed by corporals (10%), privates (5.6%), sub lieutenants (5%), and officers (2.1%). Compared with privates, the unadjusted OR for sergeants was 2.49 (95% confidence interval, 1.35, 4.58). This finding remained statistically significant after adjustment for several control variables but was eliminated by age.

CONCLUSION

The mental health of firefighters is affected by social class position. Mental health promotion efforts should focus on longitudinal research and work toward interventions aimed at modifying the hierarchical structure of workplaces.

Occupational class, capitalist class advantage and mortality among working-age men

BACKGROUND

Disparities in mortality have been firmly established across occupational grades and the incomes they earn, but this line of research has failed to include individuals' relationships to capital, as suggested by class analysists.

METHODS

According to Wright's classification, the research generated 10 mutually exclusive classes based on occupation and investment income: worker; capitalist worker; professional; capitalist professional; supervisor; capitalist supervisor; manager; capitalist manager; self-employed; and capitalist self-employed. The study participants (n=268 239) were randomly selected from the Statistics Finland population database and represent 33% of Finnish men aged 30-64 years. The mortality data were monitored over the 1995-2014 period.

RESULTS

The sociodemographic-adjusted HRs for mortality were lowest for capitalist managers (HR 0.50; 95% CI 0.36 to 0.69) as compared with that for workers without a capitalist class advantage. A positive occupational class gradient was found from managers to supervisors to workers. The capitalist class advantage independently affected the disparities in mortality within this occupational hierarchy.

CONCLUSION

Different occupational class locations protect against premature death differently, and the capitalist class advantage widens the premature-death disparities among the occupational classes. To monitor and explain social inequalities in health in a more nuanced way, future research on investment income as well as the operationalisation of the capitalist class advantage is encouraged.

Work-life support: the key to managers’ happiness

Purpose

Building on the conservation of resource theory, the authors posit work-life support as an essential resource for middle managers. This paper aims to explore the positive association between work-life support, positive emotion, job satisfaction and happiness. The paper also assesses the moderating role of work pressure on work-life support and positive emotion relationship on the one hand and flextime on positive emotion and job satisfaction on the other.

Design/methodology/approach

Data collected from 512 middle managers of small and medium-sized firms including manufacturing, service and finance sectors in Taiwan were used to test the hypotheses.

Findings

The results reveal that work pressure strengthens the effect of work-life support on positive emotions, whereas time flexibility weakens the effect of positive emotion on job satisfaction. Work-life support positively influences happiness through the intervening variables of positive emotion and job satisfaction.

Practical implications

The paper highlights the importance of creating a positive work environment, as empowering middle managers with work-life support can help them handle work pressure and work-life conflict. The negative influence of flextime on positive emotion and job satisfaction highlights the need for effective handling of flextime.

Originality/value

This paper examines the work-life support and happiness of middle managers in the Chinese cultural context which has been under-explored. This paper expands the external validity of previous research results of Western samples by finding the positive influence of work pressure on work-life fit and positive emotion and negative influence of flextime on positive emotion and job satisfaction link.

Cultures under stress: A cross-national meta-analysis of cortisol responses to the Trier Social Stress Test and their association with anxiety-related value orientations and internalizing mental disorders

Acute cortisol changes are physiological indicators (i.e., biomarkers) of psychosocial stress that have been repeatedly assessed using standardized laboratory protocols like the Trier Social Stress Test (TSST). Despite this methodological standardization, however, cortisol stress responses vary considerably across different studies. Based on multilevel meta-analyses of 237 TSST studies (n = 8487 individuals), we demonstrate that ∼25% of this variability is actually attributable to systematic differences between countries. Particularly North American and European studies show a remarkable effect disparity (d = 0.45 vs. d = 0.73, respectively). Specifically, in-depth analyses suggested that the cultural orientation towards anxiety-related values in English-speaking countries (incl. the UK and Ireland) was associated with decreased cortisol stress responses. This finding was further supported by associations with the regionally varying prevalence of internalizing mental disorders (e.g., major depression or post-traumatic stress disorder) as reported by the WHO World Mental Health Surveys, a larger inequality of family incomes, larger population growth, larger expenses for health and the military, and lower tax rates. The size of these effects is comparable to the most important moderators of cortisol stress responses known to date, that is, male sex and higher age. Based on these observations, we argue that the cortisol stress response may reflect the persistent threats in the sociocultural environment an individual is accustomed too. Highly competitive cultures emphasize the individuals' responsibility for socioeconomic prosperity, but simultaneously increase the collective population stress and thus lower sustainable ontogeny and resilience towards unexpected environmental adversity.

Well-being as a staged social responsibility process for business and society

Purpose

This paper aims to conceptualize how business and society co-evolve their efforts to maximizing the greatest well-being of the greatest number following a conscious-unconscious, staged, dialectical process.

Design/methodology/approach

This study used a conceptual framework linking eight components of well-being (economic, environmental, social, cultural, psychological, spiritual, material and physical), with stages of consciousness and the co-evolution of business and society.

Findings

Stages of consciousness – traditionalist, modernist, post-modernist and integral – moderate both the pace and direction with which business and society co-evolve to the greatest well-being of the greatest number across eight components of well-being.

Research limitations/implications

This is a conceptual framework which integrates existing empirical relationships, but the overall framework itself is yet to be empirically tested.

Practical implications

The whole process of maximizing well-being can become more conscious for both business and society. This requires making unconscious components conscious and becoming conscious of the inseparability of the eight components of well-being as a counter-balanced set.

Social implications

Businesses and societies can maximize well-being across eight inseparable components. But implementing this is a staged process requiring progressing populations through stages of consciousness. Earlier stages lay the platform for a critical mass of people able to integrate the eight components.

Originality/value

Knowledge of well-being is dominated by disciplinary disconnection and bivariate studies; yet, current meta-crises and calls for post-conventional leaders indicate the importance of an integrated multidisciplinary well-being model which explains past efforts of business and society, diagnoses current problems and points towards more viable paths.

Mental illness, drinking, and the social division and structure of labor in the United States: 2003-2015

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.

RESULTS

Occupations involving manual labor and customer interaction, entertainment, sales, or other service-oriented labor were associated with increased odds of mental illness and drinking outcomes. Looking for work, more hours of housework, and a higher productivity-to-pay gap were associated with increased odds of mental illness. Physical/risky work was associated with binge and heavy drinking and serious mental illness; technical/craft work and automation were associated with binge drinking. Work characterized by higher authority, autonomy, and expertise was associated with lower odds of mental illness and drinking outcomes.

CONCLUSIONS

Situating work-related risk factors within their material context can help us better understand them as determinants of mental illness and identify appropriate targets for social change.

Hop Compounds: Extraction Techniques, Chemical Analyses, Antioxidative, Antimicrobial, and Anticarcinogenic Effects

Hop plants comprise a variety of natural compounds greatly differing in their structure and properties. A wide range of methods have been developed for their isolation and chemical analysis, as well as for determining their antioxidative, antimicrobial, and antigenotoxic potentials. This contribution provides an overview of extraction and fractionation techniques of the most important hop compounds known for their health-promoting features. Although hops remain the principal ingredient for providing the taste, stability, and antimicrobial protection of beer, they have found applications in the pharmaceutical and other food industries as well. This review focuses on numerous health-promoting effects of hops raging from antioxidative, sedative, and anti-inflammatory potentials, over anticarcinogenic features to estrogenic activity. Therefore, hops should be exploited for the prevention and even healing of several prevalent diseases like cardiovascular disorders and various cancer types. New ideas for future studies on hops are finally presented: computational investigations of chemical reactivities of hop compounds, nanoencapsulation, and synergistic effects leading to a higher bioavailability of biologically active substances as well as the application of waste hop biomass from breweries for the production of high-added-value products in accordance with the biorefinery concept.

Neo-Marxian social class inequalities in oral health among the South Korean population

AIM

The aims of this study were to examine inequalities in periodontitis and tooth loss among South Korean adults using the Wright's Neo-Marxian social class (NMSC) indicator and to assess the impact of material, psychosocial, health behavioural and workplace environmental factors in the association of social class with oral health.

METHODS

This study used the data from the 4th Korea National Health and Nutrition Examination Survey with 6710 participants aged 19-54 years old. Participants were classified into 12 social class positions based on the Wright's social class map. Healthy gum and absence of tooth loss were the health outcomes. Mediating factors were material (M), psychosocial (PS), health behavioural (HB) and workplace environmental (WPE) factors. A series of logistic regressions were performed to analyse the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results.

RESULTS

For the absence of periodontal pockets status, expert supervisors were the healthiest periodontal group among the social classes (OR = 2.15 95% CI 1.59-2.90) in the age and gender adjusted model. For the absence of tooth loss, skilled workers had the highest OR for absence of tooth loss (OR = 1.64 95% CI 1.31-2.05) in the age- and gender-adjusted model. For absence of periodontal pockets, the explanatory power of the M factor was the highest in all social class positions except for nonskilled supervisors followed by the HB factor. Additionally, the absence of tooth loss had a fairly similar pattern. The explanatory power of the M factor was the highest in all social class positions except for the petty bourgeoisie (highest: HB) and nonskilled supervisors (highest: WPE) followed by the HB and WPE factors.

CONCLUSION

There were nongradient oral health inequalities among the South Korean population according to the NMSC. Oral health promotion programmes that focus on changing the socioeconomic environment and health behaviours should be implemented.

Kinds of individuals defined by patterns of variables

This paper argues that investigators should consider replacing the popular practice of comparing individuals varying in gender, social class, and/or ethnicity on one or more continuous measures with a search for kinds of individuals defined by patterns of properties that include not only their values on outcome measures but also their gender, social class, and ethnicity. Investigators who believe that a particular predictor contributes to an outcome independent of the gender, class, or ethnicity of the participants often implement statistical procedures that promise to remove the contributions of the above categories. These analyses lead to misleading conclusions when the controlled category is correlated with the dependent measures. The final sections summarize the properties of genders, classes, and ethnic groups that make distinctive contributions to many psychological outcomes. The paper ends by noting that a society's ethical beliefs constitute a defensible basis for ignoring the biological properties associated with these categories in order to allow members of these groups access to whatever educational or occupational goals they desire.

Right-to-Work-for-Less: How Janus v. AFSCME Threatens Public Health

In February 2018, the Supreme Court heard oral arguments in Janus v. AFSCME, a case poised to make right-to-work (or, as some call it, right-to-work-for-less) the law in the public sector. At issue is the constitutionality of requiring non-union members, who benefit from collective bargaining, to pay fees that support contract negotiations on the terms and conditions of their employment. We argue that a win for Janus would threaten public health by eroding organized labor's power to improve working conditions. Furthermore, we critique the dubious legal theory underpinning Janus's case and describe the moneyed political interests backing his legal representation. Finally, we chart a path forward for labor organizing in a post- Janus world, drawing inspiration from the winter 2018 educators' strike in West Virginia. Regardless of how Janus itself is decided, the issues raised in this article remain crucial because the ongoing weakening of unions by legislative and judicial means undermines workers' health and exacerbates inequities.

Embodied Neoliberalism: Epidemiology and the Lived Experience of Consumer Debt

A growing set of epidemiological data links personal financial debt to negative mental and physical health outcomes. These findings point to debt as a potentially significant socioeconomic determinant of population health, especially given rising rates of household and consumer debt in industrialized nations. However, the political and economic contexts in which rising consumer debt is embedded and the ways in which it is experienced in everyday life are underexplored in this epidemiological literature. This gap leaves open questions about how best to situate and understand debt as a health determinant with both psychosocial and neo-material attributes. In this article, we discuss findings from a qualitative study of personal debt experience in Boston, Massachusetts. Participants’ debt narratives highlight the powerful feelings of shame, guilt, and personal responsibility that debt engenders. The findings point to the influence of neoliberal ideology in shaping emotional responses to debt and suggest that these responses may be important pathways through which debt affects health. We discuss our findings within the broader landscape of American neoliberal economic policy and its role in shaping trends of consumer debt burden.

"Stuck in the Middle with You?" Supervisory Level and Anger about Work

Although sociologists have long been interested in the stratification of emotions, the occupational stratification of anger has been investigated in only a few general population studies. Through analyses of data representative of workers in Toronto, we evaluate the hypothesis that workplace hierarchical position, defined by supervisory level, has an inverted u-shaped association with the frequency of anger about work. We also evaluate the more specific hypothesis that the difference in work-related anger between front-line supervisors and nonsupervisory workers will be relatively larger among workers in the commodified services sector than other sectors. Results are generally consistent with our hypotheses. We find that both front-line supervisors in the commodified services sector, and secondary supervisors in all employment sectors, report more frequent anger about work than do nonsupervisory workers. In contrast, higher level supervisors report anger about work at about the same frequency as nonsupervisory workers. These associations are only slightly reduced by controls for work stress and stressors. We discuss how supervisory relations might explain differences in anger about work among workers at different levels in organizational hierarchies.

Value in the middle: cultivating middle managers in healthcare organizations

Purpose

Senior executives in healthcare organizations increasingly display preference for a closer handling of operational levels, bypassing middle managers, and de-emphasizing the need to cultivate the next cadre of leaders, creating the potential for leadership and performance gaps. The authors argue that middle managers are a vital resource for healthcare organizations and review the benefits for including them in leadership development and succession planning programs. The paper aims to discuss these issues.

Design/methodology/approach

Current theories and common practices in addition to data collected from government sources (e.g. BLS), business and industry surveys and reports (e.g. Moody’s, Witt/Kieffer, Deloitte, American Hospital Association) are used to classify the roles, skills, and strategic value of middle managers in healthcare organizations.

Findings

The combination of a greater executive span with less hierarchical depth creates a dual effect of devaluing middle management, and a decrease in middle managers’ autonomy. Healthcare middle managers who stay away or lay low further trigger perceptions of low expectations leading to low morale and high levels of stress. Others become hypereffective or develop exit strategies. Major problems are: rising turnover costs; and insufficient attention to succession planning, internal promotion, and leadership development.

Practical implications

The outcomes of this study are useful for management development, particularly at times of change. Practitioners and researchers can have a better understanding of the value of middle managers and their development needs as well as the factors and dynamics that can influence their motivation and affect retention.

Originality/value

Understanding and implementing the ideas developed in this paper by healthcare organizations and other companies can lead to a drastic change in the current perceptions of the importance of middle managers and should lead to long-term retention, well-being, and extrinsic benefits for both the company and its employees.

Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction

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. Thus, population health disciplines marginalize rich traditions in Marxist theory whereby 'class' is understood as a 'hidden' social mechanism such as exploitation. Yet Neo-Marxist social class has been used over the last two decades in population health research as a way of understanding how health inequalities are produced. The Neo-Marxist approach views social class in terms of class relations that give persons control over productive assets and the labour power of others (property and managerial relations). We critically appraise the contribution of the Neo-Marxist approach during the last two decades and suggest realist amendments to understand class effects on the social determinants of health and health outcomes. We argue that when social class is viewed as a social causal mechanism it can inform social change to reduce health inequalities.