ArticleEpidemiology (Cambridge, Mass.)2021
The Serpent of Their Agonies: Exploitation as Structural Determinant of Mental Illness.
Article in Epidemiology (Cambridge, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- The social determinants of ideal cardiovascular health: A global systematic review.Annals of epidemiology · 2022Pooled it
- Denial of Earned Wages and Psychological Distress among Latino Day Laborers: The Impact of Work-Related Mistreatment and Powerlessness on Mental Health.Journal of racial and ethnic health disparities · 2026Article
- Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level.Addictive behaviors reports · 2025Article
- Working Conditions, Worker Rights, and Managerial Domination During the COVID-19 Pandemic: Assessing Their Toll on Precariously Employed Workers and Family Well-Being.International journal of social determinants of health and health services · 2024Article
- Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level.Social psychiatry and psychiatric epidemiology · 2024Article
- Longitudinal plasmode algorithms to evaluate statistical methods in realistic scenarios: an illustration applied to occupational epidemiology.BMC medical research methodology · 2023Article
- A tutorial on a marginal structural modeling approach to mediation analysis in occupational health research: Investigating education, employment quality, and mortality.American journal of industrial medicine · 2023Article
- Employment trajectories and mental health-related disability in Belgium.International archives of occupational and environmental health · 2023Article
- Article
- Wage theft and life expectancy inequities in the United States: A simulation study.Preventive medicine · 2022Article
- Cumulative exposure to state-level structural sexism and risk of disordered eating: Results from a 20-year prospective cohort study.Social science & medicine (1982) · 2022Article
- Free agents or cogs in the machine? Classed, gendered, and racialized inequities in hazardous working conditions.American journal of industrial medicine · 2022Article
- US trends in binge drinking by gender, occupation, prestige, and work structure among adults in the midlife, 2006-2018.Annals of epidemiology · 2021Article
- Union Burying Ground: Mortality, Mortality Inequities, and Sinking Labor Union Membership in the United States.Epidemiology (Cambridge, Mass.) · 2021Article
- "Beyond the flood: Exploring the psychosocial consequences and resilience challenges in the aftermath of "El Niño" in Tumbes, Peru".The journal of climate change and healthArticle
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundSocial 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.
methodsData are from the 1983 to 2017 waves of the Panel Study of Income Dynamics, a nationally representative cohort study (baseline N = 3059). We operationalized "unconcealed exploitation" as the percentage of individuals' labor income they were hypothetically not paid for productive hours. We ascertained psychologic distress and mental illness with the Kessler-6 (K6) scale.
resultsWe fit inverse probability-weighted marginal structural models and found that for each unit increase in unconcealed exploitation, psychologic distress increased by 1.6 points (95% confidence interval = 0.71, 2.5) on the K6 scale and the odds of mental illness tripled (odds ratio = 3.0, 95% confidence interval = 1.5, 6.1). Results were not driven entirely by overwork and were robust to different inverse probability-weighted estimation strategies and sensitivity analyses.
conclusionsExploitation is associated with mental illness. Focusing on exploitation rather than its consequences (e.g., socioeconomic status), shifts attention to a structural process that may be a more appropriate explanatory mechanism, and a more pragmatic intervention target, for mental illness.
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