A summary collection and critical appraisal of current research that reveals the abhorrent effects of capitalism on mental health was recently published as a chapter in Oxford Textbook of Social Psychiatry by epidemiologists Jerzy Eisenberg-Guyot and Seth Prins.
Psychiatry and the social sciences’ focus on individual factors has failed to account for the role of structures and systems—such as capitalism—in the development of mental illness and differences in psychological forms of suffering.
The authors write:
“What explains these trends and inequalities? Although this question is a major concern of quantitative social science, the answers received have not always directly engaged with capitalism, a socioeconomic system that not only structures the societal distribution of health-affecting resources and power, but also modulates our experiences of reality. and the production of knowledge therein. Instead, mental health researchers have focused on the roles of individual-level factors such as “risk behavior” or socioeconomic status. Moreover, the ubiquity of capitalism makes it difficult to isolate pathways through which it affects any individual outcome such as mental health.
To move away from this individualizing tendency, the authors review recent and historical literature and empirical research that illustrate the impact of capitalism on mental health in this chapter.
For example, studies show that people who adhere to capitalist values are more likely to experience loneliness and reduced psychological well-being. Capitalism has also previously been conceptualized as a social determinant of health.
Eisenberg-Guyot and Prins agree, as they “recognize that all research on the social determinants of mental illness involves capitalism.” In addition, however, they draw an explicit connection between capitalism and racism, colonialism and patriarchy, making a visible connection between capitalism and the suffering of women, people of color, the colonized, and other minority groups.
Original research on the relationship between capitalism and mental health
Using official data and observations, Friedrich Engels developed one of the first epidemiological studies ever to include information on physical and mental health in Britain. He found a link between the poor working conditions of early industrialization and the disease and premature death of workers. Engels also found that capitalist promotion of competition led to increasing loneliness, indifference and isolation. Furthermore, repetitive tasks lead to a lack of creativity and autonomy and increase boredom. Finally, he describes how physical ailments developed at work lead to irritability, hopelessness and depression.
Through similar methods, Karl Marx identified how industrial material conditions and dynamics affected the mental and emotional life of the working class. By minimizing workers’ tasks, the capitalist “increases efficiency and productivity (and thus profit), but degrades and de-skills labor.” This reduces the creative capacity of the worker and generates isolation, powerlessness, boredom, restlessness and lack of purpose. Time spent working also took away from the time and energy the worker needed to engage in social life and more fulfilling activities.
Marx and Engels also identified how women and children worked in worse conditions than adult men, received less pay and had additional responsibilities such as housework, leading to a disparity in “exhaustion, lung disease, injury, poisoning” and more -low life expectancy (or infanticide).
While class differences were the primary focus of Marx and Engels’ epidemiological analyses, Marx briefly acknowledged the role of colonialism and slavery in the creation and maintenance of capitalism and how they generated mass death and suffering among colonized groups.
Marx did not theorize sexism and racism, but the authors explain that “feminist and black radical theorists have filled these gaps by arguing that capitalism depends on racism and sexism to maximize profits through hyper-exploitation, colonialism, imperialism and patriarchy.”
“They argue that capitalism has been racialized and gendered from its inception, and that it has used such hierarchies to expand—by appropriating resources and labor from Africa, the Americas, other parts of the Global South, and elsewhere, and by creating and gender exploitation division of labor.”
Alienation and work environment
Many researchers are influenced by Marx’s theory of alienation, which states that under capitalism workers are estranged – or separated – from the fruits of their labor (with the capitalist taking both what the workers create and most of the profit that is made from their work), from themselves (their needs and wants) and from others (such as other workers , friends, family, and community).
The social psychologist, Seeman, expands on Marx’s work and identifies different dimensions of alienation, such as impotence (belief in the impossibility of achieving goals), nonsense (lack of confidence in predicting the results of one’s actions), abnormality (he has to engage in socially unacceptable behavior to achieve his goals) and isolation (lack of connection with others). In addition, he and other researchers have found that alienation is associated with depression, anxiety, low self-esteem, hopelessness, and self-esteem about physical health.
The authors found similarities between these findings and other theories. For example, they mention how psychoanalytic theorists also believed that the dehumanization of workers under capitalism inhibited their creativity, social connections, and ability to satisfy their needs and desires. Eisenberg-Guyot and Prins also see compatibility between these ideas and the diathesis-stress model (which posits that the interplay between socially modeled experiences and stressful life experiences, along with a person’s history, contribute to the development of mental illness) as structured working life class, along with their alienation and personal histories influence the development of mental illness.
Occupational research has also found a link between alienation and mental health. Karasek developed search/control or operating voltage model, which studies two aspects of work. The first one is job requirements or the effort required to perform the job and the stress that arises from other tasks and interpersonal conflicts in the workplace). It’s the second work control, the employee’s ability to change the work environment or how they perform their tasks.
According to this line of research, people whose jobs had higher demands and lower control were more likely to report more anxiety, depression, exhaustion, distress, and stress-related physical health problems. However, Karasek fails to recognize the power dynamics that play out due to class relations and the capitalist structure. Workplace stress in itself is not the cause of health differences between classes, but a result of inequality.
Due to changing social structures and dynamics, sociologists and psychologists abandoned the capitalist/worker dichotomy and began to use a model that responded to emerging hierarchies in the workplace. This included the capitalist, the manager, the supervisor and the worker. Managers and supervisors are characterized by the contradiction of their class location, since they do not own the means of production but ignore the work of the worker. Using class conflict theory, researchers found that low-level managers have less control over workplace policies, the environment, and decision-making processes. Being “dominated and exploited by capitalists and antagonized by subordinates (controversial class location hypothesis),” these low-level managers were at higher risk of developing mental illness, reporting higher levels of depression , anxiety, and alcohol use disorder compared to both managers and higher-level workers.
Other studies show that capitalists and managers report better psychological well-being than workers and executives. However, the association between class and health is stronger among men than among women. They suggest that this difference may be due to differences in the division of housework between heterosexual couples, among other reasons. In addition, recent research has found that petty bourgeoisie (or entrepreneurs, small business owners, professionals, etc.) have been found to be at higher risk of mental illness than the aforementioned classes because they often compete with capitalists without having the same number of resources and often end up being part of the working class.
While most research in these areas has used self-reports that measure a person’s perception of workplace stress, other researchers have used different types of data to examine social relationships in the workplace and their impact on mental health. For example, in 2015 Muntaner and colleagues measured exploitation at the organizational level use of for-profit or not-for-profit employer status and measured managerial dominance in the frequency of violations of labor relations. They found that US nurses exposed to greater organizational level exploitation and managerial dominance were at higher risk for depression.
Studies using similar, more objective measures found that the percentage of workers with incomes that were not paid commensurate with their labor increased the workers’ chances of developing mental illness. Also, employees whose jobs became more automated were more likely to engage in binge eating than workers with more power and autonomy in their jobs.
Although class status often predicts mental health outcomes, research shows that people of color experience poorer health outcomes across most classes. From the beginning of the 20th century, researchers have linked capitalism, colonialism, racism, and patriarchy to mental health disparities. More recent studies have identified how the mental health of racialized workers is affected by chronic stress, alienation, double shifts, residential and occupational segregation, and various forms of state violence; racialized women are disproportionately affected.
Psychiatric epidemiology often fails to examine the interconnected structural and systemic factors (eg, colonialism, racism, colonialism, sexism, misogyny and patriarchy, LGBTQphobias, etc.) that influence mental health. Future studies should aim to fill research gaps on the relationship between capitalism and the objective conditions in which people of color and people from the Global South live.
Eisenberg-Guyot, J. & Prins, SJ (2022). The Impact of Capitalism on Mental Health: An Epidemiological Perspective. In D. Bhugra, D. Moussaoui & TJ Craig (Eds.) Oxford Textbook of Social Psychiatry (pp.195-222) https://doi.org/10.1093/med/9780198861478.003.0022 (Link)