Indeed, disparities in both mental and physical health are firmly established across traditional measures of socioeconomic status (SES) such as income, educational attainment, and other indicators of social rank ( Lynch and Kaplan 2000 Muntaner and Ng et al. Social disadvantage is associated with higher risk of most adverse mental health outcomes ( Dohrenwend and Dohrenwend 1969 Dohrenwend 1990 Faris and Dunham 1988 Hollingshead and Redlich 1953 Muntaner and Ng et al. 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, e.g., domination and exploitation.

Data on full-time workers from the National Epidemiologic Survey on Alcohol and Related Conditions (N=21,859) show that occupants of contradictory class locations have higher prevalence and odds of depression and anxiety than occupants of non-contradictory class locations. We test whether the relational construct of contradictory class location, which embodies aspects of both ownership and labour, can explain this nonlinear pattern. Although prevailing indicators of socioeconomic stratification (e.g., SES) cannot detect or easily explain such patterns, relational theories of social class, which emphasise political-economic processes and dimensions of power, might. Despite a well-established social gradient for many mental disorders, evidence suggests that individuals near the middle of the social hierarchy suffer higher rates of depression and anxiety than those at the top or bottom.

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