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

Am J Ind Med. 2019 Feb;62(2):131-144. doi: 10.1002/ajim.22935. Epub 2018 Dec 19.


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.

Keywords: division of labor; drinking; mental health; occupational health; occupations; social class; work.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Alcohol Drinking*
  • Employment / psychology*
  • Female
  • Humans
  • Income*
  • Male
  • Mental Disorders / etiology*
  • Occupations*
  • Risk Factors
  • Unemployment / psychology
  • United States