This paper develops a Marxist analysis of the relationships between class position, work experience, the psychological effects of this experience, and subsequent health outcomes. Specifically, it is argued that the structural imperatives of capitalist production make work for those in working-class positions subject to greater routinization and less control than work for those in other class positions. Routinization and control are argued, in turn, to predictably affect two key psychological variables, self-esteem and stress, which are further argued to affect health in predictable ways. Position in the capitalist labor process is thus linked to health via the psychological consequences of the immediate work experience it engenders. Survey data from workers, managers, supervisors, and semi-autonomous employees in five capitalist firms are used to test the descriptive adequacy of this model linking capitalism to ill health for those in working-class positions.