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Film ed as received. Xerox University Microfilm s 300 North Zeab Road Ann Arbor, Michigan 48106 76-18,667 I I RASSEL, Gary Raymond, 1944- INNOVATION IN LOCAL PUBLIC BUREAUCRACIES: THE CASE OF PUBLIC HEALTH IN MICHIGAN. Michigan S ta te U n iv e r s it y , P h .D ., 1976 P o l i t i c a l Science, p u b lic a d m in is tra tio n Xerox University Microfilms t Ann Arbor, Michigan 46106 (?) Copyright by GARY RAYMOND RASSEL 1976 INNOVATION IN LOCAL PUBLIC BUREAUCRACIES: THE CASE OF PUBLIC HEALTH IN MICHIGAN By Gary Raymond Rassel A DISSERTATION Submitted to Michigan S ta te U n iv e rs ity in p a r t i a l f u l f i l l m e n t o f the requirements f o r the degree o f DOCTOR OF PHILOSOPHY Department o f P o l i t i c a l Science 1976 ABSTRACT INNOVATION IN LOCAL PUBLIC BUREAUCRACIES: THE CASE OF PUBLIC HEALTH IN MICHIGAN By Gary Raymond Rassel The d eterm in ation o f c h a r a c te r is t ic s o f o rg a n iza tio n s and a d m in is tra to rs which are c o r r e la te d w ith innovation in p u b lic bureaucracies is the major purpose o f t h is s$udy. A theory which assumes r a t i o n a l i t y on the p a r t o f a l l p a r tic ip a n t s is used to develop hypotheses. An am bition theory o f a d m in is tra tio n is developed from l i t e r a t u r e in p o l i t i c a l science and r e la te d f i e l d s . This theory is a type o f economic theory o f o rg a n iza tio n s which makes assumptions about and focuses on in d iv id u a ls to p re d ic t bureau behavior. Two major sources form the basis o f the t h e o r e tic a l framework f o r the study. The theory discussed by Anthony Downs in Insid e Bureaucracy is in te g r a te d w ith assumptions and fin d in g s from the am bition theory l i t e r a t u r e in e le c t i v e p o l i t i c s . Both o f these approaches focus on the c a re e r ambitions o f in d iv id u a ls to p r e d ic t t h e i r b eh avio r. Downs uses the assumptions to p r e d ic t how bureaus w i l l behave in the aggregate as w ell as to p r e d ic t the behavior o f p a r t i c u l a r types o f bureaucrats. Ambition theory p re d ic ts the behavior o f p o l i t i c i a n s based t h e i r career g o a ls . Two types o f Gary Raymond Rassel am bition are suggested f o r the bureaucrats In the study. Climber am bition is possessed by those who seek more p re s tig io u s and w ell paying p o s itio n s . Conserver ambition is t h a t held by those who wish to m aintain a less p re s tig io u s but less demanding occupational p o s itio n . Program innovation in local p u b lic h e a lth departments in Michigan is the dependent v a r ia b le . Data was gathered from these h ea lth departments, t h e i r d ir e c to r s and deputy d ir e c to r s - Organi­ z a tio n a l c o rr e la te s o f innovation are hypothesized. The ambition o f the a d m in is tra to rs and t h e i r backgrounds are als o hypothesized to be r e la t e d to each o th e r and to the innovation o f the p u b lic h e a lth department. One set o f hypotheses r e la te s c h a r a c t e r is t ic s o f the hea lth d ir e c to r s to t h e i r l i k e l y ambitions and suggests the type o f department in which each is l i k e l y to be found. Several c h a r a c t e r is t ic s o f o rg a n iza tio n s associated w ith larg e s iz e were found to be r e la te d to higher ra te s o f innovation in these p u b lic health departments. Resources, the size o f the departm ent's budget, was concluded to be the most important o f these. Resources enabled the department to h ir e personnel in a g re a te r number o f s p e c ia liz e d program areas p e rm ittin g the d e p a rt­ ment to innovate. The ages, types o f t r a i n i n g , and careers o f the health a d m in is tra to rs were found to be r e la t e d to am bition. Younger d ir e c to r s w ith less experience in p r iv a te p r a c t ic e are more l i k e l y to have h ig h e r a s p ir a t io n s — clim b er am bitions— and are more l i k e l y to be in in n ovative departments than are o ld e r d ir e c to r s w ith le n g t h ie r p r iv a t e p ra c tic e experience. Gary Raymond Rassel M u lt i v a r i a t e models in c lu d in g departmental resources, d ir e c t o r background, d ir e c t o r am bitions, and innovation are developed. The re la tio n s h ip s among these v a ria b le s a re analyzed and the manner in which they r e l a t e to innovation is s p e c ifie d . The importance o f ambition theory to a d m in is tra tiv e and p o l i t i c a l leadership and p o lic y development is suggested. ACKNOWLEDGMENTS A number o f people have p rovided a id in many ways in the w r i t i n g o f t h i s d i s s e r t a t i o n . I wish to thank e s p e c ia lly th e members o f my d i s s e r t a t i o n com m ittee, Professors Cleo Cherryholmes, Joseph S c h le s in g e r, and Kent Chabotar f o r t h e i r h e lp . P ro fes so r Cherryholmes agreed to the chairmanship o f the committee a f t e r the o r i g i n a l chairman went on leave and subsequently l e f t the departm ent. His und erstanding, c o o p e ra tio n , and encouragement have been g r e a t l y a p p re c ia te d . P ro fe s s o r S c h le s in g e r c o n tr ib u te d c r i t i c a l in s ig h t to the use o f am bition th e o ry and P ro fe s s o r Chabotar provided v a lu a b le a s s is ta n c e in the o r g a n iz a tio n o f several p o r tio n s and a l e r t e d me to some im p o rta n t aspects o f p u b lic a d m in is t r a t io n . Two o th e r i n d i v i d u a l s have been p a r t i c u l a r l y h e l p f u l . Mr. Roy Manty o f the Bureau o f Local H e a lth A d m in is tra tio n o f the Michigan Department o f P u b lic H e alth has been most generous in p ro v id in g advice and access to department records which have been very v a lu a b le . He has a ls o given generously o f his time and has been v e ry su p po rtive o f my e f f o r t s . A c o lle a g u e , Dr. H arold E. O ld , J r . , als o o f the Michigan Department o f P u blic H e a lt h , helped to sharpen the th eo ry and the a n a ly s is in many ways by being a good l i s t e n e r and f r i e n d l y c r i t i c . Many o th e r i n d i v i d u a l s , in c lu d in g p ro fe s s io n a ls in p u b lic h e a lth in M ichigan, co lle a g u e s and f r i e n d s have been h e lp f u l in ways too numerous too mention. I am g r a t e f u l to a l l . i i TABLE OF CONTENTS LIST OF T A B L E S ..................................................................................................... v LIST OF F I G U R E S .............................................................................................................vi1 LIST OF A P P E N D IC E S ................................................................................................... v i i i Page Chapter I . INNOVATION AND AMBITION; REVIEW OF THE LITERATURE . . In tr o d u c tio n ........................................................................................ I n n o v a t i o n ...................................................... . ................................. A m b i t i o n ............................................................................................... F o o t n o t e s ............................................................................................... I I . HYPOTHESES, RESEARCH SETTING AND RESEARCH DESIGN . . . C o rre la te s o f Inn ovatio n in P u b lic H e alth Departments C o rr e la te s o f D ir e c t o r Am bition . D i r e c t o r ’ s Background and Departmental . . Types o f D ir e c t o r s ' Goals and Types o f Departments Ambition and In n o v atio n ........................................................ Research Design .................................................................................. F o o t n o t e s ............................................................................................... In n o v a tio n . . . I I I . HYPOTHESIS TESTING; DEPARTMENTAL CHARACTERISTICS, . DIRECTOR'S BACKGROUND AND DIRECTOR'S AMBITION . . 1 1 2 13 30 38 39 50 56 57 60 63 75 79 . ..................................... ........................................................................... 79 H e alth Department C h a r a c t e r is t ic s and In n o v atio n 90 M u l t i v a r i a t e A n a ly s is o f Department V a r ia b le s . Summary o f F i r s t P a rt o f Chapter I 95 D ir e c t o r Ambition 97 Age and A m b i t i o n ......................................................................................... 103 105 P r i v a t e P r a c t ic e and Ambition I l l Number o f Years o f P r iv a t e P r a c t ic e and Am bition Advanced Degree in P u b lic H e a lth and Ambition I l l . D ir e c t o r s W illin g n e s s to Change P o s itio n s and ................................................ . . . . . . . I I A m b i t i o n ....................................................................................................... 112 iii Chapter Page M u lt i v a r i a t e A n aly sis o f D ire c to r Background V a r i a b l e s .............................................................................................. 118 Summary........................................................................................................... 120 F o o t n o t e s .................................................................................................... 123 IV . HYPOTHESIS TESTING: DIRECTOR'S AMBITION AND INNOVATION AND THE DEVELOPMENT OF MULTIVARIATE MODELS . . . . 127 Health Department D i r e c t o r ’ s Background and Ambition and Departmental Innovation .................................................. ........................................ .................................................. Departments, D ata, and V a riab le s Adoption as Dependent V a ria b le Departmental F a c t o r s ..........................................................................137 Tests o f Ambition H y p o th e s e s .............................................................139 M u lt iv a r ia t e Models o f Innovation Analysis o f T h re e -V a ria b le Path Models . 146 Resources, Climber Ambition,and Innovation . 148 Resources, Conserver Ambition, and Innovation 150 152 . Resources, P o lic y A m bition, and Innovation I n t e r a c t i o n .............................................................................................. 153 Four V a ria b le Models o f Innovation . F o o t n o t e s .....................................................................................................168 ............................................ 135 . . . . . . . . . . . . . 128 136 143 159 V. SUMMARY AND CONCLUSIONS............................................................................... 171 F o o t n o t e s .....................................................................................................180 APPENDICES........................................................................................................................ 181 BIBLIOGRAPHY .............................................................................................................. 197 i v LIST OF TABLES Simple C o rr e la tio n s Between Independent Departmental V a riab le s and Innovation f o r 1968 and 1971 . Step-Wise M u l t i p l e Regression A nalysis o f Departmental V a riab le s f o r 1968 and 1971 w ith Innovation Step-Wise M u lt i p l e Regression A nalysis o f Changes in Selected Departmental V a ria b le s w ith Innovation Page 84 91 94 C o rre la tio n s Between D ir e c to r C h a r a c te r is tic s and Measures o f Expressed Ambition .............................................. 106 D ir e c t o r 's Preference f o r P o s itio n as D ire c to r o f a Large Public Health Department by Age ........................... 107 D ir e c t o r 's Preference f o r P o s itio n as D ir e c to r o f a Small P ublic Health Department t h a t is S tab le in S ize by Age ...................................................................................... D ir e c t o r 's Preference f o r a P o s itio n Which Would Allow the D ir e c to r to In flu e n c e P u b lic Health P o lic y by Age * ............................................................................................. 107 108 D ir e c t o r 's Preference f o r P o s itio n Other Than C urrent P o s itio n by Age . ............................................................ 109 D ir e c t o r 's Contentment to Remain in Present P o s itio n U n til Retirem ent by Age ............................................................ 109 D i r e c t o r 's Preference f o r a P o s itio n Other than Current P o sitio n by P r iv a te P ra c tic e . ................................. 110 D ir e c t o r 's Degree o f Contentment to Remain in Current P o s itio n U n t il Retirement by P r iv a te P ra c tic e . D ir e c t o r 's Preference f o r a P o s itio n as the D ir e c to r o f a Small P u b lic Health Department th a t is not Changing in Size by Advanced Degree in Public Health D i r e c t o r 's Preference f o r a P o s itio n Which Would Allow the D ir e c to r to In flu e n c e P u b lic Health P o lic y by Advanced Degree in Public H ealth ........................................ 110 113 113 v Table Page 3-14. D ir e c t o r 's Preference f o r a P o s itio n Other than Current . P o sitio n by Advanced Degree in P ublic H ealth . 114 3 -1 5. D i r e c t o r ’ s Contentment to Stay in Current P o sitio n U n til Retirem ent by Advanced Degree in Public Health 114 3 -1 6. Associations Between D ir e c t o r 's Ambition and Preference f o r Other P o s itio n s and Contentment w ith Present P o s i t i o n ............................................................................... 116 3 -1 7 . D ir e c t o r 's Preference f o r a P o s itio n Other Than the One C u rre n tly Held by Preference f o r Small Public Health Department th a t is S tab le in S ize . . . . 116 3 -1 8 . M u ltip le Regression w ith Preference f o r P o s itio n as D ire c to r o f a Large P ublic H ealth Department as Dependent V a ria b le ......................................................................... 119 3 -1 9 . M u lt ip le Regression w ith Preference f o r P o s itio n as D ire c to r o f a Small Public H ealth Department th a t is S tab le in S ize as Dependent V a r i a b l e ....................... 119 3- 20 . M u lt ip le Regression w ith Preference f o r P o sitio n Allowing the D ir e c t o r to In flu e n c e P o lic y as the Dependent V a ria b le ......................................................................... 119 4 -1 . C o rre la tio n s Between D ir e c to r C h a r a c te r is tic s and A d o p t i o n .......................................................................................... 141 4 -2 . C o rre la tio n s Between Adoption and Ambition and Departmental Resources ............................................................ 141 4 -3 . C o rre la tio n s Between D ir e c to r Ambition and Adoption . 141 4 -4 . D ir e c t o r 's Preference f o r P o s itio n as D ir e c to r o f a Large Department by R e s o u r c e s ............................................142 4 -5 . D ir e c t o r 's Preference f o r P o s itio n as D ir e c to r o f a Small Department th a t is S tab le in Size by Resources 142 4 -6 . Regression C o e ff ic ie n t s o f Innovation on Ambition fo r a l l Departments and Low and High Resource D e p a r t m e n t s .................................................... 156 4 -7 . Regression Equations f o r M u l t i p l i c a t i v e F o u r-V a ria b le M o d e l s ................................................................................................ 160 4 -8 . Regression Equations f o r M u l t i p l i c a t i v e F iv e -V a ria b le M o d e l s .................................................................................................167 v i LIST OF FIGURES Elements o f a Model o f O rg an iza tio n al Innovation D ire c tio n o f In flu e n c e Among Elements o f a Model o f Innovation ......................................................................... Path Diagram o f P o p u la tio n , Resources, and Innovation f o r 1968 ...................................................................................... Path Diagram Supported by Actual P a r t i a l C o rre la tio n s f o r 1968 ............................................................................................. Page 29 72 89 89 Path Diagram f o r Clim ber Ambition and Resources w ith Innovation ...................................................................................... 149 Path Model w ith Path C o e ffic ie n ts f o r Climber Am bition, Resources, and Innovation ..................................................... 149 Path Diagram f o r Conserver Ambition and Resources w ith ...................................................................................... Innovation 151 Path Diagram w ith Path C o e ffic ie n ts f o r Conserver A m bition, Resources, and Innovation ................................. 151 Path Diagram o f Resources and P o lic y Ambition Innovation ...................................................................................... 154 Path Diagram w ith Path C o e ffic ie n ts f o r Resources and P o lic y Ambition w ith Innovation ........................................ 154 C o rre la tio n s Among Four Elements o f Departmental Innovation Model Using the Degree o f Climber Ambition ............................................................................................. C o rre la tio n s Among Four Elements Using the Degree o f Conserver Ambition ......................................................................... Causal Path Models f o r Climber Ambition ........................... Causal Path Models f o r Conserver Ambition ........................... 162 162 164 166 v i 1 LIST OF APPENDICES Appendix Page A. P ublic Health Programs f o r Secondary Innovation Index . 182 B. Q uestionnaire Sent to Local P u b lic Health Departments, Department D ire c to rs and Department Deputy D ire c to rs . 184 v i i i CHAPTER I INNOVATION AND AMBITION: REVIEW OF THE LITERATURE In tr o d u c tio n The main concern o f t h i s d is s e r t a t i o n is to apply a th e o ry o f b u r e a u c ra tic decision-m aking to a type o f o r g a n iz a tio n a l b eh av io r* in n o v a tio n . The theory used i s a type o f economic theory o f o r g a n i­ z a tio n s which makes assumptions about and focuses on in d i v i d u a l s to p r e d ic t bureau b eh av io r. The c la s s o f o r g a n iz a tio n s chosen f o r a n a ly s is a re lo c a l and d i s t r i c t departments o f p u b lic h e a lth in the s t a t e o f Michigan. I focus on the ad o p tio n o f new p u b lic h e a lth programs as the measure o f in n o v a tio n . Ideas from am bition th e o ry in e l e c t i v e p o l i t i c s are i n t e ­ grated w ith those from Anthony Downs' In s id e Bureaucracy.^ Since the theory is used to suggest t h a t the in n o v a tio n o f the departments is determined in p a rt by th e d ir e c t o r s in those departm ents, I t e s t hypotheses about these i n d i v i d u a l s . This s e t o f hypotheses i d e n t i f i e s those I n d iv id u a ls as to the typ e o f am bition th ey are l i k e l y to have and suggests the c h a r a c t e r i s t i c s o f the o rg a n iz a tio n s in which each am bition type is most l i k e l y to be found. I a ls o i n v e s t ig a t e the r e la t io n s h ip s between o r g a n iz a t io n a l c h a r a c t e r i s t i c s and in n o v a tio n . A more complete model i s suggested which in c lu d e s in d iv id u a l as w e ll as o r g a n iz a tio n a l v a r i a b l e s and r e l a t i o n s h i p s lin k in g th e elements o f t h i s model a r e an a ly zed . 2 Innovation Innovation as a to p ic and a concept has been d e a lt w ith co n siderably in the behavioral sciences in recent y e a rs . Studies in v e s t ig a t in g the d if f u s i o n o f innovations among In d iv id u a ls and o rg a n iza tio n s are q u ite numerous w hile o th e r approaches have looked a t c o r r e la te s o f innovation among in d iv id u a ls and o rg a n iz a tio n s . Among these are two studies d ealin g e x p l i c i t l y w ith inn ovatio n in p u b lic h e a lth . 2 Although p u b lic h e a lth o rg a n iza tio n s as p u b lic bureaucracies d i f f e r from business and i n d u s t r i a l fir m s , the c h a r a c te r is t ic s o f business firm s which have been found to be c o rr e la te d w ith in n o v a tio n , such as s i z e , resources, and p ro fe s ­ s io n a lis m , have also been found to c o r r e la te w ith innovation in p u b lic bureaucracies. Considerable v a r i a t i o n e x is ts in the number o f non- t r a d i t i o n a l health care programs adopted from one department to another and in the amount o f resources a llo c a t e d to these programs. Some departments are q uick to adopt and implement new programs which are advocated by h e a lth p ro fe s s io n a ls w h ile o ther departments are slow to begin even re q u ire d programs. I f we look a t any change in p o lic y as innovatio n, then the relevance o f the study o f inno­ vation f o r p o lic y development and implementation is g re a t. This d is s e r t a t i o n , however, focuses on a narrower range o f p o lic y , the adoption o f new programs in p u b lic h e a lth . Drawing from Anthony Downs' In s id e Bureaucracy, I apply a v a r ia n t o f his theory to an e m p iric al s it u a t io n . 3 The term inn ovatio n has been used in so many d i f f e r e n t ways th a t i t s meaning can appear q u ite ambiguous. For t h is reason i t is important to s p e c ify how I w i l l use the concept and how i t d i f f e r s from o th e r usages. Innovation w i l l be d efin e d here as the degree to which an in d iv id u a l o r o rg a n iza tio n adopts new ideas o r p ra c tic e s e a r l i e r than o th e r members in his or i t s s o c ia l system. This is probably the most common usage o f the term although a l t e r n a t i v e and less in c lu s iv e d e f i n i t i o n s have been o f fe r e d . 3 Thompson defines innovation as "the g e n e ra tio n , acceptance, and implementation o f new 4 ideas, processes, and products or s e rv ic e s ." This im p lies t h a t the o rg a n iz a tio n o r in d iv id u a l is involved a ls o in the c re a tio n o f the idea or process. Various degrees o f inn ovatio n may e x i s t , from a ca p ac ity to adopt the good ideas o f o thers to the a b i l i t y to generate and adopt one's own new ideas. 5 I t is im portant to separate the concept o f innovation from th a t o f in v e n tio n . In v e n tio n im plies b rin g in g something new in to being; innovation im p lie s b ring ing something new in to use. This d is t in c t i o n is p a r t i c u l a r l y important in researching o rg a n iz a tio n s f o r we are in te r e s te d a t times in whether an o rg a n iz a tio n can c re a te something new f o r i t s own use o r f o r s a le , e x p l o i t a t i o n , o r use by o th e rs , and a t times in whether an o rg a n iz a tio n can s u c ce ssfu lly adopt g o a ls , processes o r p o lic ie s th a t a re new to th a t o rg a n iz a tio n .^ Most p ra c tic e s which are new to local p u b lic h e a lth departments are innovations in the sense t h a t they have been developed elsewhere and are considered f o r adoption by the lo c a l departments. Although o c c a s io n a lly the term 'in n o v a tiv e * is used to r e f e r to what i s more 4 g e n e r a lly c a l le d ' i n v e n t i v e , ' adoption i s u s u a lly an im p ortan t aspect o f d e f i n i t i o n s o f in n o v a tio n . 7 Rogers proposes a d e f i n i t i o n o f in n o v a tio n which is e s s e n t i a l l y Q the same as the one suggested f o r t h i s d i s s e r t a t i o n . A less In c lu s iv e d e f i n i t i o n o f in n o v a tio n t h a t has been o f f e r e d is the one by Mohr: "the successful i n t r o d u c t io n I n t o an a p p lie d s i t u a t i o n o f means o r q ends t h a t a re new to t h a t s i t u a t i o n . " T h is d e f i n i t i o n focuses on adoption o r u t i l i z a t i o n o f new p r a c t ic e s r a t h e r than on in v e n tio n . However, i t re q u ire s a more thorough s p e c i f i c a t i o n o f what i s a successful in t r o d u c t io n . In n o v a tio n can a ls o be d e fin e d in terms o f system o r o rg a n i­ z a t io n a l change. O r g a n iz a tio n a l development o fte n r e f e r s to a change in the p r o p e r t ie s o f an o r g a n iz a tio n and the r e la t io n s h ip s among these p r o p e r t ie s .^ ® Hage and Aiken i n v e s t ig a t e in n o v atio n by r e l a t i n g ra te s o f program change, o r a d o p tio n , to changes in o r g a n iz a t io n a l c h a r a c t e r i s t i c s such as d e c is io n -m a k in g , jo b d e s c r i p t io n , and the jo b s a t i s f a c t i o n o f employees. The measure o f ra te s o f change is t h e i r measure o f in n o v a tio n . They discuss the d if f e r e n c e between program adoption and change 1n o r g a n iz a t io n a l p r o p e r tie s as the change w i t h i n a system as opposed to the change o f a s y s te m .^ Parsons makes a s i m i l a r d i s t i n c t i o n . 12 Changes o f a system a re not considered in n o v a tio n by Hage and Aiken and the d e f i n i t i o n given e a r l i e r f o r t h i s study omits them as w e l l . These au th ors suggest lo o kin g a t changes in the system r a t h e r than the ad o p tio n o f p r a c t ic e s o r te c h n o lo g ie s . In t h i s sense, many o r g a n iz a t io n a l and s o c ia l changes amount to new ways 5 o f doing th in g s . S tru c tu ra l changes in o rg a n iz a tio n s , i f d e l ib e r a t e ly made, are expected to change r e la tio n s h ip s among the members o f the o rg a n iz a tio n and r e s u l t in system wide changes. O rg an iza tio n al change may be slow and als o non-del 1 b e ra te . Gradual changes in o rg an i­ z a tio n a l p ro p e rtie s and the r e la tio n s h ip s among them may take place over time and may g r e a t ly a f f e c t in d iv id u a ls in the o rg a n iz a tio n s . O r d in a r i ly , though, these changes would not be termed Innovation. However, changes in the c o n fig u ra tio n o f o rg a n iz a tio n a l p ro p e rtie s may fa v o r the adoption o f innovations. 13 The d e f i n i t i o n o f inno­ va tio n to be used in t h is d is s e r t a tio n excludes changes of a system as innovation and i s concerned only w ith the d e lib e r a t e adoption programs. With few excep tio ns, innovation studies are c ro s s -s e c tio n a l and not lo n g it u d in a l. In order to draw inferences as to cause and e f f e c t among v a ria b le s in v o lv e d , time s e rie s stu d ies are necessary. Hage and Aiken measured the r a t e o f program change over a f i v e y e a r period but r e la te d t h is r a te to o th e r o rg a n iz a tio n a l p ro p e rtie s which were measured c r o s s - s e c tio n a lly o n ly. 14 To demonstrate more co n c lu s iv e ly th a t changes in o rg a n iz a tio n a l p r o p e r t ie s , i . e . changes in a system, led to in n o v a tio n , lo n g itu d in a l stu d ies would be necessary. Most studies o f innovation focus on a s in g le p o in t in tim e , mainly the time o f adoption or a p p lic a tio n o f an in n o v atio n . Some studies do broaden t h is to look a t the process o f adoption and tr a c e the e x te n t to which a p r a c tic e is implemented a f t e r adoption. Mohr, f o r example, includes a d e f i n i t i o n o f Innovation t h a t allows f o r Increased emphasis upon in n o vative programs r e c e n tly introduced. 1 5 D iffu s io n studies tra c e the adoption process across subjects but seldom in v o lv e a lo n g itu d in a l study o f the separate o rg an iza tio n s or in d iv id u a ls t h a t comprise the population o f in q u ir y . The data f o r determining the d if f u s io n process is u s u a lly gathered r e t r o - s p e c tiv e ly r a th e r than by studying an on-going process over time. 16 Previous studies o f innovation in o rg a n iza tio n s have found the set o f fa c to r s in d ic a tin g s iz e , w e a lth , and the a v a i l a b i l i t y o f resources to be c o r r e la te d w ith i n n o v a t i o n . ^ I n f o r m a l it y , com plexity, and d e c e n t r a liz a t io n in o rg a n iz a tio n a l s tr u c tu r e are o th e r c h a ra c te r- i s t i e s which have been shown to be in d ic a to rs o f in n o v a tio n . 1 Q A survey in v e s t ig a t in g the determinants o f innovation in lo c a l health departments in I l l i n o i s , Michigan, Ohio, New York, and O ntario was completed by Larry B. Mohr in 1966. A f a c t o r s tro n g ly r e la t e d to innovativeness in these o rg a n iza tio n s was s iz e . 19 I t appears th a t Mohr d efined s iz e as the s iz e o f the community served r a t h e r than as the s iz e o f the o rg a n iz a tio n . He found resources to be important f o r in n o v a tio n ; in f a c t resources were a prime reason t h a t larg e departments were able to innovate. Mohr's major hypothesis was t h a t innovation was d i r e c t l y r e la te d to the m o tiva tio n o f the health d ir e c t o r to innovate, in v e r s e ly r e la te d to the obstacles to inno- v a tio n , and d i r e c t l y r e la te d to the resources o f the department, 20 Mohr used as an in d ic a t o r o f m o tiva tio n to inn ovate, the h e a lth department d i r e c t o r 's answers to a psychological scale tapping his ideology and perception o f the r o le o f the p u b lic h e a lth o f f i c e r . His measure o f the le v e l o f resources was the h ea lth departm ent's 7 exp en d itu res f o r the y e a r j u s t preceeding the tim e p erio d covered by h is a n a ly s is . P r i o r to beginning h is study Mohr v e r i f i e d w ith p u b lic h e a lth o f f i c i a l s the o b s e rv a tio n t h a t the h e a lth d i r e c t o r was one o f the most im p ortan t f a c t o r s d eterm in in g the in n o v atio n o f the h e a lth departm ent. 21 His m ajor hypothesis was g e n e r a lly confirm ed. Mohr concluded t h a t although s i z e was th e s tro n g e s t p r e d i c t o r o f in n o v a tio n , t h is was e x p la in e d by h ig h e r l e v e ls o f resources and fewer o b s ta c le s to in n o v a tio n asso c ia ted w ith l a r g e r departments. R. E. M y tin g e r had e a r l i e r stu d ied lo c a l p u b lic h e a lth d e p a r t­ ments in C a l i f o r n i a . He als o found t h a t f i n a n c i a l resources were im p ortan t p r e d ic to r s o f in n o v a tio n . 22 He found t h a t the main o b s ta c le to in n o v atio n as p erc eiv ed by the h e a lth department d ir e c t o r s was the e x is te n c e o f o th e r agencies which competed in the same a c t i v i t y area s. Lack o f s t a f f and lack o f funds were a ls o considered to be im portant b a r r i e r s to in n o v a tio n . 23 A number o f o th e r research ers have a l l concluded t h a t o r g a n iz a tio n a l s iz e and w ealth a re among the s tro n g e s t p r e d ic to r s o f in n o v a tio n . 24 M a n f ie ld 's r e s u l t s in d ic a te d t h a t the len g th o f tim e t h a t an i n d u s t r i a l f ir m w a its b efo re using a new technique tends to be i n v e r s e ly r e l a t e d to i t s s i z e . 25 C a r r o ll found t h a t in n o v a tiv e medical schools had l a r g e r f a c u l t i e s and a l a r g e r number o f departments than less in n o v a tiv e schools. His i n t e r p r e t a t i o n was t h a t in n o v a tiv e schools have more academic subcultures and t h a t t h i s was l a r g e l y due to g r e a t e r s iz e and more departments. 26 8 Becker and S ta ffo rd found a d m in is tra tiv e s iz e to be r e la te d to inno- va tio n among savings and loan as so c ia tio n s . 27 I n f o r m a l it y , com plexity, and d e c e n t r a liz a t io n in o rg an i­ z a tio n a l s tru c tu re are other o rg a n iz a tio n a l c h a r a c t e r is tic s which have been shown to be in d ic a to rs o f innovation. James Wilson argues t h a t innovation in an o rg a n iz a tio n is a fu n ctio n o f d i v e r s i t y o f the types o f tasks and in c en tiv es a v a ila b le in the o rg a n iz a tio n . He claims th a t "the g r e a te r the d i v e r s i t y . . . the g re a te r the lik e lih o o d th a t some members w i l l conceive major in n o v atio n s , the g re a te r the lik e lih o o d th a t some members w i l l propose innovations, and the less the l ik e lih o o d t h a t the o rg a n iza tio n w i l l adopt the in n o v atio n s ." 28 He suggests th a t t h is may e x p la in why the evidence is inconclusive on whether la rg e o r small o rg an iza tio n s are more in n o v a tiv e . 29 Sapolsky ap p lied W ilso n 's hypothesis to the study o f department stores and reasoned t h a t an o rg a n iz a tio n which h ires p ro fess io n als who have outside referen ce groups and unprogrammed tasks would be more in n o v a tiv e . 30 He found th a t the in n o vative experience o f a group o f department stores was the r e s u l t o f un- planned s tr u c tu r a l arrangements. 31 The p r o fe s s io n a liz a t io n o f an o rg a n iza tio n has been used as a v a r ia b le in many s tu d ie s . Some authors have used t h is as a dimen­ sion upon which to c a te g o riz e o rg a n iz a tio n s . Blau, Heydebrand, and S to u f f e r f o r example, found t h a t task d i f f e r e n t i a t i o n seemed to f u r t h e r the development o f a c e n t r a liz e d hierarchy o f a u t h o r ity unless the o rg a n iz a tio n is p ro fe s s io n a liz e d . 32 P ro fe s s io n a liz a tio n when used in referen ce to o rg a n iza tio n s can have a meaning a t le a s t 9 as ambigous as t h a t o f in n o v a tio n , however. The most comnon use of the term i s one t h a t r e fe r s to the degree to which the members o f the o rg a n iz a tio n s are p ro fe s s io n a ls , i . e . , persons who have p a r t ic u ­ l a r tr a in in g o r are i d e n t i f i e d w ith a recognizable p ro fess io n . P r o fe s s io n a liz a tio n as an o rg a n iz a tio n a l c h a r a c t e r is t ic d i f f e r s , furtherm ore, from p r o fe s s io n a liz a tio n as a c h a r a c t e r is t ic o f in d iv id u a l s. The p r o fe s s io n a liz a t io n o f an o rg a n iza tio n has been found in a number o f studies to be r e la t e d to i t s innovatio n. 34 However Zald and Denton found th a t one o rg a n iz a tio n was in n o vative because i t did not have a commitment to a p a r t i c u l a r ideology. 35 Browning, on the o th e r hand, concluded in a study o f budgeting p ra c tic e s in two s ta te agencies th a t the p ro fess io n al memberships o f the members co n trib u ted g r e a t ly to the in n o v ativ e budget p ra c tic e s in the inno- v a tiv e agency. 36 He also found th a t the in n ovative W elfare Department devoted more resources and time to searching f o r innovations among i t s c o n s titu e n t professions than did the non-innovative Labor Department.37 Grodzins r e fe r s to the in flu e n c e o f the p ro fession al associations o f s t a t e o f f i c i a l s on decision-m aking. 38 Sapolsky found t h a t the p r o f e s s io n a liz a t io n o f an o rg a n iza tio n was lin k e d to i t s innovatio n. 39 And Evan and Black in v e s tig a te d the e f f e c t s o f the p r o f e s s io n a liz a tio n o f management on in n o v a tio n .40 The foregoing discussion has focused on o rg a n iz a tio n a l c o rr e la te s o f in n o v atio n . To t h is should be added c h a r a c t e r is t ic s of in d iv id u a ls which seem to be r e la t e d to t h e i r being innovato rs. 10 The considerable work on innovation done by E v e re tt Rogers contains many fin d in g s on in d iv id u a ls and In n o v a tio n .4 ^ In e x p lo ra to ry in te rv ie w s , Mohr found a consensus among p u b lic health p ro fe s s io n a ls on the importance o f a t t it u d e s o f the h e a lth o f f i c e r — the c h i e f a d m in is tra tiv e o f f i c e r o f each department. The health o f f i c e r was considered to be the most im portant s in g le f a c t o r f o r the inno- vativeness o f h e a lth departments. 42 The innovativeness o f the department was dependent on the w illin g n e s s o f the health o f f i c e r to advocate change and seek resources. 43 Mohr subsequently used a measure o f the h ea lth o f f i c e r ' s ideology and a c tiv is m as in d ic a to rs o f th a t o f f i c e r ' s m o tiva tio n to innovate. These as a combined measure were found to c o r r e la t e w ith innovation in Mohr's s tu d y .44 Other in d iv id u a l v a ria b le s which he found to be r e la te d to innovation were age, r e c e ip t o f Master o f P ublic Health Degree, number o f p u b lic health p o s itio n s held per ten y e a r s , and length o f time in p r i v a t e medical p r a c t ic e . T rain in g and age o f key personnel other than the d ir e c t o r were found to be r e la t e d to in n o v atio n . These l a t t e r two fa c t o r s , however, could be tr e a te d as o rg a n iz a tio n a l v a ria b le s unless one deals w ith in d iv id u a ls o th e r than the d i r e c t o r . In general the a t t i t u d e s o f an in d iv id u a l toward change were found to be im portant by Blau, Rogers, E is e n s ta d t, Becker, and Katz and Coleman. 45 Blau found both the competence and the m a te ria l and status in t e r e s t s o f an in d iv id u a l to be associated w ith in n o v atio n . 46 Marshall Becker found t h a t those in d iv id u a ls who were in n o v ativ e had high p re s tig e among t h e i r f e llo w health o f f i c e r s and tended to be c e n t r a l l y lo c ate d in re le v a n t p u b lic health communication networks. 47 11 Rogers a ls o found o p in io n le a d e rs h ip s ta tu s to be asso c ia ted w ith in n o v a tio n . 48 The In n o v a tiv e p u b lic h e a lth o f f i c e r s in B ecker's study were more l i k e l y to view t h e i r r o le as t h a t o f a p ro fe s s io n a l in the p u b lic h e a lt h f i e l d than were those who were not in n o v a to rs . 49 Katz and Coleman r e p o rt s i m i l a r fin d in g s in a study o f the adoption o f a new drug among p r i v a t e p h y s ic ia n s . 50 Becker found t h a t inno­ v a t iv e p u b lic h e a lth o f f i c e r s were more l i k e l y to view p ro fe s s io n a l jo u rn a ls as an im portant source o f in fo rm a tio n about new programs in p u b lic h e a lt h . 51 Rogers re p o rts t h a t the in d i v i d u a l who is w i l l i n g to seek in fo rm a tio n about innovations and advice can be expected to be more in n o v a tiv e than the in d iv id u a l who does n o t. 52 The c a re e r ex p erience o f in d iv id u a ls has been r e l a t e d to in n ovatio n and is im p o rtan t here in the s tu d ie s o f p u b lic h e a lth in n o v a tio n . Mohr found t h a t the more p r i v a t e p r a c t i c e the h e a lth o f f i c e r had had b efo re coming to p u b lic h e a lth was n e g a t iv e ly c o r r e la te d w ith in n o v a tio n . M y tin g e r found the younger h e a lth o f f i c e r s to be more r a d ic a l in t h e i r w illin g n e s s to suggest new p r a c t ic e s . Both Mohr and M y tin g e r found h e a lth o f f i c e r ten u re and tu rn o v e r to be r e l a t e d to in n o v a tio n in the d ep artm en t, although Mohr found tu rn o v e r in job s held p er ten years to be o n ly weakly r e la t e d to in n o v a tio n . 53 Since the purpose o f t h i s d is s e r t a t i o n i s to deal w ith in n o v a tio n in p u b lic b u re a u c ra c ie s , I w i l l discuss b r i e f l y s tu d ie s which have looked a t p u b lic p o l i c y making and p o l i c y change as i t may r e l a t e to in n o v a tio n . One may wonder a t the re le v a n c e o f ap p ly in g th e o rie s and s tu d ie s which are e s s e n t i a l l y o r g a n iz a tio n a l 12 in focus to p o lic y making bodies. The fo llo w in g discussion should shed some l i g h t on t h i s . The question may be asked whether the a d m in is tra tiv e agencies are responsible f o r o r able to Innovate or whether they merely fo llo w the mandates o f the l e g i s l a t i v e bodies or the e x ec u tiv e. Researchers have found th a t in some cases the formal decision-making bodies d id not account f o r a very la rg e segment o f p u b lic p o lic y making and p o lic y change. The impetus f o r change, more o fte n than n ot, came from the bureau or agency i t s e l f . 54 Studies to d a te , however, have o ften merely been case studies o r comparisons o f processes in a few agencies to determine the cause o f d iffe r e n c e s in in n o v a tio n . 55 The l i t e r a t u r e in p u b lic a d m in is tra tio n has been d e f i c i e n t in re p o rtin g studies o f innovation although several stu d ies in p u b lic p o lic y making have been i m p l i c i t l y concerned w ith inn ovatio n w h ile a few others focus on t h is as the primary dependent v a r ia b le . 56 At l e a s t one author claims t h a t the f i e l d o f p ub lic a d m in is tra tio n i t s e l f is not a t a l l in n o v a tiv e . 57 Others, however, take an opposing view. 58 We would expect to fin d d iffe re n c e s from one agency to another o r from one a d m in is tra to r to another in the degree to which they innovate. The question a t hand here is whether i t pays to look w it h in and a t the s tr u c tu r e o f an agency to e x p la in the d iffe re n c e s in in n ovatio n. The approach taken in t h is study argues t h a t t h is is a worthwhile endeavor. The con­ clusions o f a number o f studies lends weight to t h is argument. Findings and conclusions are not conclusive on the a b i l i t y o f the a d m in is tra tiv e agencies to be in n o v a tiv e . Sayre and Kaufman, in t h e i r study o f New York C i t y , w rote th a t l i n e a d m in is tra to rs faced 13 too many o b s tac le s in terms o f vested i n t e r e s t s and t r a d i t i o n s to be in n o v a tiv e . 59 A d ria n , in a study o f p o lic y in n o v a tio n and le a d e r ­ ship in t h r e e council manager c i t i e s , found t h a t the c i t y manager and members o f h is a d m in is tr a tio n took p r i n c ip a l p a rts in both area s. He found t h a t the l e g i s l a t i v e body played a r a t h e r l im it e d r o l e . ^ Browning, in a comparison o f two s t a t e agencies found th a t i n t e r e s t groups and th e l e g i s l a t u r e had very l i t t l e to do w ith the d if f e r e n c e s in in n o v a tio n and budget success between the agencies. The impetus f o r change and in n o v a tio n came from w it h in the agency and from p ro fe s s io n a l groups whose members were employees o f the in n o v a tiv e agency. Indeed, Browning concluded t h a t the number o f p r o fe s s io n a ls in the agency was a s i g n i f i c a n t f a c t o r in the agency's budget success.®^ In a study o f the d i f f u s i o n o f in n o v atio n s among American s t a t e s , Jack Walker found t h a t the process o f search and d e c is io n by agencies was im p o rta n t. He concluded t h a t the d e c is io n ru le s used by the decisio n -m akers were o f g r e a t importance. What had been s u c c e s s fu lly adopted by a given s t a t e ' s neighboring s t a t e was q u it e o fte n used when a problem re q u ire d a new approach. Walker als o found t h a t the l a r g e r , w e a l t h i e r , more i n d u s t r i a l i z e d s ta te s are more in n o v a tiv e than the s m a lle r , le s s developed s ta t e s . 62 Ambition There are two bodies o f th eo ry which have m o tiva te d t h is study and which I w i l l draw upon. These a re complementary th e o rie s having a number o f s i m i l a r i t i e s . The f i r s t o f these is th e th eo ry 14 o f the r a t i o n a l b u re a u c ra t as o u t lin e d by Anthony Downs in his book In s id e Bureaucracy. 63 The second is p o l i t i c a l am bition th e o ry , developed by J . A. S c h le s in g e r and r e c e n t ly te s te d by a number o f researchers in va rio u s s e t t in g s . 64 Both o f these bodies o f th eo ry have basic s i m i l a r i t i e s to the com positive method o f economics. This method develops hypotheses about s o c ia l b eh avio r from models o f purposive beh avio r by i n d iv id u a ls and has a ls o been described as m ethodological in d iv id u a lis m . 65 Proponents o f t h i s p o s itio n i n s i s t t h a t statements o r d e s c rip tio n s about the group o r the beh avio r o f groups must be d e riv e d from in fo rm a tio n about in d iv id u a ls .® ® The in d iv id u a l consumer, e n t r e ­ preneur, employee, p o l i t i c i a n , o r in Downs' case, b urea u c ra t is the c e n tra l f i g u r e . He is assumed to face a s e t o f p o s s ib le ac tio n s and to choose the one w it h in the p o s s ib le s e t t h a t he most p r e f e r s . He is a chooser and is goal d ir e c t e d . This is in c o n tr a s t to his p a r t in the c h a r a c t e r i s t i c method o f sociology which has dominated the study o f bureaucracy in the p a s t. The s o c io lo g ic a l approach t y p i c a l l y develops hypotheses about s o c ia l beh avio r from models o f r o l e b e h av io r by aggregate id e a l typ es . The i n d iv id u a l is more o f a r o le p la y e r in some l a r g e r s o c ia l drama.®7 In the econom ist's approach to th e o ry r e f e r r e d to h e re , the l a r g e r environment in flu e n c e s the beh avio r o f the i n d iv id u a l by c o n s tra in in g h is s e t o f p o s s ib le a c t io n s , by changing the r e l a t i o n s between a c tio n s and outcomes, and, to some e x t e n t , by in flu e n c in g his personal p re fe re n c e s . The economist develops models o f purposive behavior by i n d i v i d u a l s , not to e x p la in the b e h av io r o f in d iv id u a ls 15 but to generate hypotheses concerning the ag g re g a tiv e consequences o f the in t e r a c t io n among in d iv id u a ls and t h e i r environments. fifi Downs' theory and am bition theory do, however, deal w ith the r e la tio n s h ip s between environmental c h a r a c t e r is t ic s and the ambitions o f In d iv id u a ls . In t h is d is s e r t a t i o n , I w i l l be con­ cerned w ith these r e la t io n s h ip s . Downs explains the behavior o f bureaus by the actions o f the bureaucrats t h a t c o n s t it u t e the bureau. Ambition theory exp lain s the ac tion s o f p o l i t i c i a n s as a response to t h e i r o f f i c e goals. I t also focuses on how the s tr u c tu r e o f o p p o rtu n itie s in a p o l i t i c a l s it u a t io n shapes a p o l i t i c i a n ' s goals. Of the stu d ies d ealing e x p l i c i t l y w ith innovation in o rg a n iz a tio n s , I am aware o f none which have tre a te d i t fo rm a lly in the manner to be suggested h e r e .6 ^ A number o f works, however, have d e a lt w ith economic models o f o r g a n iz a t io n s .70 Niskanen in v e s tig a te s budget and output behavior o f bureaus under d i f f e r e n t conditions and develops a theory o f supply by bureaus. His assumptions are c o n s is te n t w ith those Downs uses but are less r e s t r i c t i v e . As Downs s ta te s and Niskanen im p lie s , whenever o f f i c i a l s have any d is c r e t io n , they w i l l use a t le a s t some o f i t to advance t h e i r own i n t e r e s t s . 7^ This fo llo w s from the as­ sumptions o f r a t i o n a l i t y and u t i l i t y m aximization and w i l l be used to suggest an e x p la n a tio n f o r the v a r ia t io n in innovation among o rg a n iza tio n s . The general approach being discussed here has been used in analyzing the behavior o f p r iv a t e firm s as w ell as th a t o f p o l i t i ­ cians and bureaucrats. The search f o r a s u b s tit u t io n f o r the 16 c la s s ic a l assumption o f p r o f i t m axim izatio n o f th e f ir m led to the assumption o f the m a xim iza tio n o f s e l f - i n t e r e s t by the manager. This s e l f - i n t e r e s t was f u r t h e r assumed to ta k e the form o f m axi- mi zing the p e r q u is ite s o f his o f f i c e o r f u r t h e r i n g his c a re e r . 72 Since bureaus— and alm ost a l l o th e r p u b lic ag encies— are not managed by p r o f i t o r loss c r i t e r i a , some s u b s t i t u t e f o r th e p r o f i t maxi­ m iza tio n assumption must be made i f t h is economic approach i s to be used to study b u r e a u c ra tic b e h a v io r. The assumption t h a t is o fte n made is t h a t th e b u re a u c ra t, d i r e c t o r , o r o th e r a c to r w i l l attem pt to maximize h is s e l f - i n t e r e s t by maximizing e i t h e r d i r e c t l y o r i n d i r e c t l y some p e r q u is ite s o f h is o f f i c e o r h is c a re e r g o a l. Some a n a ly s ts go beyond j u s t making t h i s assumption to determ ine the n atu re o f the b u r e a u c ra t's g o a l. That is th e approach taken here. Since much o f the t h e o r e t i c a l work u n d e rly in g th is study borrows from Anthony Downs and am b itio n theory each w i l l be described in tu r n . The fundamental premise o f Downs' theory is t h a t b u r e a u c ra tic o f f i c i a l s , l i k e a l l o th e r agents in s o c ie t y , are s i g n i f i c a n t l y , though not s o l e l y , m o tiva te d by t h e i r own s e l f - i n t e r e s t s . 73 His th e o ry fo llo w s the t r a d i t i o n o f economic thought from Adam Smith fo rw ard and is c o n s is te n t w ith re c e n t c o n trib u tio n s to p o l i t i c a l science by R ik e r , Olson, Buchanan and T u llo c k , and o th e rs. 74 The th eo ry o f In s id e Bureaucracy r e s ts on th re e c e n tr a l assumptions: 1. B u re a u c ra tic o f f i c i a l s (and a l l o t h e r s o c ia l agents) seek to a t t a i n t h e i r goals r a t i o n a l l y . They a re u t i l i t y maxim izers. 17 This means th a t bureaucrats w i l l take those actions which w i l l best enable them to reach t h e i r goals. I t a ls o means th a t they w i l l attem pt to get as much o f a valued goal as they can. 2. Bureaucratic o f f i c i a l s in general have a complex set o f goals in c lu d in g power, income, p r e s t ig e , s e c u r i t y , convenience, l o y a l t y , p rid e in e x c e lle n t work, and d e s ire to serve the p u b lic i n t e r e s t . Regardless o f p a r t i c u l a r goals in v o lv e d , every o f f i c i a l is s i g n i f i c a n t l y m otivated by his own s e l f - i n t e r e s t even when a c tin g in a p u rely o f f i c i a l c a p a c ity . 3. Every o r g a n iz a tio n 's social fu n c tio n s stro n g ly in flu e n c e i t s in te r n a l s tr u c tu r e and behavior and v ic e versa. The environment th a t Downs' bureaucrats operate w ith in is one in which in fo rm atio n is c o s t ly , decision-makers have only lim it e d decision-making c a p a b i l i t i e s , and u n c e rta in ty is u su ally involved in making . d ecisions. . . 75 Downs c l a s s i f i e s a l l bureaucrats in to f i v e ideal types based on the ranking o f goals included in the b u re a u c ra ts 1 set o f p r e f e r ­ ences. He claims t h a t bureaucrats can be expected to use d i f f e r e n t means to maximize u t i l i t y depending upon what t h e i r goals a r e . D iffe re n c e s in goals may be due to age, len g th and type o f t r a i n i n g , o p p o rtu n itie s a v a i l a b l e , resources a v a i l a b l e , and o rg a n iz a tio n a l s tr u c tu r e . Much o f the a n a ly s is , th e r e f o r e , is independent o f the d e f i n i t i o n o f the id e a l types o f bureaucrats. The an a ly s is and the p ro po sition s th a t flo w from i t f o llo w — according to Downs— d i r e c t l y from the three c e n tr a l axiom s.^* Downs' theory w i l l not be accepted as sta ted but a s e t o f assumptions which are a m o d ific a tio n o f Downs and are also c o n s is te n t 18 w ith am bition th eo ry w i l l be suggested. Although th e complex s e t o f goals l i s t e d in Downs' assumption 2 is p ro b ab ly i n c l u s i v e , I suggest t h a t bureaucrats tend p red o m in an tly to have e i t h e r one o f two s e ts , the im p o rtan t elements o f which a r e ( a ) power, income, and p r e s t ig e , o r (b ) s e c u r it y and convenience. The i n d i v i d u a l s c o r r e ­ sponding to these sets o f goals a r e what Downs c a l l clim b ers and conservers, r e s p e c t i v e l y . ^ T his type o f c a t e g o r i z a t i o n i s also more s i m i l a r to the classes o f a m b itio n u s u a lly suggested by S c h les in g er and o th e rs in p o l i t i c a l am b itio n th e o ry . 78 Complementing Downs' th e o ry a re the f in d in g s o f am bition th eo ry. This body o f l i t e r a t u r e a ls o focuses on a r a t i o n a l s tr a te g y by the a c to r in v o lv e d , in t h is case by p o l i t i c i a n s running f o r e l e c t i v e o f f i c e . This departs from a method o f stu d ying p o l i t i c i a n s through case s tu d ie s employing p s y c h o a n a ly tic methods o r by accumu- l a t i n g s o c ia l background data o f p o l i t i c a l le a d e rs . 79 In an e a r l y e x p li c a t io n o f am bition th e o ry , S c h le s in g e r suggests: The c e n tr a l assumption o f am b itio n th e o ry is t h a t a p o l i t i c i a n ' s b ehavior is a response to h is o f f i c e g o a ls . O r, to p u t i t an o ther way, the p o l i t i c i a n as o f f i c e seeker engages . cal a c ts and makes d ec is io n s a p p r o p r ia te to g a in in g o f f i c e . I t makes l i t t l e d if f e r e n c e to the th e o ry o f a m b itio n whether they adopt the am bitions s u i t a b l e to the o f f i c e o r a t t a i n the o f f i c e because o f t h e i r a m b itio n s . t h a t governors o f New York w i l l behave as though they were P r e s id e n t ia l candidates w h ile governors o f M is s is s ip p i or South Dakota w i l l n o t . I t i s s u f f i c i e n t to conclude in p o l i t i ­ . S c h le s in g e r examined the re c r u itm e n t p a tte r n s among various o f f i c e s in the U n ited S ta te s . One v a lu a b le idea in h is work i s the co n ten tio n t h a t a man's p o l i t i c a l m otives and d e s ir e s a re molded by the a v a i l a b i l i t y o f p o l i t i c a l o p p o r t u n it ie s and t h a t such o p p o rtu n i- t i e s a re s t r u c t u r a l l y determ ined. 81 A number o f s tu d ie s have since 19 been done t e s t in g hypotheses suggested by S c h le s in g e r1s work and focusing on one o r more aspects o f h is th eo ry o f am bition - 82 One c o r r o l l a r y o f h is work is the suggestion t h a t the o f f i c e - h o l d e r responds p r i m a r i l y to the immediate fo rc e s in h is p o l i t i c a l e n v ir o n ­ ment r a t h e r than to f a c t o r s t h a t occurred in the more d is t a n t past o f the p o l i t i c i a n . According to Black: . . (th e p o l i t i c i a n ) probably tends to make d ecisio n s on the . bases o f the c o s ts , b e n e f i t s , and p r o b a b i l i t i e s t h a t o p e ra te a t the time o f h is d e c is io n . should pay much more a t t e n t i o n to the immediate circumstances surrounding a p o l i t i c i a n a t the tim e o f a d e c is io n r a t h e r than some s e t o f f a c t o r s in h is childhood o r e l s e w h e r e . ® ^ I f t h i s i s th e case, then one These works have stren g th en e d , e la b o r a te d , and complemented S c h le s in g e r*s th e o ry and f i n d in g s . The study o f p o l i t i c a l am bition is e s s e n t i a l l y the study o f m o tiv a tio n and re q u ire s data on i n d i ­ v id u a ls ; however, as Black has observed, S c h le s in g e r d id not " r e a l l y focus on the a c tu a l i n t e r a c t i o n between the s tr u c t u r e o f o f f i c e s and the am bitions o f in d i v i d u a l p o l i t i c i a n s . " ® ^ Several o f the more re c e n t s tu d ie s have d e a lt w ith data gathered from o r about in d iv id u a l p o l i t i c i a n s . Black developed a th eo ry o f p o l i t i c a l am bitions which r e s ts on the idea t h a t o f f i c e - s e e k e r s atte m p t to behave in a r a t i o n a l manner in s e l e c t in g among a l t e r n a t i v e o f f i c e s and te s te d hypotheses using survey d a ta on San Francisco Bay area p o l i t i c i a n s . He concluded . . t h a t the study o f p o l i t i c a l am bition g e n e r a lly can . b e n e f i t from an approach t h a t assumes t h a t p o l i t i c i a n s atte m p t to behave in a r a t i o n a l manner in seeking t h e i r p o l i t i c a l a s p ir a t io n s e x p la n a tio n o f th e c a r e e r choice process may prove to be the road to an adequate th e o ry o f p o l i t i c a l a m b itio n . Our fin d in g s a ls o suggest t h a t p o l i t i c a l am b itio n develops in p a r t as a r e s u l t o f th e investm ents t h a t p o l i t i c i a n s make in t h e i r p o l i t i c a l a c t i v i t y . 85 . f in d in g suggests t h a t a r a t i o n a l i s t i c . . 20 The th e o ry which u n d e r lie s the a n a ly s is f o r my study u t i l i z e s an assumption b asic to both t h e o r ie s discussed above; t h a t i s , the assumption t h a t in d iv id u a ls atte m p t to behave in a r a t i o n a l manner. The s e t o f assumptions necessary f o r the theory seems to be c o n s is te n t w ith both Downs and am bition th eo ry and is as fo llo w s : 1. In d iv id u a ls a c t in t h e i r own s e l f - i n t e r e s t . They have a complex s e t o f goals but a re s i g n i f i c a n t l y m o tivated by t h e i r own s e l f i n t e r e s t even when a c tin g in a p u r e ly o f f i c i a l c a p a c ity . 2. B u re a u c ra tic o f f i c i a l s seek to a t t a i n t h e i r goals r a t i o n a l l y . They a re u t i l i t y m axim izers. 3. 4. b i l i t i e s . In fo rm a tio n is c o s t ly . In d iv id u a ls as decisio n -m akers have only l i m i t e d capa­ From 3 and 4 i t fo llo w s t h a t d e c is io n s a re made in a c o n d itio n o f u n c e rta i n t y . The f i r s t assumption means t h a t i n d i v i d u a l s — in t h i s case p o l i t i c i a n s and b u re a u c ra ts — have personal goals toward which they d i r e c t t h e i r a c tio n s . The p u b lic s e r v a n t, in t h is v ie w , may have an a l t r u i s t i c view o f the p u b lic i n t e r e s t in mind when doing his j o b , but t h is is not h is prim ary goal as the o ld e r l i t e r a t u r e in p u b lic a d m in is t r a t io n would have us b e lie v e . 86 The p u b lic i n t e r e s t may be an i n s i g n i f i c a n t aspect o f the b u r e a u c ra t's goal complex. S i m i l a r l y , in e l e c t i v e p o l i t i c s , i t is assumed t h a t men have some p r i v a t e am bition t h a t they seek to f u l f i l l in t h e i r e f f o r t s to be e le c te d . The t r a d i t i o n t h a t a p o l i t i c i a n only wishes to seek e l e c t i o n to serve the p u b lic is not considered very c re d a b le . 21 Based on the assumption t h a t In d iv id u a ls maximize u t i l i t y , economists assumed t h a t the best way f o r the manager o r owner to do t h i s was to maximize p r o f i t s . More re c e n t work in the behavior o f the f i r m has expanded the maximand o f the manager to in c lu d e o th e r th in g s , f o r example such p e r q u is it e s o f o f f i c e as s t a f f , s a la r y , and f r i n g e b e n e f i t s . 87 P u b lic b ureaucracies can seldom i f e v e r be e v a lu a te d on a p r o f i t versus loss b a s is , so th e assumption t h a t bureaucrats atte m p t to maximize p r o f i t w i l l not be u s e fu l. However, re c e n t work in p o l i t i c a l science has adopted the economic mode o f a n a ly s is and used the assumption t h a t people who work fo r p u b lic agencies atte m p t to maximize u t i l i t y and attem p t to do so r a t i o n a l l y . This must be done through some method o th e r than p r o f i t m axim izatio n by the agency, however. The t y p ic a l process in these stu d ie s has been to d e te rm in e , e i t h e r by assumption, by h yp o th es is , or by o th e r v a r i a b l e s , goals t h a t th e p o l i t i c i a n o r b urea u c ra t w i l l atte m p t to o b ta in . Follow ing Downs and o t h e r s , I determ ine the goals t h a t bureaucrats can be expected to have and how they may attem p t to reach them. The assumption o f r a t i o n a l i t y — assumption two— im p lie s t h a t the i n d i v i d u a l , when confronted w ith a d e c is io n , w i l l examine the a l t e r n a t i v e s w ith which he is c o n fro n te d , t h a t he w i l l e v a lu a te those a l t e r n a t i v e s in terms o f the l i k e l i h o o d o f t h e i r occurrence and the value they hold f o r him, and t h a t he w i l l choose t h a t a l t e r n a t i v e which y i e l d s f o r him the g r e a t e s t expected va lu e . 88 In t h is formu­ l a t i o n , one assumes t h a t the in d iv id u a l is atte m p tin g to s e l e c t the best a l t e r n a t i v e f o r h im s e lf, i . e . , t h a t a l t e r n a t i v e which maximizes 22 his expected v a lu e , but he may n o t, o f course, always be c o rre c t in his choice. 89 and expensive. He may make e rro rs because info rm ation i s lim it e d In fo rm a tio n is obtained a t a c o s t, and the amount r e a d ily a v a ila b le to a decision-m aker is lim it e d . The decision-m aker also is lim it e d in h is a b i l i t y to process and e v a lu a te in fo rm a tio n . He can only devote a lim it e d amount o f time to making any one d ec is io n . Assumptions th re e and fo u r imply th a t decisions are made in a con­ d it io n o f u n c e r ta in ty . "U n ce rtain ty in d ecision theory describes a l l shades o f knowledge o f the p r o b a b ilit y d i s t r i b u t i o n o f the states o f n atu re ranging from near accurate estim ates based upon o b je c tiv e experience to an extreme case in which no knowledge e x is ts ." Decision-makers do not have p e r fe c t in fo rm ation and do not know the exact p r o b a b i l it i e s o f the outcomes o f a c tio n s . They can only make estim ates as to these p r o b a b i l i t i e s based on past e x p erie n c e, the experience o f o th e rs , and present in fo rm atio n . "The decision-m aker must g e n e ra lly a r r i v e a t his d ecision through the process o f an educated 'g u e s s .'" 91 Moreover, as the cost o f info rm ation in c re a s e s , o f f i c i a l s w i l l gather less o f i t f o r the same p a y o ff. 92 The concept o f u t i l i t y maximization is o fte n contrasted w ith a competing n o tio n o f s a t i s f i c i n g . In the c la s s ic a l economic l i t e r a t u r e , u t i l i t y maximization im plied t h a t the decision-m aker was ab le to co n sider the e n t i r e set o f a l t e r n a t i v e s from which he would choose h is a c tio n . To each a l t e r n a t i v e was attached a set o f consequences— the events t h a t would ensue i f t h a t p a r t i c u l a r 23 a l t e r n a t i v e was chosen. The decisio n -m aker could rank a l l a l t e r ­ n a tiv e s and t h e i r consequences from most p r e fe r r e d to l e a s t p re ­ f e r r e d . He then s e le c te d the l a t e r n a t i v e lea d in g to th e most p re f e r r e d s e t o f consequences. 93 The d ec isio n -m aker i s making an optimal ch o ice and th e re b y maximizing h is u t i l i t y . Simon and o th e rs have pointed o u t d i f f i c u l t i e s w it h t h i s model o f r a t i o n a l man. . . i t makes t h r e e exceed ing ly im p o rta n t demands upon the . choice-m aking mechanism. o f cho ice a re each a l t e r n a t i v e a re known { in one o f the th re e senses c o r r e ­ sponding to c e r t a i n t y , r i s k , and u n c e r t a i n t y , r e s p e c t i v e l y ) (3 ) t h a t the r a t i o n a l man has a complete u t i l i t y o rd e rin g . f o r a l l p o s s ib le sets o f consequences.94 (2 ) t h a t a l l the consequences a tta c h e d to I t assumes ( 1 ) t h a t a l l th e a l t e r n a t i v e s ' g i v e n ' ; . . A d e c is io n -m a k e r, March and Simon c la im , is u s u a l l y con­ cerned w ith f i n d in g s a t i s f a c t o r y a l t e r n a t i v e s , not o p tim a l ones. "An a l t e r n a t i v e is s a t i s f a c t o r y i f : ( 1 ) th e re e x is t s a s e t o f c r i t e r i a t h a t d e s c rib e s m in im a lly s a t i s f a c t o r y a l t e r n a t i v e s , and (2 ) the a l t e r n a t i v e in q uestion meets o r exceeds these c r i t e r i a . " 95 An o r d in a r y d e c is io n -m a k e r cannot always search f o r the b e s t p o s sib le s o lu tio n to the problems he fa c e s ; he has n e i t h e r the time nor th e energy. He in s tea d fin d s an a l t e r n a t i v e t h a t he thinks is good enough to m a in ta in the values im p o rta n t to him. "The l im it s o f r a t i o n a l i t y p re v e n t him from maximizing h is b e n e f it s i n every s i t u a t i o n ; r a t h e r he ' s a t i s f i c e s , ' o r chooses a course o f a c t io n t h a t seems s a t i s f a c t o r y under the circum stances."^® Man's b eh av io r in o rg a n iz a tio n s is " in te n d e d ly r a t i o n a l . " 97 Simon has two r a t h e r im p o rtan t things to say concerning what is " s a t i s f a c t o r y . " F i r s t o f a l l men do not p e rc e iv e a t o t a l s i t u a t i o n , 24 Simon claim s, but only th a t p o rtio n o f the t o t a l which is meaningful and s i g n i f i c a n t to them. In o th e r words, p ercep tion is s e le c t iv e . 98 Secondly, he asserts t h a t what is s a t i s f a c t o r y a t any given moment is in flu e n ce d by achievement and defeats o f the past as w e ll as things t h a t are p re s e n tly going on. That i s , a s p ir a tio n le v e ls are conditioned. 99 Luce and R a if f a describe a m o d ific a tio n o f u t i l i t y theory which brings the fo rm a l, r a t io n a l approach more in l i n e w ith Simon’ s approach. This m o d ific a tio n includes the p o s s i b i l i t y " th a t people can n e ith e r d is c rim in a te p e r f e c t l y between a l t e r n a t i v e s w ith respect to preferences nor between events w ith respect to lik e lih o o d ."^ ® ® The bureaucrats in Downs' theory are u t i l i t y maximizers as are the actors in most r a t io n a l choice approaches in p o l i t i c a l science.^®^ However, Downs' theory contains elements o f both the maximizing and the s a t i s f i c i n g approaches. The theory underlying th is d is s e r ta tio n tr e a t s in d iv id u a ls as maximizers; they are r a t io n a l in Simon's sense o f being in ten d ed ly r a t i o n a l . 102 That i s , they attempt to choose the best a l t e r n a t i v e under the l i m i t s o f time pressure, lack o f in fo rm a tio n , and lack o f energy. An a l t e r n a t i v e which is good enough in some s it u a tio n s may not be good enough in o th e rs . In the co n text o f o rg a n iz a tio n a l in n o v a tio n , the foregoing assumptions lead us to analyze behavior which is best i l l u s t r a t e d by the fo llo w in g passage from Downs: . . a n a ly sis o f o rg a n iz a tio n a l change . . in d iv id u a ls . Because they are u t i l i t y m axim izers, they are always w i l l i n g to adopt a new course o f a c tio n i f i t promises . focuses . . . . on 25 to make them b e t t e r o f f , even i f they are r e l a t i v e l y happy a t present. However, they cannot search f o r new cources o f a c tio n w ith o u t expending resources. Since the supply o f these is l i m i t e d , they tend to avoid f u r t h e r search whenever the l i k e l y rewards seems small a p r i o r i pay o ff seems s m a lle r than the expected marginal c o s t) . This is the case whenever t h e i r c u rre n t behavior seems q u ite s a t is f a c t o r y in l i g h t o f t h e i r recent exp erience. *03 ( t h a t i s , the expected marginal The theory o f In s id e Bureaucracy and am bition theory suggest th a t the m o tiva tio n o f the i n d i v i d u a l , t h a t i s , the goals he has set f o r him self determ ine, in p a rt a t l e a s t , the action s t h a t he takes. In d iv id u a ls choose and e v a lu a te t h e i r goals by ta k in g in to consideration t h e i r present p o s it io n , age, competence, past success and f a i l u r e s . They probably also compare themselves to o th e rs l i k e them in e v a lu a tin g t h e i r chances f o r o b ta in in g a p a r t i c u l a r goal. W ithin th is framework then, they take action s which they b e lie v e w i l l bring them c lo s e r to t h e i r g o a ls , i . e . , bring them the g re a te s t amount o f u t i l i t y . The a c to r in t h is s it u a t io n must take in to consideration the resources and o p p o rtu n itie s a t hand. In cases where resources a re necessary to develop p o lic y which w i l l bring the in d iv id u a l p r e s t ig e , the in d iv id u a l d e s irin g p re s tig e w i l l be f r u s t r a te d i f these resources are not a v a i l a b l e . In both ambition and b u re a u c ra tic ambition th e o ry , the a c to r 's behavior is a response to his c a re e r goal as d efined w ith in the context o f the research i n t e r e s t . That i s , the e le c te d o f f i c i a l has a s e t o f possible o f fic e s the a tta in m e n t o f which is evaluated a g ain st o th e r a l t e r n a t i v e s . For the b u rea u c ra t, the c a re e r goals are from a set o f p o s itio n s o r circumstances w ith in the s tr u c tu r e o f his r e le v a n t p rofession o r bureaucracy. 26 Downs' In s id e Bureaucracy has not been accepted w ith o u t c r i t i ­ cism. Those reviews which have appeared have been mixed but some have had s t i f f c r i t i c i s m f o r c e r t a i n aspects o f Downs’ work. Probably the most common c r i t i c i s m o f the book is t h a t in i t Downs does not r e a l l y p re s e n t a th e o ry . Murray gives a mixed re vie w o f the work s t a tin g t h i s c r i t i c i s m . I t f a i l s to be a th e o ry , Murray c la im s , because Downs i s unable to work w ith a f i x e d s e t o f v a r ia b le s and t a l k o nly about the i n t e r - r e l a t i o n s h i p s between them. But Murray goes on to say: . . once one r e a l i z e s t h a t In s id e Bureaucracy is not a re a l . theory and not a v a l i d basis f o r e x p la in in g the d if f e r e n c e between s t a t e - r u n and p r i v a t e o r g a n iz a tio n s , one can go on to a p p re c ia te Downs' o r i g i n a l and p e rc e p tiv e a n a ly s is o f any number o f la r g e and small phenomena which a r i s e in the in t e r n a l o p e ra tio n o f any la rg e o r g a n i z a t i o n . ^ ^ C recin e a ls o c r i t i c i z e s and p ra is e s the book, f a u l t i n g Downs f o r in tro d u c in g “a hopeless number o f v a r ia b le s " and f a i l i n g "to u t i l i z e h is 'axioms' in any meaningful way." 105 According to some c r i t i c i s m Downs’ "Laws" a re not d e riv e d from the axioms but merely appear. The p ro p o s itio n s als o a re not fo r m a lly d e riv e d from the assumptions and would be very d i f f i c u l t to t e s t f o r the most p a r t according to these c r i t i q u e s . ^ 06 Downs' is not a f u l l y fo rm a liz e d th eo ry but does present an i n t e r e s t i n g and p o t e n t i a l l y useful framework which u t i l i z e s many o f the ideas o f am bition th e o ry . I w i l l suggest hypotheses to be te s te d from the combination o f am bition th eo ry and In s id e Bureaucracy. These hypotheses w i l l not be d e riv e d in a formal sense but t h e i r r e l a t i o n s h i p to the th eo ry presented w i l l be shown. Furtherm ore, 27 a number o f Downs' p ro p o sition s are te s te d . Downs' theory appears to be what Rudner r e f e r s to as a p a r t i a l fo rm a liz a tio n or a less than complete e la b o ra tio n o f a theory as a deductive system. The occurrence o f non-indigenous terms in a p a r t i a l l y fo rm alized theory in d ic a te s t h a t some p o rtio n o f the re s u lts o f o ther d is c ip lin e s or areas o f knowledge are being presupposed in the theory. 108 This also seems to be the case in Downs' theory and i t w i l l be c a rrie d f u r t h e r by the combining o f aspects o f In s id e Bureaucracy w ith ambition theory and o rg a n iz a tio n th eo ry. Downs' theory is also q u a s i-d e d u c tiv e , th a t i s , i t purports to be d e d u c tiv e ly e la b o ra tin g to meet the requirements f o r being a deduction. Such f a i l u r e u s u a lly stems from n e g le c tin g , d e l ib e r a t e ly eschewing, or being unable to make e x p l i c i t a l l o f the statements r e q u is it e as premises, as w ell as neg lectin g o r being unable to make e x p l i c i t a l l o f the ru les and steps required in a r r i v i n g a t the c o n c lu s io n .109 . f a i l s . but . . . . The c r i t i q u e s o f In s id e Bureaucracy mentioned e a r l i e r in d ic a te th a t i t is c h a ra c te riz e d by q u a si-dedu ctio n. Rudner, however, seems to fin d th is kind o f a theory less u nd esirab le than does Crecine in his r e v ie w .110 The theory t h a t I have o u tlin e d from Inside Bureaucracy and ambition theory w i l l be both q u a si-d e d u c tiv e and only p a r t i a l l y f o r m a l i z e d . ^ The hypotheses th a t I present w i l l f o r the most p art be generated from the theory but the deductions w i l l be incom­ p le t e . Arguments and fin d in g s o f o th e r d i s c i p li n e s , mainly o rg a n i­ zatio n theory and am bition th e o ry , w i l l be brought in to show why the r e la tio n s h ip s in the hypotheses are to be expected in terms o f the theory and previous research. The assumptions necessary to show 28 the deduction o f the hypotheses may not a l l be made e x p l i c i t and the steps in the deduction w i l l not always be complete. However, the assumptions o u tlin e d e a r l i e r and the d iscussion w i l l be s u f f i c i e n t , in most cases to e s t a b lis h the hypotheses. In o th e r cases, hypotheses d i r e c t l y from In s id e Bureaucracy w i l l be t e s te d . The ta s k o f the study i s e x te n s iv e . The prim ary dependent v a r ia b le is o r g a n iz a tio n a l in n o v a tio n . The f i r s t s e t o f hypotheses examines the r e l a t i o n s h i p o f in n o v a tio n to o r g a n iz a tio n a l c h a r a c te r ­ i s t i c s o f the p u b lic h e a lth departm ents. Hypotheses c o n s id e rin g the c h a r a c t e r is t ic s o f the b u re a u c ra ts , in t h i s case the lo c a l P u b lic H ealth d i r e c t o r s , and t h e i r r e la t io n s h ip s to the expressed am bitions o f these o f f i c i a l s w i l l be t e s t e d . Another s e t o f hypothesis w i l l r e l a t e i n d iv id u a l c h a r a c t e r i s t i c s o f d ir e c t o r s to departm ental v a r ia b le s . A f i n a l s e t o f hypotheses w i l l suggest an e x p la n a tio n f o r o r g a n iz a t io n a l in n o v a tio n in terms o f the expressed am bitions o f bureaucrats and the c h a r a c t e r i s t i c s o f the departments. S c h e m a tic a lly , the study w i l l deal w ith the v a r i a b l e s e t in Figure 1. The next ch apter w i l l discuss hypotheses t h a t l i n k these elements to each o th e r. 29 D i r e c t o r expressed ambi t io n O rg a n iz a tio n a l v a r ia b le s Inn ovatio n ‘D i r e c t o r backgroun v a r ia b le s Figure 1 - 1 . --E lem e n ts o f a Model o f O rg a n iz a tio n a l In n o v a tio n . Chapter I — Footnotes Robert E. M y tin g e r , "In n o v atio n s in P u b lic H ealth" (un­ published doctoral d i s s e r t a t i o n , U n iv e r s it y o f C a l i f o r n i a a t Los Angeles, 1965 ); Lawrence B. M ohr,"Determ inants o f In n o v atio n in O rg an ization s" (unpublished doctoral d i s s e r t a t i o n , U n iv e r s it y o f M ichigan, Ann A rb o r, 1 9 6 6 ); L. B. Mohr, "Determ inants o f Inn ovatio n in O rg a n iz a tio n s ," frnerican P o l i t i c a l Science Review, 63 ( 1 9 6 9 ) , pp. 111-126. p See Mohr, American P o l i t i c a l Science Review, ojk c r t - , p. 112 V ic t o r A. Thompson, Bureaucracy and In n o v a tio n ( U n iv e r s it y o f Alabama, U n iv e r s ity o f Alabama P re ss , 19 69 ); pp. 5 , 6 and 68; E v e r e t t M. Rogers, D iffu s io n o f In n o v a tio n s (New York; 19 62 ), p. 308; James Q. W ils o n , "In n o v a tio n s in O rg a n iza tio n s : Notes Toward a T heory," Approaches to O r g a n iz a tio n a l Design, ed. James D. Thompson ( P itt s b u r g h : U n iv e r s it y o f P itts b u rg h P ress, 1 9 6 6 ), p. 196; Homer G. B a r n e t t , Company, 1 9 5 3 ), p. 7; John W. Loy, J r . , " S o c ia l-P s y c h o lo g ic a l C h a r a c te r is tic s o f In n o v a to r s ," American S o c io lo g ic a l Review, 34 (1 9 6 9 ), p. 75. In n o v atio n (New York: McGraw-Hill Book Free Press o f Glencoe, 3 Thompson, op.- c i t . 4 I b i d . c Mohr, American P o l i t i c a l Science Review, pp. c i t . , p. 112; Rogers, op- c i t . , pp. 1 9 5 -1 9 6 ; H erbert A. Simon, "The Changing Theory and Changing P ra c tic e o f P u b lic A d m in is t r a tio n ," P o l i t i c a l Science: Toward E m p irical T h e o ry, ed. (New York: McGraw-Hill Book Company, 1 9 6 7 ), p. 107. in Contemporary I t h i e l De Sola Pool ®Mohr, op. c i t . , p. 113; Thompson, ojs. c i t . , pp. 5 - 6 . 7Rogers, 0£. c i t . , p. 2; Loy a ls o r e l i e s on Rogers' d e f i n i t i o n See Loy, o{K c i t . O Mohr, oj>. c i t . , p. 112. ^Larry K ir k h a r t and Orion W hite, "The Future o f O rg a n iz a tio n a l Development," Pu blic A d m in is tra tio n Review ( M a r c h /A p r il, 1 9 7 4 ), pp. 129-140. i o J e r a ld Hage and Michael A iken, "Program Change and O rg an i­ z a tio n a l P ro p e rtie s : A Comparative A n a ly s is ," American Journal o f S o c io lo g y , 72 (March, 1 9 6 7 ), pp. 503-519. 30 31 ^ T a l c o t t Parsons, The S o c ia l System {Glencoe, I l l i n o i s : The Free Press, 1 9 5 1 ), Chapter 12. 12 Hage and A ik e n , ofK c i t . . ; P e te r B la u , " S tr u c tu r a l E f f e c t s , " American S o c io lo g ic a l Review, 25 ( 1 9 6 0 ) , pp. 178-193. 13 14 15 Hage and A ike n , o|>. c i t . , p. 518. Mohr, Oja. c i t . , p. 113. James S. Coleman, E. K a tz , and H e rb e rt M en zel, Medical In n o v a tio n : A D i f f u s i o n Study ( I n d i a n a p o l i s , B obbs-M erri11 Company, 1966). 16Mohr, 0 £ . c i t . , pp. 1 1 2 -1 1 7 , 11 9-1 26 ; Edwin M a n s fie ld , "The Speed o f Response o f Firms to New Techniques," Q u a r te r ly Journal o f Economics (May, 1 9 6 3 ), pp. 2 3 9 -3 0 4 ; M y tin g e r, o£. c i t . , p. 212; Hage and A ike n , 0 £ . c i t . , pp. 5 1 6 -5 1 7 ; Samuel N. E is e n s ta d t, The P o l i t i c a l System o f Empires (New York: The Free Press o f Glencoe, 1 9 6 3 ), pp. 27, 33 -1 1 2 ; Rogers, 0 2 .. c i t . , pp. 4 0 , 285-292. ^ H a g e and A ik e n , 0 £ . c i t . , pp. 50 3-519. ^8Mohr, 0£ . c i t . , pp. 111-126. 19I b i d . , pp. 114. 2 0 I b i d . , pp. 114-115. ^ M y t i n g e r , o]3. c i t . , p. 212. 22 Robert E. M y tin g e r, " B a r r ie r s to Adoption o f New Programs as Perceived by Local H e a lth O f f i c e r s , " P u b lic H e a lth R e p o rts , 82 (F e b ru a ry , 1 9 6 7 ), pp. 108-114. 23 M a n s fie ld , op. c i t . ; E is e n s ta d t, 0 2 ,. c i t . ; Rogers, ojd. c i t . 2^ M a n s fie ld , 0£. c i t . , p. 309. ?5 Jean C a r r o l l , "A Note on Departmental Autonomy and Inno­ v a tio n in Medical Schools," Journal o f Business (O cto ber, 1 9 6 7 ), pp. 533-534. Selwyn Becker and Frank S t a f f o r d , "Some Determ inants o f O r g a n iz a tio n a l Success," Journal o f Business (O cto ber, 1 9 6 7 ), p. 511. 27W ilson, O fK c i t . , p. 198. 28 I b i d . , p. 200. 29 I b i d . , p. 205. 32 30 Harvey Sapolsky, "O rg a n iza tio n al S tru c tu re and Inno­ v a t io n ," Journal o f Business (October, 1967), p. 498. 31 I b i d . , p. 509. 32 P eter Blau, S. Heydebrand, and R. S t o u f f e r , "The S tru c tu re o f Small B ureaucracies," American S o cio lo q ica l Review, 31 ( A p r i l , 1966), p. 186. 33 34 I b i d . , p. 187; V ic t o r A. Thompson, oj>. c i t . Mayer Zald and P a t r i c i a Denton, "From Evangalism to General Service: The Transform ation o f the YMCA," A d m in is tra tiv e Science Q u a r te r ly , 8 (September, 1963 ), pp. 235-246. 35 Rufus P. Browning, " In n o v a tiv e and Non-Innovative Decision Processes in Governmental Budgeting," Readings I l l i n o i s : F .;E . Peacock P u b lis h e rs , 1 9 6 8 ), pp. 128-145. in Theory and P r a c t i c e , ed. R. T. Golembiewski ( I t a s c a , in P ublic Budgeting and Finance: 37 R. S. Friedman, L. B. Mohr, and R. M. Northrup, "Innovation in S ta te and Local Bureaucracies, Paper d e liv e re d a t the American P o l i t i c a l Science A sso ciatio n Annual Meeting, New York C i t y , September 6 -1 0 , 1966. 38 39 Sapolsky, oja. c i t . R. Evan and S. Black, "Innovation in Business O rg a n iza tio n s ," Journal o f Business (October, 1967 ), pp. 519-531. 40 41 Rogers, 0 £ . c i t . Mohr, d is s e r t a t i o n , p. 71. 42I b i d . , p. 47. 43 Mohr, American P o l i t i c a l Science Review, pp. 115-118. 44 P e te r Blau, The Dynamics o f Bureaucracy (Second E d it io n , revised; Chicago: U n iv e r s ity o f Chicago Press, 1962); Rogers, op. c i t . ; E is e n s ta d t, op_. c i t . ; Marshall Becker, "Factors A ffe c tin g D iffu s io n o f Innovations Among Health P ro fe s s io n a ls ," American Journal o f P u b lic H e a lth , 60 (February, 1970 ), pp. 294-304; Coleman, Katz, and M enzel, op. c i t . / 45 M y tin g e r, Innovation in P u b lic H e a lth , p. 195; Rogers, op. c i t . , pp. 285-292. See L. B. Mohr, American P o l i t i c a l Science Review, p. 113. 46 B lau, The Dynamics o f Bureaucracy, p. 246. 33 47 48 Becker, o£. c i t . Rogers, D iffu s io n o f In n o v a tio n , op. c i t . 49 50 51 52 Becker, o£. c i t . Coleman, Katz, and Menzel, o£. c i t . Becker, ojk c i t . E. M. Rogers and A. E. Havens, “P re d ic tin g In n o vativen ess," S o c io lo g ic a l In q u iry (1 9 6 2 ), p. 38. Mohr, d is s e r t a t i o n , pp. 100, 161, and 163; M ytin g e r, op. c i t . 53 54 Friedman, Northrup, and Mohr, o£. c i t . ; Aaron W ildavsky, L i t t l e , Brown, and The P o l i t i c s o f the Budgetary Process (Boston: Company, 1964). 55 56 57 58 59 For example, Browning, oj>. c i t . Friedman, Northrup and Mohr, o£. c i t . Thompson, Bureaucracy and In n o v a tio n , p. 60. Simon in I t h i e l de Sola Pool, 0 £. c i t . Wallace Sayre and H erbert Kaufman, Governing New York C ity (New York: Russell Sage Foundation, 1960). ^ C h a r le s A d ria n , Four C i t i e s : A Study in Comparative P o lic y Making (P h ila d e lp h ia : U n iv e r s it y o f Pennsylvania Press, 1963). ^B row n in g , in Golembiewski, oj>. c i t . ®2Jack Walker, "Innovations in S ta te P o l i t i c s , " in P o l i t i c s in the American S tate s: A Comparative A n a ly s is , ed. H erbert Jacob and Kenneth Vines (Second e d i t i o n ; Boston: L i t t l e , Brown, and Company, 1971), pp. 354-387, e s p e c ia lly pp. 363*368, and 359. CO L i t t l e , Brown, and Company, Boston, 1967. 64Joseph A. S c h les in g er, Ambition and P o l i t i c s (Chicago: Rand McNally and Company, 1966). Others who have done em p iric al research on ambition theory include Gordon S. B lac k, "A Theory o f P o l i t i c a l Ambition: Career Choices and the Role o f S tru c tu ra l In c e n tiv e s ," American P o l i t i c a l Science Review, 66 (March, 1 9 7 2 ), pp. 144-159; Kenneth P r e w it t and W illia m Nowlin, " P o l i t i c a l Ambitions and the Behavior o f Incumbent P o l i t i c i a n s , " The Western P o l i t i c a l 34 Q u a rte rly (June, 19 69 ), pp. 298-308; Kenneth P r e w i t t , The Recruitment ” o f P o l i t i c a l Leaders: A Study o f C itiz e n P o l i t i c i a n s (New York: B o b b s -M e rril1 Company, 1970); Paul L. Hain, "American S tate L e g is la to rs ' Ambition and Careers: The E ffe c ts o f Age and D i s t r i c t C h a r a c te r is tic s " (Unpublished Ph.D. d i s s e r t a t i o n , Michigan S tate U n iv e r s it y , 1971); E. N. Swinerton, "Ambition and American State Executives," Midwest Journal o f P o l i t i c a l Science, 12 (November, 1968), pp. 538-549; R. L. Engstrom, " P o l i t i c a l Ambitions and the P ro s ec u to rial O f f ic e , " Journal o f P o l i t i c s , 33 (February, 1971), pp. 190-194. 65 W illia m A. Niskanen, J r . , Bureaucracy and Representative Government (Chicago: A ld in e -A th e rto n , 1971 ), pp. 5 -6 . ®®May Brodbeck, "Methodological In d iv id u a lis m : D e f in it io n and Reduction," ed. Brodbeck (New York: McMi11 an, 19 68 ), pp. 280-303. in Readings in the Philosophy o f the Social Sciences, ^ N is k a n e n , 0£. c i t . 69 Richard Cyert and James March, A Behavioral Theory o f the Firm (Englewood C l i f f s , New Jersey, 1963), t r e a t innovation b r i e f l y and in a very lim ite d way. ^ I n a d d itio n to C yert and March, 0 £ . c i t . , see O liv e r W illiam son, The Economics o f D is c re tio n a ry Behavior: Managerial O bjectives in~a Theory o f the Firm (Englewood C l i f f s , New Jersey: P r e n tic e -H a l1, I n c . , 1964); and R. J. Monson, J r . , and Anthony Downs, "A Theory o f Large Managerial Firm s," American Economic Review, 73 (June, 1965), pp. 221-236. ^Downs, Insid e Bureaucracy, pp. 75-112; Niskanen, 0£ . c i t . , pp. 40-41. 72 O li v e r E. W illiam son , "A Model o f R ational Managerial Behavior," J. G. March, pp. 237-252. in A Behavioral Theory o f the F irm , ed. R. M. Cyert and 73 Downs, 0£ . c i t . , p. 2. ^ W i l l i a m H. R ik e r, The Theory o f P o l i t i c a l C o a litio n s (New Haven: Yale U n iv e rs ity Press, 1962); Mancur Olson, J r . , The Logic o f C o lle c t iv e Action (Cambridge, Massachusetts: Harvard U n iv e rs ity Press, 1965); Gordon T u llo c k , The P o l i t i c s o f Bureaucracy (Washington, D . C . : P ublic A f f a i r s Press, 1965); James Buchanan and Gordon T u llo c k , The Calculus o f Consent (Ann Arbor: U n iv e rs ity o f Michigan Press, 1962). 75 Downs, 0 £. c i t . , p. 2 - 3 . 35 7fi I b i d . , p. 91. Downs r e fe r s to these assumptions as hypotheses. However, they are never te s te d d i r e c t l y nor is the suggestion made th a t they be te s te d . T h e ir t r u t h i s only assumed and p ropositions f o r t e s t in g are generated from them. They th e re fo re are more properly c a lle d assumptions. See J u lia n Simon, Basic Research Methods in Social Science (New York: Random House, 19 69 ), pp. 35-38. 77Downs, 0£. c i t . , p. 88. 78 Schlesinger suggests th ree major types o f am bition: s t a t i c , d is c r e t e , and progressive (S c h le s in g e r, 0 £. c i t . , pp. 1 0 -1 1 ). Those w ith s t a t i c ambitions d e s ire to m aintain t h e i r present e l e c t i v e o f f i c e , those w ith progressive ambitions would d e s ire a higher o f f i c e . Black expresses a s i m il a r notion by o u t lin in g two le v e ls o f p o l i t i c a l commitment, p o s itio n a l commitment, which is the p o l i t i c i a n ' s commitment to h is c u rre n t p o s itio n ; and progressive commitment, the p o l i t i c i a n ' s commitment to seek o th e r p o l i t i c a l and governmental p o s itio n s (Gordon Black, of)., ci t . , p. 150). Both bear s i m i l a r i t i e s to Downs' clim b e r/ conserver c a te g o riz a tio n o f b u re a u c ra tic types o f am bition. In a p re lim in a ry attem pt to v a lid a t e the appropriateness of I discussed aspects o f the theory and my proposed study Downs' c l a s s i f i c a t i o n to the study o f P u b lic Health o f f i c i a l s in M ichigan, w ith a number o f p ro fe s s io n a ls in the f i e l d o f Public Health in Michigan. One suggested t h a t t h is c l a s s i f i c a t i o n g e n e ra lly described the types o f in d iv id u a ls found as h e a lth o f f i c e r s in lo c a l j u r i s ­ d ic tio n s w ith in the s t a t e . 79 on 81 Gordon Black, o£. c i t . S c h les in g er, oj). c i t . , pp. 6 -9 . Black, op. c i t . , p. 144. Black gives support to th is notion although he does not v e r i f y i t e m p ir ic a lly . t h a t the ambitions o f in d iv id u a ls are s tro n g ly shaped by the a v a i l a b i l i t y o f o p p o rtu n itie s and t h a t t h is e f f e c t is stro n g ly manifested in the p r o b a b i l it y estim ates t h a t p o l i t i c i a n s assign to various a l t e r n a t i v e s . " " . . . I suspect 82 83 P r e w it t , o£. c i t . , pp. 186-188; P re w itt and Nowlin, o(K c i t . Black, American P o l i t i c a l Science Review, 1972, p. 145. 8 4 I b i d . , p. 144. 85 I b i d . , pp. 145, 158-159. OC Niskanen, oj). c i t . , p. 36-37. 87 Williamson in Cyert and March, OfK c i t . 36 88 Black, American P o l i t i c a l Science Review, 1972, pp. 145- 146. See R. D. Luce and Howard R a i f f a , Gaines and Decisions (New York: John Wiley and Sons, 1957 ), and Anthony Downs, An Economic Theory o f Democracy (New York: Harper and B ro th ers, 1 9 5 7 ), pp. 4 -1 1. 89 90 Black, op. c i t . , p. 146. Stephen H. A rc h e r, "The S tru c tu re o f Management Decision Theory," in Public A d m in is tra tio n : Readings in I n s t i t u t i o n s , Processes, and Behavior, ed. R. T. Golembiewski, F. Gibson, and G. Cornog (Chicago: Rand McNally and C o., 19 66 ), pp. 3-1 8 . 91 92 Black, ojk c i t . Downs, Insid e Bureaucracy, pp. 176-178. / 93 James March and Herbert Simon, O rganizations (New York: John Wiley and Sons, 1958). 94I b i d . , p. 138. 95I b i d . , p. 140. 96 97 Walker in Jacob and Vines, o^. c i t . , p. 365. Ruth P. Mack, Planning on U n c e rta in ty : Decision Making in Business and Government (New York: p. 61. John Wiley and Sons, I n c . , 197l7» 98I b i d . , p. 62. 99 Herbert Simon, "A Behavioral Model o f Rational Choice," Models of Man (New York: John Wiley and Sons, I n c . , 1 9 5 7 ), p. 253. 100Luce and R a i f f a , o|>. c i t . , p. 373. 10^Downs, In s id e Bureaucracy, p. 168. His theory contains aspects o f both the "maximizing" and " s a t i s f i c i n g " approaches to r a t i o n a l i t y and d ecision making. 102 Herbert Simon, A d m in is tra tiv e Behavior (Second e d it io n ; New York: MacMillan Company, 1961”). i m Downs, oja. c i t . , p. 168. ^84J. Murray, "Review o f Anthony Downs," In s id e Bureaucracy, Public A d m in is tra tio n Review (Janu ary/F eb ru ary, 19 68 ), p. 92. 105John P. Crecine,"Review o f Anthony Downs," In s id e Bureaucracy, American Science Review, 63 (1 9 6 9 ), pp. 182-183. 37 ^ ^ R ic h a r d S. Rudner, The Philosophy o f Social Science (Englewood C l i f f s , N .J .: P r e n tic e - H a l1, I n c . , 1966), p. 47. 108I b i d . , p. 48. 109I b i d . , p. 50. 11° I b i d . , pp. 50-53. ] 1 1 I b i d . , p. 50. CHAPTER I I HYPOTHESES, RESEARCH SETTING AND RESEARCH DESIGN In t h i s ch a p te r I s e t f o r t h the hypotheses and p resen t argu­ ments f o r the r e la t io n s h ip s which a re p re d ic te d by them. The d i s ­ cussion w i l l atte m p t to show how the hypotheses a re c o n s is te n t w ith the th eo ry presented in the p revious ch apter- However, much o f the argument w i l l r e l y on r e l a t e d th e o r ie s and o th e r research f in d in g s which support the r e la t io n s h ip s in each hypothesis.^ Although th e re a re th re e major sets o f hypotheses, I w i l l begin by focusing on those hypotheses which in c lu d e in n o v a tio n as t h e i r dependent v a r i a b l e . I w i l l then extend the d iscu ssio n to in c lu d e hypotheses w ith o th e r dependent v a r ia b le s and atte m p t to e x p la in the r e la t io n s h ip s by grounding the hypotheses in the theory o u t lin e d in Chapter I . Although Downs argues t h a t d i f f e r e n t types o f bureaucrats a re more l i k e l y to be found in some bureaus o r o r g a n iz a tio n s than o th e r s , I w i l l d elay the d iscussion o f hypotheses d e a lin g w ith these v a r ia b le s u n t i l a l a t e r s e c tio n . These hypotheses w i l l be im p ortan t when I argue t h a t i n d iv id u a ls w ith c e r t a i n c h a r a c t e r i s t i c s are more l i k e l y than o thers to be found as d ir e c t o r s o f departments w ith c e r t a in kinds o f output o r p o l i c y , e . g . , in n o v a tio n . We have to go beyond S c h le s in g e r 's am bition th eo ry to p r e d ic t t h a t some o f the 38 39 v a r ia t io n in o rg a n iz a tio n a l innovation is due to the goals o f the d ir e c to r s o f the o rg a n iza tio n s o r departments. Ambition theory suggests t h a t p o l i t i c i a n s w i l l have d i f f e r e n t goals and t h a t these w i l l be important f o r behavior. But t h i s w i l l have to be developed f u r t h e r to e x p la in why some bureaucrats w i l l be more in n o v ativ e than o th e rs . In a l a t e r section I w i l l discuss why i t is reasonable to expect clim b ers, more than conservers, to be in n o v a tiv e . C o rrelate s o f Innovation in Public Health Departments There are a number o f fa c to r s beside the d ir e c t o r which w i l l in flu e n c e h e a lth departments, and many other o rg a n iz a tio n s , to be more o r less in n o v a tiv e . Although the aggressiveness o f the d ir e c t o r w i l l in flu e n c e the innovation o f the department th ere are a number o f o rg a n iz a tio n a l c h a r a c t e r is t ic s which are l i k e l y to have an e f f e c t on innovation separate from th a t o f the d ir e c t o r . So, although the d ir e c t o r is im p o rtan t, we can p r e d ic t t h a t , f o r example, departments w ith more f in a n c ia l resources w i l l be more in n o vative d e s p ite the type o f bureaucrat who is the d ir e c t o r . The com plexities o f the j o i n t in flu e n c e o f o rg a n iz a tio n a l fa c to r s and d ir e c t o r types on innovation w i l l be d e a lt w ith in various succeeding sections. Without data on in d iv id u a ls in o rg a n iz a tio n s , researchers must f i r s t deal w ith o rg a n iz a tio n a l v a ria b le s and be c a re fu l about any statements a t t r i b u t i n g p o lic y output to the in d iv id u a ls in the o rg a n iz a tio n s . I can, however, based on the theory o u tlin e d e a r l i e r , show how the o rg a n iz a tio n a l fa c to rs to be discussed in flu e n c e inno­ va tio n by making i t more or less d i f f i c u l t o r l i k e l y t h a t the department 40 w i l l Innovate. Mohr, M y tin g e r, and others have obtained data on in d iv id u a ls and departmental resources and Mohr has in v e s tig a te d a d d itiv e and m u l t i p l i c a t i v e models which included the personal c h a r a c t e r is t ic s o f the h e a lth department d i r e c t o r as w ell as o rg a n iz a tio n a l and community c h a r a c t e r is t ic s . 2 However, he did not r e l y on a u n ify in g theory to generate hypotheses o r e x p la in r e la tio n s h ip s . My procedure w i l l be to in v e s t ig a t e f i r s t some o rg a n iz a tio n a l c o rr e la te s o f innovatio n. I w i l l then incorporate in to the a n a ly s is the goals and backgrounds o f the d ir e c to r s o f the health departments to help e x p la in the r e la tio n s h ip s which are found. The f i r s t hypothesis o f t h is set is : Hypothesis A - l : The le v e l o f resources w i l l be p o s it i v e l y c o rr e la te d w ith innovation in lo c al p u b lic h e a lth departments. The le v e l o f resources has been one o f the fa c to r s th a t has con­ s i s t e n t l y been found to c o r r e la t e p o s i t i v e l y and u su ally s tro n g ly w ith in n o v atio n . M an sfield found t h is to be the case in in d u s t r ia l o rg a n iza tio n s as did Mohr and M ytinger in p u b lic h e a lth departments. 3 I w i l l t e s t t h is hypothesis using a l t e r n a t i v e in d ic a to rs o f the le v e l o f resources. However, t h is v a r ia b le w i l l be p r im a r ily o p e ra tio n a liz e d by using the s ize o f the departmental budget. The measures o f the v a ria b le s w i l l be discussed in a l a t e r sectio n when I present the te s tin g o f the hypotheses. Larger amounts o f resources im p lies more money a v a ila b le f o r h ig h e r s a la r ie s which would a t t r a c t more h ig h ly q u a l i f i e d personnel and more l i k e l y more tec h n ica l help such as s e c re ta rie s 41 and c l e r i c a l a id . Larger resources may also lead to more subscrip­ tio n s to pro fession al jo u rn a ls and the c a p a b ilit y to t r a v e l to pro­ fe s s io n a l meetings. A la r g e r amount o f resources suggests th a t th ere w i l l be more slack resources, t h a t is uncommitted funds, f o r assignment or use by the d is c r e tio n o f the d ir e c t o r and s t a f f . 4 Mohr made the assumption, which 1 f e e l i s v a l i d , t h a t g re a te r resources would mean g re a te r d is c r e tio n in the commitment o f resources f o r o rg an izatio n s in g e n e ra l. 5 Resources would seem to be a necessary, i f not s u f f i c i e n t , p r e r e q u is ite f o r o th e r departmental mechanisms such as s p e c ia lis ts and research by which departments may innovate. The s a la r y range o f the departments also seemed to be a close function o f the s iz e o f the budgets o f the departments. Closely r e la te d to the resources o f the department as measured by budget are the s ize o f the department in terms o f the number o f employees and the s iz e o f the population served by the department. The s iz e of the o rg a n iz a tio n i t s e l f suggests th a t th e re are more people a v a ila b le to develop new programs and to bring them to the a t t e n t io n o f the d i r e c t o r . In a d d it i o n , la r g e r departments are l i k e l y to have more s p e c ia lt ie s among t h e i r employees than sm aller departments, in c re as in g the number o f d i f f e r e n t types o f programs suggested. Larger departments a re also more l i k e l y to be able to assign personnel to fewer tasks than spending a lim it e d amount o f time on a v a r ie ty o f th in g s . The former aspect would a llo w the employees to become more s p e c ia liz e d and knowledgeable about problems and p o s sib le s o lu tio n s . A second hypothesis, th en , is : 42 Hypothesis A -2: The number o f employees 1n a department w i l l be p o s i t i v e l y c o r r e l a t e d w ith the inno­ v a tio n o f th e departm ent. Past research has supported t h is hypothesis a ls o .® In the la r g e r departments th e d i r e c t o r i s l i k e l y to be aid ed by a deputy d i r e c t o r and p o s s ib ly an a s s i s t a n t d i r e c t o r o r an a d m in is t r a t iv e aid e. This r e l ie v e s the d i r e c t o r o f many o f the r o u tin e adm inis­ t r a t i v e chores so he can devote more tim e to p o lic y and program development. Or he can d e le g a te some o f these l a t t e r tasks to h is a s s is t a n t s . In a d d it i o n , the l a r g e r departments are a b le to have more persons working in problem areas in which th ey have e x p e r t is e . These persons are made aware o f problems as w ell as p o s s ib le s o lu tio n s and a r e ab le to suggest and work on programs r e le v a n t to s o lv in g these problems.^ The arguments supporting th e hypothesis o f a r e la t io n s h ip s between s iz e and in n o v a tio n a ls o suggest the a d d it io n a l hypotheses: Hypothesis A -3: The p r o f e s s i o n a l i z a t i o n and d i v e r s i t y o f a department w i l l both be p o s i t i v e l y c o r r e la te d w ith i t s in n o v a tio n . I suggested in Chapter I t h a t a number o f s tu d ie s had found the p r o f e s s i o n a l i z a t i o n o f the o rg a n iz a tio n to be r e l a t e d to inno­ v a tio n . Other s tu d ie s have worked w ith s p e c i a l i z a t i o n and d i v e r s i t y , two concepts which o fte n appear to be very s i m i l a r to the usage o f the concept p r o f e s s i o n a l i z a t i o n . One way o f accounting f o r the r e l a t i o n s h i p between p r o f e s s i o n a l i z a t i o n and in n o v a tio n is to look a t the r o l e t h a t s p e c i a l i z a t i o n plays in o r g a n iz a tio n s . Smith presents an argument f o r a system's c a p a c ity f o r in n o v a tiv e a c t i v i t y . The argument: g 43 r e s ts on t h i s b as is : more complex, h ig h ly d i f f e r e n t i a t e d systems, in c o r p o ra tin g w it h in them a g r e a t e r number o f ro le s through a system o f s p e c i a l i z a t i o n and the d iv is i o n o f la b o r a ls o in c o rp o ­ r a t e a g r e a t e r le v e l o f knowledge and in fo rm a tio n processing a b i l i t y . ® Smith uses th e argument to im ply t h a t d i v e r s i t y o f ro le s leads to more in fo rm a tio n processing a b i l i t y in a system which then a id s in n o v a tio n . "The r e l a t i o n s h i p between system d i f f e r e n t i a t i o n , conceived o f as in fo rm a tio n -p ro c e s s in g a b i l i t y o r le v e l o f know­ ledge and e x p e r t i s e , is r e f l e c t e d throughout much o f the s o c io lo g ic a l l i t e r a t u r e on both comnunities and formal o r g a n i z a t i o n s . " ^ Note t h a t Wilson a ls o makes the argument th a t d i v e r s i t y in an o r g a n iz a tio n leads to more in n ovatio ns being suggested. I w i l l t e s t the hypothesis t h a t s p e c i a l i z a t i o n i s r e l a t e d to in n o v a tio n . However, i t seems t h a t i t is n o t simply the number o f ro les in a system which in c re as es in fo rm a tio n processing a b i l i t y , but the presence o f c e r t a in types o f r o le s . T h a t i s , i t is s p e c i a l i ­ z a tio n o f p r o f e s s i o n a l i z a t i o n , r a t h e r than d i v e r s i t y i t s e l f which accounts f o r in n o v a tio n which i s due to in fo rm a tio n processing a b i l i t y . Smith turns to a s i m i l a r argument. A supplementary e x p la n a tio n o f the d i f f e r e n t i a t i o n - i n n o v a t i o n lin k a g e , going beyond the argument t h a t s p e c ia liz e d ro le s in c o r p o ra te a g r e a t e r le v e l o f s p e c ia liz e d knowledge, tak es i n t o account th e sources o f t h i s knowledge. Hage (1965) has argued t h a t the s p e c i a l i s t s o f any o rg a n iz a tio n have channels o f i n f o r ­ mation both w it h in and o u ts id e the o r g a n iz a tio n which make them more aware o f the need f o r in n o v a tio n in response to e x t e r n a l and i n t e r n a l s t r a i n s . The g r e a t e r the number o f such occu­ p a tio n a l s p e c i a l t i e s w it h i n th e o r g a n iz a t io n , the more c l o s e ly is t h a t o r g a n iz a tio n lin k e d w ith o th e rs and the g r e a t e r th e flo w o f In fo rm a tio n in t o the . . system .11 . Jack Walker uses a s i m i l a r l i n e o f reasoning in connection w ith s t a t e bureaucracies and the co n tacts t h a t p ro fe s s io n a ls m a in ta in 44 outsid e these o rg a n iz a tio n s . 12 C ra in , e t a l . » evidence supports t h is reasoning. They found t h a t communities w ith the more p ro fe s ­ sional c i t y manager, having g r e a te r c o n ta c ts , are more l i k e l y to adopt a wide v a r i e t y o f progressive community programs. 13 Browning also concluded th a t the contacts t h a t members o f a s ta te agency had w ith pro fession al as so ciatio ns outsid e the agency were a major f a c t o r - - in innovation. . . 14 In a d d itio n to t e s tin g the hypothesis t h a t r o le d i v e r s i t y in a p u b lic health department is r e la t e d to in n o v a tio n . I w i l l attempt to t e s t the r e la t io n s h ip between p ro fess io n al ro le s or professional s p e c ia lt ie s w ith in the o rg a n iz a tio n and in n o v a tio n . This i s what I w i l l mean by p r o fe s s io n a liz a t io n and i t w i l l be measured in two ways. F i r s t , i f i t is the p ro fe s s io n a l contacts th a t the department has w ith o u ts id e pro fession al o rg a n iza tio n s th a t a id in in n o v a tio n , the g r e a te r the number o f professions to which the department has t i e s , the g re a te r would be the types o f in fo rm ation a v a ila b le and the g r e a te r the in n o v atio n . So one measure o f p r o fe s s io n a liz a t io n w i l l be the number o f separate pro fession al occupations represented by the employees o f the department. But also important is the number o f in d iv id u a ls m aintain ing such co n tacts. The more in d iv id u a ls w ith outsid e p ro fession al a f f i l i a t i o n s , the more in fo rm ation -processin g a b i l i t y and the more awareness o f programs w i l l be in the department. There w i l l also be support from more in d iv id u a ls f o r in n o v a tiv e programs. I t is not only the number o f professions to which the department has channels 45 but the number o f persons m a in ta in in g these channels which are important f o r in n o v a tio n . Persons o f d i f f e r e n t professions are l i k e l y to be concerned w ith a number o f d i f f e r e n t problems and suggest programs to help solve these perceived problems. The la r g e r number o f professions and p ro fe s s io n a ls in a department may help to increase the innovativeness o f the department due to these persons keeping up w ith developments in t h e i r p ro fess io n s, a tte n d in g meetings, gaining new in fo rm atio n on techniques, and being less r e s is t a n t to new ideas presented in the department. 15 These employees would also tend to be more cosmopolitan in t h e i r outlooks and o p p o rtu n itie s f o r employment in o th e r o rg a n iza tio n s would e x i s t leading them to s t r i v e f o r innovations f o r which they can take r e s p o n s i b i l i t y . Here we see the employee s t r iv i n g to keep up his p ro fess io n al re p u ta tio n and probably responding to the norms o f a referen ce group e s s e n t i a ll y outsid e o f his department. This type o f employee would also be less threatened by changes he opposed w ith in the department i f employment o p p o rtu n itie s were a v a ila b le elsewhere. The number o f s p e c ia lt ie s i t s e l f w i l l be used as a v a r i a b l e , however. Smith argues th a t more ro le s provides more in fo rm ation processing a b i l i t y to the system which leads to more innovation.^® Hage and Aiken measure s p e c ia liz a t io n by the number o f d i f f e r e n t types o f work which are done in the o r g a n iz a t io n .17 I w i l l use a s i m il a r measure. Durkheim presents an argument t h a t com petition among s p e c ia lt ie s leads to more innovation through the attem pt to o b ta in more resources. 18 So the g r e a te r the number o f separate s p e c i a l t i e s , the g r e a t e r the e f f o r t s to expand and the more innovation 46 w i l l be attempted. I w i l l measure d i v e r s i t y by the number o f occu­ p a tio n a l s p e c i a l t ie s w it h in the department and t e s t the fo llo w in g c o r o lla r y o f hypothesis A - 3: Hypothesis A -4: The number o f occupational s p e c ia lt ie s w i l l be p o s i t i v e l y c o r r e la te d w ith innovation in p u b lic health departments. The assumptions o f r a t i o n a l i t y and s e l f - i n t e r e s t apply to a l l department employees* as w ell as to a l l s o c ia l a c to r s , not j u s t to the d i r e c t o r , although I w i l l only have in d iv id u a l data on the d ir e c t o r s . But we can expect each employee to a c t in his o r her s e l f - i n t e r e s t . Each s p e c i a l i s t , f o r in s ta n c e , w i l l attempt to b u ild up his sectio n of the department and to o b ta in more resources f o r what he i s doing. The more the s p e c i a l i s t has a f f i l i a t i o n s w ith e x tr a -o r g a n iz a tio n a l professions the more he i s l i k e l y to be aware o f new techniques as w ell as want to implement them. He w i l l also want to b u ild a good employment re p u ta tio n f o r h im self and w i l l o f course have his p ro fess io n al o rg a n iz a tio n as a referen ce group. The next hypothesis in th is set concerns the s iz e o f the population served by the h e a lth department. Hypothesis A-5: The s iz e o f the population o f the com­ munity served by the department w i l l be p o s i t i v e l y c o r r e la te d w ith the innovation o f the department. Population may be h ig h ly c o r r e la te d w ith department size and resources, so i t could be d i f f i c u l t to separate the c o r r e la tio n o f these th ree v a ria b le s w ith innovatio n. Larger population are accompanied by la r g e r ab s o lu te amounts o f resources f o r the d e p a rt­ ment. So inasmuch as l a r g e r populations are a cause o f la r g e r resources, we would expect population to be r e la te d to in n ovatio n. 47 However, th ere are reasons to b e lie v e t h a t the s i 2 e o f the population may have an e f f e c t by i t s e l f on in n o v atio n . Larger populations u su ally imply a g re a te r number and type o f problems to be d e a lt w ith , thus evoking a g re a te r search f o r s o lu tio n s . 19 There may be a g re a te r demand f o r h e a lth s e rv ic e s . The h ea lth department personnel can use the f a c t o f g r e a te r population as a supportive argument f o r new programs. Larger populations also suggest t h a t an urban area is in v o lv ed , where the p opulation may have organized i n t e r e s t groups along some l i n e s , such as w e lfa re mothers, f o r example. There is probably an in t e r a c t io n here between population and s iz e o f department. That i s , i f a department has a la rg e population but a small s t a f f , i t may be less in n o v a tiv e than a department w ith a sm a lle r population to serve t h a t is able to assign adequate s t a f f to dealing w ith lo c al health problems. I suspect t h a t the c o r r e la t io n between department s ize and population size is q u ite stron g , however. Mohr found community s iz e to be r e la t e d to innovation and made an e f f o r t in his a n a ly s is to tra ce the e f f e c t s o f community size on resources and innovatio n. 20 Mytinger found the more inno­ v a tiv e h e a lth departments in C a lif o r n ia to be serving la rg e popu- l a t i o n groups. 21 Both o f these researchers found several o f the fa c to rs d e s c r ip tiv e o f larg e s ize to be c o rr e la te d w ith innovation. Although I have argued th a t each o f these f a c to r s - - r e s o u r c e s , s iz e , and p o p u la tio n — has a separate c o n trib u tio n to in n o v a tio n , they have been found to be so h ig h ly c o rr e la te d w ith each o th e r th a t some d i f f i c u l t y may a r is e in assessing t h e i r separate e f f e c t s . 48 An a d d it io n a l set o f f a c t o r s to be considered here a re the changes In re so u rces, s i z e , and p o p u la tio n . One might expect an increase in resources o r personnel to be fo llo w ed by the adoption o f new programs, i . e . , in n o v a tio n . An increase in the budget is l i k e l y to be asso c ia ted w ith in n o v a tio n f o r a number o f reasons. Innovation may be used by a d i r e c t o r as a s tr a t e g y to in crease the departm ent's t o t a l resources. Although budgets tend to r i s e each y e a r anyway, a new program would probably r e q u ir e more a d d it io n a l resources than co n tin u in g ongoing programs. An in c re a s e in resources o r s iz e may i n d ic a t e the adding o f new s t a f f in program areas which are in n o v a tiv e . Increased resources may a ls o be i n d i c a t i v e o f uncommitted resources which may then be used to innovate. 22 A change in the s iz e o f a department may als o be expected to be asso ciated w ith in n o v a tio n . An o r g a n iz a tio n t h a t is growing may be h ir in g new personnel t h a t can in n o v a te in the program areas discussed as in n o v a t iv e . My theory a ls o p re d ic ts t h a t c lim b e rs — those w ith a s p ir a t io n s o f power, money, and p r e s t i g e — a re drawn to growing o rg a n iz a tio n s and are more l i k e l y to press f o r in n o v a tio n than are conservers who are not l i k e l y to be found in growing o r g a n iz a tio n s . 23 The f o llo w in g hypotheses are suggested: Hypothesis A -6: There w i l l be a p o s i t i v e c o r r e l a t i o n between the change in resources and the in n ovatio n o f p u b lic h e a lth departm ents. Hypothesis A-7: There w i l l be a p o s i t i v e c o r r e l a t i o n between the change in the s iz e o f a department and the in n o v a tio n o f the departm ent. A change in p o p u la tio n o f the j u r i s d i c t i o n served may a ls o be expected to c o r r e l a t e w ith in n o v a tio n . An in c re a s e in p o p u la tio n 49 may present the department w ith new h e a lth problems t h a t need to be d e a lt w it h . However, i f an increase in population is not accompanied by an increase in funds and personnel from the county commissioners or o th e r sources, then the department w i l l f a l l behind in i t s p ro v is io n o f s e rv ic e s . A slow but steady increase in population w i l l l i k e l y be accompanied by increases in resources and lead to innovation f o r the reasons discussed. However, a larg e or sudden increase in population is l i k e l y to r e s u lt in a lag in services and may be n e g a tiv e ly cor­ re la te d w ith inn ovatio n. The hypothesis suggested is : Hypothesis A-8: The change in population served by the h e a lth department w i l l be c o rr e la te d w ith in n o v a tio n . The te s tin g o f t h is f i r s t set o f hypotheses w i l l explore o rg a n iz a tio n a l c h a r a c t e r is t ic s which are necessary f o r o r conducive to in n o v atio n . L a te r sections w i l l show t h a t the c h a r a c t e r is t ic s o f the d ir e c t o r s o f the h e a lth departments involved are r e la te d to o rg a n iz a tio n a l innovatio n. The hypotheses in th is set imply th a t c e r ta in o rg a n iz a tio n a l p ro p e rtie s are responsible f o r a major share o f the variance in in n o v atio n . The im p lic a tio n a t th is p o in t is th a t these c h a r a c t e r is t ic s a re conducive to innovation independently o f the type o f bureaucrat who is the d i r e c t o r o f the department. Mohr has analyzed a m u l t i p l i c a t i v e model which takes in t o con­ s id e r a tio n the m o tiva tio n o f the h e a lth o f f i c e r . L a te r s e c tio n s , as in d ic a te d p re v io u s ly , w i l l bring in to the an a ly s is the c h a ra c te r­ i s t i c s o f the d ir e c to r s o f the p u b lic h e a lth departments. I n t e r ­ ac tio n may be expected between the department and d ir e c t o r v a r ia b le s . For example, given the same amount o f resources, the innovation o f the department w i l l depend g r e a t l y on the ac tio n s o f the le a d e rs h ip . 50 However, the leadership o f the d ir e c t o r w i l l have g re a te r o r less e f f e c t on innovation depending upon the le v e l o f resources and o th e r o rg a n iz a tio n a l f a c t o r s . F i r s t , the o rg a n iz a tio n a l and d ir e c t o r c o rr e la te s o f innovation w i l l be analyzed s e p a ra te ly and then the j o i n t in fluen ces w i l l be considered. In t e r a c t io n e f f e c t s o f these two sets o f independent v a ria b le s w i l l also be included. C o rrelate s o f D ire c to r Ambition A second set o f hypotheses deals w ith c h a r a c te r is tic s o f the d ir e c to r s o f the h e a lth departments. Before p lacin g these d ir e c to r s in the a n a ly s is w ith o rg a n iz a tio n a l s tr u c tu r e and in n o v a tio n , I discuss the hypotheses which a llo w me to form the l i n k between in d iv id u a ls ' background c h a r a c t e r is t ic s and t h e i r expressed goals. Then a d d itio n a l hypotheses which r e l a t e goals to behavior and to o rg a n iz a tio n a l v a ria b le s w i l l be discussed. The p u b lic h ea lth studies in innovation found a number of in d iv id u a l c h a r a c t e r is t ic s as w ell as o rg a n iz a tio n a l c h a r a c t e r is t ic s to be r e la t e d to the innovation o f the h e a lth departments. The theory o u tlin e d in Chapter I suggests t h a t in d iv id u a ls w i l l be found in o rg a n iz a tio n s th a t best enable them to o b ta in t h e i r p r iv a te and p u b lic goals. Based on the axioms o f the th e o ry , I can c la s s if y the h e a lth department d ir e c to r s in to c a te g o rie s o f expressed ambition and expect t h a t those w ith d i f f e r e n t ambitions w i l l behave d i f f e r e n t l y in performing t h e i r job s. Of course the o rg a n iz a tio n a l environment is im portant in determining these o f f i c i a l s action s als o . 51 D i f f e r e n t l i f e experiences w i l l g iv e r i s e to d i f f e r e n t am bitions among b u re a u c ra ts . These l i f e experiences in c lu d e t r a i n i n g , past c a re e r and a ls o age. But the o p p o r t u n itie s t h a t a p u b lic h e a lth d i r e c t o r o r any o th e r kind o f b urea u c ra t c o n fro n ts , and h is experience w ith them w i l l in flu e n c e his a m b itio n s . In Chapter IV I w i l l t e s t hypotheses which l i n k c h a r a c t e r i s t i c s o f the department d ir e c t o r s to departm ental in n o v a tio n and attem p t to make some assessment o f the process by which t h is occurs. But p r i o r to t h i s I w i l l discuss and t e s t hypotheses which l i n k the c h a r a c t e r i s t i c s o f these in d i v i d u a l s to t h e i r am b itio n s. Downs bases much o f h is a n a ly s is on the c l a s s i f i c a t i o n o f bureaucrats according to t h e i r g o a ls . This is s i m i l a r to the am bition approach taken by S c h le s in g e r and o th e rs . The fo llo w in g hypotheses deal w ith c h a r a c t e r i s t i c s o f d ir e c t o r s which can be used to help c l a s s i f y them according to am b itio n . The hypotheses in t h i s se ctio n concern v a r ia b le s which are expected to be r e l a t e d to the g o a ls , and thus the a m b itio n s , o f b u re a u c ra ts . The d iscu ssio n up to now has drawn on the th eo ry developed in the previous c h a p te r. However, much o f the d iscussion has r e l i e d on r e l a t e d t h e o r ie s and o th e r research fin d in g s which support the expected r e l a t i o n s h i p s in each hyp oth esis. The d iscussion in t h i s s e c tio n w i l l c o n tin u e in l i k e manner. However, I w i l l discuss the hypotheses which a r e more c e n tr a l to the am bition th eo ry o u tlin e d in the f i r s t c h a p te r. In the fo llo w in g s e c tio n I discuss some hypotheses by which we can help to i d e n t i f y b u reau crats according to t h e i r a m b itio n . 52 As a b urea u c ra t becomes o ld e r we would e x p ec t him to be more con­ cerned w ith keeping the jo b t h a t he has than w ith moving to a new one w ith a d d it io n a l r e s p o n s i b i l i t i e s . I f a man has had l i t t l e suc­ cess in the past in g a in in g promotions* f o r example, he w i l l view h is p res en t o r f u tu r e chances o f moving to a b e t t e r * more re s p o n s ib le , h ig h e r paying p o s itio n as being f a i r l y low. The o ld e r an o f f i c i a l i s , the more l i k e l y he is to become a co n server. 24 As he g ets o l d e r , h is chances f o r r e a l l y s u b s ta n tia l f u t u r e advancement o r achievement o f any kind are reduced unless he is near the v e ry top o f the h ie r a r c h y . The g r e a t e f f o r t s re q u ire d in ta k in g the i n i t i a t i v e to change ca re ers o r p o s it io n s are more d i f f i c u l t f o r an o ld e r man. 25 In S c h le s in g e r ' s terms th e degree o f p ro g re s s iv e am bition d e c lin e s w ith in c re a s in g age. 26 Hypothesis B—1: The p ro p o rtio n o f d ir e c t o r s having am bitions i d e n t i f i e d as those o f conservers increases w ith in c re a s in g age; the p ro p o rtio n o f d ir e c t o r s having am b itio n s i d e n t i f i e d as those o f clim b ers decreases w ith in c re a s in g a g e . 27 A number o f s tu d ie s in am b itio n theory have v e r i f i e d t h is hypothesis f o r p o l i t i c i a n s . In a d e t a i l e d a n a ly s is o f the age p r o p o s it io n , Hain found t h a t among s t a t e l e g i s l a t o r s the r a te s o f p ro g re s s iv e p o l i t i c a l am bitions and o f p ro g res sive subsequent p o l i t i c a l careers d e c lin e d as age in c re as ed . The ra te s o f s t a t i c p o l i t i c a l am bitions and o f s t a t i c p o l i t i c a l c a re e rs increased w ith age. 28 P r e w i t t and Nolan r e p o r t f in d in g support f o r S c h le s in g e r 's age hypothesis as does P r e w it t in h is book. 29 Mohr's research lends some support to t h i s age h yp o th esis. He found le s s in n o v a tio n among the o ld e r h e a lth 53 d ir e c t o r s . He a ls o found th a t o ld e r health o f f i c e r s were less l i k e l y to fe e l th a t the p o s itio n o f h e a lth o f f i c e r should be an a c t iv e one in persuing support f o r p ub lic h e a lth o b je c tiv e s than the younger o f f i c e r s . 30 B ureaucratic ambition th eo ry suggests t h a t those w ith clim ber ambitions w i l l take advantage o f employment o p p o rtu n itie s to increase t h e i r sa la ry and professional p re s tig e and p o s itio n . They w i l l take advantage o f new jo b o p p o r tu n itie s , be more w i l l i n g to take a chance or r is k change to improve t h e i r p o s itio n than w i l l those w ith o u t such am bition. Also as conditions in an o rg a n iz a tio n are such t h a t they f r u s t r a t e the goals o f a c lim b e r, e .g . the o rg a n iz a tio n d eclin es in s iz e o r grows more slowly than others o f a s i m il a r n a tu re , o r lacks resources, the clim b er is more l i k e l y than the conserver to lea ve . Downs argument im p lie s th a t clim bers w i l l be more l i k e l y to change jobs hence they w i l l experience a g re a te r job tu rn o v er in t h e i r careers than conservers. 31 Conservers are change a v o id e rs , according to Downs, and we would expect clim bers to be more w i l l i n g to make or contemplate a change in jobs than conservers. When a given bureau grows f a s t e r than o th e r comparable o rg a n iz a tio n s , many clim bers jump in to i t from elsewhere. Conversely, i f i t co n trac ts o r grows more slowly than o th e r o rg a n iz a tio n s , climbers tend to jump out o f 32 i t . One would expect to f in d clim bers attem pting to move to the la r g e r o rg a n iza tio n s where s a la ry and o ther advantages are g r e a te r . And in doing so they may have found i t necessary to change jobs a number o f times. Conservers are more l i k e l y to put up w ith a f r u s t r a t i n g s i t u a t i o n than w i l l clim b ers. To the conserver, the 54 cost o f changing jobs r e l a t i v e to the b e n e f i t , is less than some other s tra te g y such as lowering a s p ir a tio n s . Stated as an hypothesis then, we have: Hypothesis B-2: Climbers are more w i l l i n g to change jobs than conservers. The p ub lic h e a lth department d ir e c t o r who has an advanced degree in p u b lic h e a lth is in a p o s itio n to have more in fo rm ation about new programs and techniques in t h is f i e l d . He w i l l also have clo s e r t i e s w ith a p rofessional school o f P u b lic Health and o th e r public h e a lth p ro fe s s io n a ls . We can also expect him to be more concerned about implimenting the pro fession al goals o f t h is group than someone who does not have an advanced degree in the p ro fess io n . Here we are considering the p ro fe s s io n a liz a tio n o f the d i r e c t o r . In a t e s t o f ambition theory among c i t y councilment, Gordon Black found t h a t those w ith a g re a te r commitment to a c a re e r in p o l i t i c s had more com pletely adopted the norms o f t h e i r p ro fession . 33 A s i m il a r s it u a t io n could be expected to e x i s t w ith p u b lic health d ir e c t o r s . The degree o f commitment t h a t the in d iv id u a l has toward h is p ro ­ fession i s probably r e la te d to o th e r aspects o f his career and career goals. Hypothesis B-3: D ire c to rs w ith an advanced degree in p ub lic h e a lth are more l i k e l y to be clim bers than are those d ir e c to r s w ith ou t an advanced degree. D ire c to rs w ith o u t an advanced degree in p u b lic health are more l i k e l y to be con­ servers than are those d ire c to rs w ith an advanced degree. The p ublic h e a lth o f f i c e r who has come in to p ub lic h e a lth a f t e r a period o f time in p r iv a t e p r a c tic e is more l i k e l y to want a 55 s ta b le p o s itio n and have less i n t e r e s t in r is in g to g re a t heights in the profession than the young M.D. j u s t e n te r in g the f i e l d from medical school. In a d d it io n , the physician who has spent several years in p r iv a t e p r a c tic e w i l l have a d i f f e r e n t s e t o f p rofessional standards and c o n ta c ts , and a f a r d i f f e r e n t b e l i e f about the proper r o le o f p u b lic h e a lth in s o c ie ty . His so c ia l philosophy is more l i k e l y to be one which views the proper r o le o f p u b lic h ea lth as being r a th e r l im it e d . In f a c t the len g th o f time t h a t the d ir e c t o r has spent in p r iv a te medicine should be r e la t e d to h is a tt it u d e s toward the proper r o le o f p u b lic h e a lth in a s o c ie ty . So we would expect the presence o f a career in p r i v a t e p r a c t i c e to be n e g a tiv e ly associated w ith a d i r e c t o r 's d es ire to o b ta in a p o s itio n o f great r e s p o n s ib ilit y and p re s tig e in p u b lic h e a lth . Physicians who have changed from p r i v a t e p r a c t ic e to a p ublic h e a lth care er are l i k e l y to have d i f f e r e n t p ro fe s s io n a l goals than the physician who goes in to p u b lic h e a lth w h ile in medical school or immediately a f t e r o b ta in in g his degree. His age f o r one thing is l i k e l y to be d i f f e r e n t . The change may have been made f o r reasons which cause us to d escribe him as a conserver. P u b lic h e a lth , f o r one th in g , may be viewed by many as a much less demanding profession than p r i v a t e p r a c t ic e . 34 The physician going in t o p u b lic health a t an e a r ly age w i l l probably want to b u ild a long range care er in t h is profession . He w i l l more l i k e l y be a c lim b e r than a conserver. But those who have obtained an advanced degree w i l l have made a g re a te r investment in p u b lic h e a lth than those w ith o u t an advanced degree. Two hypotheses w i l l be tested from t h is discussion above: 56 Hypothesis B-4: Those p u b lic health d ir e c to r s th a t have maintained a p r iv a t e p r a c tic e are more l i k e l y to be conservers than those who have not had any p r iv a te p r a c tic e experience. Those w ith ou t p r iv a te p r a c tic e are more l i k e l y to be climbers than those w ith p r iv a t e p r a c t ic e . Hypothesis B-5: As the length o f time the health d ir e c t o r spent in p r iv a t e p ra c tic e increases, the degree o f clim b er ambition w i l l decrease, and the degree o f conserver ambition w i l l increase. Those h e a lth o f f i c e r s in L arry Mohr's study w ith many years o f p r iv a t e p ra c tic e took a con servative view toward the proper a c t i v i t i e s o f p u b lic h e a lth . Mohr also found th a t the c o r r e la tio n between inno­ vation o f the department and the number o f years t h a t the h ea lth o f f i c e r had spent as a p r iv a t e medical p r a c t i t i o n e r was strong and negative. 35 D i r e c t o r 's Background and Departmental Innovation The hypothesis in t h is section provides a t r a n s i t i o n from the d i r e c t o r 's background to departmental innovatio n. This hypothesis suggests a s s o c ia tio n s between these background v a ria b le s and d e p a rt­ mental innovation but do not include the measures o f clim b er o r con­ se rv er am bition. Two f i n a l sections o f the study in v e s tig a te models which include lin k s among a l l three o f these f a c t o r s - - d i r e c t o r ' s background, d i r e c t o r 's am b itio n , and departmental in n o v atio n — as w ell as departmental resources. Hypothesis C-l summarizes the r e l a ­ tion sh ips between the background v a ria b le s and in n o v atio n . These re la tio n s h ip s are explained and elaborated in a section in Chapter IV . 57 Hypothesis C - l : D ir e c t o r s w ith exp erience in p r i v a t e p r a c t ic e and d ir e c t o r s w ith o u t advanced degrees in p u b lic h e a lth w i l l tend to be asso c ia ted w ith less in n o v a tiv e departments than w i l l those d ir e c t o r s w ith o u t experience in p r i v a t e p r a c t i c e and those d ir e c t o r s w ith advanced degrees in p u b lic h e a lth . The age o f the d i r e c t o r and the number o f years o f p r i v a t e p r a c t ic e exp erie n c e o f the d i r e c t o r w i l l be in v e r s e ly c o r r e la t e d w ith the in n o v a tio n o f the department. Types o f D i r e c t o r s 1 Goals and Types o f Departments Hypotheses in the f o llo w in g s e c tio n connect the d ir e c t o r s w ith the type o f department in which they are most l i k e l y to be found. They in d ic a t e how o f f i c i a l s are l i k e l y to be found in d i f f e r e n t types o f departments according to t h e i r , the d i r e c t o r s , goals and how they may a f f e c t t h a t o r g a n iz a t io n 's in n o v a tiv e o u tp u t. Downs argues t h a t bureaucrats o f d i f f e r e n t types w i l l be more o r less l i k e l y to be found in o rg a n iz a tio n s w ith d i f f e r e n t c h a r a c t e r i s t i c s . I w i l l develop and add to these arguments and t e s t some o f these hypotheses from Downs. Although the d i r e c t o r who is i d e n t i f i e d as a clim b e r is probably going to be in n o v a tiv e , both as a s tr a te g y to improve his chances o f advancement and because i t w i l l g e n e r a lly be less c o s tly f o r him to do so than f o r the c o n se rv er, the hypothesis t h a t clim bers w i l l be found in th e in n o v a tiv e departments can be made on o th e r bases as w e l l . Climbers are l i k e l y to a s p ire to those departments which a re in n o v a tiv e because o f th e fa c t o r s which make them inno­ v a t i v e . That i s , l a r g e r departments w ith more resources a re p re d ic te d 58 to be the more in n o v a tiv e departm ents. But clim b ers a re expected to a s p ir e to be d ir e c t o r s o f l a r g e r departments because o f the s a l a r y , p r e s t i g e , and o p p o r tu n itie s which these departments o f f e r . Climbers in s m a lle r departments may have to r e l y on in n o v a tio n as a s tr a te g y to improve t h e i r chances o f reaching the l a r g e r departments whereas the clim b ers in the l a r g e r departments w i l l f i n d them to be inno­ v a t iv e to a g r e a t e x te n t anyway. Although we may f i n d a number o f clim b ers in s m a lle r d e p a rt­ ments, a number o f them w i l l have reached the l a r g e r departments. Something t h a t S c h les in g er emphasizes more than Downs is the f a c t t h a t o p p o r t u n it ie s in flu e n c e am b itio n s. That i s , am bitions develop. T his is an idea c e n tr a l to much o f H e rb e rt Simon's work. He f e e ls t h a t a s p ir a t i o n le v e ls a re c o n d itio n e d . 35 We could expect someone who is successful in a l a r g e r department and sees the o p p o r tu n itie s i t a ff o r d s him to become a c lim b e r. That i s , he may want to go on f u r t h e r as he has successful e x p erie n c es . So we may f i n d some d ir e c t o r s expressing c lim b e r am bitions o n ly a f t e r having reached c e r t a in p o s it io n s . There may be a c e r t a i n amount o f ego p r o t e c tio n here a ls o . A d i r e c t o r who i s predisposed to be a c lim b e r because o f h is background may not express the d e s ir e f o r a c lim b e r p o s itio n u n t i l he has some experience which b rin g s him to r e a l i z e t h a t some h ig h e r le v e l p o s itio n is a r e a l i s t i c a s p ir a t i o n f o r him. Hypothesis C-2 o f t h i s s e t i s taken from Downs' n otion th a t the b u rea u c ra ts w i l l be a t t r a c t e d to an o rg a n iz a tio n in which i t is most probable t h a t they can o b ta in t h e i r g o a ls . 37 However, the i m p lic a t io n from S c h le s in g e r 's am bition th e o ry i s t h a t a s p ir a tio n s 59 develop. This is supported by some psych olo gical s tu d ie s a ls o . 38 One d if f e r e n c e in Downs' approach and am bition th eo ry is t h a t Downs seems to c la im t h a t clim b ers seek o u t l a r g e r o r g a n iz a t io n s . This may als o be im p lie d in am bition theory but in the l a t t e r th e develop­ ment o f a s p ir a tio n s i s im p o rtan t. O p p o rtu n itie s g iv e r i s e to a m b itio n s. In Downs am bitions a re more predeterm ined. 39 E i t h e r way we would expect the d ir e c t o r s o f l a r g e r p u b lic h e a lth d e p a r t­ ments to be clim bers r a t h e r than conservers. For those clim b ers in the s m a lle r departm ents, we would expect them to be in n o v a tiv e . So, whereas I have hypothesized t h a t resources and in n o v a tio n w i l l be p o s i t i v e l y asso c ia ted i f the type o f am bition i s c o n t r o ll e d , I w i l l als o hypothesize t h a t the type o f am bition and in n o v a tio n a re r e l a t e d i f the le v e l o f resources is held co n sta n t. The discussion then leads us to expect an a s s o c ia tio n between the degree o f c lim b e r am bition and the s iz e and resources o f the department. However, t h i s a s s o c ia tio n might not be very s tro n g . Some o f those w ith c lim b e r am bition may be on the way up, so to speak, and w i l l s t i l l be in the s m a lle r departm ents. I f they stay here lo n g , though, they are l i k e l y to become conservers unless they can change the n atu re o f t h e i r departm ent. The a s p ir a tio n s o f these d ir e c t o r s in s m a lle r departments may s t i l l be develop ing . At any r a t e the fo llo w in g a s s o c ia tio n s are p r e d ic te d between s iz e and resources and types o f a m b itio n . 60 Hypothesis C-2: There w i l l be a p o s it iv e c o r r e la t io n between the degree o f clim b er am bition o f the d ir e c t o r and the s iz e and resources o f the department. There w i l l be a n egative c o r r e la tio n between the degree o f conserver am bition o f the d ir e c t o r and the s iz e and resources o f the department. Ambition and Innovation I have argued th a t climbers r a th e r than conservers are l i k e l y to be found in la r g e r departments. I t is these departments which are als o expected to be the most in n o v ativ e. So a p o s it iv e c o rre ­ l a t i o n between the degree o f clim ber am bition and innovation is expected. Conversely, a negative c o r r e la tio n between conserver ambition and innovation is expected. But in o rd er to hypothesize t h a t d ir e c to r s t h a t are climbers w i l l be associated w ith inn ovative departments because they use innovation as a means to o b ta in t h e i r g o a ls , some a d d itio n a l arguments need to be made. Because a p u b lic agency u s u a lly has no m arkets, i t s members cannot be d i r e c t l y appraised in terms o f t h e i r c o n trib u tio n to the value o f i t s output o r to the p r o f i t o f agency o r bureau. In order to be promoted or gain o th e r goals an o f f i c i a l needs to fo llo w o th e r s t r a t e g ie s . Downs l i s t s th ree s t r a te g ie s t h a t climbers can fo llo w . These are promotion, aggrandizement, and jumping or moving to a new jo b . 40 These in turn enable the clim b er to gain more p r e s t ig e , power, and money. There i s some em p iric al evidence which in d ic a te s t h a t innovation is a r a t io n a l s tra te g y f o r the clim b er. Evidence also in d ic a te s t h a t those persons w ith a t t r i b u t e s which I have described as clim b er a t t r i b u t e s are associated w ith in n o v atio n . 61 Slau found, I n a study o f two p u b lic b u re a u c ra c ie s , an i n d i v i d u a l ' s m a te r ia l and s ta tu s in t e r e s t s to be asso ciated w ith in n o v a tio n . He a ls o found t h a t the more competent bureaucrats were more amenable to change. 41 Becker concluded t h a t the p u b lic h e a lth d i r e c t o r ’ s d e s ir e to m a in ta in o r in crease p r e s tig e and p ro fe s s io n a l s ta tu s m otivated him to be in n o v a tiv e . He found t h a t i t was p r e s tig io u s among lo c a l p u b lic h ea lth d ir e c t o r s to be known as an in n o v a to r and t h a t in n o v a tiv e d ir e c t o r s m a in ta in ed a c e n tr a l p o s it io n in communi­ c a tio n and o p in io n networks among p u b lic h e a lth p r o fe s s io n a ls . How­ e v e r , Becker concluded t h a t i t was inn ovatio n t h a t c re a te d the d i r e c t o r ’ s p o s it io n in t h is n etw ork, not the p o s it io n which d e t e r ­ mined i n n o v a t i o n . ^ In Mohr's a n a ly s is o f in n o v a tio n , he concluded th a t a f t e r the s o lu tio n o f immediate problems the quest f o r p r e s tig e r a t h e r than the quest f o r o r g a n iz a t io n a l e f fe c t iv e n e s s o r c o rp o ra te p r o f i t m otivated the adoption o f most new programs and te c h n o lo g ie s . 43 He r e f e r r e d to t h i s as s la ck in n o v a tio n . He i n f e r r e d t h a t s la ck innovation in P u b lic H e alth departments would be in n o v a tio n m otivated l a r g e l y by a d e s ir e f o r p r e s tig e and p ro fe s s io n a l s ta tu s on the p a r t o f the h e a lth o f f i c e r and o th e r h e a lth department s t a f f members. 44 Mohr als o concluded t h a t la rg e departments had a strong tendency to adopt a v a r i e t y o f in n o v a tiv e programs as t h is brought p ro fe s s io n a l approval to i t s s t a f f . The v i s i b i l i t y o f the h e a lth d i r e c t o r i s probably an im p o rta n t f a c t o r in h is upward m o b i l i t y . There are s tu d ie s which have assessed the importance o f the v i s i b i l i t y o f a manager to h is c a re e r . 4 5 I f 62 in n o v atio n b rin g s the d i r e c t o r p ro fe s s io n a l p r e s t ig e and a t t e n t i o n , i t would c e r t a i n l y in crease h is v i s i b i l i t y to o th e rs in the pro­ fe s s io n . We would expect a d i r e c t o r w ishing to increase o r m a in ta in h is p r e s tig e to co n sider t h i s o p tio n . The c lim b e r would be anxious to maximize p r e s tig e f o r i t s own sake but a ls o to increase the o th e r goals he has. In a d d itio n th e clim b e r w i l l f i n d i t e a s ie r to inno­ v a te because o f his p ro fe s s io n a l contacts and in fo rm a tio n sources. The c lim b e r , by h yp o th es is , has a g r e a t e r commitment and investment in p u b lic h e a lth than a d i r e c t o r who is not a c lim b e r. I f he has expended the e f f o r t to get an advanced degree he w i l l want to g e t a re tu r n on t h i s . But by d e c id in g to go i n t o p u b lic h e a lth a t an e a r l y p o in t in h is c a r e e r , the p h y sician has in c u rre d some o p p o r tu n ity co s ts ; t h a t i s , he has foregone a p o s s ib ly very l u c r a t i v e c a re e r in p r i v a t e p r a c t i c e and w i l l want to make his investm ent pay. The c lim b e r w i l l a ls o be more apt to view h im s e lf as a p ro fe s s io n a l in the f i e l d o f p u b lic h e a lt h . His o r i e n t a t i o n w i l l be toward o th e r p ro fe s s io n a ls and he w i l l want to implement the goals o f h is p ro fe s s io n and o f the people who a re respected in h is p ro fe s s io n . These w i l l be the persons f o r whom i t w i l l be im p ortan t to the d i r e c t o r to make a good im pression, t h a t i s , to be thought o f and viewed as a p ro g res sive d i r e c t o r . Some research in managerial m o b i l i t y in in d u s try has emphasized the importance o f the v i s i b i l i t y o f the manager to h is upward m o b i l i t y . This may be a general phenomenon t h a t a p p lie s to most types o f managers o r d ir e c t o r s a t a l l but the ve ry top l e v e l s o f management. At any r a t e , the people to whom th e c lim b e r 's r e p u t a t io n is im p o rta n t, such 63 as p u b lic h e a lth o f f i c i a l s in the s ta te agencies, Schools o f Public H e a lth , his colleagues in o th e r departments, and fe d e ra l agencies, are concerned about the s w i f t adoption o f new techniques and programs in p u b lic h e a lth . 46 Climbers can be expected to a c t as i f they are responding to the opinions and evalu atio n s o f t h i s group. The other hypothesis in t h is se t w i l l be discussed in g r e a te r length a f t e r those in the f i r s t sets have been te s te d . The hypothesis is stated here als o . Hypothesis C-3: The degree o f clim b er am bition o f the d ir e c t o r w i l l be p o s it i v e l y c o rre la te d w ith the innovation o f the h e a lth d ep art­ ment. The degree o f conserver ambition w i l l be n e g a tiv e ly c o rr e la te d w ith the innovation o f the h e a lth department. Research Design This section w i l l describe the u n its o f a n a ly s is , the d ata, and the methods o f data c o l l - c t i o n . A d e t a ile d d e s c rip tio n o f the o p e ra tio n a l measures o f each o f the v a ria b le s w i l l be delayed u n t i l the chapters which describ e the te s tin g o f the hypotheses. Data were c o lle c te d on l o c a l — c i t y , county, and d i s t r i c t — health departments in Michigan. Budget data on the departments was gathered from Public H ealth Department records a t the S ta te Depart­ ment o f P ublic Health in Lansing. P o pu lation , revenue, and expendi­ tu re data f o r c o u n tie s --th e basic geographical u n its f o r the d ep art­ ments' j u r i s d i c t i o n — were c o lle c te d from the Local Government Budget Document o f the Department o f Treasury o f the S tate o f Michigan. The data were fo r the years 1968 through 1971. A two p a r t mail q u e stio n n aire was sent to each department in the summer o f 1972. 64 The f i r s t p a r t o f the q u e s tio n n a ire s o l i c i t e d data on program a c t i v i ­ t i e s as w e ll as rece n t e x p e n d itu re and budget data o f the departm ents. The second p a r t o f the q u e s tio n n a ire sought data from the d i r e c t o r o f each department. Deputy d ir e c t o r s were a ls o requested to f i l l out and r e tu r n a copy o f the second p a r t o f the q u e s tio n n a ire . Of 49 q u e s tio n n a ire s sent to departm ents, 40 were re tu rn e d . T h i r t y - nine o f the 46 d ir e c t o r s and deputy d ir e c t o r s retu rn ed the q u e s tio n ­ n a ir e s . However, two o f these were not usable as not enough in fo rm a tio n was included on them. I sought in fo rm a tio n about the d i r e c t o r s ' employment e x p e rie n c e , t r a i n i n g , te n u re , s a t i s f a c t i o n w ith p re s e n t j o b , and d e s ir e f o r o th e r p o s itio n s among o th e r t o p ic s . Data on departments and d ir e c t o r s were supplemented by S ta te D epart­ ment o f P u b lic H e alth records and p u b lic a t io n s . A ll data were c o l ­ le c te d d urin g the s p rin g , summer, and f a l l o f 1972. Q u e stio n n aire s were coded and the data keypunched during the f a l l o f 1972. The data s e t in c lu d e s a l l lo c a l p u b lic h e a lth departments in e x is te n c e in Michigan during the years 1966-1972 i n c lu s iv e . A subset o f these which e x is te d a t the tim e o f the q u e s tio n n a ire m a ilin g and the d ir e c t o r s o f the departments i s the basic s e t o f elements upon which a n a ly s is w i l l proceed. A t the time the data were c o l le c t e d th e re were f o r t y - n i n e p u b lic h e a lth departments in M ich ig an , ranging in s iz e from seven to 293 and serving p o p u la tio n s which v a rie d from 28,00 0 to 1 ,5 1 1 ,0 0 0 . Although th e re were th re e c i t y h e a lth d epartm ents, the b asic j u r i s ­ d ic t io n a l and governmental u n it f o r h e a lth departments is the county. There a r e 83 counties in Michigan and each, by law , must be served 65 by a p u b lic health department, e i t h e r i t s own o r in as so c ia tio n w ith one or more o th e r counties in a m u lti-c o u n ty o r d i s t r i c t health department. Each county th e r e fo r e c o n trib u te s to the maintenance o f a h e a lth department and receives the services o f one. In 1972 th e re were th re e c i t y h e a lth departments; o th e r c i t y departments p rev io u sly fu n c tio n in g had combined w ith the county departments o f the counties in which the c i t i e s were lo c ate d . Several departments were m u lti-c o u n ty u n its . During the time covered by the a n a ly s is , the counties comprising these departments changed. In the coding o f the d a ta , each combination o f counties making up a d ep art­ ment is uniquely i d e n t i f i e d as a d i f f e r e n t department. Population sizes and o ther county data were combined f o r each county in the m u lti-c o u n ty departments to make up the data f o r those u n its . A nalysis on the departments subsequently proceeded only on those departments which e x is te d over the t o t a l time period o f 1966 to 1972 and f o r which q u e stio n n aire s had been re tu rn e d . This l e f t a t o t a l o f 36 departments f o r a n a ly s is . There are two measures o f the major dependent v a r ia b le in n o v atio n . Both o f these are based on the adoption o f p u b lic h ealth programs. I have defined innovation as— the degree to which an in d iv id u a l or o rg a n iz a tio n is r e l a t i v e l y e a r l i e r to adopt a given p r a c tic e than o th e r in d iv id u a ls o r o rg a n iza tio n s in t h e i r o r i t s social system. ^ The f i r s t measure o f in n o v atio n is based on the adoption times o f fo u r p u b lic h e a lth programs. The second i s based on the adoption o f nine p u b lic h e a lth programs. 66 The two previous p u b lic h e a lth s tu d ie s discussed e a r l i e r d e fin e d and o p e r a t io n a liz e d in n o v atio n d i f f e r e n t l y than I have. My measure o f in n o v a tio n i s most s i m i l a r to one used by Jack W alker. 48 Walker based h is measure on the tim e o f adoption o f a number o f pieces o f l e g i s l a t i o n by American s t a t e governments. The per centage o f y e a rs t h a t had passed between the f i r s t and most re c e n t adoptions a t the tim e t h a t a p a r t i c u l a r s t a t e adopted a p iece o f l e g i s l a t i o n was used as an In n o v a tio n measure f o r t h a t s t a t e f o r t h a t type o f l e g i s l a t i o n . He d id t h i s f o r each o f a la rg e number o f pieces o f l e g i s l a t i o n and the average f o r the t o t a l s e t was taken to g iv e an in n ovatio n score f o r each s t a t e . 49 I asked the h e a lth departments to respond to questions about two sets o f programs. For the f i r s t s e t I chose a number which I had e s ta b lis h e d were in n o v a tiv e o r a t l e a s t new to Michigan and had re c e iv e d some advocacy by p ro fe s s io n a l p u b lic h e a lth o r g a n iz a t io n s , the M ichigan Department o f P u b lic H e a lt h , o r both. The departments were asked to r e p o r t th e d a t e , to th e n e a re s t month, t h a t they had begun any a c t i v i t y in the in n o v a tiv e program a re a . The programs in the f i r s t s e t , although they were new, had been in e x is te n c e f o r a few y e a rs . T h is , I reasoned, was necessary to in s u re t h a t each department could have had a chance to adopt the programs. These s ix programs were f a m ily p la n n in g , drug abuse, alc o h o lism c o n t r o l, on s i t e m u lt i- p h a s ic sc re e n in g , alco h o l-h ig h w a y s a f e t y , and m ig rant h e a lt h . The p rim ary in n o v a tio n measure was based on th e tim e o f adoption o f fo u r o f the o r i g i n a l s i z programs. Two o f these were 67 such t h a t they were not a p p ro p ria te f o r the in n o v a tio n index. The number o f departm ents, moreover, to which they were r e le v a n t was r a t h e r s m a ll. Rogers makes a good case f o r a d ju s tin g f o r those p r a c tic e s which do not apply to a group o f p o t e n t i a l ad o pters. 50 The two programs o m itted were M ig ran t H e a lth — many areas in the s ta te do not have any m ig ra n t workers— and the Alcohol-Highway S a fe ty Program. This l a t t e r program was removed f o r c o n s id e ra tio n because, although i t is in n o v a tiv e and i s r e le v a n t f o r a l l d e p a r t­ ments, those departments i n i t i a l l y conducting the program (and a l l o f those conducting th e program a t th e time o f the q u e s tio n n a ire ) were e s p e c i a l l y s e le c te d by the Michigan Department o f P u b lic H e a lth . Thus th e re was a la r g e f a c t o r in the s e le c tio n o f departments to adopt th e program which was not under the c o n tro l o f the lo c a l department. The adoption times f o r each program were scored so t h a t they ranged from 0 to 100. T h is has the advantage o f w e ig h tin g each program e q u a lly . 51 The score f o r each program was added to o b ta in a t o t a l score f o r each department. Since t h is index was based o nly on the tim e o f a d o p tio n , those departments adopting the program l a s t would re c e iv e the same score as a department not having adopted the program. So an a d d it io n a l w eight was added f o r the f a c t t h a t the program had been adopted by the department. The fo llo w in g paragraphs g iv e a d e t a i l e d d e s c r ip tio n o f the c a l c u l a t i o n o f the prim ary in n o v a tio n , o r speed o f a d o p tio n , ind ex. For each o f the f o u r programs, the number o f y e a rs between the f i r s t adoption and the l a s t adoption by a Michigan p u b lic h e a lth 68 department was determined. Then one minus the per cent o f years in to t h i s period t h a t a department adopted the program was c a lc u la te d f o r each department. This was m u lt ip lie d by 100 {to g iv e the score 1n whole numbers). Then 10 was added to each score f o r those departments which had adopted the program. By way o f an example: i f the f i r s t department to adopt a fa m ily planning program did so in 1966 and the l a s t department did so in 1972, the time span fo r adoption would be s ix y e a rs . Then i f department number f i f t e e n adopted the program in 1968 o r two years in to t h is p e rio d , i t s innovation score f o r t h a t program would be 1 - ( 2 / 6 ) x {100) = 1 - .3333 (100) = 6 6 .6 7 . The f i r s t department to adopt the program would get 1 - ( 0 . 6 ) (100) = 1 A (100) - 100 and the l a s t adopter would get 1 - ( 6 / 6 ) (100) = 0. Those departments which had not adopted the program would als o get a score o f 0. To d is tin g u is h the l a s t department adopting each program from those not having adopted the program, and to give more weight to adoption i t s e l f , 10 was added to the department's index f o r each adoption. Department number f i f t e e n would then g e t a score o f 66.67 + 10 = 76.67 f o r t h is program. I f a department had not adopted the program but was in the process o f planning f o r the ado ption , 5 was added to the departm ent's score. The departments were asked to re p o rt the time o f adoption to the nearest month so f r a c t io n a l p arts o f a year were also involved in the computation. However, I used only even years f o r s i m p l i c i t y in t h is example. A score f o r each o f the fo u r programs was computed f o r each department and then the scores f o r the fo u r programs were added to form the index f o r the prim ary Innovation measure. The range o f t h i s Index was 5 . 0 to 3 0 8 .0 5 . A department could accumulate from 0 . 0 to 1 1 0 p o in ts f o r each o f the m ajor programs making the p o s s ib le range o f th e p rim ary in n o v a tio n score— speed o f a d o p tio n — 0 . 0 to 440. A d iscussion by Rogers shows t h a t although computing an in n o v a tio n measure by sunmlng the number o f adoptions o n ly is c lo s e ly c o r r e la t e d to tim e o f a d o p tio n , in d ic e s based on tim e o f adoption are much more s e n s i t iv e and can be based on fewer p r a c t ic e s . I By sco ring th e programs from zero to 110, each is weighted the same and the le n g th o f time covered by the adoption p e rio d s , i f d i f f e r e n t , does not w eigh t one program more than an o ther. 53 A second measure o f in n o v a tio n was based on the responses to the second s e t o f programs. (See Appendix A f o r these programs.) T his s e t o f programs co nsisted o f n in e programs which were very new to the f i e l d o f p u b lic h e a lt h , a t le a s t in M ich ig an , although each program had been adopted by a t le a s t one departm ent. The secondary measure o f in n o v a tio n was based on whether the department had adopted each program o r not and the score on t h i s index was simply the number o f programs adopted by the departm ent. T h is index was c o r r e la te d ( r = .4 0 ) w ith the p rim ary in n o v atio n measure. A l l o f the programs in the second s e t were much more re c e n t developments than those in the f i r s t s e t . These programs were some o f the newer and c u r r e n t l y more popular programs in p u b lic h e a lth a t t h a t tim e . In o rd e r to conclude t h a t the d i r e c t o r had some in flu e n c e on the adoption o f programs by the departm ent, i t was necessary to choose programs which were adopted during the tenure o f the h e a lth department d i r e c t o r . So these v e ry l a t e programs were 70 chosen. I f the departments f o r a n a ly s is were l i m i t e d to those whose d ir e c t o r s had been in t h e i r p o s itio n s during the e n t i r e time covered by the study, t h a t would have s u b s t a n t i a l l y reduced the number o f departments. There a re a d d it io n a l advantages in using two in n o v a tio n measures. I t i s usefu l to know the e x te n t to which each o f these measures tap in n o v atio n and the c o r r e la tio n s o f th e independent v a r ia b le s to each o f the measures. The secondary measure s t i l l adheres to the conceptual d e f i n i t i o n o f adoption in t h a t those e a r l y adopters o f the new programs w i l l be the ones who a re in n o v a tiv e . 54 T h e r e fo r e , the a n a ly s is which deals w ith the departmental c h a r a c t e r i s t i c s , w ith o u t in c lu d in g the d i r e c t o r v a r i a b l e s , uses both measures o f in n o v a tio n as dependent v a r ia b le s alth o u g h the speed o f adoption measure is considered to be the major index o f in n o v a tio n . This provides an a id to assessing v a l i d i t y a ls o . In the f i n a l sections which assess the e f f e c t o f the d i r e c t o r on in n o v a tio n , the secondary in n o v a tio n measure o n ly is used so t h a t th e g re a te s t number p o s s ib le o f the departments would be included in th e a n a ly s is . I imply in the study t h a t d ir e c t o r s w ith c e r t a i n c h a r a c te r ­ i s t i c s w i l l be a t t r a c t e d to in n o v a tiv e departm ents. So one o f th e hypotheses is t h a t d ir e c t o r s w ith r.hese c h a r a c t e r i s t i c s are more l i k e l y to be found in in n o v a tiv e departments. We would expect a c o r r e l a t i o n re g a rd le s s o f when the d i r e c t o r a r r i v e d in the d e p a rt­ ment. That i s , i f clim bers a r e a t t r a c t e d to in n o v a tiv e departments and they als o In flu e n c e departments to be in n o v a t i v e , then th e re should be a c o r r e l a t i o n between the i n d i c a t o r o f am bition and the measure o f in n o v a tio n re g a rd le s s o f when the d i r e c t o r a r r iv e d a t 71 the departm ent. But the argument goes on to c la im t h a t t h i s type o f d i r e c t o r a ls o helps to cause the departm ent to be In n o v a t iv e . Hence I want to assess the evidence i n support o f the c o n te n tio n t h a t the d i r e c t o r i s an Im p o rtan t f a c t o r in the in n o v ativ en es s o f the department. W hile i t does not prove c a u s a tio n , i t i s necessary to show t h a t the d i r e c t o r was in the department a t the tim e th e In n o v a tiv e programs were adopted. Background and some a t t i t u d i n a l data were c o lle c t e d from the then c u r r e n t d ir e c t o r s o f the lo c a l h e a lth departm ents. I was p r i m a r i l y in t e r e s t e d in t h e i r employment h i s t o r y , e x te n t o f p u b lic h e a lth t r a i n i n g and e x p e rie n c e , d e s ir e f o r p u b lic h e a lth p o s itio n s o t h e r than the one they c u r r e n t l y held and personal and p ro fe s s io n a l goals d e a lin g w ith p u b lic h e a lt h . The respondents were asked to rank o rd e r a number o f p u b lic h e a lth p o s itio n s in terms o f t h e i r p re fe re n c e f o r them. T h is , I reasoned, would g iv e me a measure o f the d i r e c t o r s ' expressed a m b itio n s . The d ir e c t o r s were a ls o asked i f they p r e f e r r e d an o th e r p o s it io n to th e one they c u r r e n t l y held and were asked how c o n te n t they were to remain in t h e i r p re s e n t p o s it io n u n t i l r e t ir e m e n t . Age was a ls o determ ined. Although the r e t u r n r a t e o f the q u e s tio n n a ire s was h ig h , i t was not t o t a l . In many cases, q u e s tio n n a ire data was supplemented by records o f the S t a t e Department o f P u b lic H e a lth . The t o t a l number o f personnel and the number employed in each s p e c i a l i z a t i o n were a ls o determined from summary s t a t i s t i c s and records compiled by the Bureau o f Local H e a lth A d m in is t r a tio n . 72 The o p e r a t i o n a l i z a t i o n o f v a r ia b le s and o th e r s p e c i f ic s o f the data w i l l be discussed as needed 1n the n ex t two chapters as I p res en t the t e s t i n g o f the hypotheses. The previous d is cu ssio n has l a i d o u t the elements o f a th eo ry o r model o f o r g a n iz a t io n a l In n o v a tio n as i t a p p lie s to lo c a l P u b lic H e alth Departments. S c h e m a tic a lly the elements and the in flu e n c e s among them may be connected as shown in Figure 2 - 1 . C D ir e c t o r Ambitions O rg a n iz a tio n a l V a ria b le s In n o v a tio n D i r e c t o r Background V a ria b le s B Figure 2 - 1 . — D ir e c t io n o f In flu e n c e Among Elements o f a Model o f In n o v a tio n . In the a n d ly s is I w i l l be concerned w ith t e s t i n g the hypotheses which e s t a b lis h th e l in k s between these sets o f f a c t o r s . The f i r s t s e c tio n o f a n a ly s is w i l l t r e a t the l i n k A— D, between o r g a n iz a tio n a l 73 f a c t o r s and In n o v a tio n . The second s e c tio n w i l l atte m p t to e s t a b lis h th e l i n k B— C and t e s t a number o f am bition hypotheses drawn from am bition th e o ry , In s id e Bureaucracy, and the theory o u t lin e d e a r l i e r . I w i l l i n v e s t i g a t e , in t h is s e c tio n o f the a n a ly s is , the c o r r e la te s o f a m b itio n . A t h i r d step w i l l be to t e s t hypotheses l in k i n g C— A, C— 0 , and B— D by b i v a r i a t e hypotheses. T h is w i l l be fo llo w e d by m u l t i ­ v a r i a t e a n a ly s is d e a lin g w ith the l i n k s among A, B, C, and D con­ c u r r e n t l y . One o f the purposes o f the study i s to determ ine how am bition in flu e n c e s in n o v atio n and some t h r e e - v a r i a b l e models w i l l be presented in t h a t s e c tio n . A f i n a l se ctio n w i l l in c lu d e the d i r e c t o r ' s background c h a r a c t e r i s t i c s in a f o u r - v a r i a b l e model which w i l l in v o lv e l in k s among the p a rts o f the model in F ig u re 2 - 1 . I suggest t h a t the o r g a n iz a t io n a l f a c to r s w i l l be r e la t e d to in n o v a tio n re g a rd le s s o f the type o f d i r e c t o r . So a n a ly s is begins w ith these f a c t o r s . However, th e le a d e rs h ip o f the d i r e c t o r o f the o r g a n iz a t io n , the p u b lic h e a lth departm ent, w i l l be im p o rta n t f o r in n o v a tio n in the department. I t is here t h a t the am b itio n th eo ry aspects o f Downs, S c h le s in g e r and o th e rs a re im p o rta n t. I suggest which types o f d ir e c t o r s we may expect to be more in n o v a t iv e , how these d ir e c t o r s may be i d e n t i f i e d , and in which types o f departments they may be found. I f i t tu rn s o u t t h a t departments w ith g r e a t e r resources are in n o v a tiv e re g a rd le s s o f the type o f d i r e c t o r , t h is suggests t h a t the d i r e c t o r v a r i a b l e s w i l l have more e f f e c t on in n o v a tio n a t d i f f e r e n t 74 values o f th e department v a r i a b l e s . This hypothesis w i l l be te s te d in the f i n a l two se ctio n s o f a n a ly s is . To r e i t e r a t e , the m ajor purposes o f the study are to account f o r v a ria n c e In in n o v a tio n and to t e s t a g eneral theory taken from Anthony Downs In s id e Bureaucracy and am b itio n theory in e l e c t i v e p o l i t i c s . Chapter I I — Footnotes ^See Chapter I , pages 20 and 21 f o r a d iscussion o f q u a si­ deduction and p a r t i a l f o r m a liz a t io n in s o c ia l science th e o ry . 2 Mohr, American P o l i t i c a l Science Review, M y tin g e r, o£. c i t . 3 4 M a n s fie ld , op. c i t . ; Mohr, o£. c i t . ; M y tin g e r, op. c i t . C y e rt and March discuss the concept o f s la c k . See A Behavioral Theory o f the Firm {pp. 2 6 0 -2 6 5 ). 5 See Mohr, 0 £ . c i t . , p. 119. ® I b i d . , p. 120; M y tin g e r, o£. c i t - , pp. 181-183. 7Mohr makes a s i m i l a r argument. "Small departments are l im it e d in th e p r o g r a m in g they a re a b le to do because o f a l i m i ­ t a t i o n on the number o f d i f f e r e n t a c t i v i t i e s i n t o which one person's time may be fragm ented. Large departments have an advantage because t h e i r g r e a t e r number o f personnel a llo w s them to assign a t l e a s t one employee to each o f a g re a t many s e r v ic e s ." Science Review, pp. 1 2 1 -1 2 2 .) ( American P o l i t i c a l o Richard A. Smith, "Community S tr u c t u r e and In n o v a tio n : A Study o f the E f f e c t s o f S o cial S tr u c tu r e on Program Adoption and Implementation" (unpublished Ph.D. d i s s e r t a t i o n , C o rn e ll U n i v e r s i t y , It h a c a , New York, 1 9 7 3 ), p. 15. 9 I b i d . , p. 16. ^Jam es Q. W ilso n , " In n o v a tio n in O rg a n iz a tio n s : Notes Toward A. T heory," James D. Thompson (P itts b u r g h : U n i v e r s i t y o f P itts b u r g h Press, 1966 ), pp. 193-218. in Approaches to O r g a n iz a tio n a l Design, ed. ^ S m i t h , of>. c i t . , p. 18. 12 13 W alker in Jacob and V in e s , ofK c i t . Robert L. Crain and Donald E. R o senth al, "Comnunity Status as a Dimension o f Local D e c is io n -M a k in g ," American S o c io lo g ic a l Review, 32 (December 1 9 6 7 ), pp. 9 7 0 -9 8 4 ; and Smith, 0 £ . c i t . , p. 18. 75 76 14 Rufus P. Browning, of). c i t . , pp. 138-142. 1 5 I b id . 1 6 Smith, 0 £ . c i t . . p. 15. ^ J e r a l d Hage and Michael A iken, "Program Change and O rg an iza tio n al P ro p e r tie s , A Comparative A n a ly s is ," American Journal o f S o ciology, 72 (March, 1 9 6 7 ), pp. 503-519. 18 Emile Durkhelm, The D iv is io n o f Labor in A S o c ie ty , tra n s la te d by George Simpson (New York: The Free Press, 1 9 3 3 ), pp. 267-270. 19 Mohr, of>. c i t . , p. 119. 2 0 I b i d . , p. 1 2 0 . 2 1 M ytin ger, 0 £. c i t . , pp. 182, 183 and 208. 22 Cyert and March, 0 £ . c i t . , r e f e r to t h is type o f resource as s la c k , pp. 278-279. 23 Downs, 0 £ . c i t . , pp. 5-24 and 88-101. 241 b ld - , pp. 96-101. 2 5 Ib id . 26 10. S c h les in g er, Ambition and P o l i t i c s , pp. 9, 10, and Chapter 2 7 Downs, Of), c i t . , pp. 266-267 and 21 and 28. 28 Paul Hain, "American S tate L e g is la t o r s ' Ambition and Careers: The E ffe c ts o f Age and D i s t r i c t C h a r a c te r is tic s " (Un­ published Ph.D. d is s e r t a t i o n , Michigan S ta te U n iv e r s it y , East Lansing, Michigan, 1971). H a in 's research was done w ith data from in te rv ie w s w ith incumbent s ta t e le g is l a t o r s in fo u r American s ta te s . This data was gathered in 1957 by John Wahlke, Heinz Eulau, W illia m Buchanan, and Leroy Ferguson, The L e g is la t iv e System (New York: W iley, 1962). Hain gathered data in 1970 on the p o s t - 1957 careers o f those same l e g is l a t o r s f o r his a n a ly s is . 29 Kenneth P r e w it t , The Recruitment o f P o l i t i c a l Leaders: A Study o f C it iz e n P o l i t i c i a n s (New York: Bobbs-Merri11 Company, 1970), pp. 186-188, te s te d a v a r ia n t o f the hypothesis r e l a t i n g age and the s ta te d ambitions among San Francisco Bay Area c i t y councilmen. C lu s te rin g respondents by f i v e - y e a r age groups he found t h a t the percentage o f c i t y counciImen w ith n o n -d is c re te ambitions declined c o n tin u a lly through age 56. 77 Kenneth P re w itt and W illia m Nowlin, " P o l i t i c a l Ambitions and the Behavior o f Incumbent P o l i t i c i a n s , " The Western P o l i t i c a l Q u a r te r ly , X X I I , No. 2 (June 19 69 ), pp. 29 8-3 08 , concluded t h a t age was " n e g a tiv e ly and l i n e a r l y r e la te d to p o l i t i c a l ambitions among incumbent o f f ic e h o ld e r s ." 30 31 Mohr, d is s e r t a t i o n , 0 £. c i t . , pp. 154-155. Downs, 0£ . c i t . , p. 100 and Chapter 2. 3 2 I b i d . , p. 96 and Chapter 11. 33 Gordon S. Black, "A Theory o f P ro fe s s io n a liz a tio n in P o l i t i c s , " American P o l i t i c a l Science Review, 64 (September, 1970), pp. 865-878. 34 See fo otn ote 6 8 , page 24, Chapter One. 3 5 Mohr, 0 £. c i t . , p. 157. 3 6 Mack, 0 £ . c i t . , p. 62. 37 Downs, 0 £ . c i t . , Chapters 2 and 9. 3 8 Mack, 0 £. c i t . , pp. 61-65. 3Q Downs, 0 £ . c i t . » Chapter 9. Although Downs has a section t i t l e d "How O f f i c i a l s Become Conservers," pp. 98 -99 , he has no comparable sectio n f o r clim bers. ^^Downs, 0 £. c i t . , pp. 92-96. P e te r Blau, The Dynamics o f Bureaucracy (Second E d itio n Revised; Chicago: U n iv e r s ity o f Chicago Press, 19 63 ), pp. 241-249. * 2Marshall Becker, "Factors A f f e c t in g D iffu s io n o f Inno­ vations Among Health P ro fe s s io n a ls ," American Journal o f P u blic H e a lth , 60 {February, 1970 ), pp. 297-302. ^3Mohr, American P o l i t i c a l Science Review, pp. 122-126. 45Ir w in Rubin, David Kolb, and James M c In ty re , O rg an iza tio n al Psychology (Englewood C l i f f s , N . J . : P r e n tic e - H a l1, 1971). 46 Becker, o£. c i t . ^ E v e r e t t Rogers and A. Havens, " P re d ic tin g In n o v ativ en es s," S o cio lo g ica l o f Innovations (New York: Free Press o f Glencoe, 1962). I n q u i r y , 32 ( 1 9 6 2 ) , pp. 34 -4 2 ; E v e re tt Rogers, D iffu s io n 78 48W a l k e r , in Jacob and Vines* 0 £ . c i t . 50 E v e r e t t Rogers and L. Edna Rogers, "A Methodological A n alysis o f Adoption S c a le s ," Rural S o c io lo g y , 26 (1 9 6 1 ), p. 335. 51 This method was used in s te a d o f o b ta in in g standard scores f o r each p r a c t i c e and summing them f o r th e departm ents. Advantages o f t h is method a r e discussed by Robert Jackman, "On the R e la tio n o f Economic Development to Democratic Perform ance," American Journal o f P o l i t i c a l S c ie n c e , 17 (August, 1 9 7 3 ), pp. 6 1 1 -6 2 1 , and W a lk e r, o p . c i t . A c r i t i q u e o f s ta n d a rd ize d in d ic e s i s Jesse F. M a rq u e tte , S t a n d a r d Scores as In d ic e s : The P i t f a l l s o f Doing Things the Easy Way," Midwest Journal o f P o l i t i c a l S c ie n c e. 16 (May, 1 9 7 2 ), pp. 2 7 8- 286. 52 E v e r e t t Rogers, " C a te g o r iz in g the Adopters o f A g r i c u l t u r a l P r a c t ic e s ," Rural S o c io lo g y . 23 ( 1 9 5 8 ) , p. 353. ^3 W alke r, 0 2 .- c i t . ; Rogers, Rural Sociology (1 9 5 8 ), p. 353. 54 Rogers shows t h a t t h i s type o f s c ale is an e s tim a te o f the a d o p tio n . He als o claim s t h a t adopters tend to make those tim e o f adoptions e a r l y . Rogers, oj>. c i t . , p. 350. CHAPTER I I I HYPOTHESIS TESTING: DEPARTMENTAL CHARACTERISTICS, DIRECTOR'S BACKGROUND AND DIRECTOR'S AMBITION The t e s t i n g o f the f i r s t two sets o f hypotheses are discussed in th is c h a p te r. The departm ental c o r r e l a t e s o f in n o v a tio n are in v e s tig a t e d and the hypotheses r e l a t i n g the c h a r a c t e r i s t i c s o f the d i r e c t o r to h is am bitions are t e s te d . M u l t i p l e re g re s s io n and c o r­ r e l a t i o n a n a ly s is a re performed using the v a r ia b le s in t h i s s e t o f hypotheses. H e a lth Department C h a r a c t e r is t ic s and In n o v a tio n The f i r s t s e t o f hypotheses to be te s te d is s e t A which r e l a t e s the c h a r a c t e r i s t i c s o f the h e a lth department to the measures o f in n o v a tio n . The hypotheses in s e t A a re r e - s t a t e d in summary form here: Hypothesis A - l : The le v e l o f resources w i l l be p o s i t i v e l y c o r r e la t e d w ith in n o v a tio n in lo c a l p u b lic h e a lth departm ents. Hypothesis A -2: The s iz e o f the department w i l l be p o s i t i v e l y c o r r e la t e d w ith in n o v a tio n in p u b lic h e a lth d ep artm en ts. Hypothesis A -3: The number o f occupational s p e c i a l t i e s w i l l be p o s i t i v e l y c o r r e la te d w it h in n o v atio n in p u b lic h e a lth departm ents. Hypothesis A -4 : The degree o f p r o f e s s i o n a l i z a t i o n o f the department w i l l be p o s i t i v e l y c o r r e la te d w ith in n o v a tio n in p u b lic h e a lth departm ents. 79 80 Hypothesis A -5: The s iz e o f the p opulation served w i l l be p o s it i v e l y c o r r e la te d w ith the innovation o f the p u b lic h e a lth department. Hypothesis A - 6 : The change in resources w i l l be p o s it i v e l y c o r r e la te d w ith Inn ovatio n in p u b lic h e a lth departments. Hypothesis A-7: The change in s iz e w i l l be p o s it i v e l y c o r r e la te d w ith innovation in p u b lic h e a lth departments. Hypothesis A -8 : The change in population served w i l l be r e la te d to the inn ovatio n o f p u b lic h e a lth departments. The f i r s t hypothesis r e l a t e s resources to in n o v atio n . Resources r e fe r s to monetary resources; personnel a r e , o f course, o rg a n iz a tio n a l resources also but are tr e a te d s e p a ra te ly . My in d ic a to r o f resources was the t o t a l budget f o r the department f o r the years 1968 and 1971. Although the fig u r e f o r 1968 is the primary in d ic a to r o f resources, as w ell as f o r the o th e r independent v a ria b le s in th is s e t , I use and re p o rt the r e s u lts f o r the fig u re s from 1971 a ls o . This 1968 budget f ig u r e should be a good in d ic a t o r o f monetary resources a v a ila b le to the department. 1 I also had wanted to use a f i g u r e f o r the e a r l y years o f the time period under a n a ly s is . Budgets f o r government agencies o f any type are u s u a lly h ig h ly c o r r e la te d over time so the budget f o r 1968 should be a good i n d ic a to r o f the budget f o r o th e r years in the a n a ly s is . To check t h i s , I c o r r e la te d the fig u re s f o r t o ta l budget f o r the years 1967 through 1971 w ith each o th e r. The lowest o f these c o r r e la tio n s was r = .9 3 . A ll o th e r c o r r e la tio n s exceeded t h i s . The highest c o r r e la t io n was r= .9 8 f o r the budgets o f 1970 w ith 1971. I a ls o examined the c o r r e la t io n o f inn ovatio n w ith some a l t e r n a t i v e in d ic a to rs 81 o f resources such as the lo c al a p p ro p ria tio n from the county or c i t y to the health department, the t o t a l county revenue, the State Equalized E v aluatio n o f the property in the j u r i s d i c t i o n o f the h e a lth department, and some per c a p ita resource in d ic a to r s . Although the major independent v a ria b le s were c o rr e la te d w ith innovation f o r each y e a r th a t they were a v a i l a b l e , these fig u re s f o r the two years 1968 and 1971 w i l l be reported here. I wanted to use a y e a r e a r ly in the time period covered by the a n a ly s is and a l a t e r one. Size o f the department, s p e c i a l t i e s , and p ro fe s s io n ­ a l i z a t i o n In d ic a to rs f o r 1968 were used as th is was the f i r s t y e ar t h a t they were a v a i l a b l e . The document from which these fig u re s were taken was not prepared by the S ta te Department o f P u blic Health u n t i l 1968 and then was done on a y e a r ly b as is . So 1968 was the f i r s t y e a r f o r which these fig u r e s were made a v a ila b le in summary form by the S ta te Department o f P ublic H e a lth . Although budget and p opulation fig u re s were a v a ila b le f o r 1967, s iz e fig u re s were n o t, so to be c o n s is te n t w ith the years o f the in d ic a to rs 1968 was chosen as the e a r ly y e a r f o r a n a ly s is . 1971 was used r a th e r than 1972 as there was a more complete s e t o f data f o r 1971 than f o r 1972. Not a l l o f the budget, p o p u la tio n , o r departmental personnel fig u re s f o r 1972 had been made a v a ila b le by the s ta te when an a ly s is was begun. The fig u re s f o r two d i f f e r e n t years were analyzed to note any d iffe re n c e s in the e f f e c t s o f independent v a ria b le s on inno­ va tio n as w ell as to note the changes in the independent v a ria b le s themselves. I th in k t h a t by re p o rtin g fig u r e s f o r two points in 82 time g r e a te r v a l i d i t y is provided to the r e la tio n s h ip s which are found and to the study as a whole. I t was also d e s ira b le to use a l a t e r f ig u r e when the analysis was completed using the d ir e c t o r v a ria b le s w ith the departmental v a r ia b le s . The independent v a ria b le s o f resources* s i z e , and population served do not need any fu r t h e r e x p la n a tio n . The c o r r e la tio n o f the a l t e r n a t i v e In d ic a to rs o f resources w ith innovation w i l l be reported in a l a t e r paragraph. However, the major measure o f resources a v a ila b le to the department is the t o t a l budget, from a l l sources f o r the y e a r in d ic a te d , e i t h e r 1968 o r 1971. The lo c a l a p p ro p ria tio n i s not an adequate measure o f resources as i t does not include a l l o f the funds a v a ila b le to the health department. There are s ta te and fed eral formula funds as w e ll as p ossible s ta te and fe d e ra l g ran ts. The lo c a l a p p ro p ria tio n makes up the major share o f the money a v a ila b le to most local h ea lth departments in M ichigan, however, and should be found to be r e la t e d to in n o v a tio n , although not as s tro n g ly as the t o t a l resources. The t o ta l a p p ro p ria tio n f o r the la r g e r departments w i l l undoubtedly be la r g e r and w i l l c o n trib u te to the departments1 t o t a l resources. The same reasons t h a t enable a department to be in n o v ativ e may also cause 1 t to have a larg e local a p p ro p r ia tio n , i . e . , la rg e population and s iz e . However, one way t h a t innovation can be funded is by seeking out s t a t e and fed eral g ran ts. These, o f course, w i l l not be r e f le c t e d in the local a p p ro p ria tio n . Size is the t o t a l number o f employees o f the h ealth d e p a rt­ ment. Population is the t o ta l p opulation o f the j u r i s d i c t i o n o f 83 the h e a lth departm ent. More e la b o r a t io n o f the measures o f s p e c i a l ­ t i e s and p r o f e s s i o n a l i z a t i o n i s necessary. I have discussed two aspects o f the o cc u p atio n a l make-up o f the department besides I t s s i z e : occupational d i v e r s i t y o r d i f f e r e n t i a t i o n and p r o f e s s i o n a l i ­ z a t io n . By d i v e r s i t y I mean the number o f d i f f e r e n t occupational c a te g o rie s in which a t l e a s t one person was employed. I r e f e r to t h is v a r i a b l e as occup ation al s p e c i a l t i e s o r , s im p ly , s p e c i a l t i e s . The S ta te Department o f P u b lic H e a lth summarizes and publishes t h i s in fo rm a tio n each y e a r , s in c e 1968, so the in fo rm a tio n was taken from t h e i r fig u re s as th ey had c a te g o riz e d them. P r o f e s s i o n a li z a t io n r e f e r s to two things ( 1 ) the number o f employment c a te g o rie s which can be assumed to re p re s e n t a p ro fes­ sio n a l a f f i l i a t i o n . For t h is i n d i c a t o r , I took the number o f employment c a te g o rie s f o r which t r a i n i n g beyond the B.A. o r B.S. degree was re q u ire d and in which a t l e a s t one person was employed. This would, I hoped, be an i n d i c a t o r o f the number o f p ro fe s s io n a l a s s o c ia tio n s to which the department m aintain ed a f f i l i a t i o n . I t would a t l e a s t be an i n d i c a t o r o f th e number o f p ro fe s s io n a l s p e c i a l ­ t i e s which were rep resen ted in the departm ent. ( 2 ) P r o f e s s io n a li­ z a tio n also r e f e r s to the number o f persons in the department who may be expected to be a f f i l i a t e d w ith a p ro fe s s io n a l o r g a n iz a tio n concerned w ith p u b lic h e a lth m a tte r s . To o b ta in t h i s measure I took the number o f persons in the p r o fe s s io n a l c a te g o rie s and t o t a l e d them f o r each departm ent. Table 3-1 p resents the sim ple c o r r e l a t i o n s o f the set o f independent v a r ia b le s w ith the two measures o f in n o v a tio n . A ll 84 TABLE 3 - 1 . — Simple C o rre la tio n s Between Independent Departmental V a ria b le s and Innovation f o r 1968 and 1 9 7 1 .a 2 3 4 5 6 7 8 Resources S ize Population Number o f S p e c ia ltie s Number o f Pro fessio nal Special tie s Number o f Professional Employees Speed o f Adoption (prim ary in n o v a tio n ) Adoption (secondary in n o v a tio n ) ( 1 ) ( 2 ) (3 ) (4 ) (5 ) ( 6 ) (7 ) ( 8 ) .96 .97 .92 .97 .92 .96 . 8 6 .81 .84 .84 .76 .70 .83 .95 .82 .83 .77 .76 .85 .82 .92 .95 .98 .96 .94 .98 .77 .80 .80 .82 .49 .35 .51 .43 .40 .41 .33 .41 .49 .55 .51 .45 ■52h .1 9 b .45 .39 .24 .25 .52 .44 .50 .29 .41 .36 .40 aThe f i r s t row of double fig u r e s is f o r 1968, the second fo r 1971. Subsequent an a ly s is showed t h a t a c u r v i l i n e a r r e la tio n s h ip e x is te d between resources 1971 and the adoption measure o f inn ovatio n. The resource v a r ia b le was transformed to resources = Log 10 (resources 1971). The c o r r e l a t i o n of the transformed v a r ia b le w ith innovation was r = .42 and r = .32 f o r speed f o r adoption and adoption respec­ t i v e l y . The use o f t h is transformed v a r ia b le i s discussed a t length in Chapter IV. 85 o f th e c o r r e l a t i o n s are in the p r e d ic te d d i r e c t i o n , although some a re c e r t a i n l y l a r g e r than o th e rs . The f i r s t l i n e o f the double row o f f ig u r e s is f o r 1968 and th e second l i n e o f each row is f o r 1971. P opulation i s not very s tr o n g ly c o r r e la t e d w ith the adoption measure o f in n ovatio n nor i s resources f o r 1971 c o r r e la t e d very s tr o n g ly w ith ad o p tio n . Subsequent a n a ly s is on resources 1971 using a tra n s fo rm a tio n showed t h a t t h i s v a r i a b l e was c o r r e l a t e d as s tr o n g ly w ith In n o v a tio n as the resource measure f o r 1968. I conclude, 3 though, t h a t th e re is support f o r hypotheses A -l through A -5 . Note t h a t the independent v a r ia b le s a re h ig h ly i n t e r ­ c o r r e l a t e d . This makes i t e x tre m e ly d i f f i c u l t to assess the unique e f f e c t s o f these v a r ia b le s on in n o v a tio n . So cial science data t y p i c a l l y s u f f e r from t h is problem. 4 However, the m u lti - c o l l i n e a r i t y is seldom as high as i t is here. While t h is problem can be minimized by employing o nly those v a r ia b le s f o r which t h i s c o v a r ia t io n i s l e a s t , t h is may c o n f l i c t w ith o th e r c r i t e r i a o f the re s e a rc h , such as s e le c t in g the best o p e ra tio n a l in d ic a t o r s o f the t h e o r e t i c a l concepts. A n aly sis w i l l continue in t h i s s e c tio n on t h i s s e t o f v a r i a b l e s . In a l a t e r s e c tio n many o f them w i l l be o m itted due to t h i s m u l t i - c o l 1 i n e a r i t y . I a ls o found t h a t th e s iz e o f the lo c a l a p p r o p r ia tio n to the h e a lth department was r e l a t e d to both in n o v a tio n measures. Among th e in d ic a t o r s o f re s o u rc e s , i t seems t h a t th e a b s o lu te s iz e o f th e d ep artm en t's budget is a s tro n g , and perhaps the most im p o rta n t, p r e d ic t o r o f in n o v a tio n . 86 T o ta l county revenue f o r the county o r d i s t r i c t was a ls o used as an i n d i c a t o r o f resources a v a i l a b l e to th e departm ent. The c o r ­ r e l a t i o n here was not very strong but in th e d i r e c t i o n p re d ic te d by the h y p o th e s is . 6 T h is , however, i s o n ly an i n d i c a t o r o f a p o s s ib le pool o f resources f o r most county fu n c tio n s . The h e a lth department has to compete f o r a share o f these funds w ith o th e r departments and ag encies. I t seems t h a t the resources o f the department are more im p o rtan t f o r in n o v a tio n to tak e p la c e than a re the resources o f the j u r i s d i c t i o n o f the h e a lth departm ent. T his may i n d i c a t e a w illin g n e s s o f the departm ental d i r e c t o r to seek resources and to use them to in n o v ate . Given th e high i n t e r - c o r r e l a t i o n s among the independent v a r i a b l e s , i t seemed t h a t a number o f them may have been measuring the same th in g . E m p ir ic a lly t h i s may be so although 1 have argued t h a t each o f the independent v a r ia b le s should have a sep arate e f f e c t on in n o v a tio n . However, many o f these v a r ia b le s a re e i t h e r a r e s u l t o f o r a cause o f the s iz e o f the departm ent. For example, i t is o n ly the la rg e departments which have la r g e amounts o f resources. Likew ise i t is the l a r g e r departments which have a g r e a t e r number o f p ro fe s s io n a l s p e c i a l t i e s and p ro fe s s io n a l employees. I probably have s e le c te d the mechanisms by which resources and s iz e le a d to in n o v a tio n . Resources themselves do not lea d n e c e s s a r ily to inno­ v a tio n but l a r g e r amounts o f resources a llo w the department to h i r e s p e c i a l i s t s which w i l l lead to in n o v a tio n . Some a tte m p t was made to p a r t i a l out the e f f e c t s o f s iz e and resources on the c o r r e l a t i o n s o f the o th e r v a r ia b le s w ith in n o v a tio n . 87 I attempted to determine 1 f the e f f e c t s o f any o f the o rg an i­ z a tio n a l v a ria b le s on innovation could e s s e n t i a ll y be determined by the o th e rs . The p a r t i a l r between p opulation and inn ovatio n w ith resources p a r t i a l led out was r = - . 1 5 . ^ This c o r r e la tio n is f a i r l y small but in d ic a te s some independent e f f e c t o f population on inno­ v a tio n . The negative p a r t i a l could mean t h a t the l a r g e r populations prevent innovation unless they are accompanied by more resources, which they u s u a lly a re . Over the long run i t is probable th a t population increases lead to increased resources which in tu rn makes inn ovatio n more l i k e l y . Much o f the c o r r e la t io n between population and innovation can be accounted f o r by resources, however. The c o r r e la tio n between resources and innovation is not merely due to t h e i r separate c o r r e la tio n s w ith p o p u la tio n . Con­ t r o l l i n g f o r population 1968 l e f t a p a r t i a l o f r = .33 w ith primary In n o v atio n . I t is apparent t h a t resources by i t s e l f , is a more im portant p r e d ic t o r o f innovation than is p o p u la tio n . One may argue t h a t population is p r im a r ily im portant in t h a t i t is c o rr e - la te d w ith resources. Q One way o f looking a t the e f f e c t o f population is by the use of a th ree v a r ia b le path diagram o r causal model. There is a problem here due to the high m u l t i - c o l l i n e a r i t y o f the two in d e­ pendent v a ria b le s but since I am not r e a l l y g e n e r a liz in g to a la r g e r p opulation from a sample the problems are not as d e b i l i t a t i n g . g The question is whether p opulation has a d i r e c t e f f e c t on inn ovatio n or whether the e f f e c t s o f p opulation are only through resources. That i s , p opulation may only e f f e c t innovation in th a t 88 higher p opulation leads to higher resources which leads to more Innovation. I assume t h a t p opulation Is p r i o r 1n time to dep art­ mental resources as measured by t o t a l budget; t h a t 1 s * le v e l o f resources has no e f f e c t on p o p u la tio n . The two proposed models and the expected c o r r e la tio n s are shown 1n Figure 1. I f the c o r r e la tio n between resources and innovation were spurious, I . e . , due to popu­ l a t i o n s ' c o r r e la tio n w ith resources and in n o v a tio n , then c o n tr o llin g f o r population would cause the p a r t i a l between resources and Inno­ va tio n to drop to zero. I t Is reduced but is s t i l l f a i r l y la rg e . The conclusion here is th a t a p a r t i a l l y spurious r e la t io n s h ip e x is ts but one which contains a s u b s ta n tia l d ir e c t in flu e n c e o f resources on Innovation. The r e s u ltin g p a r t i a l c o r r e la tio n s support a model in which population has some d ir e c t e f f e c t on innovation and in which a s u b s ta n tia l amount o f the e f f e c t o f population is due to increased resources which accompany larg e p o p u la tio n s . See Figure 2 f o r an i l l u s t r a t i o n o f t h i s model. However, i f resources are c o n tr o lle d , population has a n egative e f f e c t on innovation. That i s , w ith an increase 1 n p o p u la tio n , i f resources are c o n t r o lle d , innovation is dampened. This makes sense as i t means th a t e x i s t i n g resources are spread out over a la r g e r p o p u la tio n . The p a r t i a l c o r r e la tio n s g e n e ra lly in d ic a te t h a t s p e c i a l t i e s , f o r 1968, does not n e c e s s a rily lead to more innovation unless i t is accompanied by a s u f f i c i e n t number o f personnel and resources. The p a r t i a l s between s p e c ia lt ie s and innovation when resources and s iz e were c o n tro lle d were a l l n eg ative . C o n tr o llin g f o r s iz e and resources 89 -► R I ^ P ^ Expected P a r t ia ls ____________ r P I.R = 0 r R I.P = * 4 8 R*" Expected P a r t i a l s r P I.R = * 4 0 r R I.P = 0 Figure 3 - 1 . - - P a t h Diagram o f P o p u la tio n , Resources, and Innovation f o r 1968. p p r p i * Actual P a r t i a l s r PI . R - — 1 5 r R I . P = 3 3 Figure 3 - 2 . — Path Diagram Supported by Actual P a r t i a l C o rre la tio n s f o r 1968. 90 f o r 1968, I f i n d t h a t the p a r t i a l between primary innovation and the number o f employees In the pro fession al ca teg o ries is r *> .1 8 , In d ic a tin g t h a t t h is v a r ia b le has a t le a s t some s l i g h t e f f e c t upon innovation Independent o f s iz e and resources. M u lt i v a r i a t e Analysis o f Department V a ria b le s M u lt i p l e regression and c o r r e la tio n were also used to analyze th is s e t o f data. Step-wise regression was done f o r the independent v a ria b le s f o r both y e a rs , 1968 and 1971 f o r both measures o f in n o v a tio n . 1 0 A l l six v a ria b le s were i n i t i a l l y entered in a m u lt ip le regression equation. The m u lt ip le R f o r the s ix v a ria b le s w ith the primary innovation measure, speed o f ad o ption , was R * .69 f o r 1968 and R = .70 f o r 1971. For secondary innovation measure, ado ption , these same v a ria b le s re s u lte d in R = .83 f o r 1968 and R = .87 f o r 1971. As much as 49% o f the variance in primary innovation and as much as 76% o f the variance in secondary innovation were accounted f o r by t h is set o f v a ria b le s (see Table 3 - 2 ) . The step-w ise regression procedure was also run to p ic k the best combination o f p re d ic to rs o f in n o v a tio n . Since the independent v a ria b le s were so h ig h ly c o r r e la te d , some o f them did not c o n trib u te much to the t o t a l explained variance in the m u lt ip le regression ro u tin e .^ ^ The changes in s i z e , resources, and p opulation w ith inno­ v a tio n were also analyzed w ith simple and m u l t ip l e c o r r e la t io n ro u tin e s . I have argued t h a t increases may be used to innovate or in d ic a te e x tra resources a v a ila b le f o r inn ovatio n but also t h a t TABLE 3-2,--Step-Wise Multiple Regression Analysis of Departmental Variables for 1968 and 1971 with Innovation. Variables Professional employees Population Professional categories Specialties Size A ll variables3 F = 4.94; N = 36 Professional categories Population Resources Professional employees A ll variables3 F = 14.7; N = 36 r .41 .40 .49 .33 .51 .55 .24 .52 .41 R2 b / S.E, beta Year Innovation 1968 Speed of adoption -494/474 -2.35/1.11 2651/1130 -1954/747 829/371 -1.07 - .02 .72 -1.07 2.73 .076/.10 .16 1968 Adoption -.001/.0002 -1.89 .001/.0003 .092/.043 1.41 .77 .48 ,49 .68 .69 TABLE 3-2.--Continued. Variables Professional categories Resources Population A ll variables3 F = 8.32; N = 36 Specialties Resources Size A ll variables3 F = 27.18; N * 36 r .55 .35 .41 .44 .19 .39 .46 .49 .74 .76 R2 b / S.E. beta 3607/962 -0.66/.22 4.02/1.50 .89 -1.81 1.49 Year 1971 Innovation Speed of adoption .076/.098 .137 1971 Adoption -.0003/.0001 -3.112 .179/.024 3.29 30ther independent variables were not brought in to the equation by the step-wise regression routine. 93 In n o v a tio n Is a p o s s ib le s tr a te g y used by th e d i r e c t o r to o b ta in a l a r g e r budget. 12 Changes in the s i z e o f the department may i n d ic a t e t h a t new s e rv ic e s are being added and may p ro v id e f o r a d d it io n a l personnel so t h a t new s e rv ic e s can be planned. A la rg e change in p o p u la tio n over a s h o rt p erio d o f time may be r e l a t e d to a lower le v e l o f in n o v a tio n , e s p e c i a l l y i f the o th e r fa c t o r s do not change comparably. That i s , w ith a sudden in c re as e in p o p u la tio n to be served w ith o u t an accompanying in c re as e in resources and personnel means t h a t the e x i s t i n g resources and personnel must be s tre tc h e d to handle these needs. 13 W hile la r g e p o p u la tio n in i t s e l f is a s s o c ia te d w ith more in n o v a tio n , a la r g e upward change in p o p u la tio n w i l l p robably be a s s o c ia te d w ith les s in n o v a tio n . However, a steady average in c re a s e in p o p u la tio n over a lo n g e r p erio d may very w e ll be a s s o c ia te d w ith more in n o v a tio n . The c o r r e la t io n s support the f i r s t p a r t o f t h i s c o n te n tio n (see T ab le 5 ) . The change in p o p u la tio n from 1968 to 1971 i s n e g a tiv e ly c o r r e la t e d w ith in n o v a tio n , although the c o r r e l a t i o n w ith secondary in n o v atio n is q u it e weak. A l l o f the c o r r e l a t i o n s f o r the change scores were in the expected d i r e c t i o n , although they were not very s tro n g . However, the m u l t ip l e c o r r e l a t i o n s o f the change v a r ia b le s w ith in n o v a tio n is q u it e high. M u l t i p l e R f o r change in reso u rces, s i z e , and p o p u la tio n w ith p rim ary in n o v a tio n was R = .7 5 ; m u l t i p l e 2 R ■ .5 7 . For the secondary in n o v a tio n measure, m u l t ip l e R = .37 and R2 = .1 4 (see T ab le 3 - 3 ) . A number o f i n t e r p r e t a t i o n s can be g iven here. One is t h a t the d i r e c t o r and h is d ep u ties a re very a c t i v e in seeking out resources TABLE 3-3.--Step-Wise Multiple Regression Analysis of Changes in Selected Departmental Variables with Innovation. Variables Change in resources Change in size r .31 .21 Change in population -.22 F = 12.15; N = 33 Change in popularion Change in resources F = 2.33; N = 33 .21 .19 R2 a b / S.E. .09 .10 .57 3.88/.78 -158/112 -36/6.5 beta 1.31 - .29 -1.03 Innovation Speed of adoption .04 -.004/.002 - .46 Adoption . 14b .0004/.0002 .55 aR2 is cumulative as variables are added. bChange in size was not brought into the equation. 95 and 1 n in n o v a tin g 1 n those departments in which the resource change was l a r g e s t . In n o v atio n could be a s t r a t e g y by the d ir e c t o r s to o b ta in g r e a t e r resources. Or resources may be o btained in o rd e r to In n o v a te . Summary o f F i r s t P a rt o f Chapter I I I The hypotheses concerning the r e l a t i o n s h i p s o f the o r g a n i­ z a t io n a l f a c to r s to in n o v a tio n were a l l supported. The r e l a t i o n s h i p o f the t o t a l budget f o r 1971 w ith the adoption measure o f in n o v a tio n was r a t h e r low though. A d d itio n a l a n a ly s is w ith resources f o r 1970 showed t h i s l a t t e r v a r i a b l e to be as h ig h ly c o r r e la t e d w ith adoption as the o th e r departmental v a r i a b l e s . A n a ly s is a ls o showed t h a t the r e l a t i o n s h i p between resources 1971 and adoption was c u r v i l i n e a r and t h i s v a r ia b le was transform ed w ith a lo g a r ith m ic f u n c t io n . This transform ed v a r ia b le showed about the same c o r r e l a t i o n w ith adoption as d id resources f o r 1968. M u l t i - c o l l i n e a r i t y was so high among the independent v a r ia b le s t h a t some o f them can be considered to be measuring the same th in g and a r e e m p i r ic a l l y almost e q u iv a le n t . Previous research shows t h a t s iz e and resources a re q u ite h ig h ly c o r r e la t e d w ith in n o v a tio n in o r g a n iz a tio n s . Perhaps what I have done here is to show how these two f a c t o r s account f o r inno­ v a t io n . L a rg e r, r i c h e r o r g a n iz a tio n s can and are l i k e l y to h ir e more s p e c i a l i s t s and p ro fe s s io n a ls who can then suggest in n o v atio n s to th e department. S iz e i t s e l f is g r e a t l y dependent upon th e monetary resources o f the departm ent. So in a way resources is perhaps the 96 s in g le best In d ic a to r o f the complex o f fa c to r s which determine innovation in o rg a n iz a tio n s . However, money i t s e l f does not n e c e s s a rily lead to g re a te r in n o v atio n . I t i s when t h is money is used to obtain ap p ro p ria te personnel t h a t the department becomes in n o v ativ e. The population o f the community served by the h ea lth department is r e la t e d to innovation but were i t not f o r the g re a te r resources and la r g e r s iz e which accompanies population t h is f a c t o r would ap p aran tly be a b a r r i e r to in n o v atio n . L ik ew ise , i f a department invests i t s resources in an ongoing a c t i v i t y , perhaps to serve a ra p id ly growing p o p u la tio n , s iz e and resources w i l l not be stro n g ly c o r r e la te d w ith in n ovatio n. As growth in population is accompanied by comparable in ­ creases in resources and s iz e , we would expect increases in popu­ l a t i o n to be followed by new programs, i . e . , in n o v atio n . However, larg e o r quick changes in population may be a b a r r i e r to innovation in t h a t e x is tin g resources must be devoted to serving more people on even increases in resources must be channeled in to meeting t r a d i t i o n a l needs o f ongoing programs f o r la r g e r p o p u la tio n s . This would dampen e f f o r t s a t innovation unless the la r g e r population presented a severe need f o r a new program. The re s u lts showed th a t w ith the changes in resources c o n t r o lle d , the change in population was n e g a tiv e ly c o r r e la te d w ith in n o v a tio n , r = - . 6 9 f o r speed o f adoption and r = - . 3 2 f o r adoption. 97 D ire c to r Ambition Downs, S c h le s in g e r, and others make a number o f p re d ic tio n s and hypotheses about the a t t i t u d e s , a s p ir a tio n s and behavior o f in d iv id u a ls based on t h e i r goals. The purpose In the fo llo w in g sections is to t e s t some o f these hypotheses and to in corpo rate them in to the present study o f o rg a n iz a tio n a l in n o v atio n . In th is chapter and the next I w i l l (1 ) t e s t some o f the hypotheses from Insid e Bureaucracy and ambition theory which support the schema which I have o u t lin e d ; and (2) use the theory to in d ic a te how c h a r a c t e r is t ic s o f d ir e c to r s are r e la t e d to innovation w ith in p u b lic health departments. A f t e r t e s t in g a number o f in d iv id u a l ambition hypotheses, I w i l l r e l a t e in d iv id u a l d ir e c t o r c h a ra c te r­ i s t i c s to departmental v a ria b le s to help e x p la in the v a r ia tio n in departmental in n o v atio n . The set o f hypotheses to be te s te d now are those in which the expressed ambition o f the h e a lth department d ir e c t o r is the dependent v a r ia b le . In these hypotheses, I i d e n t i f y the ambitions of the d ir e c to r s and determine i f c e r t a in o th e r c h a r a c t e r is t ic s such as age, employment h is t o r y , and t r a i n i n g are r e la te d to these am bitions. The hypotheses o f t h is set a re r e s ta te d below. Hypothesis B - l : The p roportion o f d ir e c to r s i d e n t i f i e d as conservers increases w ith in creasin g age. The p roportion o f d ir e c to r s i d e n t i f i e d as climbers decreases w ith in c re as in g age. Hypothesis B-2: D ire c to rs w ith advanced degrees in p u b lic h ea lth are more l i k e l y to be climbers than conservers. D ire c to rs w ith ou t advanced degrees in p u b lic h e a lth are more l i k e l y to be conservers than clim b ers. 98 Hypothesis B-3: D ir e c t o r s w ith a past c a re e r in p r i v a t e medicine a re more l i k e l y to be conservers than a re those w ith o u t any p r i v a t e p r a c t i c e . D ir e c t o r s w ith o u t p r i v a t e p r a c t i c e are more l i k e l y to be clim b ers than those w ith p r i v a t e p r a c t i c e . Hypothesis B-4: The number o f years the d i r e c t o r has spent in p r i v a t e p r a c t i c e w i l l be n e g a t iv e ly c o r r e la te d w ith the degree o f c lim b e r am bition and p o s i t i v e l y c o r r e la t e d w ith the degree o f conserver am b itio n . Hypothesis B-5: Climbers w i l l be more w i l l i n g to change p o s itio n s than conservers. The data to t e s t these hypotheses a re taken from the mail q u e s tio n - n a ire * 14 One s e t o f questions asked the respondents to rank o rd er a number o f p o s itio n s in p u b lic h e a lth according to t h e i r , the d i r e c t o r s 1, p re fe re n c e f o r them. In a l l e i g h t p o s itio n s were l i s t e d f o r ranking . The f u l l s e t is given in Appendix B. However, o nly f i v e o f these were a c tu a l p o s itio n s o f employment. The o th e r th re e were d e s c rip tio n s o f aspects o f p o s it io n s . 15 One o f these w i l l be discussed in g r e a t e r d e t a i l in subsequent paragraphs. The s e t o f p o s itio n s was generated in p a r t by In s id e Bureaucracy and through c o n s u lta tio n w ith Michigan Department o f P u b lic H e alth o f f i c i a l s and co nsisted o f a number o f p o s it io n s , o r d e s c r ip tio n s o f p o s it io n s , in p u b lic h e a lth a t the s t a t e and lo c a l l e v e l . The d i r e c t o r s ' p re fe re n c e ranking o f two o f these p o s it io n were used to measure c lim b e r and conserver am b itio n . I expected from Downs d is cu ss io n t h a t clim b ers would rank p o s itio n s w ith g r e a t e r r e s p o n s i b i l i t y , p r e s t i g e , and income r e l a t i v e l y high on t h e i r p re fe re n c e o rd e rin g and would rank p o s itio n s o f les s r e s p o n s i b i l i t y and le s s p r e s t ig e and s a la r y lo w er. I a ls o 99 expected t h a t conservers would r e f l e c t a reversal o f the clim b ers' ordering w ith regard to these two p o s itio n s . By d e f i n i t i o n , climbers want to maximize t h e i r goals o f power, p r e s t ig e , and Income whereas conservers want to maximize s e c u rity and convenience.1® The oper­ a tio n a l d e f i n i t i o n o f clim b er was the preference ranking given to the p o s itio n o f d ir e c t o r o f a la rg e p u b lic health department. In general the s a la ry o f the d ir e c t o r is a d i r e c t fu n c tio n o f the size and budget o f the d ep artm en t.1^ The experience and v i s i b i l i t y th a t a d ir e c t o r o f a la rg e department in the s ta te o b ta in s , other things being eq u al, can be important in the d ir e c t o r 's m o b ilit y to o ther p o s itio n s such as s t a t e or fe d e ra l p u b lic h e a lth jo b s . I f Downs was c o r r e c t, clim bers would rank the p o s itio n o f d ir e c t o r o f th is kind o f a department higher in comparison to the o th e r p o s itio n s than would conservers. The o pe ra tio n a l d e f i n i t i o n o f conserver am bition was the preference ranking given to the p o s itio n as d ir e c t o r o f a small pub lic h e a lth department t h a t is not changing in s iz e . Again, by d e f i n i t i o n , conservers would be expected to have a high preference f o r a p o s itio n which would a llo w them to maximize convenience and s e c u r ity . Although the s a la r ie s in the sm a lle r departments are not very hig h, the demands need not be very high e i t h e r . I f the department is not changing in s ize t h is im p lies th a t th ere are fewer new problems to deal w it h , fewer new personnel to assig n, and a slow ly expanding budget to a d m in is te r. In o th e r words, lack o f change im plies convenience. So conservers would be expected to 100 have a high preference f o r t h is p o s itio n and climbers to have a low preference f o r t h i s type o f p o s itio n . A t h i r d type o f ambition was in v e s tig a te d a ls o . I had thought th a t climbers would be in te r e s te d in in flu e n c in g p o lic y in p ub lic h ea lth and used the preference ranking o f a p o s itio n which would a llo w the d ir e c t o r to in flu e n c e p u b lic h ea lth p o lic y as an in d ic a to r o f an aspect o f clim b er am bition . The p reference ranking assigned to each p o s itio n could range from one to e ig h t. Some a n a ly s is is done w ith these measures using contingency t a b le s , o rd in a l and in t e r v a l le v e l s t a t i s t i c s . I t was assumed th a t these preference rankings could be tre a te d as in t e r v a l scales. Since the ranks o f the p o s itio n s were forced in to a scale o f from one to e ig h t and the d ir e c t o r could not assign the same rank to any two p o s itio n s , the ranking assigned to any p o s itio n in d ic a te s the i n t e n s i t y o f the d i r e c t o r 's p reference f o r t h a t p o s itio n r e l a t i v e to the o th e rs . 18 Each d i r e c t o r ’ s preferences are anchored w ith in the same range. Not only do I have the d i r e c t o r 's response as to whether he p re fe rs a convenient p o s itio n to a w e ll-p a y in g one but I also have the degree o f p reference. The two types o f am b itio n , as measured, are not dichotomies and are to a g re a t e x te n t , independent o f each o th e r. That i s , a d ir e c t o r may rank both the p o s itio n used to measure the degree o f clim b er am bition and the p o s itio n used to in d ic a te degree o f conserver am bition high. Or both may be ranked f a i r l y low. I f a d ir e c t o r has a high degree o f clim b er ambition i t does not n e c e s s a rily mean th a t 101 he w i l l have a low degree o f conserver a m b itio n , although t h i s 1 s u s u a lly the case w ith the p resen t d a ta . Downs argues t h a t conservers a r e change avo ld ers whereas clim b ers a re ready to change e s p e c ia ll y 1 f 1 t w i l l b e n e f i t them. Conservers w i l l avoid change I f p o s s ib le but w i l l change p o s itio n s 1 f not to do so would damage them. But clim b ers g e n e r a lly f in d t h a t change has h ig h e r p a y -o ffs f o r them than do conservers. This has been discussed in Chapter Two where i t was hypothesized t h a t clim b ers would be more l i k e l y than conservers to r e p o r t p r e f e r r in g some p o s it io n o th e r than the one they p r e s e n tly h e ld . Climbers would a ls o be less l i k e l y than conservers to r e p o r t t h a t they are co n ten t to remain in t h e i r p resen t p o s itio n s u n t i l r e t ir e m e n t . Items on the q u e s tio n n a ire asked the respondents i f they d id p r e f e r a p o s itio n o th e r than the one t h a t they p r e s e n tly h eld . The responses were l i m i t e d to Yes o r No. The second q uestion was a f i v e p o in t item which asked th e d ir e c t o r s to i n d i c a t e how c o n ten t they would be to remain in t h e i r p res en t p o s it io n u n t i l r e tir e m e n t. The p e r­ m itte d responses ranged from Very Content to I n d i f f e r e n t to Not At A l l Content. I t fo llo w s t h a t i f conservers were change avo id ers t h a t they would be more l i k e l y to be c o n te n t than clim b ers w ith whatever p o s itio n s they p re s e n tly h e ld . They a ls o would be less l i k e l y to put f o r t h any e f f o r t to change o r to improve t h e i r p o s it i o n . 19 T h e ir p o s it io n may be o b j e c t i v e l y very d e s i r a b l e , but a t t h is p o in t they would be conservers- On the o th e r hand, clim b ers would be more l i k e l y to r e p o r t being Not Content to sta y in t h e i r p res en t p o s it io n u n t i l r e t ir e m e n t . F i r s t o f a l l as clim b ers they 102 would have ambitions which would need more p re s tig e * money* and power to s a t i s f y . I f they were In a sm a lle r department they would probably have plans on moving to a more p re s tig io u s p o s itio n o r one which pays more. L ikew ise, i f they are f r u s t r a t e d in reaching t h e i r g o a ls , whatever they may be, climbers are more l i k e l y to re p o rt being Not Content and more l i k e l y to attem pt to take some a c tio n to r e c t i f y the s it u a t i o n . At any r a te t h is in d ic a t o r should be r e la te d to the clim ber and conserver in d ic a to rs and in turn r e la te d to age and the other independent v a ria b le s o f t h is hypothesis s e t. The two questions tapping the w illin g n e s s o f the d ir e c t o r to change p o s itio n s comprise, in p a r t , a co n stru ct v a lid a t io n o f the am bition measures. 20 These questions are g e ttin g a t a t t i t u d i n a l v a r ia b le s , and as such, they d i f f e r from the o th e r measures used as in d ic a to rs f o r v a ria b le s in t h i s hypothesis s e t. The hypotheses in v o lv in g the two a t t i t u d i n a l questions are generated more f o r v a lid a t io n a l purposes than f o r theory t e s t in g . 21 Although Downs does not d e fin e conservers as change a v o id e rs , he does s ta te th a t they w i l l be. 22 So since i t has been argued t h a t conservers and climbers w i l l e x h ib i t re la tio n s h ip s to these two responses, I then t e s t f o r re la tio n s h ip s between the background v a ria b le s and these a t t i t u d i n a l v a ria b le s which are hypothesized to be a p a rt o f the conserver and clim b er am bition complex. Tables are presented showing the as so c ia tio n between the p r e f e r and contentment in d ic a to rs and the o th e r independent v a ria b le s o f age, p r iv a t e p r a c t i c e , advanced degree in p u b lic h e a lth and the number o f years o f p r iv a t e p r a c t ic e . 103 Hypotheses B -l through B-4 were te s te d by d eterm in in g the a s s o c ia tio n s between each o f th e am b itio n measures and th e independent v a r ia b le s o f t h is s e t . In a d d it io n * the a s s o c ia tio n s between the responses to the P r e f e r and Contentment measures were determ ined. These a s s o c ia tio n s a re shown in Table 3 -4 . O ther ta b le s f u r t h e r i l l u s t r a t e the a s s o c ia tio n s in contingency t a b le fo rm a t. Tables 3-1 6 and 3 -1 7 g iv e the a s s o c ia tio n s between the P r e f e r and Contentment responses and the am bition measures. The r e la t io n s h ip s w i l l be discussed in the fo llo w in g s e c tio n s . Age and Am bition Hypothesis B -l was te s te d using each o f the measures o f expressed a m b itio n . Tables were c o n s tru c te d to d is p la y the r e l a t i o n ­ s h ip s . However, since many o f the v a r ia b le s in vo lved in t h i s s e t were o r d in a l o r i n t e r v a l l e v e l , rank o rd e r o r Pearson product moment c o r r e l a t i o n c o e f f i c i e n t s are re p o rte d . 23 Tables 3 - 5 , 3 - 6 , and 3-7 show th e r e la t io n s h ip s between age and the th re e am bition measures. The p re fe re n c e rankings f o r each p o s it io n were dichotom ized a t the median to d iv id e the groups in t o high and low p re fe re n c e . Clim ber am bition decreases w ith in c re a s in g age and conserver am bition increases w ith in c re a s in g age as can be seen by Tables 3 -5 and 3 -6 . T ab le 3-7 shows the r e l a t i o n s h i p between the p o s itio n which would a llo w th e d i r e c t o r to in flu e n c e p u b lic h e a lth p o lic y and age. This shows t h a t as age in c re a s e s , th e p re fe re n c e f o r t h is kind o f a p o s itio n decreases. I have argued t h a t t h i s kind o f p re fe re n c e i s r e l a t e d to a d i r e c t o r ' s c lim b e r a m b itio n and t h is t a b le adds i n d i r e c t support f o r t h a t argument. 104 Tables 3 -8 and 3-9 show the r e la tio n s h ip s between age and the P r e f e r and Contentment responses. As age increases the d ir e c t o r is less l i k e l y to p r e f e r a p o s itio n o th e r than the one he alrea d y has. The responses to the Contentment question were collapsed in to a dichotomy as shown. The o ld e r d ir e c to r s are more l i k e l y to re p o rt being content to remain in t h e i r present p o s itio n u n t il re tire m e n t. In g e n e ra l, hypothesis B -l is supported. The c o r r e la tio n s between the independent v a r ia b le s , the d ir e c t o r s ' background v a r ia b le s , and conserver ambition was much stronger than th a t between these v a ria b le s and clim ber ambition (see Table 3 - 4 ) . For example, the c o r r e la t io n between age and conserver am bition was r = .38 and th a t between age and clim b er am bition was r = - . 2 4 . Other researchers have found strong s t a t i c ambitions developing w ith in creasin g age. 24 I t appears th a t a s i m il a r phenomenon may be found here. My use of Downs1 term conserver ambition is analogous to S c h le s in g e r's term s t a t i c ambition. I had expected t h a t p a rt o f the item concerning the d i r e c t o r 's p reference f o r a p o s itio n which would enable him to have in flu e n c e on p u b lic health p o lic y to be an i n d i c a t o r o f am bition, w ith climbers being more concerned w ith t h is p o s itio n than conservers. The c o r r e la t io n between age and the preference ranking assigned to th is p o s itio n was r = - . 2 9 . This was not p a r t i c u l a r l y strong but in the expected d ir e c t io n . As Table 3-7 shows, i t is predominately the younger d ir e c to r s who have a high p reference f o r t h is type o f p o s itio n . 105 I have support then f o r hypothesis B - l . The consistency o f the measures o f a s s o c ia tio n between the In d ic a to rs o f ambition and age a llo w me to conclude t h a t age 1 s r e la t e d to the type o f am bition, w ith o ld e r d ir e c to r s more l i k e l y to be conservers than younger d ir e c to r s and younger d ir e c to r s more l i k e l y to be climbers than o ld e r d ir e c t o r s . However, i t seems t h a t age is more c lo s e ly r e la te d to the conserver p o s itio n than to the clim b er p o s itio n . 25 P r iv a te P ra c tic e and Ambition Whether or not the d ir e c t o r had spent any time in p r iv a t e p ra c tic e was also p re d ic te d to be r e la te d to h is expressed am bition. The c o r r e la tio n between p r i v a t e p ra c tic e and the d i r e c t o r 's pre­ ference f o r the p o s itio n as d ir e c t o r o f a la rg e department, clim ber am bition, was r = - . 4 2 (see Table 3 - 4 ) . For p r iv a te p ra c tic e and degree o f conserver am bition r = .1 5 , again in the expected d ir e c t io n but a much weaker c o r r e l a t i o n . For the p o lic y p o s itio n the c o rre ­ l a t i o n was r = - . 2 2 . This again was in the expected d ir e c t io n but weak. P r iv a te p ra c tic e shows only a weak r e la tio n s h ip to the pre­ ference f o r a p o s itio n o th e r than the one h e ld , although t h is r e la tio n s h ip was als o in the expected d ir e c t io n (see Tables 3-4 and 3 -1 1 ) . The r e la t io n s h ip o f the contentment item and p r iv a t e p ra c tic e is also weak but in the expected d ir e c t io n (see Tables 3 -4 and 3 - 1 0 ). P r iv a te p r a c tic e shows the expected a s s o c ia tio n w ith am bition. Although the r e la tio n s h ip s are not a l l as strong as w ith age, I conclude t h a t I have support f o r the hypotheses r e l a t i n g p r iv a t e p r a c tic e w ith am bition. TABLE 3-4.--C orrelations Between Director Characteristics and Measures of Expressed Ambition, Preference fo r Director Background Large Departments (Climber ambition) Variables Preference fo r Small Departments (Conserver ambition) Preference fo r Policy Position (Policy ambition) Prefer Other Position Content to Remain Until Retirement Age Private Practice Number of years of Private Practive Advanced degree in Public Health3 -.24 (N-22) -.42 (N=22) -.20 (N=15) K .004 (N=22) .38 (N=22) .15 (N=22) .73 (N=15) .40 (N-22) -.29 (Ns21) -.22 (N=21) -.46 (N=14) -.13 (N=21) -.43® (N=24) .14 (N=22) -.40 (N=15) h -.04 (N=22) .47 (N=27) .17 (N=25) .58 (N=16) - .2 2 (N=22) C orrelatio n s are point b is e ria l. The responses were No or Yes and were coded with a smaller value assigned to No. C o t in the direction predicted by the hypothesis but the correlations are so low as to indicate p ra c tic a lly no relationship whatsoever. These were the only two correlations not in the predicted direction in th is table. 107 TABLE 3 - 5 . — D i r e c t o r 's P referen ce f o r P o s itio n as D ir e c t o r o f A Large P u b lic H e a lth Department by Age. Age 45 o r less 26 to 55 56 o r more High 4 (44%) 1 (17%) 0 ( 0 %) P referen ce f o r P o s itio n Low 5 (56%) 5 (83%) 7 (100%) 9 (100%) 6 ( 1 0 0 %) 7 (100%) Gairma = .83 H = 22 TABLE 3 - 6 . — D ir e c to r * P u b lic H ealth s Preferen ce f o r P o s itio n as D ir e c t o r o f Department t h a t is S ta b le in S ize by Age. a Small Age 45 o r less 46 to 55 56 o r more High 1 (13%) 2 (33%) 5 (63%) P referen ce f o r P o s itio n Low 7 (87%) 4 (67%) 3 (3 7 * ) 8 ( 1 0 0 %) 6 ( 1 0 0 %) 8 ( 1 0 0 * ) Ganvna = - . 72 N = 22 108 TABLE 3 - 7 . — D i r e c t o r 's P re fe re n c e f o r a P o s itio n Which Would A llow the D i r e c t o r to In flu e n c e P u b lic H e alth P o lic y by Age. 45 o r les s 26 to 55 56 o r more Age High 5 (63%) 1 (17%) 1 (U % ) P reference f o r P o s itio n Low 3 (37%) 5 (83%) 6 ( 8 6 %) 8 ( 1 0 0 %) 6 ( 1 0 0 %) 7 (100%) Gamma = .73 N = 21 109 TABLE 3 - 8 . — D i r e c t o r 's P re feren ce f o r P o s itio n O ther Than C u rren t P o s itio n by Age. r T ■ '■ ■ » ------------------------- '--------------------- 1 j T l , r ■ — ~ ------ J * ' T I B I Age 50 years o r le s s 51 years o r more No 8 (67%) 11 (92%) P r e f e r any p o s itio n o th e r than c u rr e n t one. Yes 4 (33%) 1 ( 8 %) 1 2 ( 1 0 0 %) 1 2 ( 1 0 0 %) N=24 Phi = 32. Gamma = - . 6 9 Per c e n t d i f f e r e n c t = 25 TABLE 3 - 9 . - - D i r e c t o r ' s Contentment to Remain in Present Posi t io n U n t i l R etirem en t by Age. Age 50 years o r less 51 y e a rs or more Yes 4 (31%) 11 (79%) Content to remain in p res en t p o s it io n u n t i l returem en t. No o r In d i f f e r e n t 9 (69%) 13 (100%) 3 (21%) 14 (100%) N=27 Phi = .4 8 Gamma = - . 7 8 Per ce n t d if f e r e n c e - 48 110 TABLE 3 - 1 0 . — D ir e c t o r 's Preference f o r a P o s itio n Other than C urrent P o sitio n by P r iv a te P ra c tic e . P r iv a te P ra c tic e No Yes No 6 ( 8 6 %) 11 (75%) P r e fe r o th e r p o s itio n Yes 1 (14%) 7 (100%) Phi = .14 Gamma = .37 4 (25%) 15 (100%) N = 22. TABLE 3 - 1 1 . — D ir e c t o r 's Degree o f Contentment to Remain in Current P o s itio n U n t il Retirem ent by P riv a te P ra c tic e . Yes Content to remain u n t il re tire m e n t No or In d i f f e r e n t P riv a te P ra c tic e No 4 (44%) Yes 9 (56%) 5 (56%) 7 (44%) 9 (100%) 16 (100%) Phi = .14 Gamma = .27 N = 25 I l l Number o f years o f P r iv a t e P ra c tic e and Ambition The c o r r e la tio n s o f t h is v a ria b le w ith the in d ic a to rs o f ambition are very high w ith one exception. Since I included a v a ria b le in the a n a ly sis on p r iv a t e p r a c t ic e , the number o f years o f p r iv a te p r a c t ic e includes only those d ir e c t o r s who had been in p r iv a te p r a c t ic e a t a l l . So the t o ta l number o f d ir e c to r s in t h is set is somewhat s m a lle r since not a l l o f the physicians had had any p r iv a t e p r a c t ic e . This v a r ia b le was measured on an i n t e r v a l scale so only the Pearson r ' s are reported to show the stren gth o f r e la t io n s h ip . A l l o f the c o r r e la tio n s are high except f o r clim ber ambition although i t is in the expected d ir e c t io n as are the others (see Table 3 - 4 ) . However, as the length o f p r iv a t e p ra c tic e increased, the p reference f o r a s m a ll, s ta b le department increased. Only a small tenure in p r iv a t e p r a c t ic e was not enough, a p p a re n tly , to give r is e to clim b er am bition. Hypothesis B-3 is supported. The P r e fe r and Contentment responses show the expected c o rre la tio n s w ith the number o f years o f p r iv a t e p r a c t ic e . The d ir e c to r s w ith longer tenure in p r iv a t e p r a c tic e were more l i k e l y to re p o rt not p r e f e r r in g a p o s itio n o th e r than the one c u r r e n tly held and more l i k e l y to be co n ten t to remain in t h a t p o s itio n u n t i l re tire m e n t. Advanced Degree in P ublic Health and Ambition Although th e re were several p ossible responses to a question in q u irin g about the d i r e c t o r 's t r a in in g in p u b lic h e a lth , the categories were coded as a dichotomy; those t h a t did not have an 112 advanced degree in p u b lic h e a lth and those t h a t had e i t h e r a M a s te r's o r a D o cto ra te in P u b lic H e a lth (see q u e stio n 6 , P a r t I I * Appendix B ). The c o r r e l a t i o n s show mixed r e s u l t s as some o f the r e l a t i o n ­ ships a re markedly s tro n g e r than o thers (see Table 3 - 4 ) . The c o r r e ­ l a t i o n w ith the degree o f conserver am bition i s m oderately strong w h ile th e re is v i r t u a l l y no c o r r e l a t i o n a t a l l between p u b lic h e a lth degree and c lim b e r a m b itio n . What l i t t l e th e re i s appears to be in the wrong d i r e c t i o n . There is e s s e m tia lly no c o r r e l a t i o n between advanced degree and p re fe re n c e f o r o th e r p o s itio n e i t h e r , although those w ith an advanced degree in p u b lic h e a lth were less l i k e l y to remain In t h e i r c u r r e n t p o s it io n u n t i l r e t ir e m e n t. About a l l I can conclude is t h a t advanced degree in p u b lic h e a lth is as so c ia ted w ith conserver a m b itio n but not w ith c lim b e r a m b itio n . Tables 3-12 through 3 -1 5 show the r e la t io n s h ip s in t a b u la r form. Even in t h i s form th e re is e s s e n t i a l l y no r e l a t i o n s h i p appearing between c lim b e r a m b itio n — as measured by p re fe re n c e f o r p o s it io n as the d i r e c t o r o f a la rg e p u b lic h e a lth departm ent— and advanced degree in p u b lic h e a lt h . D ir e c t o r s W illin g n e s s to Change P o s itio n s and Am bition The a s s o c ia tio n s between the two in d ic a to r s o f the d i r e c t o r s ' w illin g n e s s to change jobs and the background v a r ia b le s o f age, p r i v a t e p r a c t i c e , number o f y e ars o f p r i v a t e p r a c t i c e , and advanced degree in p u b lic h e a lth were a l l in th e d i r e c t i o n expected. These a s s o c ia tio n s in d i c a t e t h a t those d ir e c t o r s w ith c lim b e r a t t r i b u t e s were more l i k e l y to p r e f e r o t h e r p o s itio n s and less w i l l i n g to stay 113 TABLE 3 - 1 2 . — D ir e c t o r 's Preference f o r a P o s itio n as the D ir e c to r o f a Small P ublic H e alth Department t h a t i s not Changing in Size by Advanced Degree in P u b lic H ealth. Preference f o r P o sitio n High Med1 urn Low No 4 (33%) 5 (42%) 3 (25%) 1 2 ( 1 0 0 %) Advanced degree in P u b lic Health Yes 1 ( 1 0 %) 3 (30%) 6 (60%) 1 0 ( 1 0 0 %) Gamna = .59 N * 2 2 . TABLE 3 - 1 3 . — D ir e c t o r 's Preference the D ir e c to r to In flu e n c e Advanced Degree f o r a P o s itio n Which Would Allow Public Health Po licy by in P u b lic H e alth . Preference f o r Posi tio n High Medium Low No 3 (27%) 4 (36%) 4 (36%) 11 ( 1 0 0 %) Advanced degree in Public Health Yes 4 (46%) 3 (30%) 3 (30%) 1 0 ( 1 0 0 %) Gamma = - . 3 7 N = 21. 114 TABLE 3 - 1 4 . — D ir e c t o r 's Preference f o r a P o s itio n Other than Current P o s itio n by Advanced Degree in Public H ealth. No P re fe r o th e r p o s itio n Yes Advanced Degree in P u b lic Health No Yes 11 (79%) 6 (75%) 3 (21%) 2 (25%) 14 (100%) 8 ( 1 0 0 %) Ganna = .10 N = 22 Per cent d iff e r e n c e = 4 TABLE 3 - 1 5 . - - D i r e c t o r ' s Contentment to Stay in Current P o s itio n U n til Retirem ent by Advanced Degree in P ublic H e alth . Advanced Degree in P ublic Health No Yes Yes 5 (36%) 7 (64%) Content to stay in p o s itio n u n t il r e t i rement No or Indi f f e r e n t 9 (64%) 4 (36%) 14 (100%) 11 ( 1 0 0 %) Gamma = - . 5 5 N = 25 Per cent d iff e r e n c e = -2 8 115 in t h e i r present p o s itio n u n t i l re tire m e n t. But i t must be d e te r ­ mined i f these two measures are in turn associated w ith the am bition measures themselves. Tables 3-16 and 3-17 show the asso c ia tio n s between these two sets o f measures. With the exception o f the asso ciatio n between clim ber am bition and the p reference f o r o th e r p o s itio n s , the asso ciatio ns are in the p re d ic te d d ir e c t io n w ith clim bers i n d i ­ cating more w illin g n e s s to change jobs than conservers. However, the a s s o c ia tio n between c lim b e r ambition and p reference f o r o th e r p o sitio ns shows th a t clim bers are less l i k e l y to p r e fe r a p o s itio n other than t h e i r c u rre n t one than are conservers. This weakens the support f o r construct v a l i d i t y . However, the degree o f clim b er ambition is n e g a tiv e ly c o r r e la te d w ith the d ir e c t o r * s contentment to remain in his present p o s itio n u n t il re tir e m e n t. The degree o f conserver am bition is r e la t e d to these two measures in the expected d ir e c t io n {see Tables 3-16 and 3 -1 7 ). Only fo u r respondents reported t h a t they would p r e fe r another p o s itio n to t h e i r c u rre n t one. However, only 20 repo rted th a t they would be content to stay in t h e i r p resen t p o s itio n u n t i l re tire m e n t. The remaining 10 were i n d i f f e r e n t o r not co n ten t. Those d ir e c t o r s w ith a lower preference f o r the clim b er p o s itio n were more l i k e l y to p r e fe r a d i f f e r e n t p o s it io n . Since o nly fo u r o f the d ir e c t o r s expressed a preference f o r a d i f f e r e n t p o s itio n , th is r e la t io n s h ip may not be very im portant. So we fin d th a t the two a t t l t u d i n a l measures are r e la t e d f a i r l y s tro n g ly in the expected d ir e c t io n to the in d ic a to r o f 116 TABLE 3 - 1 6 . — Associations Between D ir e c t o r 's Ambition and Preference f o r Other P o sitio n s and Contentment w ith Present P o s itio n . Climber Ambition Conserver Ambition Pol Ic y Ambition P re fe r p o s itio n o ther than present Contentment to stay in present p o s itio n u n t i l re tir e m e n t. . 1 0 - . 0 8 .32 .29 - . 0 9 - . 3 7 (Spearman rank o rd er c o r r e la tio n c o e f f i c i e n t s . ) N=31 TABLE 3 - 1 7 . — D ir e c t o r 's Preference f o r a P o s itio n Other Than the One C u rre n tly Held by Preference f o r Small Public Health Department t h a t is Stable in S iz e . Preference f o r a Small Department High ( 1 - 5 ) Low ( 6 - 8 ) No 18 (95%) 8 (73%) P re fe r o ther p o s itio n Y u le 's Q = .74 Yes 1 (5%) 3 (27%) 19 (100%) 11 ( 1 0 0 %) 177 conserver am bition. They a re only weakly r e la t e d to the in d ic a to r o f clim b er ambition and in the case o f p reference f o r a p o s itio n o th e r than the present one, the re la tio n s h ip is in the opposite d ir e c t io n . These a t t i t u d i n a l measures are r e la t e d in the expected d ir e c tio n to the d ir e c t o r background v a ria b le s w ith one exception and t h a t as so ciatio n is so weak as to in d ic a te no r e la t io n s h ip {see Table 3 - 4 ) . I t seems th a t these two a t t i t u d i n a l dimensions may not be an in te g r a l p a r t o f clim b er am bition. N e ith e r Downs nor t h is study defines climbers as being change o rie n te d . Downs, however, does claim th a t conservers are change avoiders and t h is e x ercise supports th a t co n ten tio n. 26 Although the a t t i t u d i n a l measures were expected to be r e la te d to the measure o f clim ber am b itio n , climbers were not defined as changers. In f a c t , i f they have a high preference f o r the p o s itio n o f d ir e c t o r o f a larg e department— the o p e ra tio n a l d e f i n i t i o n o f clim ber— and a re alre a d y in t h a t p o s itio n , then they would be expected to be less w i l l i n g to change and more w i l l i n g to remain in t h a t p o s itio n u n t i l re tir e m e n t. Perhaps a b e t t e r way o f r e l a t i n g a t t it u d e s toward change to clim b er am bition would be to note the number and d ir e c t io n o f jo b changes th a t a d ir e c t o r has made in his past career. The rankings of a p o s itio n to allo w the d ir e c to r to in flu e n c e p o lic y were r e la te d to both o f these items. I t appears t h a t those d ir e c to r s w ith a g re a te r p reference f o r t h is type o f p o s itio n are more w i l l i n g to change p o s itio n s and less content to stay in current p o s itio n s than those w ith a lower preference f o r th is p o s itio n . 118 M u l t i v a r i a t e A n a ly s is o f D i r e c t o r Background V a ri abTes M u l t i p l e re g res sio n a n a ly s is was a ls o used to an a ly ze the data f o r t h i s s e t o f v a r i a b l e s . Each o f the in d ic a to r s o f am bition was regressed on the fo u r independent v a r ia b le s age, p r i v a t e p r a c t i c e , number o f y e ars o f p r i v a t e p r a c t i c e and advanced degree in p u b lic h e a lth . Nominal v a r ia b le s were converted to dunn\y v a r i a b l e s . 27 The P r e f e r and Contentment v a r ia b le s were dropped from the a n a ly s is as these were n e i t h e r background v a r ia b le s o r in d ic a t o r s o f a m b itio n . A s te p -w is e m u lt ip le re g re s s io n r o u tin e was used. A ll o f the fo u r independent v a r ia b le s were e n tered in each e q u atio n to determ ine how much o f the va ria n c e in each o f the am b itio n in d ic a to r s the set o f fo u r v a r ia b le s e x p la in e d - 28 Table 3 -1 8 g ives the re g re s s io n and m u l t ip l e c o r r e l a t i o n c o e f f i c i e n t s f o r the i n d i c a t o r o f c lim b e r am bition . The fo u r independent v a r ia b le s account f o r 45% o f the va ria n c e in c lim b e r a m b itio n . These fo u r v a r ia b le s account f o r 82% o f the v a ria n c e in the i n d i c a t o r o f conserver am b itio n (see T ab le 3 - 1 9 ) . This is c o n s id e r­ ably more than the amount o f v a ria n c e accounted f o r in c lim b e r am bition by these same v a r i a b l e s . These r e s u l t s r e in f o r c e the argument t h a t th e re are a t l e a s t two types o f a m b itio n . 29 Factors o th e r than these fo u r v a r ia b le s a re re s p o n s ib le f o r more o f the varian ce in p re fe re n c e f o r th e more p r e s t ig io u s but demanding p o s itio n than o f the v a ria n c e in p re fe re n c e f o r a less p r e s t ig io u s but safe p o s it i o n . T ab le 3-2 0 i l l u s t r a t e s the c o r r e l a t i o n s f o r the p re fe re n c e f o r a p o s it io n which would a llo w the d i r e c t o r to in flu e n c e p o lic y . 119 TABLE 3 - 1 8 . — M u lt ip le Regression w ith Preference f o r P o s itio n as D ir e c t o r o f a Large P ublic Health Department as Dependent V a r ia b le . Cumulative Independent V a ria b le s P riv a te p r a c t ic e Number o f years o f p r iv a t e p r a c tic e Advanced degree in p u b lic h e a lth Age F = 1 .8 3 ; N = 27 2 R .18 .22 .29 .45 b / S.E. beta - 4 . 3 6 / 1 . 7 5 . 3 3 / . 1 6 - 4 . 4 6 / 2 . 3 2 . 2 1 / . 1 3 - .92 - - 1 . 3 9 .98 .94 - TABLE 3 - 1 9 . — M u lt ip le Regression w ith Preference f o r P o sitio n as D ir e c to r o f a Small P u b lic Health Department th a t is S table in Size as Dependent V a r ia b le . Cumulative Independent V a ria b le s Number o f years o f p r iv a t e p r a c t ic e Age P riv a te p r a c t ic e Advanced degree in p u b lic h ea lth F = 1 0 .1 7 ; N = 27 2 R .54 .57 .63 .82 b / S.E. beta . 4 3 / . 0 8 . 2 4 / . 0 7 2 . 9 8 / . 8 9 - 3 . 6 4 / 1 . 1 8 2 .0 6 1.20 .71 .90 - TABLE 3 - 2 0 . — M u lt ip le Regression w ith Preference f o r P o s itio n Allow ing the D ir e c to r to In flu e n ce P o lic y as the Dependent V a ria b le . Cumulative Independent V a ria b le s b /S .E . beta Number o f years o f p r iv a t e p r a c t ic e P riv a te p r a c t ic e Advanced degree in p u b lic h e a lth Age .21 .26 .31 . 55 - . 3 4 / . 1 1 ■ 2 .9 3 /1 .2 3 . 7 8 / 1 . 6 - . 2 0 / . 0 9 - 1 .8 7 .81 - 1 .0 8 - 1 .1 7 F = 2 .7 9 ; N = 27 120 The Independent v a r ia b le s account f o r 55% o f the v a ria n c e in p r e f e r ­ ence f o r t h is p o s it io n . Sumnary The a n a ly s is in t h i s ch a p te r t e s ts hypotheses in sets A and B and in c lu d es hypotheses generated f o r th e purpose o f c o n s tru c t v a l i d a t i o n . The hypotheses r e l a t i n g o r g a n iz a t io n a l v a r ia b le s to in n o v a tio n are supported. The m u l t i - c o l l i n e a r i t y among the In d e ­ pendent departm ental v a r ia b le s was e x tre m e ly h ig h ; so high t h a t many o f them a re e m p i r ic a l l y e q u iv a le n t. I t was concluded t h a t , w ith the ex ce p tio n o f p o p u la tio n , the d epartm ental v a r ia b le s were mechanisms which the departments could use to be in n o v a tiv e . Each o f th ese, however, was thought to be dependent on the a v a i l a b i l i t y o f resources. P o p u la tio n is not dependent upon resources but the a v a i l a ­ b i l i t y o f resources was s tr o n g ly c o r r e la t e d w ith p o p u la tio n . A d d itio n a l a n a ly s is in d ic a te d t h a t p o p u la tio n le d to more resources which was c o r r e l a t e d w ith in n o v a tio n . P o p u la tio n had some separate e f f e c t on in n o v a tio n but i f i t were not accompanied by comparable resources the e f f e c t o f a l a r g e r p o p u la tio n on in n o v atio n was n e g a tiv e . M u l t i p l e re g re s s io n a n a ly s is o f the departm ental v a r ia b le s accounted f o r 49% and 76% o f the v a ria n c e in in n o v a tio n f o r prim ary and secondary in n o v a tio n , r e s p e c t i v e l y . I t a ls o in d ic a te d t h a t one o f the departm ental v a r ia b le s accounted f o r the m a jo r it y o f the v a ria n c e but not a l l o f i t . A d d itio n a l v a r ia b le s were brought in to the equation by a s te p -w is e reg res sio n r o u tin e but d id not add much 121 to the variance explained* More o f the variance in secondary innovation than 1 n primary innovation was exp lain ed by the d e p a rt­ mental v a ria b le s . Changes in s iz e * resources, and population from 1968 to 1971 were c o rr e la te d w ith in n o v atio n . These v a ria b le s were se lected as they seemed to be p re r e q u is ite s to the o th e r departmental v a r ia b le s . Innovation was c o rr e la te d w ith changes in each o f these v a ria b le s but not s tro n g ly . However, the m u ltip le c o r r e la tio n o f these changes w ith innovation was high: R = .75 f o r primary innovation and R * .37 f o r secondary in n o v atio n . The degree o f m u l t i - col l i n e a r i t y among the change v a ria b le s was much lower than among the o r i g i n a l v a r ia b le s . The d ir e c t o r s ' ranking o f t h e i r preferences f o r th re e positio ns in p u b lic h e a lth were used as measures o f am bition and hypotheses r e l a t i n g these to background c h a r a c t e r is t ic s o f the d ire c to rs were te s te d . Two types o f ambition were p os ite d : clim ber and conserver. A t h ir d p o s itio n was thought to measure an aspect o f clim b er am bition. D i r e c t o r 's age, p r iv a te p r a c tic e ex p erien ce, length o f p r iv a t e p r a c t ic e , and p u b lic h e a lth t r a in i n g were found to be r e la t e d to the am bition measures. However, p u b lic h e a lth t r a in in g was not r e la te d to clim b er am bition. The v a r ia b le most s tro n g ly r e la te d to conserver ambition was the length o f the d ir e c t o r 's tenure in p r iv a t e p r a c tic e . This was n e g a tiv e ly c o r­ r e la te d w ith clim b er ambition and p o s it i v e l y c o r r e la te d w ith conserver am bition. The t h i r d measure o f am b itio n , termed p o lic y am bition , showed c o r r e la tio n s w ith these background c h a r a c t e r is t ic s s i m il a r to those o f clim b er am bition. 122 Two measures o f the d i r e c t o r s ' w illin g n e s s to change jobs were Inclu d ed 1 n hypotheses w ith background v a r ia b le s and a m b itio n . G e n e ra lly the r e s u l t s showed t h a t those w ith backgrounds which would i n d ic a t e t h a t they would tend to be clim bers were more w i l l i n g to change p o s itio n s than those w ith conserver backgrounds. Con­ s e rv e r am bition was r e l a t e d to these measures in the p re d ic te d d i r e c t i o n . Strong conserver am bition was as s o c ia te d w ith les s w illin g n e s s to change. However, strong c lim b e r am bition was asso c ia ted w ith more w illin g n e s s to change on o n ly one o f the measures. C hapter I I I — F ootnotes Total exp en diture has also been used as an in d ic a to r of resources. See L. B. Mohr, "Determinants o f Inn ovatio n in Organi­ z a tio n s ," American P o l i t i c a l Science Review, 63 ( 1 9 6 9 ) , pp. 111-126. 2 A subsequent an a ly s is showed t h a t a c u r v i l i n e a r re la tio n s h ip was necessary to f i t the asso ciatio n between resources 1971 and the adoption measure o f in n o v atio n , see pages 3 The problem a ris e s as how to assess the importance and s ig n ific a n c e o f these r e s u lt s . Since I do not have a random sample, s ig n ific a n c e te s ts do not have the usual meaning. However, some authors in t h i s s it u a t io n re p o rt re s u lts t h a t would have been s i g n i f i c a n t had the group in question been a random sample. Larry Mohr, American P o l i t i c a l Science Review, p. 1 1 5 .) Russett discusses t h is problem and suggests the use o f s ig n ific a n c e tests to in d ic a te the dep artu re o f the r e s u lt s from randomness. S. M. L ip s e t, M artin Trow, and James Coleman, Union Democracy {The Free Press, 1956), Appendix I , pp. 470-485, discusses t h i s problem. They conclude th a t the r e s u lt s o f an e n t i r e p a tte rn o f hypotheses ra th e r than the s ig n ific a n c e o f any s in g le one hypothesis 1 s the important c r i t e r i a f o r judging the re s u lts o f a study. (See Since my N I s r e l a t i v e l y s m a ll, s i g n i f i c a n t r e s u lts would not seem to be merely due to la rg e numbers. However, any co rre­ in the expected d ir e c tio n l a t i o n , nominal, o r d i n a l , o r I n t e r v a l , w i l l be considered o n ly weak support f o r the hypothesis unless i t i s a t le a s t .20 . S t a t i s t i c s f o r the Social Sciences (London: The MacMillan Press, I w i l l a ls o argue t h a t r e s u lt s o f the L t d . , 1971), pp. 151-154. hypotheses taken as a s e t , even i f they are weak, are more important to the judgment o f the re s u lts o f the research and the theory than the re s u lts o f any hypothesis taken s in g ly . (See Connolly and S lu c k in , An In tro d u c tio n to ^Richard A lle n Smith, "Community S tru ctu re and Innovation: A Study o f the E ff e c t s o f Social S tru c tu re on Program Adoption and Implementation" (unpublished Ph.D. d i s s e r t a t i o n , C o r n e ll, Ith a c a , New York, A p r il 1 9 7 3 ), pp. 182-183; Robert A. Gordon, "Issues in M u lt i p l e Regression," American Journal o f Sociology (1 9 6 8 ), pp. 592-604. 5 Ib id . ®These c o r r e la tio n s were as fo llo w s : T o ta l county revenue f o r 1968 w ith prim ary and secondary in n o v a tio n , r = r e s p e c tiv e ly . T o ta l county revenue f o r 1971 w ith in n o v a tio n , r = .29 and r = .34 and 4 = .2 7 . .2 7 , 123 124 See Gordon* oj>. c i t . , and Hubert B la lo c k , " C o rr e la te d Independent V a r ia b le s : The Problem o f M u lti col 1i n e a r i t y , " S o cial F orces, 42 (December, 1 9 6 3 ), pp. 2 3 3 -2 3 7 . ®Mohr concluded t h a t alth o u g h community s iz e was a very im p o rtan t d e te rm in a n t o f in n o v a tio n , a v a i l a b i l i t y o f resources which accompanied l a r g e r s iz e communities. L. Mohr, oj>. c i t . , p. 120. i t was so because o f th e q Hubert B la lo c k , d r . , Causal In fe re n c e s in Non-Experimental Research (Chapel H i l l : The U n i v e r s i t y o f North C a ro lin a Press, 1 9 6 4 ), pp. 8 3 -9 1 ; L- Mohr, o£. c i t . , p. 120. ^Norman H. N ie , Dale Bent, and C. Hadlai H u l l , S t a t i s t i c a l Package f o r the S o c ia l Sciences (New York: McGraw-Hill Book Company, 1 9 7 0 ), pp. 196-207. ^ D u e to t h i s high m u lti col l i n e a r i t y the s te p -w is e reg res sio n r o u tin e may e v a lu a te two o r more v a r i a b l e s t h a t a re s tr o n g ly r e la te d to th e dependent v a r i a b l e q u it e d i f f e r e n t l y . V a r ia b le s a re brought i n t o the equation on the basis o f t h e i r unique c o n t r ib u t io n to the v a ria n c e in the dependent v a r i a b l e . 1 2 W illia m Niskanen makes an e x p l i c i t assumption t h a t bureau­ c r a t s atte m p t to maximize the s iz e o f t h e i r ag encies' budgets s u b je c t to c e r t a in c o n s t r a in ts . W illia m A. Niskanen, Bureaucracy and R e p re s e n ta tiv e Government (Chicago: A ld in e -A t h e r t o n , 1971 ). 1 3 The a n a ly s is on page 89 p a r t i a l l y supports t h i s . 14 See Appendix B. ^ T h e e ig h t p o s itio n s t h a t th e d i r e c t o r were asked to rank a s m a ll, but a small p u b lic h e a lth departm ent t h a t is r e l a t i v e l y (a ) D i r e c t o r o f a la r g e p u b lic h e a lth dep artm en t, (b ) growing, p u b lic h e a lth departm ent, (c ) o rd e r a r e : D i r e c t o r o f D i r e c t o r o f s ta b le 1n s i z e , (d ) Bureau c h i e f in a s t a t e department o f p u b lic h e a lt h , (e ) Program c h i e f in a s t a t e department o f p u b lic h e a lt h , ( f ) A p o s it io n which would a llo w you to e x e rc is e the most in flu e n c e on the p o lic y d i r e c t i o n o f p u b lic h e a l t h , (g ) D i r e c t o r o f a d e p a r t­ ment t h a t has D i r e c t o r o f o f p ro g re s s iv e programs (see q u e s tio n 17, page 11, on the q u e s tio n ­ n a i r e in Appendix B ) . a number o f p ro g re s s iv e programs, (h ) t h a t would a llo w you to i n s t i t u t e a number i n s t i t u t e d a department The o rd e r here does not im ply any o b j e c t iv e d e s i r a b i l i t y o f the p o s it io n s . T h is is merely the o r d e r in which they appeared in the q u e s tio n n a ir e . The remaining t h r e e , but d e s c rib e aspects o f p u b lic h e a lth p o s itio n s . ( f ) , (g)» and (h ) a re not p o s itio n s as such Items ( a ) through (e ) d es c rib e a c tu a l p o s it io n s . 125 ^ A n th o n y Downs* In s id e Bureaucracy (Boston: L i t t l e , Brown* and Company, 1 9 6 7 )* pp. 88-102. ^7T his is th e usual s i t u a t i o n 1n o r g a n iz a tio n s . My conclusion here I s based on d iscussions w ith p u b li c h e a lth o f f i c i a l s and I n f o r ­ mation from the lo c a l p u b lic h e a lth departments budgets and the Local Government Budget Document o f th e Michigan Department o f T reasu ry. 18 Edward T u f t e , "Improving Data A n a ly s is in P o l i t i c a l S c ie n c e ," World P o l i t i c s , 21 ( 1 9 6 8 - 6 9 ) , pp. 64 1-6 54 . 19 20 Downs, o p . c i t . , pp. 8 8 -1 0 2 . V a li d a t i o n techniques t y p i c a l l y r e l a t e a t e s t o r i n d i c a t o r t h a t i s assumed to measure some concept to one o r more c r i t e r i o n v a r ia b le s t h a t t h e o r e t i c a l l y should be r e l a t e d to the t e s t . Then the t e s t ' s v a l i d i t y is assessed i n terms o f how w e ll the t e s t and the c r i t e r i o n v a r ia b le s a re r e l a t e d . See C. Richard K o f s t e t t e r , "The Amatuer P o l i t i c i a n : A Problem in C on stru ct V a l i d a t i o n , " Midwest Journal o f P o l i t i c a l S c ie n c e , 15 (F e b ru a ry , 1 9 7 1 ), pp. 31- 56. H o f s t e t t e r a ls o notes t h a t " T r a i t c o n s tru c t v a l i d i t y re q u ire s the p o s t u la t io n o f a s e r ie s o f r e la t io n s h ip s between the concept the measure o f which is to be v a lid a t e d and o th e r v a r i a b l e s . . o f th e concept to be v a lid a t e d and measures f o r each o f the c r i t e r i o n v a r ia b le s then i n t e r - c o r r e l a t e d in standard f a s h io n ," p. 34. In d iv id u a l c r i t e r i a are hypothesized to r e l a t e to a measure . . . . . 21Harold P. B e c h to ld t, "C o n s tru ct V a l i d i t y : A C r i t i q u e , " American P s y c h o lo g is t. 14 (O cto ber, 1 9 5 9 ), pp. 61 9-629. 22 23 Downs, op. c i t . , p. 97. P o in t b i s e r i a l c o r r e l a t i o n s a re re p o rte d when one o f the v a r ia b le s is dichotomous. S t a t i s t i e s (New York: Linton C. Freeman, Elementary A p p lied John W iley and Sons, I n c . , 1 9 6 5 ). 2^Kenneth P r e w i t t , The R ecru itm en t o f P o l i t i c a l Leaders: A Study o f C i t i z e n P o l i t i c i a n s (New York: B o b bs-M erri11 Company, 1 9 7 0 ), pp. 186-188; Kenneth P r e w it t and W illia m Now lin, " P o l i t i c a l Ambitions and the B ehavior o f Incumbent P o l i t i c i a n s , " The Western P o l i t i c a l Q u a r t e r l y , 22 (June, 1 9 6 9 ); Paul L. H a in , "American S ta te L e g i s l a t o r 's Am bition and Careers: The E f f e c t s o f Age and D i s t r i c t C h a r a c t e r is t ic s " (unpublished Ph.D. d i s s e r t a t i o n , Michigan S ta te U n i v e r s i t y , East Lan sing , M ich ig an , 1 9 7 1 ). 25 The gamma s t a t i s t i c is h ig h e r f o r the form er p o s it i o n than the l a t t e r . However, the c u t t in g p o in ts f o r age and p re fe re n c e probably e f f e c t t h i s somewhat. A lso the zero e n t r y in th e c e l l th e t a b l e f o r c lim b e r am bition tends to i n f l a t e gamma. See W illia m Buchanan, Understanding P o l i t i c a l V a r ia b le s (Second E d i t i o n ; New York: Charles S c r ib n e r 's Sons, 1 9 7 4 ), pp. in 126 Downs, 0 £ . c i t . , p. 97. 27 Daniel B. S u it s , "The Use o f Dumny V a ria b le s in Regression Equations," Journal o f the American S t a t i s t i c a l A s s o c ia tio n . 52 (1 9 5 4 ), pp. 548-551; Jacob Cohen, " M u ltip le Regression As a General Data A n a ly tic Scheme," Psychological B u l l e t i n , LXX (1 9 6 8 ), pp. 426-443. 28 Although age and number o f years o f p r iv a t e p r a c tic e are both s tro n g ly r e la t e d to a m b itio n , the c o l l i n e a r i t y between these causes the step-w ise regression ro u tin e to e v a lu a te one as being r e l a t i v e l y im portant and the o th e r as r e l a t i v e l y unimportant. 29 Gordon S. B lack, "A Theory o f P ro fe s s io n a liz a tio n in P o l i t i c s , " American P o l i t i c a l Science Review (September, 1 9 7 0 ), pp. 86 5-878, discusses th is in h is an a ly s is o f p o s itio n a l and progressive commitment am bition. CHAPTER IV HYPOTHESIS TESTING: DIRECTOR'S AMBITION AND INNOVATION AND THE DEVELOPMENT OF MULTIVARIATE MODELS The next concern is the c o r r e l a t i o n o f the c h a r a c t e r is t ic s o f th e in d iv id u a ls who are the d ir e c t o r s o f the h e a lth departments w ith th e in n o v a tio n o f the departm ent. As discussed in Chapter I , th e re a re c h a r a c t e r i s t i c s o f in d iv id u a ls which have been found by a number o f d i f f e r e n t re se arch ers to c o r r e l a t e w ith in n o v a tio n . The q u e s tio n here is whether o r not these c h a r a c t e r i s t i c s in flu e n c e the in d iv id u a l to have an e f f e c t on the in n o v a tio n o f a department. In o t h e r words, to what e x t e n t do the c h a r a c t e r i s t i c s o f the d i r e c t o r account f o r v a r i a t i o n in in n o v a tio n o f p u b lic h e a lth departments? Previous research suggests t h a t they do have a s u b s ta n tia l e f f e c t . In t h is chapter I deal w ith the d i r e c t o r and departmental v a r ia b le s j o i n t l y . I f we a re to connect in d iv id u a l a c tio n to o r g a n iz a t io n a l o u tp u t, an atte m p t needs to be made to use the assump­ tio n s and hypotheses o f th e th e o rie s discussed e a r l i e r to r e l a t e the c h a r a c t e r i s t i c s o f in d i v i d u a l s to o r g a n iz a t io n a l c h a r a c te r ­ i s t i c s . From Downs, we a r e led to expect t h a t d ir e c t o r s w i l l d i f f e r as to the type o f department in which th ey are found according to t h e i r type o f am b itio n . These d ir e c t o r s may have sought out the departments because o f t h e i r am bition s o r the d ir e c t o r s may have developed t h e i r am bition because o f th e department th ey a re i n . 127 128 The present stu^y w i l l only p a r t l y d is tin g u is h between these two s it u a t io n s . However, we can draw some lo g ic a l conclusions a f t e r te s tin g the hypotheses r e l a t i n g d ir e c t o r s to departments. Health Department D i r e c t o r 's Background and Ambition and Departmental Innovation I w i l l in the next sectio n r e l a t e the d ir e c t o r s ' expressed ambitions to departmental c h a r a c t e r is t ic s . However, the c o r r e la tio n o f the background fa c to rs o f the d ir e c to r s w ith innovation w i l l be reported a ls o . The main purpose, though, is to assess the e f f e c t o f the d i r e c t o r ’ s am bition on the Innovation o f the department. The expressed ambitions o f the d ir e c to r s w i l l inclu d e t h e i r expressed preferences f o r the th re e p u b lic h ea lth p o s itio n described e a r l i e r : (a ) a p o s itio n as the d i r e c t o r o f a larg e p u b lic h ea lth department (b) a p o s itio n as d i r e c t o r o f a small p u b lic h e a lth department th a t is s ta b le in s iz e , and (c ) a p o s itio n which would a llo w the respondent to have the most in flu e n c e p u b lic h e a lth p o lic y . The responses to (a) and (b ) a re the o p e ra tio n a l d e f i n i t i o n s o f degree o f clim b er and conserver am bition s, r e s p e c tiv e ly . P o s itio n ( c ) may be r e la te d to the d i r e c t o r 's clim b er am bition and be an analog to Downs' advocate. 1 I t is included h ere , however, to measure the d i r e c t o r 's i n t e r e s t in in flu e n c in g p o lic y ; Downs may have confused ambitions and s t r a t e g ie s in his d e s c rip tio n o f the d i f f e r e n t types o f goals and th is i s a case o f where t h is has happened. That i s , the bureaucrat may be a z e a lo t o r an advocate in order to f u r t h e r his clim b er am bitions. However, i t may als o be the case t h a t those d ir e c to r s stro n g ly fa v o rin g t h i s type o f p o s itio n s t i l l have not 129 fo rm u lated any p r e c is e goals. I f * as many w r i t e r s suggest* goals and a s p ir a tio n s r i s e w ith success, we may v e ry w e ll f i n d these d ir e c t o r s becoming c lim b e rs . Gordon Black discusses the p ro fe s ­ s i o n a l i z a t i o n o f those comnltted to a p o l i t i c a l c a re e r and found those w ith p ro g re s s iv e am bitions to be more p r o f e s s i o n a l l y o r ie n te d . 2 I expect a s i m i l a r f i n d i n g . I a ls o p r e d i c t t h a t those d ir e c t o r s who have a high p re fe re n c e f o r in flu e n c in g p o lic y w i l l a ls o t r y to be in n o v a tiv e . As we saw in Chapter I I I , many o f the background v a r ia b le s c o r r e la te d s i m i l a r l y w ith c lim b e r am bition and w ith t h i s I n d i c a t o r o f the d i r e c t o r ' s i n t e r e s t in in f lu e n c in g p u b lic h e a lth p o l I c y . The f i r s t hypothesis to be te s te d in t h i s ch a p te r r e l a t e s th e background v a r i a b l e s o f the d i r e c t o r to the In n o v a tio n o f the department. Hypothesis C - l : D ir e c to r s w ith ex p erience 1n p r i v a t e p r a c t i c e and d ir e c t o r s w ith o u t advanced degrees in p u b lic h e a lt h w i l l tend to be a s so c ia ted w ith less in n o v a tiv e departments than w i l l those d ir e c t o r s w ith o u t e x p erie n c e in p r i v a t e p r a c t i c e and those d ir e c t o r s w ith advanced degrees in p u b lic h e a lt h . The age o f the d i r e c t o r and the number o f years o f p r i v a t e p r a c t i c e ex p e rie n c e o f the d i r e c t o r w i l l be in v e r s e ly c o r r e la te d w ith the in n o v a tio n o f the departm ent. The age o f i n d i v i d u a l s has been found to be r e l a t e d to the inno­ v a tive n e ss o f the i n d i v i d u a l . S tu dies o f o r g a n iz a tio n a l in n o v a tio n have supported th e argument t h a t the age o f the d i r e c t o r o r dominant manager o f an o r g a n iz a t io n is an im p o rtan t f a c t o r in the in n o v a tio n o f th e o r g a n iz a t io n . 3 In the previous p u b lic h e a lth study discussed e a r l i e r , Mohr v e r i f i e d the f a c t t h a t the p u b lic h e a lth department 130 d i r e c t o r was one o f the most im p ortan t fa c to r s in v o lv e d 1 n th e departm ent's in n o v a tio n . He and K y tln g e r found c o r r e l a t i o n s between age and departm ental In n o v a tio n but they were not s tro n g . Rogers and others found age to be r e l a t e d to in n o v a tio n In i n d i v i d u a l s . But one must in q u ir e f u r t h e r as to why age is r e l a t e d to in n o ­ v a t io n , e i t h e r p o s i t i v e l y o r n e g a t iv e ly and why i t is not con­ s i s t e n t l y o r s t r o n g ly r e l a t e d . And what e x p la in s Mohr's f in d in g s t h a t those o l d e r h e a lth o f f i c e r s 1 n l a r g e r departments who have had a strong c a r e e r in p u b lic h e a lth a r e as s o c ia te d w ith g r e a t e r o r g a n iz a tio n a l 4 In n o v a tio n . The In te rv e n in g v a r ia b le s o f a m b itio n , as c l a s s i f i e d according to the c lim b e r and conserver ty p o lo g y , can help e x p la in and c l a r i f y t h i s . Not o n ly age but a number o f o th e r f a c t o r s are l i k e l y to be r e la t e d to the i n d i v i d u a l ' s personal and p ro fe s s io n a l g o a ls . His t r a i n i n g , form er c a r e e r , and p ro fe s s io n a l commitment may a l l i n f l u ­ ence his g o a ls , h is a b i l i t y to o b ta in and u t i l i z e in fo r m a t io n , to persuade, to l e a d , and u l t i m a t e l y upon the degree to which he is responsible f o r in n o v a tio n w it h i n the department which he d i r e c t s . P a rt o f hypothesis C -l is t h a t age i s n e g a t iv e ly c o r r e la t e d w ith in n o v a tio n . However, o th e r f a c t o r s in v o lv e d here w i l l p ro bably r e s u l t in a r a t h e r weak c o r r e l a t i o n . I f fa c t o r s such as p r i v a t e p r a c t ic e and p u b lic h e a lth t r a i n i n g were c o n t r o l l e d , age would l i k e l y to be s tr o n g ly r e l a t e d to in n o v a tio n . The m ajor purpose o f the rem aining a n a ly s is i s to determ ine i f am bition o f th e d i r e c t o r is im p o rta n t f o r in n o v a tio n . 131 The hypothesis t h a t age i s r e l a t e d to the c a re e r goals o f bureaucrats has a lre a d y been t e s t e d . From am b itio n theory we o b ta in the axiom t h a t goals are r e l e v a n t f o r b eh av io r. 5 I have a ls o te s te d hypotheses lin k i n g o th e r c h a r a c t e r i s t i c s o f i n d iv id u a ls to some expression o f t h e i r am bitions and w i l l now discuss and t e s t hypotheses which l i n k these expressions w ith c h a r a c t e r i s t i c s o f departm ents, in c lu d in g in n o v a tio n . The t r a i n i n g o f the d i r e c t o r i s an o ther f a c t o r th a t would be expected to have an in flu e n c e on the d i r e c t o r ’ s w illin g n e s s and a b i l i t y to in n o v a te . We have a lre a d y found t h a t th e d i r e c t o r ' s t r a i n i n g i s r e l a t e d to h is expressed am b itio n . Working from the th e o ry and research o u t l in e d e a r l i e r I would exp ect t h a t those p h y s ic ia n s w ith a M a s te r 's degree o r D octorate in P u b lic H e alth would be more concerned w ith moving up in the p ro fe s s io n than w ith sim ply m a in ta in in g o r conserving a p res en t p o s it i o n . The data supported the hypothesis t h a t th e holding o f an advanced degree in p u b lic h e a lth was r e l a t e d to the degree o f co n server am b itio n . I t was n o t, however, r e l a t e d to the d i r e c t o r ' s degree o f c lim b e r a m b itio n . The d i r e c t o r w ith an advanced degree is l i k e l y to be more in n o v a t iv e , though, as he w i l l have c lo s e r access to in fo rm a tio n about new programs in p u b lic h e a lth and c lo s e r t i e s to p r o fe s s io n a ls in schools o f p u b lic h e a lth . I f he has invested the tim e and e f f o r t i n t o g e tt in g an advanced d eg re e, h is o r i e n t a t i o n w i l l be more toward t h i s p r o f e s ­ sion than w i l l a d i r e c t o r who has not in v e s te d in the degree. This a ls o suggests, in tu rn t h a t a m b itio n , a t l e a s t conserver a m b itio n , w i l l be r e l a t e d to in n o v a tio n . 132 The form er c a re e r o f the d i r e c t o r should a ls o be r e l a t e d to h is a b i l i t y and w illin g n e s s to In n o v a te . Those physicians having spent a g r e a t deal o f tim e In p r i v a t e p r a c t i c e would not be as l i k e l y to have the I n t e r e s t * e x p e rie n c e , knowledge, o r perhaps the i n c l i n a t i o n to a tte m p t to Implement many o f the newer goals o f p u b lic h e a lth . So we would expect those w ith more p r i v a t e p r a c t i c e experience to be le s s in n o v a tiv e . T h e i r p ro fe s s io n a l s o c i a l i z a t i o n would not be such as to support in n o v a tio n In p u b lic h e a lth e i t h e r . * * In f a c t , those d ir e c t o r s coming from p r i v a t e p r a c t i c e would probably r e s i s t the adoption o f many n o n - t r a d i t i o n a l programs in p u b lic h e a lth . But a ls o those d ir e c t o r s w ith more t r a i n i n g in p u b lic h e a lth would have a g r e a t e r conmitment to t h i s p ro fe s s io n and would be more l i k e l y to be c lim b e rs . And t h is i s what I found in t e s t in g the hypothesis t h a t t h e r e was a r e l a t i o n s h i p between th e p r i v a t e p r a c t i c e ex p erience o f the d i r e c t o r and h is a m b itio n . The r e la t io n s h ip s between p r i v a t e p r a c t i c e and in n o v a tio n expressed in hypothesis C -l a re th e r e f o r e p r e d ic te d . The d e s ir e o f the d i r e c t o r to be ab le to in flu e n c e p u b lic h e a lth p o lic y i s expected to be r e l a t e d to the d i r e c t o r ' s w illin g n e s s to inn ovate. A d i r e c t o r t h a t wanted to be in a p o s itio n to in f lu e n c e p o lic y would be expected to have more o f a p o s i t i v e e f f e c t on inno­ v a tio n than someone who d id not c a re about a f f e c t i n g p o l i c y . So I expect to f i n d t h a t th e c h a r a c t e r i s t i c s r e l a t e d p o s i t i v e l y to c lim b e r am bition to a ls o be r e l a t e d p o s i t i v e l y to in n o v a tio n and those c h a r a c t e r i s t i c s r e l a t e d n e g a t iv e ly to co n server am bition to 133 be n e g a tiv e ly r e la t e d to In n o v atio n . The fo llo w in g hypotheses, a ls o discussed in Chapter I I , are r e -s t a te d : Hypothesis C-2: There w i l l be a p o s itiv e c o r r e la t io n between the degree o f clim ber ambition o f the d ir e c t o r and the resources o f the dep art­ ment and a n egative c o r r e la t io n between the degree o f conserver ambition and resources. Hypothesis C-3: The degree o f clim b er ambition o f the d ir e c t o r w i l l be p o s i t i v e l y c o rre la te d w ith the innovation o f the department and the degree o f conserver ambition w i l l be n e g a tiv e ly c o rr e la te d w ith in n o v atio n . Following the theory o u tlin e d in Chapter I , I hypothesize the type o f department in which the d i f f e r e n t types o f d ir e c to r s w i l l be found. D ire c to rs o f la r g e r departments w i l l tend to be clim bers r a th e r than conservers and d ir e c to r s o f sm aller d ep art­ ments w i l l tend to be conservers r a t h e r than clim b ers. So we should f in d a c o r r e la tio n between am bition o f the d ir e c t o r and innovation o f the department even though we do not claim t h a t the d ir e c to r s cause innovatio n. The c o r r e la t io n should be found i f d ir e c to r s o f l a r g e r departments tend to be climbers and l a r g e r departments are more in n o v a tiv e . Downs argues t h a t bureaucrats w i l l be a t t r a c t e d to those o rg a n iza tio n s o r bureaus in which they can most l i k e l y accomplish t h e i r c a re e r o b je c tiv e s . I f a clim b er is not able to accomplish his goals in his present s it u a t io n he w i l l more l i k e l y consider leaving than w i l l the conserver o r he w i l l change h is goals. That i s , he w i l l lower h is a s p ir a tio n s o r higher a s p ir a tio n s w i l l f a i l to develop i f the d ir e c t o r or o th e r bureaucrat is not able to 134 leave a s it u a t io n in which the r e a l i z a t i o n o f clim b er goals is f r u s t r a t e d .^ I f climbers do attem pt to maximize power, income, and p r e s tig e , then they would be expected to seek out the l a r g e r d e p a rt­ ments. They may not y e t be in these departm ents, though. But I would expect th a t some o f these in d iv id u a ls desirous o f a d i r e c t o r ­ ship o f a la rg e department would have a t t a in e d t h e i r g o al. Also we would expect some to f in d t h a t they p r e f e r the la rg e department a f t e r being th e re . L it e r a t u r e in psychology and decision-making shows t h a t a s p ir a tio n s tend to r is e w ith success. g Schlesinger points out th a t s tr u c t u r a l c o n d itio n s , t h a t i s , the o p p o rtu n itie s a v a ila b le in a s i t u a t i o n give r i s e to am bitions. g The c o r r e l a t i o n is not l i k e l y to be s tro n g , though, as some climbers may be in sm aller departments. However, the dynamics o f the development o f ambitions w i l l play a p a r t here. I f clim ber ambitions are f a i r l y w ell e s tab lis h e d by t r a i n i n g , age, and past employment exp erience, I would expect to f i n d a good number o f climbers in sm a lle r departments. These d ir e c t o r s would be on t h e i r way up, so to speak. On the o th e r hand, i f clim b er a s p ir a tio n s and ambitions only develop w ith experience and success, in c lu d in g experience in la r g e r departments, a stronger a s so c ia tio n should be found between clim b er am bition and the resources o f the department. A fo u r v a r ia b le path model analyzed in the l a s t sectio n o f t h is chapter w i l l attem pt to separate the development o f ambition due to background from the e f f e c t o f departmental v a ria b le s . 135 On the o th e r hand we would not expect conservers to be in the la r g e r departments. They are more l i k e l y to be found in sm aller departments. Since there is some in d ic a tio n th a t conserver ambition is f a i r l y strong among those d ir e c to r s w ith a p a r t i c u l a r set o f c h a r a c t e r is t ic s , I would expect a f a i r l y strong negative c o r r e la tio n between conserver ambition and resources o f the department (see Table 3 - 4 , Chapter I I I ) . I f we f in d climbers in departments which are in n o v a tiv e , we can then see how much th is helps to account f o r the varian ce in innovation and can continue the argument t h a t climbers do perhaps use innovation as a s tra te g y to advance t h e i r in te r e s ts . Climber ambition may a f f e c t the innovation o f the department e i t h e r inde­ pendently o r in some combination w ith the resources o f the d e p a rt­ ment. The j o i n t e f f e c t s o f ambition and resources w i l l be explored in a l a t e r section o f t h is chapter. Departments, Data, and V ariab les For the a n a ly sis in th is se ctio n which combined the d ir e c t o r data w ith data on departmental v a r ia b le s , some o f the missing data f o r the d ir e c to r s was replaced w ith the a r ith m e tic means o f the v a ria b le s or estim ated by use o f m u lt ip le regression equations. In a l l , missing data was replaced o r estim ated f o r e ig h t o f 30 d ir e c to r s . I f complete data f o r a d ir e c t o r was m issin g , regression eq u ation s, o f course, could not be used. Some o f th e d ir e c t o r s , however, had f a i l e d to answer one o r more o f the questions and these missing data were estim ated on the basis o f o th e r inform ation about them. 136 The data f o r fo u r v a ria b le s was estim ated. The v a ria b le s f o r which data was estimated were the responses to the preference rankings o f the th re e p o s itio n s and age. Age was replaced by the a r ith m e tic mean o f t h a t v a r ia b le . I f info rm ation was missing f o r several o f the v a r ia b le s , missing values on the preference ranking v a ria b le s were also replaced by the a r ith m e tic mean. I t was necessary to do t h is because missing data would have g r e a t ly reduced the sample s ize in terms o f both the departments and d ir e c t o r s . I did not estim ate missing data f o r the a n a ly s is o f the d ir e c to r s alone because i t was necessary to e s ta b lis h the existence o f the r e la tio n s h ip s between d ir e c t o r c h a r a c t e r is t ic s on the basis o f the o r ig in a l data c o lle c t e d . However, once these r e la tio n s h ip s were e s ta b lis h e d , I f e l t more com fortable es tim atin g the data f o r the remaining d ir e c to r s . Some o f the a n a ly s is with the d ir e c t o r s and departments can be checked w ith the previous an a ly sis to note i f any d iffe re n c e s o b ta in between the two analyses. The use o f estim ated data here should not a f f e c t the magnitude o f the r e la tio n s h ip s very much. Any bias should be c o n s e rv a tiv e , th a t i s , the r e la tio n s h ip s would be weakened r a t h e r than strengthened.^® Adoption as Dependent V a ria b le In order to be ab le to reasonably a t t r i b u t e an innovation to the d ir e c t o r who f i l l e d out the q u e s tio n n a ire , only the adoption measure o f inn ovatio n is used in t h is s e c tio n . A l l o f the programs in th is index were very new and the index is based on the adoption o f the program o n ly , not on the times o f adoption. Also since the 137 planning f o r any adoption probably took place p r i o r to 1972, those departments whose d ir e c t o r s began t h e i r present tenure a f t e r December 30, 1971 were removed from the a n a ly s is . There were th ree departments removed f o r th is reason. Three o f the d ir e c to r s were d ir e c to r s o f two departments. In o rd er to include the departmental data f o r these departments but to avoid in c lu d in g the d ir e c t o r data tw ice f o r each o f the d ir e c t o r s , the data f o r these departments was given a w eight o f o n e -h a lf in the s t a t i s t i c a l r o u t i n e s . ^ This creates the p o te n tia l f o r bias but some c o r r e la tio n s computed w ith o u t w eighting procedure in d ic a te d only very s l i g h t d iffe re n c e s in the r e s u lt s . So t h i r t y - th ree departments remain in t h is se ctio n o f the a n a ly s is but s ix o f them a re given only o n e - h a lf the w eight o f the remaining d ep art­ ments. This l e f t a reported N o f 30 f o r the s t a t i s t i c a l ro u tin e s . Although I argue t h a t climbers w i l l be found in in n o v a tiv e departments, even though they may not be responsible f o r the inno­ v a tio n , I have also argued t h a t clim bers do t r y to inn ovate. In o rder to make an infe re n c e concerning the e f f e c t o f am bition on in n o v a tio n , i t was necessary to be ab le to reasonably assume th a t the d ir e c t o r who returned the q u e s tio n n a ire was a t le a s t p a r t l y responsible f o r the inn ovatio n o f the department. Departmental Factors Since the purpose o f th is sectio n o f a n a ly s is was to assess the j o i n t e f f e c t s o f departmental v a ria b le s and am bition on inno­ v a tio n , a s in g le o r composite measure o f departmental v a ria b le s was 138 sought. A ll o f the departmental v a ria b le s were h ig h ly c o rr e la te d w ith each o th e r and some o f them so high t h a t e m p ir ic a lly they could be said to be measuring the same th in g . So th e re d id not seem to much b e n e f it in co n stru ctin g an index out o f the s ix departmental v a r ia b le s . 1 have argued t h a t resources was perhaps the s in g le most im p ortan t v a ria b le o f t h is set f o r in n ovatio n. That i s , resources made i t p ossible f o r the departments to inno- va te through expansion o f the o th e r f a c t o r s , except p o p u la tio n . 12 Mohr found resources to be the most im portant. 13 Since I used resources f o r 1971 as a measure e a r l i e r I decided to use i t as an in d ic a t o r o f the a v a i l a b i l i t y o f departmental resources or as a surrogate measure o f the e n t i r e s e t o f departmental independent v a r ia b le s . Since I was using an in n o v atio n measure based on recent adoptions, I reasoned t h a t I should a ls o choose a resource measure as close to adoption time as p o s s ib le . T h e o r e t ic a lly i t was most reasonable to use resources f o r 1971. The composite measure was done to f a c i l i t a t e a n a ly s is in the causal path a n a ly s is . Inasmuch as a l l o f the v a r ia b le s were h ig h ly c o rr e la te d w ith each o th e r, j o i n t co n sid e ra tio n o f a l l o f the departmental fa c to r s w ith am bition was not thought to be very advantageous f o r the purpose o f t h is a n a ly s is . 14 A f a c t o r an alysis was done and the s ix departmental v a r ia b le s loaded h ig h ly on one f a c t o r . But o f these v a r ia b le s , resources had the highest loadin g. 15 T h e o r e t ic a lly and e m p i r i c a l l y , the best in d ic a to r o f the complex o f departmental v a ria b le s responsible f o r innovation seemed to be resources. 139 The m a jo rity o f c o r r e la tio n s computed were rank o rd e r— Spearman's rho— in a d d itio n to Pearson's r . G enerally rho is a good es tim ate o f Pearson's r when the re la tio n s h ip between two v a ria b le s Is not c u r v i l i n e a r . ^ In most cases in t h is a n a ly s is , Spearman's rho and Pearson's r were remarkably s i m i l a r , in d ic a tin g e s s e n t i a ll y lin e a r r e la tio n s h ip s . However, the d iff e r e n c e between rho and r f o r the r e la t io n s h ip between adoption and resources f o r 1971 was la r g e , in d ic a tin g th a t t h is r e la t io n s h ip was c u r v i l i n e a r . A scattergram o f the r e la t io n s h ip in d ic a te d t h a t a c u r v i l i n e a r r e la t io n s h ip was necessary to f i t the as so c ia tio n between adoption and resources 1 9 7 1 . ^ A tra n s fo rm a tio n o f th is resource v a r ia b le was c a lc u la te d and t h is transformed v a r ia b le used as the in d ic a to r o f departmental resources. The transformed v a r ia b le was equal to the log arith m to the base 10 o f resources 1971. 18 Tests o f Ambition Hypotheses Table 4-1 gives the c o r r e la tio n s between d ir e c t o r background v a ria b le s and the adoption measure o f In n o v atio n . Age is very weakly c o rre la te d w ith innovation but in the expected d ir e c t io n . Older d ir e c to r s are o nly s l i g h t l y more associated w ith less inno­ v a tiv e departments. However, the remaining d ir e c t o r c h a ra c te r­ i s t i c s a re moderately c o rr e la te d w ith the innovation o f the dep art­ ments and in the p re d ic te d d ir e c t io n . The d ir e c t o r v a ria b le s c o r r e la te d w ith am bition are als o c o r r e la te d w ith inn ovatio n except f o r age which has only a s l i g h t c o r r e l a t i o n w ith adoption. Table 4-2 shows the c o r r e la tio n s between the resources measure and adoption and the am bition measures. Both types o f ambition are 140 c o r r e la te d w ith resources In the p re d ic te d d ir e c t io n . The stron g er the clim b er tendencies and the weaker the conserver tendencies, the more the d ir e c t o r is l i k e l y to be associated w ith departments w ith less resources. The p o lic y am bition measure is only s l i g h t l y associated w ith resources. Tables 4 -4 and 4 -5 also d is p la y the a s s o c ia tio n between resources and am bition. Table 4 -3 shows the c o r r e la tio n s between d ir e c t o r ambition and in n o v atio n . These also support the hypothesis. Climber ambition is p o s i t i v e l y c o rr e la te d w ith innovation although the c o r r e la t io n Is only moderate. P o lic y ambition shows the same c o r r e la tio n to innovation as does clim b er am bition. Conserver ambition shows the strongest c o r r e la tio n w ith departmental in n o v atio n . Degree o f con­ se rv e r am bition is n e g a tiv e ly c o rr e la te d w ith innovation in th is set o f departments. I t appears t h a t a strong preference f o r conserver p o s itio n s emerges as age increases. But a t younger ages, the preference fo r higher p o s itio n s , w h ile g r e a te r than a t o ld e r ages, is not as strong as the preference f o r conserver p o s itio n s is among the o ld e r d ir e c t o r s . Hain found a strong s t a t i c am bition emerging w ith increasin g age among the s t a t e l e g is l a t o r s he analyzed. I t could be t h a t those w ith clim b e r ambitions set t h e i r sights on some m id -le v e l goal and not a t the top o f the job h ie ra rc h y . This may be due to a type o f contingency planning in which the younger p u b lic h ea lth d i r e c t o r w aits to see what happens in his care er before deciding on a goal. I t also suggests support f o r the fin d in g t h a t a person's a s p ir a tio n s r i s e w ith success and t h a t one's ambitions are shaped by present 141 TABLE 4 - 1 . — C o r r e la tio n s Between D i r e c t o r C h a r a c t e r is t ic s and A d o p tio n . Age P r i v a t e P r a c t ic e Number o f Years o f P r i v a t e P r a c t ic e Advanced Degree in P u b lic H ealth Adoption - . 0 6 (N=30) - . 3 0 (N=25) - . 4 2 (N=17) .5 3 (N=25) TABLE 4 - 2 . — C o r r e la t io n s Between Adoption and Ambition and Departmental Resources. Adoption Clim ber Ambi t i o n Conserver Ambition P o li cy Ambi t io n Resources3 ( lo g ) .3 9 .34 - . 3 8 .06 aThis is a tra n s fo r m a tio n o f the resource measure f o r 1971. The tra n s fo r m a tio n is resources = log 10 (resources 1 9 7 1 ). TABLE 4 - 3 . — C o r r e la tio n s Between D i r e c t o r Ambition and Adoption. C lim ber Am bition Conserver Ambi t io n Pol i cy Ambi t io n Adoption .2 6 - . 5 2 .2 6 C o r r e la t io n s are Pearson r ’ s. 142 TABLE 4 - 4 . — D ir e c t o r 's Preference f o r P o s itio n as D ir e c to r o f A Large Department by Resources. Di r e c t o r ' s Prefe rence High Medium Low Resources 1971 Low 1 ( 1 1 %) 6 (40%) 3 (38%) Medium 2 (22%) 6 (40%) 3 (38%) High 6 (67%) 3 (20%) 2 (25%) 9 (100%) 15 (100%) 8 (100%) N = 31 Gamma = - . 2 9 TABLE 4 - 5 . — D i r e c t o r 's Preference Small Department t h a t is f o r P o s itio n as Stable in Size D ir e c to r o f a by Resources. D i r e c t o r 's Preference High Medium Low Low 3 (33%) 6 (38%) 1 ( 1 4 * ) Resources 1971 Medium 4 (45%) 5 (31%) 2 ( 2 9 * ) High 2 ( 2 2 %) 5 (31%) 4 (5 7 * ) 9 (100%) 16 ( 1 0 0 %) 7 (1 0 0 *) N . 32 Ganna - .30 Resources Low = 83*300 to 176,400 Medium = 193,400 to 413,700 High = 483,400 to 11,74 7,10 0 in d o lla r s . Preference High = 1 - 4 Med i loti = 5-6 Low * 7-8 The gamma's are in the p re d ic te d d ir e c t io n . The way the tables a re s e t up causes gamma f o r Table 4 -2 - a to be n eg ative and gamma f o r Table 4 - 2 -b to be p o s it iv e . As resources increase clim b er am bition increases and conserver am bition decreases. 143 and past successes. 19 As a h e a lth o f f i c e r , o r o th e r bureaucrat, gains experience and success In a p o s it io n , he Is a b le to see what Is reasonable f o r him to o b ta in from th a t p o s itio n . He can judge what others have done 1 n s i m il a r p o s itio n s and can use the resources a t hand to accomplish things t h a t he had not p re v io u s ly thought l i k e l y . M u l t i v a r i a t e Models o f In n ovatio n Up to th is p o in t I have in v e s tig a te d the re la tio n s h ip s between departmental fa c to r s and In n o v atio n , in d iv id u a l fa c to rs and In n o v a tio n , and in d iv id u a l and departmental fa c to rs and have not d e a lt w ith r e la tio n s h ip s among the th ree sets o f v a ria b le s . This w i l l be covered in the next section o f the a n a ly s is . The an alysis has, o f course, been le a d in g up to t e s t the hypothesis t h a t innovation I f a fu nctio n o f departmental c h a ra c te r­ i s t i c s and d ir e c t o r c h a r a c t e r is t ic s . However, in terms o f the d i r e c t o r , I w i l l i n i t i a l l y consider the am bition measures r a th e r than the background v a r ia b le s . A f i n a l p ie ce o f an alysis w i l l include both o f these. The general hypothesis to be tested in t h is se c tio n o f an alysis i s : Hypothesis D - l : The Innovation o f the department is a fu n c tio n o f the resources o f the d e p a rt­ ment and the am bition o f the d ir e c t o r . The prime purpose o f th is se ctio n is to assess the r e l a t i v e i n f l u ­ ence o f each set o f fa c to r s on innovation and to determine the j o i n t e f f e c t s o f resources and ambition on in n o v a tio n . The f i r s t task is to look a t the a d d it i v e e f f e c t s o f d e p a rt­ mental v a ria b le s and am bition . Since the am bition measures themselves 144 have been found to c o r r e l a t e w ith the departm ental v a r i a b l e s , p a r t i a l c o r r e l a t i o n a n a ly s is w i l l be done to determ ine i f the r e la t io n s h ip s between in n o v a tio n and departm ental v a r ia b le s o r t h a t between am bition and in n o v a tio n , 1s s p u rio u s . That 1s , does e i t h e r s e t o f v a r ia b le s have an e f f e c t on In n o v a tio n t h a t 1 s not a t t r i b u t a b l e to the o t h e r . Is c lim b e r a m b itio n o nly found to c o r r e l a t e w ith in n o v a tio n because c lim b e r a m b itio n 1 s a s s o c ia te d w ith g r e a t e r s iz e and resources which in tu r n a r e asso c ia ted w it h more inn ovatio n? According to the th e o ry o u tlin e d in Chapter I , the m o t i­ v a tio n o f th e d i r e c t o r to in n o v ate is im p o rta n t f o r in n o v a tio n , as a re the resource c h a r a c t e r i s t i c s o f the d ep artm en t. The ease w ith which the d i r e c t o r can o b ta in in fo rm a tio n w i l l determine how in n o ­ v a t iv e he 1s. But i t may a ls o determ ine how m o tiv a te d he 1s to be in n o v a tiv e . The d i r e c t o r , in a sense, c a lc u la t e s the chances o f o b ta in in g some p o s itio n based on h is p re s e n t personal reso u rces. I f he e v a lu a te s them as f a i r l y low he w i l l n o t be very m o tiv a te d . The investm ent t h a t the d i r e c t o r has in a p u b lic h e a lth c a r e e r w i l l a ls o determ ine how m o tiva te d he is to r e c e iv e a re tu r n on a p u b lic h e a lth c a r e e r . In o th e r words t h is w i l l help determ ine the d i r e c t o r ' s am bition and h is m o tiv a tio n to in n o v ate . One a s p ec t o f t h is is th e I n t e r a c t i o n between the a m b itio n o f the d i r e c t o r and the resources o f the d ep artm en t. A d i r e c t o r w it h a l o t o f am bition cannot do very much i f the le v e l o f resources is very low. As the le v e l o f resources in c re a s e s , the d i r e c t o r ’ s am b itio n w i l l have a g r e a t e r e f f e c t on in n o v a tio n . However, t h i s 145 w i l l p robably reach both a lo w er and an upper th re s h o ld . With a la rg e amount o f resources, 1 t w i l l be easy to In n o v a te , so t h a t the d if f e r e n c e 1 n am bition w i l l not be as im p o rta n t as i t would be a t a low er le v e l o f resources. The r e s u l t s show t h a t d e p a r t­ ments w ith more resources a r e more in n o v a tiv e . I w i l l need to se p ara te th e e f f e c t s o f am b itio n from t h i s but am f a i r l y c o n fid e n t t h a t the departments w ith more resources w i l l be more in n o v a tiv e re g a rd les s o f the am bition o f the d i r e c t o r . I f the department has a very low le v e l o f re so u rce s, though, even a h ig h ly m o tiva te d d i r e c t o r w i l l not be a b le to in n o v ate . So w ith a very low le v e l o f resources d i r e c t o r am b itio n may make l i t t l e d if f e r e n c e to inno­ v a t io n , but a f t e r a lower th re s h o ld is surpassed and before an upper one is reached, the d i r e c t o r ’ s am bition w i l l have a la r g e e f f e c t on in n o v a tio n . I w i l l look a t the th re e sep arate measures o f am bition and but one measure o f departm ental resources, th e tra n s fo rm a tio n o f resources 1971. 20 Some causal m odelling w i l l be done to tr a c e out the sequences o f v a r ia b le s to f i l l out the model and to suggest a new th e o ry o r a r e v is io n i f necessary. As we saw, the a m b itio n o f the d i r e c t o r is r e l a t e d to the o r g a n iz a t io n a l v a r ia b le s which in tu rn a r e r e l a t e d to a m b itio n . The n ex t step is to determ ine whether i t i s the o r g a n iz a tio n a l v a r ia b le s in themselves t h a t determ ine in n o v a tio n o r i f these v a r ia b le s a r e determ inants o f in n o v atio n because o f the type o f d i r e c t o r t h a t they are ab le to a t t r a c t . T his i s the l i n e o f a n a ly s is t h a t w i l l be pursued in the fo llo w in g s e c tio n . 146 A p a r t i a l s o lu tio n to the above question can be obtained by the fo llo w in g procedures. F i r s t , i f i t 1s p r im a r ily the o rg a n i­ z a tio n a l v a ria b le s and not the d ir e c t o r v a ria b le s t h a t determine in n o v a tio n , c o n t r o llin g f o r d ir e c t o r ambition should not have much o f an e f f e c t on the p a r t i a l c o r r e la t io n between o rg a n iz a tio n a l fa c to r s and inn ovatio n. I f , however, o rg a n iz a tio n a l fa c to r s determine innovation only because o f the type o f d ir e c t o r t h a t is l i k e l y to be in these departments w ith c h a r a c t e r is t ic s t h a t are fa v o ra b le to in n o v a tio n , then c o n t r o llin g f o r am bition o f d ir e c t o r should considerably reduce the p a r t i a l . The methods o f p a r t i a l c o r r e la tio n w i l l be used to do a path a n a ly s is . Path models w i l l be te s te d by the p a r t i a l c o r r e la t io n c o e f f ic ie n t s and included to i l l u s t r a t e the r e s u lt s . Path c o e f f i c ie n t s w i l l then be computed and the models w i l l be drawn as causal models w ith these path c o e f f i c ie n t s included. A second procedure w i l l be to t e s t f o r in t e r a c t io n between the o rg a n iz a tio n a l and d ir e c t o r v a r ia b le s . As has been p re v io u s ly discussed, the o rg a n iz a tio n a l resources a v a i l a b l e to the d ir e c t o r w i l l determine, to some e x te n t how much he can innovate as w i l l his d es ire to innovate. However, the d i r e c t o r 's d e s ire to inno­ vate w i l l not have the same e f f e c t on innovation a t a l l le v e ls o f resources. A nalysis o f T h re e -V a ria b le Path Models In t h is s e c tio n , p a r t i a l c o r r e l a t i o n c o e f f i c ie n t s between the o rg a n iz a tio n a l and am bition measures w ith innovation are 147 presented. Causal model path diagrams w ith c o e f f i c ie n t s are also presented to help assess the r e l a t i v e in flu e n c e o f the two sets o f Independent v a r ia b le s . P a r t i a l c o r r e la t io n and regression c o e f f i c ie n t s were computed and path diagrams developed f o r the department resource v a r ia b le and each o f the am bition measures taken s e p a ra te ly . Although several path models were te s te d , only those which were supported by the p a r t i a l c o r r e la tio n s and the t h e o r e t ic a l a n a ly s is are re po rted. Noted on the path a n a ly t ic diagram are the d ir e c t io n and e x te n t o f the r e la t io n s h ip between the major v a r ia b le s . A l l o f those v a ria b le s which have been in d ic a te d as c a u s a lly p r i o r are taken as the determinants o f each successive v a r ia b le . A number o f conventions are u s u a lly employed in the re p re s e n ta tio n o f t h is type o f model. They are: 1. Causal r e la tio n s h ip s are in d ic a te d by one-way, s t r a i g h t lin e d arrows. 2. Non-causal r e la tio n s h ip s are represented by curved, double headed arrows, repres en tin g c o v a r ia tio n . 3. Those v a ria b le s p osited as being causal are drawn to the l e f t o f those regarded as the e f f e c t . 4. The numerical q u a n t it ie s associated w ith each arrow represent the e x te n t and d ir e c t io n o f the measured r e la t io n s h ip . 21 In th is a n a ly s is , the standardized regression c o e f f i c ie n t s w i l l be used as the path c o e f f i c ie n t s where c a u s a lit y is im p lie d . 22 C o va riatio n w i l l be measured by the z e ro -o rd e r c o r r e l a t i o n co e f­ f i c i e n t . S i m i l a r l y , the z e ro -o rd e r c o r r e la t io n c o e f f i c i e n t can 148 be shown to be equal to the standardized regression c o e f f i c i e n t when only one Independent v a r ia b le 1 s associated w ith any given dependent v a r i a b l e . ^ 3 Accompanying the path diagrams are the regression equations and regression s t a t i s t i c s f o r the path models. The unstandardized regression c o e f f ic ie n t s (b ) and t h e i r standard e r r o r s { S .E ., given in parentheses) are given w ith the equations. The value o f the F s t a t i s t i c f o r the equation is als o included. Resources, Climber Ambition and Innovation C o n tro llin g f o r resources reduces the c o r r e l a t i o n between clim b er ambition and inn ovatio n from r = .25 to a p a r t i a l o f r = .1 4 , in d ic a tin g th a t some but c e r t a i n l y not a l l o f the c o r r e la t io n o f clim ber am bition w ith inn ovatio n was due to t h e i r common c o r r e la tio n w ith resources. C o n tr o llin g f o r clim b er ambition changes the c o r­ r e l a t i o n between resources and innovation from r = .39 to a p a r t i a l o f r = .3 4 , in d ic a tin g t h a t resources has a s u b s ta n tia l e f f e c t , separate from the am bition o f the d i r e c t o r , on in n o v a tio n . The path model in Figure 4 -2 was c o n s is te n t w ith these d a ta . This is one in which resources has a s u b s ta n tia l e f f e c t on in n o v a tio n . Path c o e f f i c ie n t s are included f o r the model. Figure 4-1 gives the path diagrams from which the p re d ic te d p a r t i a l s were generated. The s t a t i s t i c s by themselves do not a llo w an adequate d is c r im in a tio n to be made between the two models. Assumptions must be made about the e f f e c t o f v a ria b le s and o th e r evidence must be used in o rd er to make a conclusion concerning which o f the two models is more a p p ro p ria te . 24 A. c lim b e r am bition ( a ) B. resources in n o v a tio n ( c ) 149 resources (b ) inn ovatio n c lim b e r am bition (a ) P re d ic te d c o r r e la tio n s Zero o rd er c o r r e l a t i o n s A ctual C o r r e la tio n s r b c .a “ ' 3 9 r a c .b “ 0 r bc = 3 9 r ac ' 2 6 r b c.a ” - 3 4 r a c .b = 1 4 F ig u re 4 - 1 . — Path Diagram f o r Climber Am bition and Resources w ith In n o v atio n resources c lim b e r am bition inn ovatio n Regression equation f o r path diagram in F ig u re 4 - 2 . In n o v a tio n = Resources + b ( S . E . ) beta 1 .2 8 ( . 6 9 ) .35 C lim ber am bition .1 4 ( . 1 8 ) .14 F = 2.31 F ig u re 4 - 2 . — Path Model w it h Path C o e f f i c i e n t s f o r C lim b er Am bition, Resources, and In n o v a tio n . 150 The model in Figure 4 -2 , Model B from Figure 4-1 w ith a d i r e c t l i n k from am bition to in n o v a tio n , was chosen, as i t is more reasonable to suppose t h a t the resources o f the department are responsible f o r the am bition o f the d ir e c t o r than t h a t the d ir e c t o r causes the departmental resources although he may in flu e n c e them to some e x te n t. Given the range o f resource le v e ls in t h is s e t o f departments i t i s unreasonable to assume th a t the type o f d ir e c t o r is resp o nsib le f o r the le v e l o f resources. So although the d ir e c t o r uses resources to in n o v a te , the causal arrow is drawn from resources to am bition to in d ic a te t h a t i t is the resources o f the department which cause the am bition o f the d i r e c t o r , e i t h e r by the clim ber being a t t r a c t e d to departments w ith g r e a t e r resources, or the d ir e c t o r s in departments w ith g r e a t e r resources developing clim ber ambitions once they are th e re . Resources, Conserver A m bition, and Innovation Figure 4-3 g ives a path diagram and p re d ic te d p a r t i a l c o e f f i c ie n t s generated from i t . Actual p a r t i a l and z e ro -o rd e r cor­ r e la t io n s are also g iv en . Model A shows the f i r s t diagram tested f o r clim b er ambition and the p red icte d p a r t i a l s . However, since one can reasonably expect some d i r e c t in flu e n c e o f am bition on in n o v a tio n , Model B i s drawn and the p re d ic te d p a r t i a l s m odified. The data in d ic a te s s u b s ta n tia l separate e f f e c t s o f both resources and ambition on in n o v a tio n . However, were i t not f o r the conserver am bition o f the d i r e c t o r , resources would be even more h ig h ly c o r r e la te d w ith in n o v a tio n . Figure 4 -4 shows the path a n a ly t ic model w ith path c o e f f i c i e n t s added. A. B. resources (b ) 151 ►innovation ( c ) conserver am bition ( a ) P re d ic te d c o r r e l a t i o n s Z e ro -o rd e r c o r r e l a t i o n s r a c .b ‘ 0 r bc.a - - 39 resources* (b) r ac * - 5 2 r bc ‘ 3 9 in n o v a tio n (c ) -conserver am bition (a ) P re d ic te d c o r r e l a t i o n s A c tu a l c o r r e l a t i o n s r a c .b - ® r bc.a = 0 r bc r . = - . 4 3 ac. b be. a .25 F igure 4 - 3 . — Path Diagram f o r Conserver Ambition and Resources w ith In n o v a tio n . resources .2 3 N = 31 - . 3 8 conserver ambi t io n in n o v a tio n - . 4 3 .31 Regression eq u ation f o r path diagram in F ig u re 4 - 4 . In n o v a tio n = Resources b ( S . E . ) beta .85 ( . 6 3 ) .23 + Conserver Am bition F = 6 .1 9 - . 4 5 ( . 1 8 ) - . 4 3 Figure 4 - 4 . - - P a t h Diagram w ith Path C o e f f i c i e n t s f o r Conserver A m b itio n , Resources, and In n o v a tio n . 152 The n eg ative c o r r e l a t i o n between resources and conserver a m b itio n In d ic a te s t h a t conserver am b itio n is s tro n g e r among the d ir e c t o r s o f departments w ith few er resources. However, th e re appears to be a d i r e c t e f f e c t o f co n server am bition on in n o v a tio n , which i s , as expected, n e g a tiv e . So we f i n d t h a t resources encourage In n o v a t io n , conserver a m b itio n tends to block i t . Although resources seem to in flu e n c e conserver a m b itio n , t h a t i s , conservers tend to be in departments w ith few er reso u rces; conservers may als o have the e f f e c t o f dampening the growth o f resources. Resources, P o lic y A m b itio n , and In n o v atio n Although th e re is very l i t t l e c o r r e l a t i o n between the s tr e n g th o f p o lic y a m b itio n and resources ( r = . 0 6 ) , th e re is a somewhat s tro n g e r p o s i t i v e c o r r e l a t i o n between t h is type o f am bition and in n o v a tio n . N e it h e r o f the previou s diagrams is l i k e l y to be d e s c r i p t i v e o f t h is s i t u a t i o n . The small c o r r e l a t i o n which appears between the degree o f p o lic y am bition and resources suggests t h a t the e f f e c t s o f resources and am b itio n on in n o v a tio n w i l l be alm ost co m p letely s e p a ra te . The p a r t i a l s a r e not l i k e l y to be much d i f f e r e n t than the z e r o -o r d e r c o r r e l a t i o n s . The diagram and p re d ic te d p a r t i a l s in Figure 4 -5 a re those expected f o r p o l i c y a m b itio n and resources w ith in n o v a tio n . The p a r t i a l s are e s s e n t i a l l y the same as the z e r o -o r d e r c o r r e l a t i o n s . Only th e a c tu a l p a r t i a l between resources and in n o v a tio n is increased s l i g h t l y . But the e f f e c t s o f resources and am bition on in n o v a tio n a re e s s e n t i a l l y se p a ra te from each o t h e r . 153 Figure 4-6 shows the path diagram w ith path c o e f f i c i e n t s . The small c o r r e la tio n between resources and p o lic y am bition is i l l u s t r a t e d by a double-headed arrow. I had speculated t h a t those w ith a high degree o f i n t e r e s t in in flu e n c in g p o lic y may be in sm aller departments due to t h e i r age and in e x p e rie n c e , hypothesizing th a t these would be younger d ir e c to r s j u s t out o f school w ith t h e i r M.D. or M.P.H. Thus, someone w ith t h is type o f ambition would be found in sm aller departments. The data do not support the specu­ l a t i o n t h a t the degree o f p o lic y ambition is c o rr e la te d n e g a tiv e ly w ith resources. So no causal d ir e c t io n is im plied between these v a ria b le s a t th is p o in t. In these models resources has a stro n g er e f f e c t on inno­ vation than has am bition except f o r the degree o f conserver ambition which has a higher path c o e f f i c i e n t than does resources (see Figure 4 - 4 ) . In te r a c t io n The previous t h r e e - v a r i a b l e causal models have assumed a d d i t i v i t y o f the e f f e c t s o f independent v a r ia b le s . However, t h is might not be as r e a l i s t i c as a m u l t i p l i c a t i v e r e la t io n s h ip . We may expect an in n o v a tiv e ly minded d i r e c t o r to have more e f f e c t where there is some s u f f i c i e n t le v e l o f resources than where resources are very sm all. In very small resource departments, an in n o v a tiv e * d ir e c t o r might not have much, i f any, e f f e c t a t a l l on resources. Forbes and T u fte suggest t h a t causal models and path c o e f f i c ie n t s may d i f f e r f o r d i f f e r e n t subsets o f a set o f data. 25 154 innovation (c) Resources (b) P o lic y ambition Predicted c o r r e la tio n s Actual c o r r e la tio n s Z ero -o rd er c o r r e la tio n s = .35 be. a dC* b h = * 2 6 r, be. s = . 39 ac. b K = * 2 6 r bc ■ - 3 9 r ac ' ‘ 2 6 Figure 4 - 5 . --P a th Diagram o f Resources and P o lic y Ambition Innovation. resources .38 innovation p o lic y ambi tio n .24 N = 30 Regression equation f o r path model in Figure 4 -6 . Innovation = Resources b ( S .E .) 1.4 0 ( . 6 3 ) + P o lic y ambition .31 ( . 2 2 ) F = 3 .6 0 Figure 4 - 6 . — Path Diagram w ith Path C o e ff ic ie n t s f o r Resources and P o lic y Ambition w ith In n o v atio n . 155 In o rd er to t e s t f o r In te r a c t io n and to t e s t the previous models w ith d i f f e r e n t subsets o f the d a ta , the health departments were d iv id e d in to subgroups on the basis o f resources. Innovation was then regressed on each o f the ambition measures f o r each sub­ group. I f th ere was in t e r a c t i o n between the le v e l o f resources and innovation the regression c o e f f ic ie n t s f o r the two groups would d i f f e r from each o th e r and from the regression c o e f f i c i e n t f o r the e n t i r e group o f departments. S p e c i f i c a l l y , the regression co e f­ f i c i e n t s o f innovation on ambition would be s m a lle r in the group o f departments w ith g r e a t e r resources. I have argued t h a t l a r g e r departments are able to innovate because o f the resources and personnel a v a ila b le . Although the leadership o f the d i r e c t o r may be im portant, i t w i l l have less e f f e c t r e l a t i v e to resources than w i l l the leadership in s m a lle r departments. The e f f e c t o f the d ir e c t o r in the sm aller departments r e l a t i v e to resources w i l l be g re a te r as these departments g e n e ra lly w i l l not have the adequate s t a f f and resources to Innovate w ithout the encouragement o f the d ir e c t o r . There may be considerable pressure from the p ro fess io n al s t a f f on the d ir e c to r s o f la rg e departments to adopt in n o v a tiv e programs. This pressure would not be present in the sm a lle r d ep art­ ments and the d ir e c t o r is l a r g e ly responsible f o r encouraging inno­ v a tio n . The s e t o f departments was d ivid ed a t the median f o r the transformed resources v a r ia b le in to high and low subgroups. The regressions o f innovation on ambition were run f o r the t o t a l group and f o r both subgroups. Table 4 -6 presents the regression 156 TABLE 4 - 6 . — Regression C o e f f ic ie n t s o f In n o v a tio n on Ambition f o r a l l Departments and Low and High Resource Departments. A. A l l Departments (N = 33) B. Low Resource Subgroup (N = 16) C. High Resource Subgroup (N = 15) Expressed Ambi t io n Clim ber Conserver Pol 1cy C lim ber Conserver P o lic y C lim ber Conserver P o lic y beta b ( S . E .) .26 - . 5 2 .26 .37 - . 3 2 .13 .16 - . 6 4 .39 .25 ( . 1 9 ) - . 5 5 ( . 1 7 ) .34 ( . 2 5 ) .43 ( . 3 1 ) - . 3 8 ( . 2 3 ) .15 ( . 3 0 ) .15 ( . 2 5 ) - . 7 2 ( . 2 4 ) .54 ( . 3 5 ) c o e f f i c i e n t s f o r a l l th re e groups. These r e s u l t s in d i c a t e t h a t th ere is i n t e r a c t i o n between resources and a m b itio n . The re g re s s io n c o e f­ f i c i e n t ( e i t h e r s ta n d a rd ize d or u n s ta n d a rd ize d ) o f in n o v a tio n on c lim b e r am bition is g r e a t e r in the subgroup w ith low resources than in the t o t a l o r in the subgroup w ith high resources. There is also i n t e r a c t i o n between the o th e r two am b itio n measures and resources on in n o v a tio n (see T able 4 - 6 ) . However, the c o e f f i c i e n t s are g r e a t e r in the high resources subgroup than in the low resources subgroup f o r both conserver and p o lic y a m b itio n . The re g re s s io n c o e f f i c i e n t s show t h a t c lim b e r a m b itio n has a s tro n g e r e f f e c t on in n o v a tio n in the low resources subgroup than in th e high resources subgroup. One e x p la n a tio n f o r t h is i s t h a t 157 la r g e r departments tend to be more In n o v a tiv e than small d e p a rt­ ments anyway so th a t the ambition o f the d ir e c t o r does not have much added e f f e c t * These la r g e r departments have more s p e c ia lt ie s and p ro fess io n al personnel which lead to Innovation so th e inno- v a t iv e ly minded d ir e c t o r is not as Im portant to them. Sm aller departments, w ith some minimum le v e l o f resources, need the inno- v a t iv e ly minded d ir e c t o r in order to in n o v ate . In f a c t , the d ir e c t o r may be the most important f a c t o r in innovation f o r these sm aller departments. Resources, both money and personnel, are not q u ite s u f f i c i e n t in themselves f o r these small departments but with a d i r e c t o r who is a clim ber they are able to innovate. So we see the d i r e c t o r 's clim b er ambition having more o f an e f f e c t on innovation in sm aller departments. However, there may be a threshold o f resources below which the am bition o f the d ir e c t o r w i l l have l i t t l e impact on in n ovatio n. I f the resources are too low the department w i l l not be ab le to innovate regardless o f the d eterm ination o f the d ir e c t o r . The regression c o e f f ic ie n t s f o r conserver am bition in d ic a te th a t th ere is in t e r a c t i o n between t h is v a r ia b le and resources. The e f f e c t o f conserver ambition is g r e a te r in the departments w ith la r g e r amounts o f resources than in those w ith le s s . Note again t h a t the e f f e c t o f the degree o f conserver am bition on innovation is n e g a tiv e , the more the d i r e c t o r tends to have con­ server a m b itio n s , the less in n ovative is h is department. I t appears th a t the conserver d ir e c t o r may a c t i v e l y be a b a r r i e r to innovation in the l a r g e r departments. A discussion from Downs may help ex p la in t h is . 158 Downs r e fe r s to what he c a l l s the " sh rin k in g v i o l e t syndrome." The excessive t e r r i t o r i a l s e n s i t i v i t y o f o th e r social agents makes 1t d i f f i c u l t f o r a bureau to avoid s t i r r i n g up c o n f l i c t s when i t changes i t s own beh avio r. Since these c o n f lic t s are o fte n extrem ely c o s tly to the bureau, i t norm ally seeks s t r a t e ­ gies by which i t can minimize the amount o f c o n f l i c t engendered w h ile i t is c a rry in g out i t s necessary changes.27 Downs claims th a t any change in a bureau which has ex te rn a l e f f e c t s w i l l engender some c o n f l i c t in the environment. I f t h is is the case, then we would expect conservers to be less w i l l i n g than climbers to enact changes and to enact those changes which are l i k e l y to cause the le a s t c o n f l i c t . In the p u b lic health departments, c o n f l i c t is most l i k e l y to come from the local medical as so ciatio n and r e c a l c i t r a n t county commissioners. 28 The conserver, in his d e s ire to minimize c o n f l i c t , w i l l not be as l i k e l y as the clim b er to adopt new, n o n -t r a d itio n a l programs. I f his department grows, I t w i l l be in terms o f expanding e x is t in g programs r a th e r than i n i t i a t i n g new ones. The clim b e r, on the o th e r hand, w i l l be more w i l l i n g to face c o n f l i c t and w i l l be more w i l l i n g to adopt new programs. The clim b e r w i l l not be as frig h te n e d by c o n f l i c t as the conserver. Since he is more w i l l i n g to change jobs he does not have to worry about l i v i n g in the environment. He w i l l probably t r y to a f f e c t changes th a t p u b lic health p ro fess io n als who he views as s i g n i f i c a n t p erceive as im portant and w i l l weight the b e n e fits o f the new programs a g a in s t the d i s - u t i l 1 ty o f c o n f l i c t . Perhaps the most im portant th in g is t h a t those who are conservers do not a c t iv e ly support innovation in sm a lle r departments. 159 Since those departments are not l i k e l y to be In n o v ativ e w ithout the In flu e n c e o f an In n o v ativ e minded d i r e c t o r , the conserver does not block inn ovatio n as 1 t would not take place w ith o u t the help o f the d i r e c t o r . The la r g e r departments would be more inn ovative i f i t were not f o r the degree o f conserver am bition. The r e s u lt is a sm aller e f f e c t o f conserver ambition on Innovation in the departments w ith lower resources. Regression equations in c lu d in g an in t e r a c t io n term were run and are given in Table 4 - 7 . The in t e r a c t io n term was Resources x Ambition and was added to the regression equations f o r the path models to determine how much a d d itio n a l variance could be explained by the in t e r a c t io n between these two v a r ia b le s . The in c lu s io n o f the in t e r a c t io n term c o n trib u te d very l i t t l e to the amount o f 2 variance e x p la in e d . The R term f o r the o r ig in a l equation w ithout the in t e r a c t io n term 1s presented f o r comparison in Table As Mohr found, although i n t e r a c t i o n is p re s e n t, the a d d it iv e models provide almost as good a f i t to the data as do the equations w ith in t e r a c t io n terms. 29 Blalock notes t h a t f a i r l y good a d d it iv e approximations o f r e la tio n s h ip s th a t are a c t u a l ly more complex a re to be expected. 30 Four V a ria b le Models o f Innovation In the f i n a l s e c tio n , a path model is developed to l in k to gether a l l o f the sets o f fa c to r s d e a lt w ith in the a n a ly s is up to t h is p o in t. This complete model includes the fo u r fa c t o r s : Departmental resources, d i r e c t o r background c h a r a c t e r is t ic s , TABLE 4-7.—Regression Equations fo r M u ltip lica tive Four-Variable Models. Innovation = Resources + Climber ambition + Resources x Climber ambition .64 (1.68) .64 .13 (.44) .48 (R without interaction term = .17) b (S.E.) beta R2 = .18 - 1.84 F b (S.E.) beta 2 = ,32 r F = 3.99 b (S.E.) beta 2 R = .21 F = 2.34 .50 (2.69) .136 2 .41 (2.35) .112 2 .14 (1.22) .31 2 Innovation = Resources + Conserver ambition + Resources x Conserver ambition -.21 (1.25) -.20 .07 (.35) .295 (R without interaction term = .31) L 9 0 Innovation = Resources + Policy ambition + Resources x Policy ambition .68 (1.50) .52 .10 (.39) .29 (R without interaction term = .21) 161 d i r e c t o r a m b itio n , and in n o v a tio n . The tr a n s fo r m a tio n o f th e 1971 t o t a l budget f i g u r e was used as an i n d i c a t o r o f departmental resources. A composite index o f the background c h a r a c t e r i s t i c s o f the d i r e c t o r was co n stru c te d . The v a r ia b le s age, number o f y e a rs o f p r i v a t e p r a c t i c e , and advanced degree in p u b lic h e a lt h were scored so t h a t they ranged from 0 to 1 0 0 and the d i r e c t o r ' s score obtained by summing the score f o r each and d iv id in g by the number o f v a r ia b le s . Some o f the values f o r the number o f y e ars o f p r i v a t e p r a c t ic e were missing so th e sum o f the rem aining two v a r ia b le s in the index was d iv id e d by two. I f the number o f years o f p r i v a t e p r a c t i c e was a v a i l a b l e the sum was d iv id e d by t h re e . The advantages o f t h is procedure a re t h a t i t weights each v a r i a b l e in the index the same and a llo w s f o r s i m i l a r ranges and v a ria n c es f o r each. I t a ls o aid s in handling the missing d a ta . 31 For th e index p r i v a t e p r a c t i c e was not included as a separate v a r i a b l e . However, those d ir e c t o r s w it h o u t any p r i v a t e p r a c t i c e were assigned the va lu e 0 on the v a r i a b l e number o f y e a rs o f p r i v a t e p r a c t i c e and included in t h i s manner. This index i s used to f a c i l i t a t e the completion o f the lin k a g e s among the fo u r aspects o f th e model. The a n a ly s is o f only two measures o f am bition w i l l be inclu d ed here: clim b e r and conserver a m b itio n . Path models w i l l be presented using measures o f these two types o f a m b itio n . Figures 4-7 and 4-8 show th e c o r r e l a t i o n s between the in d ic e s f o r each o f the f a c t o r s in th e schematic model. 162 c lim b e r am bition .30 .39 d i r e c t o r c h a r a c t e r is t ic s (background) .26 adoption .5 0 .34 resources .28 F ig u re 4 - 7 . — C o r r e la tio n s Among Four Elements o f Departmental In n o v atio n Model Using the Degree o f Clim ber Ambi t i o n . - . 3 8 resources .28 conserver am bition .39 d i r e c t o r c h a r a c t e r i s t i c s (background) - . 5 2 adoption .50 F ig u re 4 - 8 . — C o r r e la tio n s Among Four Elements o f Departmental In n o v a tio n Model Using the Degree o f Conserver Ambi t i o n . 163 Two models a r e ev alu ate d f o r each type o f a m b itio n . The f i r s t model in c lu d e s a d i r e c t path from background c h a r a c t e r i s t i c s to d i r e c t o r am b itio n only and no d i r e c t path from background to in n o v a tio n . The second model in c lu d es a d i r e c t path from background to in n o v a tio n . The assumption o f a d d i t i v i t y , as we saw in the previous s e c tio n is not v a l i d . I n t e r a c t i o n e f f e c t s w i l l be d i s ­ cussed in the f o llo w in g s e c tio n . Path models f o r c lim b e r am b itio n are i l l u s t r a t e d in F igure 4 - 9 . N o tice t h a t a s u b s t a n t i a l l y g r e a t e r amount o f v a ria n c e in in n o v atio n is e x p la in e d by the model in c lu d in g a d i r e c t path from background to in n o v a tio n . A p p a re n tly a s u b s ta n tia l amount o f the d i r e c t o r ' s in flu e n c e on in n o v a tio n i s a d i r e c t r e s u l t o f h is t r a i n i n g and ex p erience although t h i s is a ls o c o r r e la te d w it h his am b itio n . Resources e x p la in s s l i g h t l y more o f the v a ria n c e in the model w ith c lim b e r am bition than the one w ith co n server a m b itio n . Background v a r i a b l e s account f o r much more o f the v a ria n c e in conserver am b itio n than in c lim b e r a m b itio n . T h is is c o n s is te n t w ith the a s s e r t io n t h a t am bitions develop over tim e and t h a t s t r u c t u r a l f a c t o r s tend to g iv e r i s e to a m b itio n s . That i s , a p erso n's a s p ir a t i o n s r i s e w ith ex p erience in a la r g e departm ent. However, background v a r i a b l e s , e s p e c i a l l y age and te n u re in p r i v a t e p r a c t ic e a r e v e ry i n f l u e n t i a l 1 n d eterm in in g a d i r e c t o r ' s degree o f conserver a m b itio n . The degree o f conserver am b itio n i s e a s i l y p re d ic te d from th e background v a r i a b l e s ; the degree o f c lim b e r am bition is les s so. 164 ( a) d i r e c t o r ' s background .22 .28 c lim b e r am b itio n as resources . 1 4 .35 in n o v atio n R = .17 (b) d i r e c t o r ' s backgroun< .2 8 c lim b e r am bition -♦ in n o v atio n V 2 resources .04 .2 6 J l R = 32 Regression e q u atio n f o r ( b ) . Innovation = Resources + C lim ber am bition + D i r e c t o r 's background b ( S . E . ) .97 ( . 6 5 ) .04 ( . 1 7 ) .03 ( . 0 1 ) F = 4 .1 3 N = 30 Figure 4 - 9 . --C a u s a l Path Models f o r Clim ber Am bition. 165 Climber ambition in general is less w ell s p e c ifie d than conserver am bition* leading to the sp ecu latio n th a t bureaucrats engage in some s o rt o f contingency p lanning; t h a t t h e i r backgrounds may predispose them to be a clim b er but t h a t these am bitions only develop through experience and success w ith jobs and perhaps subse­ quent advancement. Conserver am b itio n , on the o th e r hand, i s f a i r l y w ell developed by the background v a r ia b le s . The path models f o r conserver ambition a re shown in Figure 4 -1 0 . Inspection o f these models in d ic a te s t h a t more o f the e f f e c t o f background c h a r a c t e r is t ic s o f t r a i n i n g , age, and p r iv a t e medical experience on innovation is tra n s m itte d through the d i r e c t o r 's am bition f o r conserver am bition than f o r clim b er am bition . When the background v a ria b le is included in the models, degree o f clim ber ambition has less separate e f f e c t than does the degree o f conserver am bition. These fin d in g s a re c o n s is te n t w ith the t h r e e - v a r i a b l e models considered in the previous s e c tio n . These causal path models in Figures 4 -9 and 4-10 assume, however, t h a t i n t e r a c t io n between the independent v a ria b le s is not present o r is n e g li g ib l e . This assumption is not v a lid as was seen in the previous s e c tio n . A term f o r in t e r a c t io n between resources and am bition was added to the regression equations. These equations are given in Table 4 -1 2 . As was the case w ith the previous models, the a d d it iv e models provides as good a f i t as do the m u l t i p l i c a t i v e models. The in c lu s io n o f the i n t e r a c t i o n term adds very l i t t l e to the amount o f varian ce explained. 166 (a) d i r e c t o r 's background .28 / / " \ 4 9 conserver --------- am bit1on - . 4 3 — ► innovation resources R = .31 (b) d i r e c t o r 's background .28 - . 4 9 V conserver am bition Regression equation f o r ( b ) . innovation .21 I T = .37 Innovation = Resources + Conserver am bition + D i r e c t o r 's background - . 2 9 ( . 2 1 ) .77 ( . 6 2 ) .02 ( . 0 1 ) b ( S .E .) F = 5.09 N = 30 Figure 4 - 1 0 . --Causal Path Models f o r Conserver Ambition. TABLE 4-8.--Regression Equations fo r M u ltip lica tive Five-Variable Models. Innovation = Resources + Climber ambition + D irector's background + Resources x Climber ambition b (S.E.) beta -.27 (2.5) -.07 .84 (1.6) .84 -.03 (.01) -.42 .21 (.41) .76 2 (R without interaction term = .32) R2 = .33 F = 3.08 Innovation = Resources + Conserver ambition + D irector's background + Resources x Conserver ambition 1 6 7 b (S.E.) beta 2 R = .37 F = 3.69 .31 (2.2) .08 -.04 (1.2) -.04 -.0 2 (.01) -.29 .07 (.34) .31 2 (R without interaction term = • 37) C h a p te r IV — F o o tn otes Downs, o£. c l t . , p. 8 8 . Downs describes advocates as " . . . Loyal to a broader s e t o f functions or to a broader o rg a n i­ z a tio n . s i g n i f i c a n t In flu e n c e upon p o lic ie s and ac tion s concerning those functions o r o rg a n iz a tio n s ." . They also seek power because they want to have a . . I am focusing on Downs' two p u rely s e l f - i n t e r e s t e d o f f i c i a l s (p. 8 8 ). Downs may be d es crib in g a s tr a te g y t h a t climbers use. ^Black (1 9 7 0 ), 0£ . c i t . , p. 867-872. 3See Chapter I . 4 Mohr, d is s e r t a t i o n , pp. 154-158. 5 S c h le s in g e r, oj). ci t . , p. 6 . 6Mohr (1 9 6 9 ), op. c i t . j A r t h u r S. Goldberg, American P o l i t i c a l Science R e v ie w t l 9697, p. 16. Goldberg te s ts a r a t i o n a l i t y model which includes the assumption t h a t "group based norms produce e f f e c t i v e r a t i o n a l i t y w ith regard to the goals o f the group." Katz and Coleman, op. c i t . , a ls o discuss t h i s . . . . 7 Downs, op. c i t . , pp. 92-103. Q Mack, pp. c i t . , pp. 61-65 . g S c h les in g er, pp. c i t . , pp. 116-117. ^ J . Cohen, " M u ltip le Regression As a General Data A n a ly tic System," Psychological B u l le t in (1 9 6 8 ), p. 431. ^ N i e , Bent, and H u l l , S t a t i s t i c a l Package f o r Social Science, op. ci t . 1 2 13 14 See my an a ly s is in Chapter I I I , pp. Mohr, pp. ci t . , p. 120. See my conclusions concerning the department v a ria b le s a t the end o f Section One, Chapter I I I . 15 Mark Levin suggests using the v a r ia b le w ith the hig hest loading on the f i r s t p r i n c ip l e component as the best in d ic a to r o f 168 169 a s e t o f h ig h ly c o r r e l a t e d v a r i a b l e s . Resources f u l f i l l t h is c r i t e r i a . See Mark S. L e v in , “Standard Scores As In d ic e s : The P i t f a l l s o f Not Thinking I t Through," American Journal o f P o l i t i c a l S c ie n c e , 17 (May, 1 9 7 3 ), pp. 43 1-4 40 . ^®N1e, B ent, and H u l l , SPSS, op. c i t . ^7 0 ne extrem ely high budget f i g u r e skewed the d i s t r i b u t i o n f o r resources 1971 g r e a t l y . The budget f i g u r e from t h i s department was missing f o r the 1970 d a ta . Some a n a ly s is w ith t h i s l a t t e r s e t showed t h a t resources were c o r r e l a t e d w ith in n o v a tio n . An amazing s i m i l a r i t y was e v id e n t using th e budget f ig u r e s f o r 1970 and the r e s u l t s o f some a n a ly s is w ith in n o v atio n and s iz e o f department 1971. However, the data f o r 1970 was not as complete as f o r 1971, so 1970 was not used. The a n a ly s is done w ith a tra n s fo r m a tio n o f the 1971 resources showed r e s u l t s comparable to the b r i e f a n a ly s is done w ith 1970 resources. 1 o H ie , B ent, and H u l l , oj>. c i t . ; N. R. Draper and H. Sm ith, A p p lied Regression A n aly sis (New York: W ile y , 1 9 6 6 ), and J. B. K ru s k a l, “Transform ations o f D a ta ," 1n I n t e r n a t i o n a l Encyclopedia o f the Social S c iences, ED. David L. S i l l s (New York: MacMi1 I a n , 1 9 6 8 ), Volume 15, p p . 182-192. These l a t e r two sources c o n ta in good discussions o f the use o f tra n s fo rm a tio n s . 19 Mack, o|D. c i t . ; M a r jo r ie Hershey, "Incumbency and the Minimum Winning C o a l i t i o n , " American Journal o f P o l i t i c a l S c ie n c e , 17 (August, 1 9 7 3 ), pp. 63 1-637. 20 I did sor.ie a n a ly s is using o th e r departm ental v a r i a b l e s . The r e s u l t s were remarkably s i m i l a r to those using the transformed resources v a r i a b l e . 21 22 23 Sm ith, 0 £ . c i t . , p . 117. N ie , Bent, and H u l l , 0 £ . c i t . Because my measure o f am bition may not have the p r e c is io n le v e l measures which re g res sio n procedures r e q u i r e , o f i n t e r v a l the r e p o rtin g o f s ta n d a rd iz e d re g re s s io n c o e f f i c i e n t s may appear in a p p r o p r ia te . However, Hubert B la lo c k , J r . , Causal Non-Experimental Research (Chapel H i l l : The U n iv e r s it y o f North C a ro lin a Press, 1 9 6 4 ), pp. 3 2 - 3 5 , discusses a j u s t i f i c a t i o n o f the use o f regressio n techniques f o r o rd in a l le v e l d a ta . In fe re n c e s in 24 25 B la lo c k , Casual I n f e r e n c e s . Hugh Forbes and Edward T u f t e , "A Note o f Caution in Causal M o d e llin g ," American P o l i t i c a l Science Review, 62 (December, 1 9 6 8 ), pp. 1261-1262. 170 26 27 Mohr, American P o l i t i c a l Science Review, pp. 123-124. Downs, 0 £ . c i t . , p. 216. 28M yt1nger, oj>. c i t . 29 30 Mohr, oj>. c i t . Hubert B la lo c k , J r . , "Theory Building and the S t a t i s t i c a l Concept o f I n t e r a c t i o n , " American S o cio lo g ica l Review, 30 (June, 1965), p. 375. 31 Jackman, 0 £ . c i t . CHAPTER V SUMMARY AND CONCLUSIONS The d ata has provided c o n s id e ra b le support f o r the th eo ry o u t lin e d a t the beginning o f t h i s study. Most o f the hypotheses have been supported although t e s t s o f s ig n if ic a n c e have not been used. A s e t o f o r g a n iz a tio n a l v a r ia b le s expected to c o n trib u te to in n o v atio n were found to be c o r r e la t e d w ith in n o v a tio n . How­ e v e r , these v a r ia b le s are als o h ig h ly c o r r e la te d w ith each o th e r . Although each o f the o r g a n iz a tio n a l v a ria b le s a c ts as a mechanism to a id in n o v a tio n , they are a l l dependent in some way upon resources. Resources were a ls o used as an i n d i c a t o r o f t h is complex o f f a c t o r s . The am b itio n hypotheses form a s e t which were g e n e r a lly supported. However, not a l l o f th e hypotheses r e l a t i n g d i r e c t o r c h a r a c t e r i s t i c s and a t t i t u d e s to am bition and departm ental v a r ia b le s were supported. But over the e n t i r e s e t o f am b itio n hypotheses, co n sid e ra b le evidence was o u t l in e d in support o f th e th eo ry. Background v a ria b le s r e l a t e d to the age and experience o f the d i r e c t o r were hypothesized to be r e la t e d to t h r e e measures o f a m b itio n . G e n e r a lly these hypotheses received c o n s id e ra b le su p p o rt. Two a t t i t u d i n a l measures were a ls o hypothesized to be associated w ith the measure o f expressed a m b itio n . The d ir e c t o r s were asked 171 172 1 f th e re were any o th e r p o s itio n s in P u b lic H e a lth th a t they p r e f e r r e d to the one they c u r r e n t l y h e ld . They were als o asked to i n d ic a t e how c o n te n t they would be to s ta y in t h e i r c u r r e n t p o s it io n u n t i l r e t ir e m e n t . These questions were generated from Downs' n o tio n t h a t conservers were change a v o ld e rs and t h a t clim b ers were more w i l l i n g than conservers to change jobs to f u r t h e r t h e i r i n t e r e s t s . Since these two measures were a t t i t u d i n a l measures which were expected to be r e l a t e d to the am bitions o f clim b ers and co n se rv ers , a s s o c ia tio n s between them and the back­ ground v a r ia b le s were hypothesized. These were g e n e r a lly sup­ p o rte d . However, since these two measures were not background c h a r a c t e r i s t i c s nor were they d i r e c t in d ic a to r s o f types o f a m b itio n , they were not inclu d ed in the a n a ly s is subsequent to the hypotheses r e l a t i n g them to background v a r i a b l e s and am bition measures. A f a i r l y stro n g a s s o c ia tio n was found between the background v a r ia b le s and the degree o f conserver a m b itio n . A strong c o r r e l a t i o n between the number o f years o f p r i v a t e p r a c t ic e and the degree o f conserver am bition was p a r t i c u l a r l y e v id e n t. The v a ria n c e in the degree o f conserver am bition was g r e a t l y accounted f o r by the fo u r background v a r i a b l e s . The r e l a t i o n s h i p o f the background v a r ia b le s w ith the degree o f c lim b e r a m b itio n were not as strong as the a s s o c ia tio n s w ith conserver a m b itio n . The hypotheses were sup­ p o rted however. Much less o f the v a ria n c e in c lim b e r am bition than in conserver am b itio n was e x p la in e d by the f o u r background v a r i a b l e s . This is c o n s is te n t w ith the fin d in g s o f s tu d ie s o f 173 am bition in e l e c t i v e p o l i t i c s . H aln, f o r example, found a strong s t a t i c ambition emerging w ith Increasin g age. The data is co n siste n t w ith the p ro p o s itio n t h a t a s p ira tio n s change and r i s e w ith success. We might suggest t h a t clim b er ambition develops only through experience and success. Whereas the back­ ground fa c to rs g r e a t ly determine the degree o f conserver am bition, the fa c to rs merely predispose d ir e c to r s w ith the proper values on these v a ria b le s to be clim bers. I t takes a c e r ta in amount or type o f experience before climber ambitions a c t u a lly develop. However, i t i s l i k e l y t h a t many, but not a l l , o f those who are predisposed by the background fa c to rs to become climbers a c t u a lly w i l l be clim b ers. A d iffe r e n c e between Downs' Insid e Bureaucracy and ambition theory a ris e s in the fin d in g s . Although Downs includes lea rn in g in h is th eo ry, the ambitions o f h is bureaucrats are more o r less given . That i s , they do not develop according to r e la tio n s h ip s w ith o th e r v a r ia b le s . An exception is made to th is however. In Downs, bureaucrats become conservers as they become o ld e r and by being f r u s t r a t e d in o ther goals. So Downs allows f o r the develop­ ment o f conserver ambition but not f o r the development o f clim ber am bition. A b u re a u c ra t's clim b er ambition i s , to a g re a t e x te n t, a given in Downs. In am bition th e o ry , on the o th e r hand, ambitions are developed through experience. S c h les in g er concludes th a t the o p p o rtu n itie s a ffo rd e d by the s t r u c t u r a l co n dition s o f the routes to o f f i c e give r i s e to ambitions a p p ro p ria te f o r the incumbent in 174 t h a t o f f i c e . ^ He and others show how the e l e c t o r a l system ac ts as a f i l t e r to s i f t out a l l but those w ith the stron g est am bitions. Some l i t e r a t u r e in psychology and o rg a n iz a tio n theory concludes r a t h e r c o n fid e n tly th a t a s p ir a tio n s r is e w ith success. 2 This is more in l i n e w ith ambition theory than w ith Downs. As an i n d i ­ vidual succeeds and views h is resources, h is a s p ira tio n s r i s e and become a p p ro p ria te to his s i t u a t i o n . Downs c la im s, by hypothesis, t h a t clim bers are a t t r a c t e d to growing o rg a n iza tio n s because they can best accomplish t h e i r goals in t h a t type o f o rg a n iz a tio n . I hypothesized t h a t , since by d e f i n i t i o n climbers seek to maximize power, p r e s t ig e , and income, t h a t they w i l l attem pt to be in the l a r g e r departments since s a la r y , p r e s t ig e , power and v i s i b i l i t y a re g re a te r th e re . But ambition theory im p lies t h a t those in the l a r g e r departments, o r the growing departments, would be clim bers because o f th a t s i t u a t i o n . That i s , t h e i r clim b er ambition would develop because o f the type o f department t h a t they were 1n. A f t e r seeing what is possible in the present s i t u a t i o n , the d i r e c t o r would take on ambitions a p p ro p ria te to t h a t s it u a t i o n . My data do not allow me to d is tin g u is h adequately between these two s it u a tio n s . However, the f a c t th a t the background c h a r a c t e r is t ic s are more s tro n g ly r e la t e d to conserver ambition than c lim b e r, and given the a s s o c ia tio n between resources and am bition , one may suggest t h a t th e re is more development o f clim b er ambition among these d ir e c to r s than Downs would Imply. I do fin d re la tio n s h ip s between the department resource v a r ia b le and both 175 types o f am bition. Climber ambition 1s stron g er among d ir e c to r s o f la r g e r departments than o f sm a lle r departments and conserver ambition 1s stronger among the d ir e c to r s o f sm aller departments. However* we are not ab le to conclude from t h is data whether the d ir e c t o r Is in the department due to his am bition o r h is ambition is In fluen ced or determined by the department. We f in d th a t the degree o f clim ber ambition is r e la te d to innovation In the sm aller departments. In n o v atio n , however, is r e la t e d to the background c h a r a c t e r is t ic s o f the d ir e c t o r . Very l i t t l e o f the e f f e c t o f background c h a r a c t e r is t ic s on Innovation is mediated by clim b er ambition {see Table 4 - 1 0 ) . A much g r e a te r amount o f the e f f e c t o f background c h a r a c te r is tic s on innovation is tra n s m itte d through conserver am bition. A general hypothesis t h a t was being te s te d in the study is th a t innovation is a fu n c tio n o f departmental v a ria b le s and the ambition o f the d ir e c t o r . This hypothesis was supported. However, types o f am bition a ffe c t e d innovation d i f f e r e n t l y . Departmental mechanisms as measured by departmental resources were an Important in flu e n ce on innovatio n. However, th e re were d iffe re n c e s in the r e l a t i v e e f f e c t s o f these two v a ria b le s according to the le v e l o f resources. In the path models which included the background v a ria b le s o f the d ir e c t o r s , these v a ria b le s had a la rg e d i r e c t e f f e c t on in n o v atio n . However, th ere was also a s u b s ta n tia l d ir e c t e f f e c t o f conserver am bition on innovation (see Figure 4 - 1 0 ) . In a review o f a c r i t i q u e o f r a t i o n a l i t y models, Arrow c ite s Koopmans ". . . perhaps (we) should look a t determinants o f the u t i l i t y 176 index r a th e r than a t the Index i t s e l f . ” 3 This study supports th is suggestion. However, ambition as a v a r ia b le does add a l o t to the fin d in g s and an i n t e r p r e t a t i o n o f them. The p o lic y im p lic a tlo n s o f the study are many. F i r s t in terms o f the development o f a body o f l i t e r a t u r e in bureaucracy, o rg a n iz a tio n th eo ry, and decision-m aking, a c o n trib u tio n i s made. A number o f hypotheses from Insid e Bureaucracy are te s te d and th is work is modified to be more co n siste n t w ith the body o f l i t e r a t u r e known as ambition th eo ry. Findings suggest fu r t h e r m o d ific a tio n s o f Downs and f u r t h e r in c o rp o ra tio n o f ambition theory in t o a theory o f bureaucracy. S e le c tio n o f the most important v a ria b le s to focus upon or to include in research o f t h is nature depends p a r t l y upon ones' purpose in doing the research. To an a d m in is tra to r o r P u b lic Health o f f i c i a l , the most important v a r ia b le s may be those which have an e f f e c t on innovation and which he, the a d m in is tr a to r , can most e a s ily change o r c o n tr o l. The most important t h e o r e t i c a l va ria b le s may not be the most important a d m in is t r a t iv e ly . To the local o f f i c i a l o r the s ta t e o f f i c i a l , the c h a r a c t e r is t ic s o f the in n ovative h e a lth o f f i c e r may be most im portant; t h a t i s , what is important to consider in s e le c tin g a lo c a l p u b lic h ea lth department d ir e c t o r . Making money a v a ila b le f o r t r a v e l and a tte n d in g conven­ tio n s is a way o f encouraging the o rg a n iz a tio n to keep up in the professional s p e c i a l t ie s . The m anipulation o f these and o th e r mechanisms is something t h a t lo c al o f f i c i a l s may want to urge the fed eral agencies to consider. 177 The a d m in is t r a t iv e o r p o l i t i c a l s c i e n t i s t may be more in t e r e s t e d In d i f f e r e n t aspects o f the research . The r a t i o n a l i t y assumption and the am bition concept may prove to be very u seful to those engaged in th eo ry b u ild in g and pure r a t h e r than a p p lie d research. A g re a t deal o f l i t e r a t u r e has been developed which a p p lie s th e methods o f th e new p o l i t i c a l economy to behavior in e l e c t i v e p o l i t i c s - However, l i t t l e e m p iric a l work has been done using t h i s approach in the study o f bureaucracies and o th e r o r g a n i­ z a tio n s . This p resen t study i s an attem p t to c o r r e c t th is d e f ic ie n c y . Although the p res en t study was o f p u b lic h ea lth departm ents, the cla im is t h a t the fin d in g s a re a p p ro p r ia te to a l a r g e r c la s s o f o r g a n iz a tio n s , lo c a l p u b lic b ureaucracies in g e n e r a l. Although t h is has been a study o f o r g a n iz a t io n a l b e h a v io r, the r e s u l t s have im p lic a tio n s f o r p o l i t i c a l development as w e l l . The r e l a t i o n s h i p s between p o l i t i c a l le a d e rs h ip , economic develop­ ment and p o l i c y o utput may f o llo w a p a t t e r n s i m i l a r to th a t among b u r e a u c ra tic le a d e rs h ip , o r g a n iz a t io n a l resources and o r g a n iz a tio n a l o utp ut. The in c e n tiv e s a v a i l a b l e to leaders and en trep ren u ers in the a d m i n is t r a t iv e and p o l i t i c a l world can have g r e a t Importance. The a v a i l a b i l i t y o f resources, which may take d i f f e r e n t forms in various s e t t i n g s , is a ls o c r u c i a l . But as t h is study has shown, the importance o f le a d e rs h ip may d i f f e r g r e a t l y a t d i f f e r e n t l e v e l s o f re so u rces. This in tu rn im p lie s t h a t the importance o f in c e n tiv e s f o r le a d e rs and the o p p o r tu n ity s t r u c t u r e , e i t h e r f o r p o l i t i c i a n s o r a d m in is t r a t o r s , w i l l a ls o va ry according to the a v a i l a b i l i t y o f resources. 178 More emphasis needs to be placed on the o p p o rtu n itie s and c a re e r paths a v a ila b le to bureaucrats than was done here. I have only looked a t the In c e n tiv e s f o r a few p o s itio n s in one p ro fession . To adequately t e s t and develop a theory o f b u re a u c ra tic ambition the actual careers o f people employed in th a t p ro fession should be follow ed. The p r o b a b i l it y o f a p u b lic h e a lth p ro fe s s io n a l moving from a p o s itio n to a higher p o s itio n should be determ ined, both e m p ir ic a lly and t h e o r e t i c a l l y . An extension o f the present study is advised. I t would be o f i n t e r e s t to fo llo w the careers o f the d ir e c to r s over tim e , now th a t I have an expression o f t h e i r ambi­ t io n s , to see i f t h e i r ambitions change, i f they have careers which correspond to t h e i r expressed am bitions, and to assess the behavior o f the departments o f which they are d ir e c t o r s . The theory and a n a ly s is has been based on an assumption o f r a t io n a l behavior by the i n d i v i d u a l . But the r e s u lts do not support a conclusion o f long range c a lc u la te d planning by the bureaucrat. R ather, the in d iv id u a ls seem to develop ambitions based on t h e i r p ast and present circumstances. Those d ir e c to r s who are younger and have not been in p r iv a t e p r a c tic e are more l i k e l y to be clim b ers. However, the background o f the d ir e c t o r i s more a p p ro p r ia te ly said to predispose d ir e c to r s to be clim b ers; i t does not determine t h e i r degree o f clim b er am bition. This only develops during the d i r e c t o r 's c a re e r and may not be very g r e a t , depending on the jobs and success the d ir e c t o r has. The younger d ir e c to r s may not s e t t h e i r career goals on a very high p o s itio n but perhaps i n i t i a l l y choose some m idlevel p o s itio n and then w a it to see what happens b efo re making 179 th e d e c is io n as to how f a r th ey would l i k e to progress during t h e i r c a re e r . On the o th e r hand th e degree o f conserver am bition 1s q u it e s t r o n g ly determined by the d i r e c t o r ' s p a s t. Those w ith o u t c e r t a in c h a r a c t e r i s t i c s r e a l i z e t h a t the p r o b a b i l i t i e s o f t h e i r o b ta in in g c e r t a i n goals a r e very low. To them th e p r o b a b i l i t y o f an adequate p a y - o f f i s too low to w arran t the e f f o r t 1 t would e n t a i l . I have suggested t h a t clim b ers use In n o v a tio n as a s tr a t e g y to improve t h e i r p o s it io n in the sense o f g a in in g more o f the th in g s they va lu e . But clim b ers are a b le to innovate more e a s i l y than conservers. T hat i s , those d ir e c t o r s w ith more t r a i n i n g and more re c e n t t r a in i n g in p u b lic h e a l t h , would have c lo s e r co n tac ts w ith o t h e r p u b lic h e a lth p ro fe s s io n a ls and f in d in fo rm a tio n on Inno­ v a tio n s e a s i e r to o b ta in . C h a p te r V— F ootnotes 1Joseph A. Schlesinger* Ambition and P o l i t i c s (Chicago: Rand McNally and Company, 1966). 2 Ruth P. Mack, Planning On U n c e rta in ty : Decision-Making in Business and Government A d m in is tra tio n (Hew York: John W iley and Sons, I n c . , 1 9 7 1 ), pp. 61 -65 . 3 Kenneth J . Arrow, "Mathematical Models in the Social Sciences," in Readings in the Philosophy o f the Social Sciences, ed. May Brodbeck (New York: The MacMillan C o ., 1 9 6 8 ), pp. 644-645. Also see Rutledge V in ln g , "Koopmans on the Choice o f V a ria b le s to be Studied and o f Methods o f Measurement," Review o f Economics and S t a t i s t i c s , 31 ( 1 9 4 9 ) , pp. 77-86. 180 APPENDICES 181 APPENDIX A PUBLIC HEALTH PROGRAMS FOR SECONDARY INNOVATION INDEX 182 APPENDIX A PUBLIC HEALTH PROGRAMS FOR SECONDARY INNOVATION INDEX 1* E v alu a tio n o f p a t i e n t s in long term care f a c i l i t i e s . 2. A program by which th e re are r e g u l a r l y a v a i l a b l e , e i t h e r as c o n s u lta n ts o r s t a f f members, s o c ia l o r b e h a v io ra l s c i e n t i s t s who p a r t i c i p a t e in program plann ing o r e x e c u tio n . 3. A program f o r u t i l i z i n g t r a n s a c t io n a l a n a ly s is o r behavior m o d if ic a t io n . 4 . Empathy t r a i n i n g f o r h e a lth department employees. 5. Community h e a lth e d u c a tio n . 6 . Research and development. 7. Research o r tre a tm e n t o f s i c k l e c e l l anemia. 8 . Kidney screening ( d i a g n o s t i c ) . 9. Neighborhood h e a lth c e n te rs . 183 APPENDIX 8 QUESTIONNAIRE SENT TO LOCAL PUBLIC HEALTH DEPARTMENTS, DEPARTMENT DIRECTORS AND DEPARTMENT DEPUTY DIRECTORS 184 L OCAL P U B L I C H E A L T H A D M I N I S T R A T I O N P R O J E C T Part I. F i r s t o f a l l we would i t s involvement in a number o f p u b l i c h e a l t h a c t i v i t i e s . l i k e to o b t a i n some i n f o r m a t i o n about t h i s department and F u l l o f f i c i a l name o f h e a l t h u n i t . What was the d e p a r t m e n t ’ s year? t o t a l e x p e n d i t u r e f o r the most recent complete f i s c a l What is the d e pa r t m e n t ’ s t o t a l budget request f o r the c u r r e n t f i s c a l year? 1. Does your department have a program in f a m i l y planning? / 7 Yes / 7 No IF YES When did your department and y ear) f i r s t adopt t h i s proqram? ( t o the nearest month Would you say t h a t the depar t ment 's involvement in t h i s proqram is / / / / F a i r l y e xt e n s i v e / Temporary o r onl y p a r t i a l / Very l i m i t e d is t h i s program funded p r i m a r i l y through / / Local funds____________ / __ / S t a t e funds / __ / Federal funds Is your department expanding or d e c re as i ng a c t i v i t y in t h i s program? / __ / Expanding / / Decr eas ing / __ / N e i t h e r expanding nor decreas i nq IF NO H a s y o u r d e p a r t m e n t e v e r h a d a p r o g r a m i n f a m i l y p l a n n i n g ? } / No / ___ / Y e s D u r i n g w h i c h y e a r s ? 185 186 What Is the main reason for not presently having a program in family planni rig? Does your department have plans f o r d ev el op in g o r adopti ng a program in f a m i l y p l an n i ng in t he n e a r f u t ur e? 2, Does your department have a program in M ig r a n t H e a l t h Care? / ~ 7 Yes / ' / No / / Yes / / No IF YES When di d your department f i r s t adopt t h i s program? Would you say t h a t vour d ep ar t ment 's involvement in t h i s program is / __ / F a i r l y e x t e n s i v e / / / Temporary o r only p a r t i a l / Very l i m i t e d Is t h i s program funded p r i m a r i ly through / / Local iunds / / S t a t e funds / ' / Federal funds Is your department expanding o r decr ea s ing involvement in t h i s program? / __ / Expanding / / Decreasing / __ / N e i t h e r expanding nnr de c re as i ng I F NO Has your department eve r had ,1 program in Migrant Healt h Care? / / No / / Yes During which years?_________ W h a t i s H e a 1 1 h C a r e ? t h e m a i n r e a s o n f o r n o t p r e s e n t l y h a v i n g .1 p r o g r a m i n M i g r a n t d o e s y o u r d e p a r t m e n t h a v e p l a n s f o r d e v e l o p i n g o r a d o p t i n g a p r o g r a m i n M i g r a n t H e a l t h C a r e i n t h e n e a r f u t u r e ? /"~7 Y e s / ~7 No 3. Does your department have a Drug Abuse Program o f any s o r t 7 / / Yes / / No 187 tF YES When d i d your depar tment f i r s t adopt t h i s program? Would you say t h a t your d e p a r t m e n t ' s involvement i n t h i s program is / __ / F a i r l y e x t e n s i v e / y Temporary o r o n l y p a r t i a l / __ / Ve ry 1 i mi ted Is t h i s program p r i m a r i l y funded through / / Local funds / / S t a t e funds / 7 F e d e r a l funds Is yo ur department expandi ng o r d e c r e a s i n g i nvo lv eme n t in t h i s program? / / Expanding / / D e cr ea s in g / / N e i t h e r expandi ng nor d ecr eas ing IF NO Has y o u r d epa rt ment e v e r had a Drug Abuse Program? / ' } Yes / 7 No I f Yes: What was t he n a t u r e o f the program? During what y e ar s d i d you have the program? What is t he main reason f o r not p r e s e n t l y havi ng a Drug Abuse Program? Does your depar tment have p l an s f o r d e v el o p i n g o r a d o p t i n g a Drug Abuse P r o g r am in the near f u t u r e ? A. Is your depar t ment i n vo l v e d in an A1coho 1-Highway S a f e t y Program? / '/ Yes / 7 No / / Yes / / No IF f E5 When di d your department f i r s t become i n v o l v e d in t h i s program? 188 Would you say that your department's involvement in this program is / / Fairly extensive / 7 Temporary or only partial / / Very l i m i t e d Is t h i s program funded p r i m a r i l y t hrough / / Local funds_____________ / __ / S t a t e funds / 7 F ed e ra l funds Does your d ep a r t me n t p 1 an to expand o r d e c r e a s e i nvol vement in t h i s program? / 7 Expand / / Decrease / / N e i t h e r expand nor decrease IF NO Has your depar tment e v e r had an A t co h o l - H i g h w a y S a f e t y Program? / __ / No / 7 Yes D u r i n g which years? _________ What is P rog ram? t he main reason f o r not p r e s e n t l y h a vi n g an A1coho I - H i g h wa y S a fe t y Does y o u r depart ment p l a n t o adopt o r d ev el op an A1 coho I -Hi ghway S a f e t y Program in the near f u t u r e ? 5 . Does yo ur depart ment have a program o f A l c o h o l i s m Co nt r ol { o t h e r than an A I coho 1 - Highway S a f e t y Program) ? / 7 Yes / 7 No / / Yes / / No I c YES When d i d your depar t ment f i r s t adopt t h i s program? Would you say t h a t y o ur d e p a r t m e n t ' s i n vo lv em en t in t h i s program is / / / / Fa i r 1y e xt en s i ve / Temporary o r on ly p a r t i a l 7 Ve ry I i m i ted Is t h i s program funded p r i m a r i l y through / / Local funds / 7 S t a t e funds / / F e d e r a l funds 189 Is your department expanding or decreasing involvement In this program? / / Expanding / / Decreasing / / Ne Ither expanding nor decreasing IF HQ Has your department ever had an Alcoholism Control Program? / __/ No / / Yes During which years? _ _ _ _ _ _ What is the main reason for not presently having an Alcoholism Control P rog ram? Does your department plan to develop or adopt an Alcoholism Control Program in the near future7 / 7 Yes / 7 No 6. Does your department have an On Site Multi-Phasic Screening Program? / / Yes / 7 No IF YES When did your department first adopt this program? Would you say that your department's involvement In this program is / / / / Fairly extensive / Temporary or only partial / Very limited Is your department expanding or decreasing involvement in this program? / ' 7 Expanding /~*/ Decreasing / / Neither decreasing nor expanding IF NO Has your department ever had an on Site Multi-Phasic Screening Program? / / No / ' / Yes During which years? _______ What is the main reason for not having an On Site Multi-Phasic Screening Program? Does your department plan to develop or adopt an On Site Multi-Phasic Screening Program in the near future? / 7 Yes 190 7. To what extent does your department have a philosophy of comprehensive health care or over-alt health promotion as contrasted to focusing on disease treatment? (check only one) / / Not at ail / / / / / Not a t a l l but may develop a phi lo so ph y in t h i s d i r e c t i o n 7 Are t r y i n g o r hoping to develop a philosophy in t h i s d i r e c t i o n / A d i s t i n c t p h i l os op h y o f t h i s s o r t t o a small e x t e n t / To a g r e a t e x t e n t i n t e r e s t e d We are a l s o is engaged Each program a r e a f ol l o w e d by a s et o f s t at e me n ts . Choose t hat one which best d es cr i b es your d e p ar t me nt ' s in each o f the program ar eas d escr ibed below. in your assessment o f the e x t e n t to which your department in the program a r e a . involvement is I . E v a l u a t i o n o f p a t i e n t s in long term care f a c i l i t i e s . / / / No a c t i v i t y to speak o f and none planned / No a c t i v i t y t o speak o f but are l i k e l y to pl an some in the ne ar f u t u r e / __ / No a c t i v i t y t o speak o f but a re p r e s e n t l y engaged in pl anni ng t h i s type o f program / / Some a c t i v i t y but very l i t t l e / __ / A f a i r amount o f a c t i v i t y o r a p a r t i a l program w i t h plans t o expand f / A g r e a t deal o f a c t i v i t y in t h i s area / / A c o m p r e h e n s i v e p r o g r a m 2 . A program by which t here are r e q u l a r t y a v a i l a b l e , e i t h e r as c o n s u l t a n t s o r s t a f f members, s o c i a l o r b e h a v i o r a l s c i e n t i s t s who p a r t i c i p a t e p lanni ng o r e x e c u t i o n . in proqram / 7 No a c t i v i t y to speak o f and none planned / / No a c t i v i t y t o speak o f but ar e l i k e l y t o pl an some in the near f u t u r e / / No a c t i v i t y t o speak o f but ar e p r e s e n t l y engaged in pl anning t h i s type o f program / Some a c t i v i t y b u t v e r y l i t t l e / A f a i r amount o f a c t i v i t y o r a p a r t i a l program w i t h plans to expand / A g r e a t de al o f a c t i v i t y in t h i s area / / f / / A comprehensive program 191 3- A program for utilizin g transactional analysis or behavior modification? / 1 No activity to speak of and none planned f / No activity to speak of but are likely to plan some in the near future /__ / No activity of program to speak of but are presently engaged in planning this type / / / Some activity but very l i t t l e I / A fair amount or a partial program wfth plans to expand / 7 A great deal of activity in this area / 7 A comprehensive program k. A program for providing empathy training for health department employees. / / / / / / / No activity to speak of and none planned t No activity to speak of but are likely to plan some in the near future / No activity of program to speak of but are presently engaged in planning this type / Some activity but very lit t l e / A fair amount of activity or a partial program with plans to expand / A great deal of activity in this area / "/ A comprehensive program 5- A coenunity health education program. r / / j no activity to speak of and none planned / No activity to speak of but are likely to plan some in the near future "7 No activity to speak of but are presently engaged in planning this type of program / / Some activity but very l i t t l e /__I A fair amount of activity or a partial program with plans to expand / / / A great deal of activity in this area / A comprehensive program 6. A procedure for Research and Development of new programs. / / / No activity to speak of and none planned / No activity to speak of but are likely to plan some In the near future 192 / / a c t i v i t y t o speak o f b u t a r e p r e s e n t l y engaged o f program In p la n n in g t h i s ty p e / / / / / Some activity but very l i t t l e / A fair amount of activity or a partial program with plans to expand / A great deal of activity In this area / A comprehensive program 7- A program in research or treatment of sickle cell anemia. / / No activity to speak of and none planned / J No activity to speak of but are likely to plan some in the near future / / No activity to speak o f but are presently engaged in planning this type of program / T Some activity but very l i t t l e / / A fa ir amount of activity or a partial program with plans to expand /~~7 A great deal of activity in this area / __ / A comprehensive program 8. A kidney screening program. /~""7 No activity to speak of and none planned / "7 No activity to speak of but are likely to plan some in the near future / / / / / / No activity to speak of but are presently engaged Sn planning this type of program / Some activity but very lit t l e / A fair amount of activity or a partial program with plans to expand / A great deal of activity in this area 7 A comprehensive program 9. A program for setting up and maintaining neighborhood health centers. / / / No activity to speak of and none planned / No activity to speak of but are likely to plan some in the near future / 'V No activity to speak of but are presently engaged in planning this type of program / / / / Some activity but very l i t t l e 7 A fa ir amount of activity or a partial program with plans to expand / A great deal of activity in this area / / A comprehensive program 193 Part I I . This part of the questionnaire asks for information about the people who direct I f you have already fille d out this part in your the local health departments. capacity as the director of another department, it is not necessary to fi I 1 out agai n. It 1, What is your present position? (give o ffic ia l t it le ) 2. When di d you b e g i n in t h i s p o s i t i o n ? 3- What p o s i t i o n d i d you h o ld p r i o r t o t h i s one? ( o f f i c i a l t i t l e and name o f organ i z a t i on) A. What is your age? 5. Do you have a degree in the h e a l i n g a r t s ? / / M.D. / / P . P . / 7 O. V.M. / / D . D . S . Do not have a degre e in the h e a l i n g a r t s . / V I f you have a de gr ee r e c e i v e t h i s degree? in one o f the h e a t i n g a r t s , when and where d i d you 6 . Do you now have a M a s t e r ' s Degree in Public H e a l t h o r i t s e q u i v a l e n t ? / / Do not have M . P. H. o r e q u i v a l e n t / ___ / Do not have M . P . H . or e q u i v a l e n t but have done g r a d u a t e work in P u b l i c Hea1t h / / M. P. H. / __ / M.P. H. e q u i v a l e n t ( E x p l a i n j When did you, or when do you p l a n t o , r e c e i v e the M. P. H. ? 7. Could you p l e a s e the B.S. o r B.A. l i s t the d e g r e e s , not i n cl ud ed above, t h a t you have beyond 8. Did you e ve r m a i n t a i n a p r i v a t e pract t ce? / 7 Yes / 7 No I f yes, d u r i n g which years? 194 9- When did you take your firs t public health position? What was the nature of the position? 10. Could you please lis t the different positions that you have had in public health during the past fifteen years. and name of organization.) (give name of position~-or describe — 1 1 . Is t h e r e another p u b l i c h e a l t h p o s i t i o n t h a t you would l ike? I f y es , what would t h a t be? / ^ 7 Yes / / No 12. Uhat would l i k e your next p u b l i c h e a l t h p o s i t i o n to be? 13- Would you be content to Stay ' n your pr ese n t p o s i t i o n u n t i l r e t i r e m e n t ? / / Very content / __ / Content / / / / I n d i f f e r e n t / Not co n t en t / Not at a l l content 1k , Which p r o f e s s i o n a l j o u r n a l s do you r e g u l a r l y r e c e i v e and read? IS- What two sources o f i n f o r m a t i o n about new developments in p u b l i c h e a l t h are the most i mportant t o you? 16. About how many meet ings w i t h o t h e r p u b l i c h e a l t h physici ans o r o f f i c i a l s ar e you abl e t o a t t e n d a n n u a l l y? Meetings in the state of Michigan _______ Meetings outside o f the state of Michigan _______ 195 17- Could you p l e a s e rank in number o r d e r t he f o l l o w i n g p o s i t i o n s In terms o f your p r e f e r e n c e f o r them. p r e f e r r e d ) (number I the most p r e f e r r e d , number 8 t he l e a s t / ___ / D i r e c t o r o f a l a r g e p u b l i c h e a l t h department / / D i r e c t o r o f a s m a l l , but g ro w in g , p u b l i c h e a l t h d e pa rt me nt / "~7 D i r e c t o r o f a small p u b l i c h e a l t h department t h a t is r e l a t i v e l y s t a b l e in si ze / ___ / Bureau c h i e f in a s t a t e depar tment o f p u b l i c h e a l t h / ___ / Program c h i e f in a s t a t e depar t ment o f p u b l i c h e a l t h A p o s i t i o n which would a l l o w you t o e x e r c i s e t he most the p o l i c y d i r e c t i o n o f p u b l i c h e a l t h i n f l u e n c e on D i r e c t o r o f a department t h a t has prog rams i n s t i t u t e d a number o f p r o g r e s s i v e / / D i r e c t o r o f a department t h a t would a l l o w you t o i n s t i t u t e a number o f p r o g r e s s i v e programs 18. How would you rank in number o r d e r the importance o f the f o l l o w i n g f a c t o r s in r e c o g n i z i n g a good p u b l i c h e a l t h d i r e c t o r ? i m p o r t a n t ) number 6 t he l e a s t (number 1 the most i m p o r t a n t , / / / / / / / His knowledge o f new programs in p u b l i c h e a l t h / The e f f i c i e n c y w i t h which h i s department d e l i v e r s or pro vi de s h e a l t h care t The r e p u t a t i o n he has among h i s f e l l o w p u b l i c h e a l t h p h y s i c i a n s / The c o n f i d e n c e t h a t the l oc al h e a l t h board pl a c es in him / The number o f p u b l i c a t i o n s he has in p r o f e s s i o n a l j o u r n a l s / The q u a l i t y o f l e a d e r s h i p he p r o v i d e s f o r h i s s t a f f 19. What one t h i n g would you most l i k e t o accomplish in y ou r c a r e e r in p u b l i c hea 1th? 20. What one goal would you most l i k e to see t he p r a c t i c e o f p u b l i c h e a l t h pursue? 796 Feel free to use this additional space to complete your answers to any of the questions or to make any added convnents that you may wish. BIBLIOGRAPHY 197 BIBLIOGRAPHY A d rian , Charles. Four C it ie s : A Study in Comparative P o lic y - Making. P h ila d e lp h ia : U n iv e r s it y o f Pennsylvania Press, 1963. Archer, Stephen, H. "The S tru c tu re o f Management Decision Theory." In Public A d m in is tra tio n : Readings in I n s t i t u t i o n s , Processes, and Behavior. Edited by F. Gibson and G. Cornog. Chicago: Rand McNally and Company, 1966. Arrow, Kenneth J. "Mathematical Models in the Social Sciences." In Readings in the Philosophy o f the Social Sciences. Edited by May Brodbeck. New York: The MacMillan Company, 1968. B a rn e tt, Homer G. In n o v a tio n . New York: McGraw-Hill Book Company, 1953. Bechtold, Harold P. 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