La Supervisión del Cumplimiento de Sentencia

JOB SATISFACTION AMONG THE STATE PUBLIC HEALTH AGENCY WORKFORCE BACKGROUND

Workers and their workplaces exist in a symbiotic relationship in which the thoughts and behaviors of each influence the other.(Brief & Weiss, 2002; Mathieu & Zajac, 1990) Job satisfaction is one of the most studied aspects of this relationship and has been linked to nearly all important organizational outcomes.(Judge, Thoresen, Bono, & Patton, 2001; Lu, Barriball, Zhang, & While, 2012) Studies have shown that workers with high levels of job satisfaction are more productive and motivated, perform better at their jobs, and have greater organizational commitment and

engagement.(Abelson & Baysinger, 1984; Judge et al., 2001; Lawler Iii & Porter, 1976) Job satisfaction has also been linked to reduced absenteeism.(Hacket, 1989; Hom & Kinicki, 2001) As a key predictor of employee turnover,(Carsten & Spector, 1987; Mossholder, Settoon, & Henagan, 2005; Tett & Meyer, 1993) low job satisfaction can have significant costs to organizations to replace departing and orienting new

employees.(Hellman, 1997; Schlesinger & Heskett, 1991)

While job satisfaction has been discussed in the empirical literature since the 1930s,(Hoppock, 1935) a 25-year systematic review of the public health workforce literature found limited information on job satisfaction in the state governmental public health agency workforce.(Hilliard & Boulton, 2012) Recent work by Harper et al. was

public health agency workforce finding an association between organizational and supervisory support and job satisfaction.(Harper, Castrucci, Bharthapudi, & Sellers, 2015) While this work was significant, it neglected to consider the impact of generational identity on job satisfaction.

Generational Theory and Job Satisfaction

This is a time of significant generational transition as, for the first time, there are multiple generations existing simultaneously in the U.S. workforce.(Zemke et al., 2000) The three generations that comprise the majority of the workforce are the Baby

Boomers, Generation X, and the Millennials. By the first quarter of 2015, Millennials became the largest generation in the workforce (53.5 million) followed by Generation X (52.7 million) and the Baby Boomers (44.6 million).(Fry, 2015) However, unlike in

previous generational transitions, people are living longer, healthier lives.(Collins, 2003) Therefore, as Baby Boomers are reaching the traditional retirement age many are

continuing to work well into their 60s and 70s, if not longer.(Collins, 2003) For example, a 2010 American Association of Retired Persons survey of older Baby Boomers found that nearly 40% reported that they plan “to work until they drop.”(Love & Nannis, 2010) This longevity has implications for workforce advancement and entry for younger

generations. For example, more than half of all Millennials interviewed as part of The Hartford’s 2013 Benefits for Tomorrow Study agreed that Baby Boomers who delay retirement prevent young employees from promotional opportunities and deny employment opportunities.(The Hartford, 2013)

Generational theory suggests that within each generational cohort, shared social, cultural, political experiences contribute to a unique identity.(Delli Carpini, 1989; Drew,

2015; Webb-Morgan, 2012) A generational cohort is a group of individuals similar in age who have experienced the same historical events within the same time

period.(Howe & Strauss, 2009; Ryder, 1965) Generation members share temporal and age-related events such as starting school, entering the workforce, having children, and retiring. While historical events occur simultaneously for multiple generations, each is experiencing these events at different developmental stages with young adulthood being a particularly impressionable developmental stage.(Baltes et al., 1980; Duncan & Agronick, 1995; Noble & Schewe, 2003) Each of these three generations come from very different backgrounds that shape their views and motivations and influence their relationship with the workplace, including their perceptions of job satisfaction. These differences can positively contribute to the workforce through creative strengths and opportunities.(Lancaster & Stillman, 2009) For example, 9 in 10 Millennials who participated in The Hartford’s 2013 Benefits for Tomorrow Study agreed that Baby Boomers bring substantial experience and knowledge to the workplace.(The Hartford, 2013) A similar proportion of Baby Boomers agreed that Millennials bring new skills and ideas to workplace.(The Hartford, 2013) However, about three quarters of Generation X from the same study agreed that the “entitlement generation” is an appropriate

nickname for the Millennials.(The Hartford, 2013) This demonstrates the potential for unpleasant conflict, mistrust, and miscommunication that can directly impact job satisfaction.(Hankin, 2005; Lancaster & Stillman, 2009; Ruch, 2005)

Common among models and theories used to explain job satisfaction is the concept that employees’ needs – whether they are recognition for contributions, training opportunities, structured feedback, adequate training, or quality relationships with

coworkers and supervisors – are considered and addressed. This concept can be divided into two separate themes – organizational support (training, communications, workload) and supervisory support (respect, good relationships, working well with individuals of different backgrounds).(Campbell, Fowles, & Weber, 2004; Crose, 1999; Pitts, Marvel, & Fernandez, 2011; Rowden, 2002) The different value systems

(Kupperschmidt, 2000; Zemke et al., 2000) and life experiences of each generation (Hicks & Hicks, 1999; Lancaster & Stillman, 2009; Zemke et al., 2000) can directly influence their perceptions of the workplace including reactions to organizational and supervisory support.(Lancaster & Stillman, 2009; Ruch, 2005)

Baby Boomers believe in paying their dues in an organization and a strong organizational commitment.(Hicks & Hicks, 1999; Howe & Strauss, 2009) They routinely sacrificed on behalf of their workplace with 50 or even 60-plus hour weeks, and they frequently advise young coworkers to work hard, demonstrate their dedication, and patiently wait their turn for promotions.(Chatman & Flynn, 2001; Hicks & Hicks, 1999; Howe & Strauss, 2009) They are the original workaholics who, even as young adults, had little notion of work-life balance.(McGuire, Todnem By, & Hutchings, 2007; Stauffer, 1997)

Comparatively, Generation X is characterized by a lack of organizational loyalty and an unwillingness to sacrifice family for success.(Howe & Strauss, 2009; Lancaster & Stillman, 2009) Unlike Baby Boomers, Generation X requires managers to earn respect rather than gain it by virtue of a title.(Tulgan, 1995) Moving even further from the notion of organizational commitment, empirical research indicates that Millennials do not develop organizational commitment as more senior workers have.(Howe & Strauss,

2009; Lancaster & Stillman, 2009) Instead, more than other generations, Millennials develop commitment to individuals, especially supervisors with whom they develop meaningful relationships.(Lockwood, 2009; Marston, 2010) They also expect a balance between family and careers that previous generations have not.(Carless & Wintle, 2007; Myers & Sadaghiani, 2010; Ng, Schweitzer, & Lyons, 2010; Wey Smola & Sutton, 2002)

In regard to supervisory relationships, Millennials’ interactions with supervisors are a departure from the relationships Baby Boomers and Generation X. Millennials expect open communication from their supervisors and managers, even about matters normally reserved for more senior employees.(Gursoy et al., 2008; Hershatter &

Epstein, 2010) Empirical studies also found Millennials to be more impatient about becoming recognized as valuable contributors.(Gursoy et al., 2008; Pew Research, 2010) Millennials expect communication with supervisors to be more frequent, more positive, and more affirming than has been the case with prior generations. (Gursoy et al., 2008; Hershatter & Epstein, 2010; Hill, 2002)

Research Questions and Implications

Since 2008, most governmental public health agencies have experienced job losses through a combination of layoffs and attrition.(Association of State and Territorial Health Officials, 2011, 2014) An adequate supply of well-trained, skilled public health professionals is essential for the effective operation of the governmental public health enterprise.(Baker et al., 2005) To ensure that such a supply exists, strategies are needed to address challenges to workforce retention. With fewer new graduates choosing to work for state governmental public health departments, it will be critical to

retain those who opt to enter this workforce.(K. Gebbie et al., 2002; The Association of Schools of Public Health Council of Public Health Practice Coordinators, 2000)

Job satisfaction has been shown to be a significant predictor of retention.(Irvine & Evans, 1995; Tett & Meyer, 1993) While Harper et al. published the first study to

explore correlates of job satisfaction in the state governmental public health agency workforce, given the generational differences regarding work values and attitudes, job satisfaction may be perceived differently across the multigenerational state

governmental public health agency workforce.(Harper et al., 2015) Consequently, understanding job satisfaction within each generational group may lead to increasing clarity about strategies that could be implemented to promote retention among those currently in the state governmental public health agency workforce, especially

Millennials. To inform the development of retention strategies, the present study seeks to determine if there are differences in the relationship between supervisory support and organizational support and job satisfaction across the three generational cohorts that account for at least five percent of the state governmental public health agency workforce.

METHODS Data Sources

Data used in the analyses for this article were drawn from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS) – specifically, the nationally

representative sample of central office employees of state health agencies (SHAs) in the United States. Developed by the de Beaumont Foundation in partnership with the Association of State and Territorial Health Officials (ASTHO), PH WINS is the largest

public health workforce survey of its kind.(Sellers et al., 2015) PH WINS is the only national survey of the public health workforce that collects individual-level data. As such, it is the first and only national data source that allows for investigation of generational differences in the public health workforce.

The methods used in the creation of PH WINS have been described in detail previously.(Leider et al., 2015; Sellers et al., 2015) To summarize, the purpose of PH WINS was to collect individual worker perspectives across all disciplines and

geographic regions. The development of PH WINS began in 2013, with a consensus- building process among 31 public health stakeholders representing an array of

disciplines.(Kaufman et al., 2014) A technical expert panel was convened to guide the sampling methodology, instrument creation, and protocols for survey fielding and administration.(Sellers et al., 2015)

When developing the instrument, existing and/or validated measures were incorporated when possible. Items used in PH WINS were adapted from the 2009 National Assessment of Epidemiology Capacity,(Council of State and Territorial Epidemiologists, 2009) the US Office of Personnel Management Annual Employee Survey,(U. S. Office of Personnel Management, 2008) the US Office of Personnel Management Federal Employee Viewpoint Survey,(U. S. Office of Personnel Management, 2012) the Centers for Disease Control and Prevention Technical Assistance and Service Improvement Initiative: Project Officer Survey,(Centers for Disease Control and Prevention, 2013), the Public Health Foundation Public Health Workforce Survey,(Council on Linkages Between Academia Public Health, 2010) and the Job in General Scale (abridged).(Balzer et al., 2000) The instrument adapted and

used several items from Boulton et al.'s public health workforce taxonomy to ask

respondents about occupational classification, program area, degrees and certifications, work setting, and demographics.(Boulton et al., 2014) The research team drafted new questions when appropriate existing items could not be identified. Cognitive interviews were conducted, and the instrument was pretested with three groups of public health practitioners at the state and local levels. The finalized survey was administered online in fall 2014. After pretesting and preliminary psychometric analysis (also explained in depth in previous a previous publication), the instrument was fielded among 37 states from September to December 2014.(Leider et al., 2015) The survey was confidential; contact information was retained only to ascertain whether a potential respondent had indeed responded. No contact information is associated with responses in final PH WINS data sets.

The national sampling frame of state public health employees was stratified on the basis of 5 geographic (paired HHS) regions using employee lists provided by each participating state and stratified with the state as the lowest stratum variable before selection of a random sample within each state. The complex sampling methodology for PH WINS has been outlined elsewhere.(Leider et al., 2015) A total of 40,091 survey invitations were distributed via electronic mail to health agency employees in 37

participating states; 19,171 responded for a raw response rate of 48%. After adjusting for noncentral office staff, nonpermanent employee status, undeliverable e-mail

addresses, and those who were no longer in their position, the response rate was 46% (n = 10,246). A nationally representative data set of central office staff, defined as permanent employees who work in the central office of the SHA as opposed to having

been assigned to local or regional offices, was constructed. A set of weights was calculated using balanced repeated replication to account for differential nonresponse and demographic characteristics.

Measures Generations

There is no one source that defines the generations. Various authors use slightly different cut points to define each generation. The generation definitions developed by the Pew Research Center were used for this study (Pew Research, 2014). These are also consistent with the definition used in the Federal Employee Viewpoints Survey. Using this framework, the birth year cut points are:

 Millennials: 1981 and after  Generation X: 1965-1980  Baby Boomers: 1946-1964  Silent Generation: 1928-1945

Only generations comprising five percent or more of the state public health agency workforce were included in the analysis eliminating the Silent Generation.

Organizational and Supervisory Support

Previous factor analysis using PH WINS data defined questionnaire items that comprised categories of organizational support and supervisory support.(Harper et al., 2015; Liss-Levinson et al., 2015) Items included in organizational support were (1) employees have sufficient training to fully utilize technology needed for their work, (2) my training needs are assessed, (3) communication between senior leadership and employees is good in my organization, (4) creativity and innovation are rewarded, (5)

my workload is reasonable, and (6) I recommend my organization as a good place to work.

Items included in supervisory support included (1) my supervisor/leader treats me with respect, (2) my supervisor and I have a good working relationship, (3) my supervisor supports my need to balance work and family issues, (4) my supervisor/team leader provides me with opportunities to demonstrate my leadership skills, (5)

supervisors/team leaders in my work unit support employee development, and (6) supervisors/team leaders work well with employees of different backgrounds.

Items were assessed on a 5-point Likert scale ranging from strongly disagree to strongly agree. The mean across all items in each category – organizational support and supervisory support – were included in the regression models.

Job Satisfaction

Previous PH WINS analyses used the Bowling Green State University Job in General (JIG) Scale (abridged) to measure job satisfaction.(Balzer et al., 2000) This validated scale includes 8 descriptive words or phrases such as “makes me content” and “better than most” to determine overall job satisfaction.(Balzer et al., 2000; Russell et al., 2004) Generally, a score above 27 signifies satisfaction with one's job and a score less than 22 signifies dissatisfaction.(Balzer et al., 2000) The JIG Scale

(abridged) is a global measure of job satisfaction that can be used to gauge the overall evaluative or affective judgment about one’s job. Given the complexity of the JIG Scale and the number of items required to compose the survey, analyses were done to

determine the added predictive value of the JIG Scale versus the question, “Considering everything, how satisfied are you with your job?” Responses to this question ranged

from “very dissatisfied” to “very satisfied” on a 5-point Likert scale. Analyses found that the single question was as effective in capturing job satisfaction as was the JIG Scale. Therefore, unlike in the previous analyses,(Harper et al., 2015) the single question was used to measure job satisfaction.

Demographic and Workforce Characteristics

Other independent variables included in the analysis are the respondent’s (1) supervisory status (nonsupervisory, team leader, supervisor, manager, executive), (2) gender (male, female), (3) race (White, Black or African American, Native Hawaiian or other Pacific Islander, Asian, American Indian or Alaska Native, two or more races), (4) Hispanic origin (yes, no), (5) degree earned (associate’s, bachelor’s, graduate’s

degree), and (6) pairwise region (New England and Atlantic, Mid-Atlantic and Great Lakes, South, Mountain/Midwest, West). Educational attainment, having a public health degree (any level), job classification, and program area were also collected.

Statistical Analysis

All analyses for this research were conducted in Stata Version 13 (StataCorp. 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP). To account for the complex sampling design, survey commands included in SPSS were used to produce weighted estimates using balanced repeated replication.

Bivariate analyses were conducted to determine the association between

generation and each of the items in the organizational support and supervisory support categories. Three separate logistic regression models, one for each generation, will be estimated to explore the association between organizational support and supervisory support and job satisfaction when adjusting for the influence of other variables. Job

satisfaction is dichotomized–very dissatisfied, somewhat dissatisfied, neither dissatisfied nor satisfied versus somewhat satisfied, very satisfied–for use into the logistics regression analyses.

RESULTS

Job satisfaction did not differ by generation. Among Millennials, 80.6% (95% CI 77.8%-83.2%) reported to be satisfied with their jobs compared to 78.8% (95% CI 76.5%-80.9%) among Generation X and 78.5% (95% CI 76.8%-80.2%) among Baby Boomers. While there was no difference in overall job satisfaction, additional analyses sought to determine if supervisory support and/or organizational support impacted job satisfaction differently by generation.

In all generations, there was a positive association between supervisory support and job satisfaction (Table 3.1). Like with supervisory support, the pattern between organizational support and job satisfaction is clear and consistent across all generations (Table 3.2). Generally, negative supervisory support measures were associated with lower job satisfaction scores than were negative organizational satisfaction scores. For example, average job satisfaction among those neither agreeing nor disagreeing with the supervisory measures for Millennials was 57.7% compared to 73.4% for

organizational support. This general pattern was repeated for all generations.

Movement between agreement and strong agreement had a more pronounced impact for supervisory support variables than organizational support variables. For Millennials, the average difference in job satisfaction between agreeing and strongly agreeing was 13.1 percentage points compared to 8.0 percentage points for

The logistic regression demonstrates the strong association between supervisory support and organizational support and job satisfaction.(Table 3.3) The strength of this association transcended generations.

DISCUSSION

Several past studies outside of public health have suggested that an organizational and supervisory support appealing to Millennials is different from previous generations.(Alsop, 2008; Farrell & Hurt, 2014; Ferri-Reed, 2014a, 2014b; Jerome, Scales, Whithem, & Quain, 2014) However, this study found no differences between supervisory support and organizational support and job satisfaction across the three generational cohorts that account for at least five percent of the state

governmental public health agency workforce. Supervisory support and organizational support were found to be strong indicators of job satisfaction, which is consistent with past literature, across all generations actively working in the state governmental health agency workforce. The discordance between these results and the published literature may be the result of positive-results bias,(Dickersin, 1990) which leads to the

overpublication of articles that rejected the null hypothesis presenting a unbalanced view of relationship.

While past studies outside of public health have suggested that a workplace and supervisory structure different by generations,(Alsop, 2008; Andersson, 2018; Farrell & Hurt, 2014; Ferri-Reed, 2014a, 2014b; Gibson, Greenwood, & Murphy Jr, 2009; Jerome et al., 2014; Sharp, 2015) such conclusions appear unwarranted in the state

governmental public health agency workforce. State governmental public health agency leadership should pursue improvements in supervisory and organizational support, but

these can be general and do not require generational tailoring. In a resource limited environment, these data suggest that investments in supervisory support may yield a better return than organizational changes. However, these strategies do not require tailoring based on generation.

TABLES

Table 3.1. Association between Supervisory Support and Being Somewhat or Very Satisfied with One’s Job by Generation

Millennials Generation X Baby Boomers

% (95% CI) % (95% CI) % (95% CI)

My supervisor/team leader treats me with respect

Strongly disagree 34.1 (17.8,55.3) 26.4 (18.1,36.8) 26.3 (16.7,38.9)

Disagree 29.1 (17.7,43.8) 36.5 (31.4,42.1) 37.6 (29.7,46.2)

Neither agree/disagree 52.0 (35.4,68.2) 54.2 (45.6,62.6) 53.5 (47.5,59.4)

Agree 73.2 (67.2,78.5) 78.3 (75.4,81.0) 81.9 (79.1,84.4)

Strongly agree 92.2 (90.7,93.5) 92.1 (90.0,93.7) 91.6 (89.6,93.2)

My supervisor and I have a good working relationship

Strongly disagree 72.8 (38.0,92.1) 33.8 (22.9,46.8) 41.2 (28.1,55.7)

Disagree 53.6 (30.3,75.4) 37.2 (24.8,51.5) 39.5 (30.3,49.5)

Neither agree/disagree 45.1 (31.4,59.7) 53.4 (47.4,59.2) 44.7 (38.0,51.7)

Agree 76.9 (71.2,81.7) 77.8 (75.0,80.3) 78.4 (76.1,80.5)

Strongly agree 91.8 (86.4,95.2) 90.2 (87.3,92.5) 89.9 (87.8,91.7)

My supervisor supports my need to balance work and family issues