ORGANIZATIONAL STRESSES AND HEALTH E. K. E. GUNDERSON REPORT 73-59 NAVAL HEALTH RESEARCH CENTER SAN DIEGO, CALIFORNIA 92152 NAVAL MEDICAL RESEARCH AND DEVELOPMENT COMMAND BETHESDA, MARYLAND This reproduct tor fa'-- *>"»?” xllcrjiblc Tt is the beet that can be obtained from the copy jtirnuiied to DDC, < )•' : I i ' Inst it wte of ! '•■•.•I;*: %•£» It on roll Texas Christ ian University The Navy’s continuing concern with optical utilization of its manpower resources has taken on new urgency with the implementation of the All Volunteer Force. To those responsible for medical and psychological support this concern implies a challenge to increase the capability to cope with motivational problems, mental disorders, physical illnesses, and accidents which have been recognized for many years as a major drain on human resources in the military services. Medical research programs seek to reduce losses due to employee accidents and illnesses by identifying causes and implemen- ting preventive or remedial measures. Causal factors related to health and morale problems in industry and the military are only partially understood. Certain specific environmental factors have been shown measurably’ to affect morbidity rates in the adult population and, therefore, constitute known occupational hazards (1). The relationships of demographic variables to illness rates have also been well documented in many populations. A number of recent studies have linked various forms of life stress, particularly job stress, to specific psychosomatic diseases and psychiatric disorders (2). The role that stresses and strains on the job, that is. that Gunderson K Sells 2 organizational stresses play in ill health is not well understood at this ti hut it is suspected by a number of medical invest i gal ors that physical 1 . •' '■ 1 ' t.;j he job . it ih , fini1 o ••■Mb h - • ds for : • i . f ■ ] ,-h, l 5 : ' ' ], ; ’ ; ; I f : [ ' : v , , . : . ' • ■ ; 1 ' . . t 1 1 • « ? • lli-.y do net in i ’ ■ 1 \ ■ •• i.de i i ijiic; ! •> i • ' . : i • ■ ■ ei i ■ l • ■ ’’ ,i ( 0 • Multiple rep re. ■ 'nil methods were utilised to dot . line the rel ul ive contribution of individual personnel characteristics arid work environment (job stress) factors to the prediction of illness and job satisfaction. Individuals working in physically demanding and/or hazardous environments had relatively high illness rates, and, generally, men in blue-collar jobs (Ordnance, Deck, and Engineoring/Hull) experienced more illnesses than those in white-collar or technical jobs. This finding is consistent with related results from morbidity studies in civilian industry. One observation of special interest occurred in these early Navy studies. It was noted that overall illness rates varied considerably from ship to ship. In one study it was possible to evaluate statistically the relative contribution of specific organization (ship) to the prediction of illnesses among crew members. The results were impressive (5). By including specific ships as variables in the prediction equation, the variance accounted for by the multiple correlation with the illness criterion (based upon a combination of demographic and job-related variables) was almost doubled. Further analysis revealed that the specific ship variable had a greater effect on prediction of infectious diseases than on prediction of traumatic injuries. Gunderson & Sells 4 Substantial differences in illness rates among ships could not be explained in terms of differences in operational schedules, crew composition, i iv i line.- s »•« port ing procedure:-, and i 1 ’.as by pot lies i cod that a «*< nbival 5 on . : , .Mo lift 5 (habi hi lily) 1 » ' 1 i 1 r :ial con- ’ . . -1 in i i : i n in ships and other types of organizations; if conditions could he identified which were associated with high illness rates and poor morale, appropriate corrective or preventive measures might be devised. Large variations have also been found in psychiatric illness rates and alcoholism rates not only between different types of ships (for example, destroyers vs. nuclear submarines) but also among ships of the same type (for example, aircraft carriers). In earlier research, focused principally on problems of long-duration space flights, Sells had developed a social systems model which enumerated a list of social system components for taxonomic analysis (6). Major compon- ents of this model were included under the general headings of goals and objectives, philosophy and value systems, personnel composition, organi- zation, technology, environment, and temporal factors. The present authors (7) have more recently extended these social system concepts and outlined methodologies applicable to behavioral research required for long-duration space missions. In view of the generality of these approaches, their broader relevance for comparative studies of other types of organizational units, such as ships, was appreciated, and the rationale of the present study was formulated. Based on these social system concepts and the back- Gunderson & Sells 5 ground of epidemiological and shipboard research outlined above, proposals wore prepared to carry out an intensive si udy of some of the determinants of ill' : d i her fm - of ••• r I-.; inclT.-d ivene s in indi\i(h.a’l s ; ] i id ■. 1 ,11 , V of . i I : :u • c , . I'M llr.r ;■ .11' M edich . 1 : i'll • I d , 1 . ’ tor- i' ' i i ■ s . ’ . , 1 ‘ i • uc t I ; i i 1 til i . , id 1 1 ■ . . 1 o * id j i ‘ 1 n t l _y . . p. i . 'o n si hy 1 he ! >a 'a t.1 ol Medicine and Surgery and the Office of Naval Research, is now in its second yea r. A study of this scope requires diverse professional talents. Major con- tributors to t lie research program are Dr. Lawrence K. James, and Dr. Allan P. Jones of the institute of Behavioral Research, Texas Christian University, Fort Worth, and Dr. Blair W 7 . McDonald, formerly of t lie Navy Medical Neuropsychiatric Research Unit, San Diego, and presently with the General Motors Corporation, Detroit, Michigan. The study involves three phases. The first phase, consisting of a pilot study which involved 13 Navy ships and 1,200 crew members, was con- cerned mainly with development, testing, and revision of research instruments. The second phase now in progress includes the major data collection from a larger sample of organizations, including shore stations and civilian organ- izations; 20 Navy ships and 6,000 crew members have participated in this part of the study. Questionnaires, interviews, on-site observations, and personnel and organizational records have been gathered by research teams aboard ships under operational conditions and at selected shore facilities. Approximately half of these units are scheduled for a second round of data collection after an interval of four to six months in order to provide L _ . -=r--J Gunderson & Sells 6 longitudinal data on major variables. The third phase of the project con- cerned with data analysis and interpretation will, conclude' v.u'lh final reports, ;> . ,• tiny finding:’ and r. v. • a*’, it U a. lo the Hu* . u of 1 ' dic'n. . nd Sue. .cry .1 • . i 1 j •! • i I - o ’ ■ l ’ i i ' . ' i ' ‘ . •, .d (■"'.ill i i • i a t i • is ' . . ’ • ' 1 ci • M , d ■ d j 1 1 i Tag 1 1 i 1 ' 1 I array of information lias b. gun. A brief try of the kinds of data included in the study is given below. Physical Envi ronmental Ev aluations . Trained research staff made obser- vations of light, noise, temperature, ventilation, space (crowding), cleanli- ness/orderliness, and privacy in berthing, messing, head, and recreational areas. In addition, photographs were taken of the same areas, and those were compared with standard sets of photographs representing objective habita- bility scales. Habitability Questionnaire . These items were designed to obtain crew members' perceptions of the same habitability dimensions that were estimated b^ objective means, namely, lighting, temperature, ventilation, cleanliness, privacy, etc., in berthing, messing, work, leisure and recreation, and head areas. Organizational Climate Questionnaire . This instrument includes questions intended to tap crew members' perceptions of their work and social environ- ments in terms of job characteristics (role ambiguity, job pressure, growth opportunities), leadership (support, confidence and trust), work group factors (friendliness and warmth, cohesiveness, group pride), and organi- zational characteristics (communication up and down, identification with the . *^underson & Sells 7 Navy, concern for individual). biographical Pain. A number of items porta to personal and inili- d are f pel the work situation and liuw , - h ilk ‘ill i i i l‘ JO Service Records and Shi p 1 s Reco rds, Personnel data such as aptitude scores, service schools completed, performance murks, disci pi inary actions, and reenlistment information are gathered on all subjects. Sick Call Check ! i st. All visits to the dispensary are recorded on cards containing identifying information, type of illness, and disposition. These cards are accumulated and provide illness criterion infonnation for individ- uals, work groups, and ships. Officer Questi onna ires and I nterviews . Department Heads and Division Officers are asked a number of questions pertaining to habitability, working conditions, organizational goals and procedures, formalization and centrali- zation of authority, interdependence of organizational subunits, and adequacy of medical care. The data described above will be used to develop taxonomies of individ- uals, situations, ships (organizations), and individual and gi-oup behavior outcomes. Such taxonomies will facilitate analysis of the interrelationships of individual characteristics (abilities, attitudes), environmental and organizational (habitability, climate) variables, and health and organizational effect iveness. Gunderson & Sells 8 A general model of organizational behavior and effectiveness has been developed as a means of ordering the large number of variables at the individ- ual vo rk j roup, and . r srii national levels • n order to < • • 1 ■ ; m t < > the mediating : • d lu i’ ' . *• 1 ' t .1 - 1 ’ i ■' ; ' ’ ' ' ' i . :• • I ( h : ' ", ■ ■ ‘ , i .. : . ,v) ■ ■■ b 1 i; bl ( ( .-h ■ ' 4 ' , b-.i ! ■ IV I ■ .1 , , ! - rational context, organizational cli: ate). Some eliments of this : .• >dol v.hioh are relevant to individual and organizational performance are presented in Figure 1. The model views individual behaviors and attitudes, for example, job satisfaction, as a joint function of a subset of individual characteristics and a subset of variables representing the organizational situation. The research is seeking to determine, by various multivariate analysis techniques, the extent to which organizational climate can be predicted by variables repre- senting individual characteristics and situational factors; it is also pur- suing questions concerning the extent to which certain criteria, such as illness rates and injury rates, can be predicted by combinations of individual, situational, and organizational variables. At another level in this research the organization (ship) will be treated as the unit of analysis. Organizational differences in environmental conditions (habitability), crew composition, leader behavior, organizational climate, operational schedules, and other aspects of overall functioning will be related to illness and accident rates, disciplinary actions, reenli stment rates, and evaluations of organizational efficiency. A preliminary factor analysis of the Habitability Questionnaire in the pilot study identified ten item composites reflecting significant aspects of Gunderson & Sells 9 perceived habitability on ships. These are: (1) crowding, (2) conditions of sanitary facilities (heads), (3) work area conditions, (-1) ship size and con- ' . . (5) • ■ ge . 1 ■ • (6) color, (7) overall t < pro turn and ventil- • ’••..()■ ’ ’ ’ ' ’■ (If) ■ i ■ ' . i ; ' y _ ■! ’ d • ' > l I > i • v "f . hip. I.o.li c ■ ' ■ o ■' .>•! io.i:5 v.» re (.]•* a iuod which pri.,\ ed n. ■•fill for cl a i ly ing sliij.s in 1 . of 1 i v i ng and working conditions and for identifying salient differences in habita- bility di '...elisions 1 bat distinguish the wine. .weepers, the destroyers, and t lie aircraft carrier (9). Among the results noted in the pilot study were significant differences in perceived organizational climate among the three types of ships (10). Profiles of scores on five factoi-s of organizational climate — friendliness and warmth of the work environment, job identification, leadership effective- ness, group homogeneity, and job standards and demands — were found to be related to differences in ships in relation to their location (overseas vs. continental U.S.), illness rates, and performance indices. A pattern of organizational climate was found which was associated with the tendency of ships' crews to have relatively high illness, accident, and disciplinary rates and a relatively low rate of intention to reenlist. The major study, now well under way, provides a comprehensive set of variables supported by standardized measurement scales and should contribute useful information concerning the relative importance of the physical environ- ment, organizational factors, and individual characteristics as they affect health, job satisfaction, and work effectiveness in naval organizations. Gunderson & Sells Comparison of results from selected civilian organizations should contribute to general theoretical formulations concerning relationships of individual characteristics •• d ;i1 ■ ' ' il variables to individual and or; : . : 1 i < ■ l Gunderson & Sells II References 1. Ayer, H. E. , and Lynch, J. R. , "Association of Disability and Selected t 1 . \ i 1 . 1 1 ' 1 • • 1 (\ 1 ■ * . i i *. \ i ’ ) , j ; • dii' \ . 1 , , C7?.*J ’ !*•••! ' r iv iron 1th 25, 92-197 (1972). Rubin, R. T., G . E. K. i nd Arthur, R. J., "Li fo St re s and 1 1 l.noss Fa ! ! > i :!,e C.S. Nuv y : VI. Environ •.•nt al, P< >g rapliic, and Prior Life Change Variables in Relation to illness Onset in Naval Aviators during a Combat Cruise," P-yehy>o:n Med 24 , 533-547 (1972). 5. McDonald, B. W. , Pugh, W. M. , and Gunderson, E. K. f. , "Organizational Factors and Health Status," J tilth Soc Behnv , in press. 6. Sells, S. B. , "A Model for the Social System for the Mult iman Extended Duration Space Ship," Aerosp Med 37 , 1130-1135 (1966). 7. Sells, S. B. , and Gunderson, E. K. E. , "A Social System Approach to Long- Duration Missions," in Human Factors in Long- Du rat ion Spaceflight , National Academy of Sciences, Washington, D.C. (1972). 8. James, L. R. , "Methodological Considerations in Social Systems Analysis," Report No. 72-52, Navy Medical Neuropsychiatric Research Unit, San Diego, California 92152 (1972). 9. Jones, A. P. , "Functioning of Organizational Units Related to Differences in Perceived Climate and Habitability," presented to the Annual Meetings of the American Psychological Association, Montreal, Quebec, Canada, August 1973. Gunderson & Sells 10. Jones, ft. P. , James, L. R. , and llornlck, C. B. , "Organizational Climate Related shipboard functioning: ft Preli-inary study,.. 1 Ur: Technical . . i \ • 'Ton,' ~r . ' . ... i. 7? t. . [n ■ • •• i ■ . : 1 p, •ll. T. ■■ ( ’, ■ ! C... J.-r ■ m dll'll s root notes •'•'Report Number 73-59, supported by 1 he Bureau of Medicine end Surgery, Department of the Navy, under Research Work Unit Ml'51. 524. 002-5015DX5F and by the Office of Naval Research under Co ntract N..- hers N00014-72--A-017 9-0001 and RR042-0S01 . NR170-743. Opinions expressed are those of the authors and are not to be construed as necessarily reflecting the official view or endorsement of the Department of the Navy. **Head, Epidemiology and Operational Psychiatry Division, Navy Medical Neuropsychiatric Research Unit, San Diego, California 92152. ***Director, Institute of Behavioral Research, Texas Christian University, Fort Worth, Texas. Acknowledgments The technical assistance of William Pugh, Jeanne Erickson, George Seymour, and LTJG John Levine, MSC, USNR, of the Navy Medical Neuropsychiatric Research Unit, San Diego, and Kurt Helm and Christopher Homick of the Institute of Behavioral Research, Texas Christian University, Fort Worth, is gratefully acknowledged. UNCL ASSIFIED StCu»'’* C- r : C AT IC* 01 T»is e»cE Omit l REPORT DOCUMENTATION PAGE iff 73-59 i 4 T( t _ £ „nd Subtitle' i ! Or I’.mi zatlonal Stresses and Health. -> Arc I READ INSTRUCTIONS AOC I BE FORE COMPLETING FORM ' GOVT ACCESSION NO. | j HEClPilHT’S CATALOG NUMBER . \ K. K. Vie Cl • \ I a & - I :t. II s : • *•»*•*»■* **- . 0 i , 9 1 ii L i 01, I /') i V3 Naval Health Research C. nter ) San Diego, CA 92152 MF5.1 . 524 . 002-50 ; 5DX5F M COS"»OLL!nG O - p i C £ My- 4 s C SS J ort, " 8T DATE Naval Medical Research & Develop ".ent Coe aid . October 3973 Bethesda, HD 20014 13 number o*yre»«i : 13 r _, Ti MONITORING AGENCY name a ADPRESSf/f different from Controlling Office) I ’5 SECURITY CL (ot thfm /effort) toiler 197 3 Bureau of Medicine & Surgery Department of the Navy Washington, DC 20372 DiS’RibjTlON STATEMENT ( oi f his Report) UNCLASSIFIED l'« DF 1 . tSSl F 1C ATiCN DCfN .SHADING scne pul e Approved for public release; distribution unlimited. 19 KEY WORDS f Continue on te.erne mid e it end identity by block mtwbwj Organizational Stress Organizational Climate Morbidity Naval Personnel Environmental effects Job Satisfaction \ Habitability reveree mlde II neceeeery end Identify fcv block n<>wbmr) \4 large-scale research program, supported by the Navy Bureau of Medicine and Surgery and the Office of Naval Research, has been initiated to investigate the relative importance of individual characteristics, environmental factors, and organizational stresses in illness incidence, job satisfaction, and organization.' 1 effectiveness in naval and civilian settings. A social systems model has been developed to order the large number of variables involved, and multivariate analysis techniques will be used to evaluate individual and situational variables and their interactions. Preliminary analysis of pilot studv data has provided ^ ” 14/3 LOITIOX Of I NOV «5 I JAN 73 IH/ J S/N 0107 l F 014 f>6 01 V 65 IS OBSOL E T t UNCLASSIFIED -n H | T V CL»SSiriC»TlON O* T»H rimn Omlm I UNCLASSIFIED JECUHItv CL »4SlHC*HON or this PACLrtt Ti.n D.i» InfrmO) 'perceived habitability dimensions and organizational climate dimensions which differentiate among three types of ships. The major study now in progress pro- vides a comprehensive set of descriptors of naval organizations and related these variables to health, job satisfaction, and individual and group effectiveness. /V r, . . -..V m ¥ □ ' □ \ SOUS , t ] UNCLASS1FIEF SrCuWlTr Cl AS&fFlC ATlO*. or T H|$ PAof ***** t ">•'•6