Generation X Research Articles

Consumer Engagement in Health Care Among Millennials, Baby Boomers, and Generation X: Findings from the 2017 Consumer Engagement in Health Care Survey

The EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) is an online survey that examines issues surrounding consumer-driven health care, including the cost of insurance, the cost of care, satisfaction with health care, satisfaction with health care plans, reasons for choosing a plan, and sources of health information. It is co-sponsored by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates, with support from seven private organizations. The 2017 survey was conducted online Aug. 10 to Sept. 1, 2017, using the Ipsos’ consumer panel. Over 3,560 adults ages 21−64 who had health insurance provided through an employer, purchased directly from a carrier, or purchased through a government exchange participated in the survey. However, most survey participants (82 percent) received coverage through an employer. The sample was weighted to reflect the actual proportions in the population ages 21–64 with private, health-insurance coverage. This Issue Brief focuses on differences in consumer engagement in health care by generational cohorts – i.e., Millennials, Baby Boomers, and Gen Xers. Key findings: • Millennials are more satisfied than other generational cohorts with various aspects of their health coverage. More than other generational cohorts, Millennials are satisfied with their health coverage, out-pocket costs, and health plan choices. • Millennials and Generation X engage with health care providers differently than Baby Boomers. Baby Boomers are more likely than Gen Xers and Millennials to have a primary care provider (PCP). Among those with a PCP, Baby Boomers are more likely than Generation X and Millennials to report that they make healthier lifestyle choices after seeing a PCP; that it is important that their PCP knows them and their medical history personally; that their PCP is aware of all of the other medical care that they receive; and that they are comfortable telling their PCP about their health issues. Both Millennials and Generation X are more likely than Baby Boomers to report that they have used a walk-in clinic. • Millennials have the highest rates of wellness program participation. Millennials are nearly across the board more likely than Baby Boomers to participate in various aspects of wellness programs. They are more likely to report that they have visited an on-site clinic; made a tobacco-free pledge or participated in a smoking cessation program; participated in counseling or stress management training; participated in activity-based wellness challenges; received reimbursement for fitness club memberships; attended free seminars; and received financial wellness resources. Millennials are less likely than Baby Boomers to have completed a health risk assessment or biometric screenings.

Generation X versus Millennials communication behaviour on social media when purchasing food versus tourist services

Knowledge and proper understanding of the needs, expectations, desires, demands, values or preferences of Generation X and Millennials is an essential goal of any company. The mission of marketers is increasingly diffi cult because they have to develop a marketing mix able to target effi ciently all customers, invoking satisfaction and loyal behavior. Communication strategy therefore has a special role to play. While Millennials are easier to target, persuade even infl uence through social media, Gen Xers are more conservative, preferring to look for additional information about products and companies themselves, which makes the marketer’s job even more diffi cult. Nowadays, social media plays an increasingly important part in infl uencing consumers and their consumption behavior. Being able to expand beyond geographical borders, social media creates strong links between consumers in different states and social environments. Research conducted among Gen Xers and Millennials shows that whenever they choose food products and tourist services based on recommendations and the information available on social media, their purchasing behavior depends on their own personal desire to become informed, and the characteristics they expect from a piece of information and from the Internet as a general source of information. Given this, companies changed and adapted their communication strategies in order to be more present online. In addition, for those interested, companies create offi cial pages that can represent a strong support for those interested in acquiring information. Quite often, consumers have the possibility to compare goods and services before buying, minimizing the risks attached to these acquisitions. The results reveal that Millennials have stronger affi nity with, and place greater reliance upon online information than Gen Xers. From a managerial perspective, this paper provides retailers with the opportunity to better understand the behavior of customers of different ages, making their targeting more successful.

Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study.

BackgroundSubstance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment.ObjectiveThe aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery.MethodsWe conducted a cross-sectional survey of patients in 4 intensive outpatient substance use disorder treatment facilities in Philadelphia, PA, USA. Logistic regressions were used to examine associations among variables.ResultsSurvey participants (N=259) were mostly male (72.9%, 188/259), African American (62.9%, 163/259), with annual incomes less than US $10,000 (62.5%, 161/259), and averaged 39 (SD 12.24) years of age. The vast majority of participants (93.8%, 243/259) owned a mobile phone and about 64.1% (166/259) owned a mobile phone with app capabilities, of which 85.1% (207/243) accessed the internet mainly through their mobile phone. There were no significant differences in age, gender, ethnicity, or socio-economic status by computer usage, internet usage, number of times participants changed their phone, type of mobile phone contract, or whether participants had unlimited calling plans. The sample was grouped into 3 age groups (Millennials, Generation Xers, and Baby Boomers). The rates of having a social media account differed across these 3 age groups with significant differences between Baby Boomers and both Generation Xers and Millennials (P<.001 in each case). Among participants with a social media account (73.6%, 190/259), most (76.1%, 144/190) reported using it daily and nearly all (98.2%, 186/190) used Facebook. Nearly half of participants (47.4%, 90/190) reported viewing content on social media that triggered substance cravings and an equal percentage reported being exposed to recovery information on social media. There was a significant difference in rates of reporting viewing recovery information on social media across the 3 age groups with Baby Boomers reporting higher rates than Millennials (P<.001). The majority of respondents (70.1%, 181/259) said they would prefer to use a relapse prevention app on their phone or receive SMS (short message service) relapse prevention text messages (72.3%, 186/259), and nearly half (49.1%, 127/259) expressed an interest in receiving support by allowing social media accounts to be monitored as a relapse prevention technique.ConclusionsTo our knowledge, this is the first and largest study examining the online behavior and preferences regarding technology-based substance use disorder treatment interventions in a population of patients enrolled in community outpatient treatment programs. Patients were generally receptive to using relapse prevention apps and text messaging interventions and a substantial proportion supported social media surveillance tools. However, the design of technology-based interventions remains as many participants have monthly telephone plans which may limit continuity.

Evolution of ‘radical convenience’ delivered in an integrated healthcare model

Healthcare providers face unprecedented pressure in delivering primary care services at a reduced cost. At the same time, we face increased expectations from our patients related to access, convenience, quality and service. Henry Ford Health System, a large integrated health system in Detroit, Michigan, looked to attract additional patients to its primary care services. In 2014, Henry Ford made an operational commitment to provide patients with convenient and affordable access to primary care in ways that went beyond those traditionally offered by healthcare providers. An internal initiative called ‘radical convenience’ was adopted to attract patients to its primary care services and reduce unnecessary and costly utilisation of emergency departments and Urgent Care. Patients were introduced to radical convenience through a branding campaign called ‘Call, Click or Come In’. Radical convenience was extended to include the development of an innovative, retail healthcare solution called QuickCare. A QuickCare Clinic was launched in August 2015 to meet the needs and expectations of a growing workforce in downtown Detroit comprising technology-driven Millennials and Gen X-ers.

Attitudes toward Star Ratings: Generational Differences among Indian Consumers

ABSTRACTThis study examined generational discrepancies among Indian Gen X and Millennial consumers' attitude toward online star ratings. The results show online star rating involvement has an impact on perceived ease of use and perceived usefulness of star ratings as well as the intention to use online ratings for both generations. However, Millennial consumers find star ratings to be user-friendly, but there is no effect on their attitude toward star ratings. The results also indicate that high star ratings have an effect on Gen Xers' attitudes, while Millennials find that low star ratings have an impact on their attitudes. In addition, Gen Xers rely on low star ratings while Millennials prefer to use high star ratings for intention to use. For managerial suggestions, e-commerce retailers may focus on a product quality indicator such as star ratings for Millennials. However, for Gen Xers, more descriptive informationcan be more effective.

Can Four Generations Create Harmony Within a Public-Sector Environment?

The purpose of this quantitative study was to examine the relationship between generational cohort and cohort perceptions of managerial effectiveness within the context of the federal public service. Data in this study were derived from the Federal Employee Viewpoint Survey, which included 421,748 full-time, part-time, and nonseasonal federal government employees geographically dispersed across the United States and overseas. The results of the study indicated that ratings of managerial effectiveness by all four generational cohorts for all three levels of managers studied were relatively high with correlation coefficients ranging from .96 to .99. However, the only cohort association that consistently had a statistically significant relationship with managerial effectiveness across all three levels was Generation Xers and Millennials. The &lt;em&gt;p &lt;/em&gt;value for this relationship was &lt;em&gt;p &lt;/em&gt;&lt; .05 for all three managerial levels studied. Based on the study’s data, there was little difference in perceptions regarding managerial effectiveness among the four cohorts. Recommendations for future research include adding perspectives from Generation Z employees who are now entering the federal workforce, and studying how supervisors rate their own supervisors, given their unique managerial experience and perspective within the context of their generational cohort, would add to the body of knowledge on managerial effectiveness among generational cohorts.

Cross-Cultural Investigation of Consumers’ Generations Attitudes Towards Purchase of Environmentally Friendly Products in Apparel Retail

AbstractRecent changes of the environment and in the society have altered consumers’ preferences and brought new concerns among local communities regarding environmental protection and organizations responsibility, the adoption of environmentally friendly strategies, as well as offering more sustainable products. Consumers tend to select retailers based on their focus on environmental friendly products and on various “green” strategies regarding waste disposal, package recycling, etc. This study aims to highlight Romanian and Slovak consumers’ attitudes towards purchasing of goods from retailers that strive a clear focus on environmental responsibility and environmental friendly practices in apparel, footwear and sportswear retail. By means of a quantitative research based on a questionnaire administered to consumers of international retail chains with operations in both countries, the authors highlight differences in their perceptions and attitudes for buying green apparel, footwear and sportswear. Whereas Millennials and Gen Xers consumers in Romania and Slovakia believe that international apparel, footwear and sportswear retailers are less concerned about environmentally responsible behavior and the need of selling green products, Baby Boomers are more sensitive to such aspects and carefully select retailers according to their green strategy. This research provides specific findings about attitudes of different consumers’ generations within two emerging European countries (Romania, Slovakia).

Social Media as a Public Sphere? Politics on Social Media

ABSTRACTSocial media platforms are popular sites, attracting millions of users who connect digitally. This has prompted some to argue that social media has promoted the return of Habermas’s ([1989] 1991) public sphere. We use data from in-depth interviews with Millennials and Generation Xers to refute this claim. Specifically, our results suggest that respondents do not engage in communicative action typical of the public sphere because they avoid political discourse online. Three factors influence this: (1) fear of online harassment and workplace surveillance; (2) engagement only with politically similar others; and (3) characterization of social media as a place for “happy” interactions. In addition, we find that these three factors interrelate, often sequentially, and we explore similarities and minor differences between Millennials and Generation Xers regarding each factor.

Recruiting long-term healthcare missionaries

Background: The CMDA/MedSend Healthcare Missions Leadership Summit is an annual gathering of 75 mission sending agencies who share Christ through healthcare missions. The summit is jointly sponsored by MedSend and the Christian Medical &amp; Dental Associations (CMDA). The purpose of the meeting is to network, examine relevant research issues (such as recruiting), etc. &#x0D; Objective: The purpose of the 2015 Launch survey was to learn from medical missionaries how to more effectively recruit and launch new healthcare professionals and their families into long-term missions. The objective of the 2016 Relocating for the Gospel survey was to learn from students and other aspiring healthcare missionaries the obstacles they perceive in their journey into long-term missions. Results were presented at the 2015 and 2016 Healthcare Missions Leadership Summits.&#x0D; Methods: Two multiple-choice surveys were developed to ascertain the positive and negative factors involved in the decision making process to launch into the healthcare mission field. Participants were invited to participate in the surveys via email.&#x0D; Results: The 2015 Launch survey analyzed 177 responses from healthcare missionaries with 63% of respondents still currently serving as long-term missionaries. 37% of the respondents are former missionaries. Participants included millennials (39), Gen Xers (54), and baby boomers (84). Responses indicated that key positive factors include personal interaction with a long-term worker as well as a supportive agency, leader, or team to join. The 2016 Relocating for the Gospel survey analyzed responses from students and other aspiring missionaries who are millennials (79). The strongest overall factor that discouraged missions involvement was student loan debt. Other key obstacles include concerns over being lonely or isolated overseas, as well as difficulty in finding a good fit with a team or organization.&#x0D; Conclusion: The overall findings from the two surveys include four main points. First, effective launch into missions service is more relationally dependent than informationally dependent. Second, launching into missions service is more like a marathon than a sprint. Third, those who are exploring missions want to join a team so they will not feel lonely or isolated. Finally, aspiring missionaries want a placement that fits them well even if that does not match the top priorities of the agency.

Study of work-family and family-work conflicts overturns generational stereotypes

PurposeThis paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.Design/methodology/approachThis briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.FindingsOne of the most unexpected findings was that Baby Boomers showed the most family–work conflict followed by Generation X-ers and then Millennials. Meanwhile, Generation X-ers reported the most work–family conflict followed by Millennials and Baby Boomers. Another unexpected finding was that employees with children aged between 13 and 18 reported the biggest work–family conflict.Practical implicationsThis paper provides strategic insights and practical thinking that have influenced some of the world’s leading organizations.Originality/valueThe briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

Examining millennials’ online gambling behavior: a comparison of generational differences

PurposeThis study aims to examine Millennials and generational differences in online gambling activity by comparing online gambling behavior across four different generations: Silent Generation, Baby Boomers, Gen Xers and Millennials.Design/methodology/approachThe sample comprised tracked gambling data at the individual player level provided by an online casino accepting real money wagers in a major US gambling market. Attributes of gambling behavior were examined and compared across different generations using Kruskal–Wallis test and pairwise comparisons.FindingsGenerational differences were observed in 13 of the 16 behavioral variables. Millennials spent the least amount of time on gambling and exhibited the lowest scores on the number of days for slot gambling, trip length and trip frequency among all generations. However, their average table gaming volume per play day was greater than those of other generations.Practical implicationsThe results of this study provide a better understanding of the generational differences in online gambling behavior. They also help casino operators and gaming machine manufacturers develop casino games and products that can appeal to different generational groups in the online gambling market.Originality/valueDespite the on-going industry discussion about Millennials and their potential influence on the online gambling market, there appears to be a paucity of empirical research on the online gambling behavior of the Millennial generation. This study fills that gap in empirical evidence, addressing generational differences in online gambling.

Valuing shipscape influence to maximise cruise experience using a choice experiment

While many studies have identified the important aspects on the ship to cruisers, none has evaluated these attributes to determine cruisers’ willingness to pay for each attribute. This paper is the first to use a choice experiment to unbundle the overarching cruise price to explore the preferences of cruisers. The absence of a status quo effect suggests that cruise passengers are novelty lovers who welcome innovative offerings apart from those who cruise specifically to “get away”. Overall, males, Gen X-ers and first timers were willing to pay the most for a cabin with a view while the desire to be pampered influenced preferences for cabin comfort and shore excursion choice. Concern over value for money explained whether a respondent would be more prone to choosing the new options presented instead of remaining with the status quo.

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects.

BackgroundThe use of complementary and alternative medicine (CAM) is growing. However the factors contributing to changes over time and to birth cohort differences in CAM use are not well understood.SettingWe used data from 10186 participants, who were aged 20–69 years at the first cycle of data collection in the longitudinal component of the Canadian National Population Health Survey (1994/95-2010/11). We examined chiropractic and other practitioner-based CAM use with a focus on five birth cohorts: pre-World War II (born 1925–1934); World War II (born 1935–1944); older baby boomers (born 1945–1954); younger baby boomers (born 1955–1964); and Gen Xers (born 1965–1974). The survey collected data every two years on predisposing (e.g., sex, education), enabling (e.g., income), behavior-related factors (e.g., obesity), need (e.g., chronic conditions), and use of conventional care (primary care and specialists).ResultsThe findings suggest that, at corresponding ages, more recent cohorts reported greater CAM (OR = 25.9, 95% CI: 20.0; 33.6 for Gen Xers vs. pre-World War) and chiropractic use than their predecessors (OR = 2.2, 95% CI: 1.7; 2.8 for Gen Xers vs. pre-World War). There was also a secular trend of increasing CAM use, but not chiropractic use, over time (period effect) across all ages. Factors associated with cohort differences were different for CAM and chiropractic use. Cohort differences in CAM use were partially related to a period effect of increasing CAM use over time across all ages while cohort differences in chiropractic use were related to the higher prevalence of chronic conditions among recent cohorts. The use of conventional care was positively related to greater CAM use (OR = 1.8, 95% CI: 1.6; 2.0) and chiropractic use (OR = 1.2, 95% CI: 1.1; 1.4) but did not contribute to changes over time or to cohort differences in CAM and chiropractic use.ConclusionThe higher CAM use over time and in recent cohorts could reflect how recent generations are approaching their healthcare needs by expanding conventional care to include CAM therapies and practice for treatment and health promotion. The findings also underscore the importance of doctors discussing CAM use with their patients.

Work-family conflict: differences across generations and life cycles

PurposeThe purpose of this paper is to examine work-to-family conflict and family-to-work conflict, taking into account generational cohort and life cycle stage differences.Design/methodology/approachSurvey participants (428 employed individuals with families) represented different generations and life cycles. Key variables were work/family characteristics and centrality, work-family and family-work conflict, and age.FindingsGenerational differences in both directions were found. Gen X-ers reported the most work-family conflict, followed by Millennials and then Baby Boomers. Baby Boomers exhibited family-work conflict the most, followed by Gen X-ers, and then Millennials, a surprising finding given generational stereotypes. Some of these differences remained after controlling for children in the household (based on life cycle stage theory) and age. Millennials were highest in work centrality, whereas Baby Boomers were highest in family centrality. Employees with children ages 13-18 reported the most work-family conflict, and employees with children under the age of six reported the most family-work conflict.Research limitations/implicationsThis study found that generation and children in the household make a difference in work-family conflict, but it did not support some of the common generational stereotypes. Future studies should use a time-lag technique to study generational differences. To reduce work-family conflict, it is important to consider its directionality, which varies across generations and life cycle stages.Practical implicationsThis informs organizations on how to tailor interventions to help employees balance work/life demands.Originality/valueThis study is the first to simultaneously examine both generation and life cycle stage (children in the household) in regard to work-family conflict.

An investigation of Generation Y travellers’ beliefs and attitudes towards green hotel practices: a view from active and passive green Generation Y travellers

AbstractGeneration Y, also known as Millennial, have a reputation for being more environmentally conscious than the Baby Boomers and Generation Xers who preceded them. However, the literature on hospitality and tourism has not discussed Generation Y’s changing beliefs and attitudes towards sustainability and encompassing their points of view about lodging green operations, even though millennial travellers will be a dominant customer segment in the hotel industry for the next 20 years. This study identified heterogeneous groups among members of Generation Yers who hold similar beliefs and attitudes towards the environment and examined the green hotel practices they seek when travelling. A questionnaire survey was developed and administered in New York, Florida and Michigan. Using 318 samples, this study categorized millennial green travellers as active or passive, based on their beliefs and attitudes towards green initiatives. The results indicated that to Generation Y travellers in general, green hotels ...

Our Gang: A Racial History of “The Little Rascals.”

Our Gang: A Racial History of “The Little Rascals.”

Do different generations look differently at high performance organizations?

PurposeMany researchers argue that the shared values of a generation affect people’s attitude, commitment, and ethics toward work. It is also argued that generational differences may cause tension between employees and with that prevent projects – such as a transition to a high performance organization (HPO) – from being completed successfully. The purpose of this paper is to examine whether generational differences in work values influence people’s perceptions of HPO, and if so, in what ways and how management could deal with it. The HPO Framework developed by de Waal (2012b) was used as a starting point for the study.Design/methodology/approachThis study was performed at a Dutch multinational with a management trainee program. In this program, young talents, all belonging to Generation Y, followed a series of internships in various business units. A questionnaire on HPO was distributed among the trainees and their direct managers (all Generation Xers). The average scores for the five factors described in the HPO Framework were calculated for both groups. In addition, attention points were identified for the multinational, i.e. issues that needed to be addressed by the organization in order for it to become an HPO. The scores and the attention points were discussed in a workshop with both trainees and managers. Finally, the results of the workshop were analyzed and several weeks later presented by the authors to a larger audience, to validate the research findings.FindingsThe research results showed that there was a close match between the opinions of trainees (Generation Yers) and of managers (Generation Xers) concerning the general importance of the HPO factors, the organization’s performance on these factors, and the actions needed to improve on them. There were several explanations for the fact that generational differences did not influence the opinions of both generations on HPO. For example, the corporate culture in a multinational may be predominant over national culture, creating uniform thinking; or new employees adapt quickly to the organization and behave according to established patterns and thereby comply to the accepted way of thinking in the company.Research limitations/implicationsThe practical implication of this study is that an organization does not have to target specific groups to convince people of the importance of HPO. It should be sufficient to hold an informative session for all staff on HPO before starting the joint HPO transition process.Originality/valueThis is the first study into how generational differences in work values could influence the opinions of various generations on HPO.

Increasing Trajectories of Multimorbidity Over Time: Birth Cohort Differences and the Role of Changes in Obesity and Income.

Chronic conditions and multimorbidity are increasing worldwide. Yet, understanding longitudinal changes in multimorbidity over the lifecourse is limited. We compared the age-trajectory of multimorbidity by birth cohort and examined effects of socio-demographic (e.g., sex, income) and behavioral risk (e.g., obesity) factors in multimorbidity. Using data from the Canadian Longitudinal National Population Health Survey (1994-2010), we examined 10,186 participants born 1925-1974 grouped in 5 birth cohorts. Data on the number of chronic conditions (up to 17), income, education, and behavioral risk factors were collected biannually. We used multilevel logistic growth modeling techniques for analyses of multimorbidity defined as the presence of 2+ chronic conditions versus 1 or none. We found significant cohort differences in the age-trajectory of multimorbidity: at corresponding ages, each succeeding recent cohort had higher odds of reporting multimorbidity than their predecessors. Access to healthcare did not fully explain these differences. Women, having lower income, being obese, smoking, and a sedentary lifestyle had increased odds of reporting multimorbidity. Obese individuals, particularly Gen Xers and younger boomers, reported multimorbidity at an earlier age than those of normal weight. We observed divergent trajectories of greater multimorbidity for lower than higher income individuals. Furthermore, after accounting for age and risk factors there was an apparent increase in reporting multimorbidity over time (period effect) across all ages. Our findings indicate that multimorbidity is not only becoming the norm, but is emerging earlier in the lifecourse and particularly for low income and obese individuals from more recent cohorts. The findings point to the importance of planning interventions and policies to deal with more recent birth cohorts entering into older age with worse health than their predecessors.

Next Generation Leadership: The Changing Culture of Leadership in the Senior Student Affairs Officer (SSAO) Position

The purpose of this quantitative study was to identify and compare differences in leadership behaviors of senior student affairs officers (SSAOs) based on their generational cohort (Baby Boomer, Generation X, Millennial). The Multifactor Leadership Questionnaire (MLQ) was used to measure nine leadership behaviors and three leadership outcomes. Surveys were administered electronically to 3,361 individuals identified as a chief student affairs officer or director of student affairs in the Higher Education Online Directory (2014). There were 449 respondents including 246 Baby Boomers, 192 Generation Xers, and 11 Millennials. The findings showed that whereas generation x SSAOs exhibited more transactional leadership behavior, baby boomers were more transformational. The results of this study have implications for the field of student affairs as research and practice support the need for more transformational leaders in senior administrative positions in higher education.

Research shows young single women holding their own in charitable giving

Bucking the trend of millennials and Gen Xers being less generous than their predecessors, young single women today are giving at levels on par with their counterparts 40 years ago—those of the Silent Generation, according to the newest report in the Women Give series by the Women's Philanthropy Institute at the Indiana University Lilly Family School of Philanthropy.