Three Ways Social Factors Stratify Individual Choices About Organizations

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The goal of this dissertation is to articulate specific modes and mechanisms by which the process of an individual choosing an organization is shaped by (1) the status of the organization, and (2) the attributes of the chooser. I do this with three types of chooser attributes: individual demographics, neighborhood context, and cultural values; and in two settings: choosing a hospital for cancer treatment, and choosing a church to attend and contribute to financially. Chapters 1 and 2 use data from the SEER-Medicare linked database to demonstrate the relationship between chooser (patient) demographics, at both the individual and neighborhood levels, on the likelihood of choosing a "high-status" cancer hospital in California. Chapter 1 does this in multiple ways. First, it shows that a patient's propensity to seek treatment for their cancer is a function of the patient's race, sex, and age, and by the racial makeup of a patient's neighborhood. Second, it shows that a patient's propensity to leave California for treatment is a function of both patient attributes and attributes of the hospitals they choose. Finally, it shows that patient choice of high-status cancer hospitals is moderated by the educational level of the patient's neighborhood. Chapter 2 shows that patient choice of high-status cancer hospitals is moderated by both individual-level race and the racial composition of the patient's neighborhood. Chapter 3 uses data from multiple sources to describe the ways that congregants' cultural values interact with organizational status (denomination) in the church choice process. Specifically, I use the National Congregations study to demonstrate the organization-level returns to nondenominational status on both legitimacy (attendees) and performance (tithes). Nondenominational churches are uniquely successful, even when compared only to conservative churches. I then use over 45,000 individual-level responses from the nationally-representative Religious Landscape/Faith in Flux Survey and Congregational Life Studies to demonstrate the individual-level valuative mechanisms behind organizational returns to categorical ambiguity. Though the settings and attributes differ across the three chapters, they all point to a similar conclusion: candidate choice processes are shaped by attributes of both candidates and choosers, and a neglect of chooser attributes misses important stratification in the choice process.






Bloom, Nick (2019). Three Ways Social Factors Stratify Individual Choices About Organizations. Dissertation, Duke University. Retrieved from


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