The Institutionalized Consumer

T. Bettina Cornwell, University of Memphis
Terrance G. Gabel, University of Memphis
ABSTRACT - Despite rapid growth and increased levels of consumer choice within the institutionalized population in the United States, the consumer behavior of these 3.33 million individuals has been largely ignored. Through both analysis of pertinent literature, as well as the presentation of findings from multiple field studies, this paper provides a preliminary examination of the consumer behavior of institutionalized persons. Specifically, in light of constraints inherent in diverse institutionalized environments, the effects of institutionalization on both the current and future consumption behaviors of institutionalized individuals, their friends, and family members as well are discussed in regard to surrogate consumer usage and gift-giving behaviors.
[ to cite ]:
T. Bettina Cornwell and Terrance G. Gabel (1995) ,"The Institutionalized Consumer", in NA - Advances in Consumer Research Volume 22, eds. Frank R. Kardes and Mita Sujan, Provo, UT : Association for Consumer Research, Pages: 686-691.

Advances in Consumer Research Volume 22, 1995      Pages 686-691

THE INSTITUTIONALIZED CONSUMER

T. Bettina Cornwell, University of Memphis

Terrance G. Gabel, University of Memphis

ABSTRACT -

Despite rapid growth and increased levels of consumer choice within the institutionalized population in the United States, the consumer behavior of these 3.33 million individuals has been largely ignored. Through both analysis of pertinent literature, as well as the presentation of findings from multiple field studies, this paper provides a preliminary examination of the consumer behavior of institutionalized persons. Specifically, in light of constraints inherent in diverse institutionalized environments, the effects of institutionalization on both the current and future consumption behaviors of institutionalized individuals, their friends, and family members as well are discussed in regard to surrogate consumer usage and gift-giving behaviors.

"It has gotten to the point where jail is almost becoming an acceptable life style." - New York Times, July 24, 1992.

According to 1990 Census data, there are more than 6.6 million Americans living in non-household settings or "group-quarters" (U.S. Bureau of the Census 1990). Of these individuals, nearly half are classified as "institutionalized persons." In fact, in 1990, 1.34 percent of the total American populationCover one out of every 100 personsCwas institutionalized in some form or another.

Despite the large and growing number of institutionalized persons in the U.S., the consumer behavior of these individuals has been largely ignored by marketing and consumer behavior researchers. This is perhaps because much of the purchasing for persons confined to institutions, for whatever reason, has historically taken place at the institutional level, where little individual end-consumer choice was involved. While this may have been the case in the past, there is now evidence that consumer choice alternatives for the institutionalized are expanding, and will continue to do so to an even greater extent, in coming years. As a result, there will be an even greater need to understand the consumer behavior of institutionalized individuals.

The purpose of this paper is to provide a preliminary examination of the consumer behavior of institutionalized persons. Through both analysis of pertinent literature, as well as the presentation of findings from multiple field studies, we examine the pervasive effects of institutionalization on both the current and future consumption behaviors of institutionalized individuals, their friends, and family members. Specific consumer research issues discussed include both surrogate consumer usage, which is likely to be prevalent among the institutionalized due to the fact that direct purchase and consumption is restricted, and gift-giving behaviors, where surrogate usage may manifest itself. In this regard, a series of propositions is developed to both stimulate and guide future research efforts. Also, suggestions are offered concerning how marketers and public policy makers might best use this information to most effectively and responsibly meet the needs of the growing institutionalized consumer population.

INSTITUTIONALIZED CONSUMERS IN THE UNITED STATES

Examination of census information reveals that the number of institutionalized Americans has been growing for at least the last 20 years, increasing from a total of 2.13 million in 1970 (U.S. Bureau of the Census 1970) to 2.51 million in 1980 (U.S. Bureau of the Census 1980), then rising sharply to the current total of 3.33 million (U.S. Bureau of the Census 1990). Table 1 also illustrates other interesting trends with respect to the institutionalized population. Most notably, in 1970, census information included only three categories of institutionalized persons, with a staggering 36.4 percent of these individuals classified as "other inmates." [Given the "other inmate" and the corresponding percentage of 1990 correctional institution inhabitants, it can be assumed that many of the 775,114 "other inmates" in 1970 were in fact incarcerated in jails and prisons of one form or another.] This possibly reflects a trend in recent years to better understand the heterogeneous nature of the institutionalized population. Also, the increasing number of nursing home patients over the last two decades is evident, due largely to the continuing aging of the American population. Moreover, note in Table 1 that both the absolute number and overall proportion of mental patients has dropped dramatically over the last twenty years, possibly indicative of public policy of the 1980s reflecting perceptions of mental problems not as organic illnesses, but rather as controllable, "deviant aspects" of the sufferer.

With both the increased focus of the Clinton Presidential Administration on social welfare reform programs (Andreasen 1993), as well as the aging of the American population, the size of the institutionalized population is likely to continue to escalate in coming years. Specifically, while the number of persons confined to correctional facilities is difficult to forecast due to ongoing ethical and economic debates regarding how to best deal with the problems of rampant crime and prison overcrowding, the number of individuals living in many other types of institutions, such as drug and alcohol rehabilitation centers and mental hospitals, is likely to increase dramatically.

In addition to the documented growth of the institutionalized population in recent years, also noteworthy is the fact that figures such as those reported in Table 1 tell but part of the story regarding the magnitude of institutionalization in the United States. In that persons often move in and out of institutions over the course of their lives, the reported numbers of persons living in institutions at any one time greatly understates the number of individuals that experience institutionalized living at some point in their lives. For example, although the percentage of the elderly in nursing homes is relatively small at any given time, nearly half of those people turning 65 in 1990 are likely to reside in a nursing home at some time in the future (Crispell and Frey 1993).

While the institutionalized population continues to grow, there is also strong evidence suggesting that consumer choice alternatives for many of these individuals are expanding. For example, increased personal freedoms among prison inmates such as cable and satellite television, more diverse meal choices, free phone calls and newspaper delivery, as well as the choice of wearing comfortable non-prison-issue clothing, have been well documented in recent years (see Helliker 1992; Henslik, et al. 1992; New York Times 1992). In light of these amenities, prison has been discussed as a viable life-style choice (New York Times 1992). As such, contrary to traditional perceptions of these individuals as non-consumers, totally isolated from society, institutionalized persons now represent an emerging consumer segment worthy of both consumer researcher and marketer attention.

TABLE 1

NUMBER OF INSTITUTIONALIZED INDIVIDUALS BY TYPE OF INSTITUTION (1990 AND 1970)

Reported numbers of the institutionalized also fail to adequately address the impact of such living arrangements on millions of friends and family members. Moreover, as evidenced in numerous studies of the institutionalized elderly (see Baltes and Wahl 1992; High 1990; Novak and Guest 1992), the consumption behaviors of all affected individuals may be significantly influenced long after the period(s) of institutionalization. Following a brief discussion of the research methodology employed in this study, implications for both the current and future consumption behavior of institutionalized individuals are examined below.

RESEARCH METHODOLOGY

Several exploratory field studies eliciting testimony from either family-member informants or actual institutionalized persons, representing the four largest segments of the institutionalized population, were conducted in order to uncover distinct consumer behavior patterns. This highly humanistic research varied in specific methodology employed, ranging from totally emergent to semi-directed in nature. With emergent methods, the primary purpose was to find emergent patterns of behavior (i.e., phenomenological constructs) to serve as the basis for further investigation and analysis. The goal of the semi-directed interviews was to both ascertain the worth of several a priori assumptions, as well as to gain more in-depth knowledge of specific forms of institutionalized consumer behavior. What follows is a brief discussion of the individual studies conducted.

Group Discussion with Juvenile Wards of the State

A series of discussions was held with a group of fifteen teens, ages 11 through 17. These individuals were temporary wards of the state and were participating in an educational program provided in conjunction with their living accommodation. Three of the fifteenCtwo female and one maleCwere parents themselves, with children living apart from them outside of the institutionalized environment. The researcher was allowed to talk with the children in a group setting while an assistant took notes. Tape recording of the discussions was not deemed appropriate by the institution.

Stressing contextualistic emergence in the existential-phenomenology tradition (Thompson, Locander, and Pollio 1989), the teens were asked general, open-ended questions regarding how they "earn" money, the products they buy, and the places they shop. They were allowed to talk freely about these matters with little further direction, other than to use some of their statements as the subject matter of subsequent, more specific, questions. General behavioral patterns were thus allowed to emerge as the discussions transpired.

In-depth Interviews with Family Members of Institutionalized Consumers

Individual in-depth interviews were conducted with three family members of both former and current institutionalized persons, including:

B the 65-year-old mother of a former drug and alcohol rehabilitation patientCa 40-year-old maleCwho spent a total of approximately three years in several different institutions

B the 62-year-old son of a woman who spent the last five to six years of her life in a number of nursing-home settings, and

B the sister-in-law of a current prison inmateCa 38-year-old maleCconvicted of larceny, who has been in and out of correctional facilities since the age of 14.

The interviews were structured around both the asking of several general open-ended questions, as well as more specific response-generated and a priori researcher inquiries. The interviews were tape-recorded and then analyzed in detail to both detect and examine emergent behavioral themes, as well as to assess the value of a priori researcher assumptions.

Interview with a Representative of a Community-Service Organization

A telephone interview was conducted with a representative of a community-service organization catering to both the spiritual and material needs of local prison inmates. This interview, prompted by researcher viewing of local television news coverage pertaining to the organization's activities, was conducted to clarify details of the service programs therein discussed, as well as to gain insight into additional services performed by the organization. As such, researcher questions included general inquiries about the organization's operations, as well as ones aimed specifically towards clarification of issues raised by television news reports. The interview was documented through the taking of notes by the researcher.

INSTITUTIONALIZED CONSUMER BEHAVIOR

Several existent areas of consumer behavior theory and research are applicable to the study of the consumption behavior of institutionalized individuals. While what might be called "normal" consumption behavior is irrefutably disrupted by institutionalization, "direct" purchase, consumption, and disposal of goods and services still occur in institutionalized environments. For example, the mother of the drug and alcohol rehabilitation patient we spoke to stated that she frequently gave her son "spending money" with which he was able to purchase goods (cigarettes) or services (haircuts) several hours each week, outside of institutional grounds, and with little or no supervision. Likewise, the teenage wards of the state interviewed were given several hundred dollars upon entering the institution with which to purchase clothing and other personal items. These individualsCboth the teenagers and the rehabilitation patientCwere also able to earn money through working at the institution, which could then be spent on goods and services.

In addition to "direct" consumption activity, other relevant consumer behavior issues among the institutionalized include the usage of surrogate consumers and the gift-giving behaviors of these individuals.

Surrogate Consumer Usage

With but few exceptions, surrogate consumer research has focused on those individuals most willing and able to formally employ the services of third-party "expert" agents to perform various consumption activities on their behalf. Researchers (e.g. Forsythe, Butler, and Schaefer 1990; Fuller and Blackwell 1992; Hollander 1971; Solomon 1986), have consistently found that consumers characterized by high levels of income and "upper" social class affiliation are most likely to employ surrogates. As a result, what has emerged from this research is but a partial picture of surrogate consumer usage.

Because of their varying levels of inability to consummate consumption activities, 3.33 million institutionalized Americans must rely on some form of surrogate intervention. Our research suggests that friends and family members of the institutionalized individual are most likely to serve in this capacity. For example, the mother of the alcohol and drug rehabilitation patient we interviewed stated that she frequentlyConce a weekCpurchased for and delivered to her son toiletry products, items of clothing, and cigarettes. The son of the woman confined to a number of different nursing homes for the last several years of her life likewise told us that he and his six brothers often bought their mother food and clothing items, as well as selected over-the-counter medications. In a more restricted institutional setting, the sister-in-law of the prison inmate reported that she tooCalthough less frequently soCacted as a surrogate consumer, purchasing and delivering "factory sealed" food products, toiletries, and items of clothing such as "tennis shoes" to wear in place of the ones provided by the institution. Interestingly, in regard to the food itemsCpredominantly candyCrequested by and purchased for the prisoner, our informant stated that she frequently had not heard of the products. She further stated that she assumed that her brother-in-law received his "cutting-edge" new product information as a result of frequent television viewing.

Virtually all institutionalized consumers are likely to rely on surrogates to some degree, with the identity and nature of the surrogate varying by type of institutional setting. While the above discussion has focused on the provision of surrogate services by family members, in the case of many institutionalized individuals, society itself, or charitable organizations may serve as the surrogate consumer. For example, as the sister-in-law of the prison inmate told us, if it were not for her and her husband's buying requested food and clothing items for the prisoner, he would have to make do with prison-provided goods. In the case of the latter, the institutionalized consumer must dependCby defaultCupon the surrogate services provided by society at large in order to meet basic consumption needs. Furthermore, it is not only those in the most restricted of institutionalized settings that depend on societally based surrogates. As the mother of the drug and alcohol rehabilitation patient we spoke to told us, her son and his fellow patients were allowed to go to local Salvation Army facilities once a month to "shop" for free donated goods. Also, these same individuals were often the recipients of food items such as cookies and donuts donated by charitable organizations.

Gift-Giving Behavior

Gift-giving behavior may manifest itself in either interpersonal or intrapersonal form (see Mick and DeMoss 1992), each of which are discussed separately below.

Interpersonal Gift Giving. Gift giving, as a form of reciprocity or exchange, is one of the processes that integrates a society (Sherry 1983). As such, it is often assumed that institutionalized individuals, given their supposed separation and isolation from society, engage in little or no gift-giving behavior. However, findings of our studies appear to refute this assumption. For example, two of the teenage wards of the state that are parents themselves told us that they buy their children gifts when they are financially able. One teen/parent described an instance in which she spent what she felt was far too much on her baby daughter, purchasing for her a $60 outfit and a $21 pair of "Barney" shoes. Another teenager in the group likewise stated that he had bought gifts for his mother.

Intrapersonal (Self) Gift Giving. Although there may be a general tendency towards decreased self-gift-giving among the institutionalized due to either inability to purchase such gifts because of confinement, or a relative lack of motivation due to low levels of control over their lives, there is evidence that self-gifting behavior nevertheless manifests itself in institutionalized environments. For example, among the teenage wards of the state we interviewed, many told us that they often buy themselves gifts such as "sweet" food items, clothes, cologne, and jewelry with the money that they earn by performing "chores" in and around their institutional facility. Also, it appears that the level of dependence encountered in the institutional setting may affect gift-giving behavior. The sister-in-law of the prison inmate we interviewed stated that he expected those people with moneyCi.e., her and her husbandCto support him by giving him items that he requested as gifts. Here, the act of self-gifting is performed through a surrogate; even though the surrogate must pay for the gift, the act of gift giving was initiated by the prisoner himself. The inmate felt that he was deserving of these items, in part, because of the adverse circumstances with which he had had to deal with throughout his life. He felt, we were told, that he was not to blame for his "failure" in life, and that individuals "luckier" than himself should provide for his well-being. Interestingly, this individual was more concernedCalmost solely soCwith what his surrogate consumers would get him for Christmas, rather than with what his two teenage children would receive from him.

Given the above discussion, institutionalization may in many cases be perceived as a failure in its own right. Accordingly, taking the causal attribution perspective of intrapersonal gift-giving suggested by Faure and Mick (1993), one would expect attribution to external, uncontrollable causes to lead to relatively high levels of self-gift-giving, or at least to a desire to engage in such activity. While the "extreme-dependence" example of a prison inmate is given here, the likening of institutionalization to failed achievement outcome situations is similarly warranted in the case of drug and alcohol rehabilitation patients due to the social stigma commonly placed upon substance abuse.

Surrogate Gift-Giving. In addition to the surrogate-based self gift-giving behavior exhibited by the prison inmate in our field study, other examples serving to simultaneously illustrate both the surrogate consumer phenomenon and gift-giving behavior among the institutionalized emerge. For example, programs sponsored by church or community-service organizations exist which serve to facilitate the exchange of Christmas gifts between prison inmates and their children. According to the representative of the organization responsible for coordinating such projects that we spoke to, this is accomplished through the collection of the childrens' "wish lists," which is followed by consultation with the the inmate/parent, and then the delivery of the requested gifts to the children in a holiday atmosphere. Gift exchanges take place either at community centers, churches, or, in a limited number of cases, on prison grounds. Some gifts are also delivered directly to the homes of the children. Regardless of method of exchange, such programs function in surrogate fashion in order to facilitate the giving of gifts between institutionalized individuals and their loved ones. Likewise, the son of the woman confined to nursing homes told us that his mother "bought" her seven sons gifts by having them "surrogate shop" for each other on her behalf.

POST-INSTITUTIONALIZED CONSUMER BEHAVIOR AND RESEARCH PROPOSITIONS

The consumption behavior of institutionalized consumers is of interest not only while these individuals are actually confined in institutional settings but also behavior after leaving these restrictive environments is also of concern due to the likelihood that post-institutionalized consumption behavior may be affected by the period of limited consumer choice and dependence on others. While such behavioral effects may be expected to vary according to, among other things, the type of incapacitation and the length of stay, the possibility that the lingering effects of institutionalization might impact the behavior of millions of Americans is indeed worthy of consumer researcher consideration.

Researchers of institutionalized environments have consistently found that behavioral patterns developed and perpetuated in such settings may lead to the continuation of certain learned behaviors once the consumer is released into society. For example, in a study of the institutionalized elderly, Baltes and Wahl (1992) discuss what they term "the dependency-support script." Specifically, the authors maintain that institutionalized individuals learn to be dependent based upon the provision of positive reinforcement for dependent behavior, while independent behavior is ignoredCand thus discouraged. Rationale cited for this scenario includes: persistent negative stereotypes of the elderly as incompetent, the caregiver ideal of helping, and social policy philosophies which dictate that independent behaviors be fostered in in-home, rather than in institutionalized, settings. The authors also contend that dependency is further reinforced by institutionalization, when in fact the stated purpose of such confinement is often to help these individuals become more self-dependent.

Just as they do during actual institutionalization, dependencies are likely to impact post-institutionalized consumer behavior in regard to both surrogate consumer usage and distinct gift-giving behaviors. These issues, and resultant research propositions, are discussed below.

Surrogate Consumer Usage

The continued usage of surrogates to perform a variety of consumption activities may occur in either direct or indirect fashion. Directly, the post-institutionalized consumer may stay in close contact with those who served as surrogates while confined in order to facilitate their being able to utilize the services of these individuals in a similar capacity after institutionalization. Indirectly, individuals may either resist direct personal dependencies, or more or less "give up" on making it on their own, becoming dependent instead on the larger society as their surrogate, through welfare or other social programs. Adopting Bagozzi and Warshaw's (1990) "theory of trying" framework, one might conclude, in this latter case, that the post-institutionalized consumer apathetically "quits trying to consume" in response to past failed attempts at independent consumption activity.

The findings of our exploratory research appear to both support and clarify the notion of continued high levels of surrogate usage. For example, the mother of the drug and alcohol rehabilitation patient we interviewed told us that her son both maintained close contact with her, as well as continued to rely on her for the consummation of certain acts of consumption, such as food purchase and preparation, immediately after actual institutionalization. However, several months after his release, and shortly after finding what was possibly a steady job, her son all but dropped out of sight. It seems that the period of post-institutionalized dependence lasted until her son was himself able to satisfy his consumption needs, at which time he became extremely independent, perhaps rebelling against his recently concluded institutionalized dependence.

The woman we interviewed who had acted as a surrogate consumer for her imprisoned brother-in-law shed additional light on the issue of post-institutionalized surrogate usage. Specifically, she told us that her brother-in-law was likely to cease contact for up to six months immediately after his release from prison. She explained that while he appeared to expect to be taken care of by surrogate consumers when in prison, he was highly independent when released, due at least in part to his being "fed up" with being dependent upon or controlled by other individuals. In fact, she stated that he invariably finds steady employment as a housepainter shortly after release, thus facilitating independent activity much in the same manner as the post-institutionalized drug and alcohol patient whose mother we interviewed. However, based on our research findings, it appears that the higher level of institutionalized dependence experienced by the prison inmate may have led to a more abrupt "rebellion" against his previous state of dependency.

This possible inverse relationship between the level of dependence while institutionalized and the level of post-institutionalized dependence should be tempered, however, with the understanding that some individuals leaving institutions are still not able to act on their own. Nursing home patients who return to the home of adult children, for example, are likely in many cases to continue to be highly dependent on the services of others. It may be then, that the inverse relationship between post-institutionalized surrogate usage and institutionalized dependence exists only for those consumers physically (or mentally) able to personally carry out consumption activities.

The above discussion suggests the possibility of the existence of two distinct forms of institutionalized dependency: physical dependency, as exemplified in the previous discussion of the nursing home patient being physically unable to perform consumption activities, and societal dependency, such as that seen in the case of the prison inmate whose sister-in-law we interviewed. This discussion suggests the following research propositions:

P1: High levels of societal dependency while institutionalized are inversely related to post-institutionalized surrogate consumer usage.

P2: High levels of physical dependency while institutionalized are positively related to post-institutionalized surrogate consumer usage.

Gift-Giving Behavior

As during actual periods of institutionalization, gift-giving behavior may manifest itself in either interpersonal or intrapersonal fashion in post-institutionalized consumer behavior. Our research findings offer little in this regard due to the fact that: (1) both the mother of the drug and alcohol rehabilitation patient and the sister-in-law of the prison inmate were unaware of gift-giving behavior of the post-institutionalized individual due to a lack of contact, and (2) there was no period of post-institutionalization with either the teenage wards of the state or the woman whose son we interviewed, who spent the last several years of her life in nursing homes. However, based on our findings applicable to actual institutionalized gift giving, the discussion of post-institutionalized gift-giving behaviors is nonetheless warranted.

Interpersonal Gift Giving. Given that gift giving appears to often persist throughout periods of institutionalization, it can be assumed that such behavior is likely to increase in post-institutionalized, as opposed to institutionalized, consumers. Not only are the physical constraints of the institutionalized environment lifted, but as in the case of both the prison inmate and drug and alcohol rehabilitation discussed in our field studies who found employment shortly after their respective releases, the possibility of having discretionary income is also a plausible antecedent of increased interpersonal gift-giving behavior. Stated more succinctly:

P3: The incidence of interpersonal gift-giving is higher among post-institutionalized versus institutionalized individuals as a result of diminished physical and financial constraints.

Intrapersonal (Self) Gift Giving. Adopting the attributional perspective proposed by Faure and Mick, we contend that post-institutionalized self-gifting is likely to increase under situations where the released individual considers his or her release a success for which they themselves are responsible. More specifically, in accordance with Faure and Mick, the "achievement outcome" must be attributed by the post-institutionalized individual to internal, controllable, and unstableC"not likely to happen again soon"Ccauses. For example, the mother of the drug and alcohol rehabilitation patient we spoke to informed us that patients were not "released" from the last of the several institutions in which her son had lived, but that they rather "graduated," giving the post-institutionalized individual a sense of achievement. In such situations, increased self-gifting is likely to occur. In addition, this tendency towards higher levels of self-gifting is likely to be increased in situations where the post-institutionalized individual makes such internal attributions upon release from settings such as prisons and drug and alcohol rehabilitation hospitals that are characterized by high levels of societal dependence. This discussion suggests the following:

P4: The incidence of intrapersonal or self gift giving is higher among post-institutionalized versus institutionalized individuals.

P5: The probability of the incidence of intrapersonal or self gift giving being higher among post-institutionalized versus institutionalized individuals is increased under circumstances of societalCas opposed to physicalCdependence during institutionalization.

DISCUSSION

Many of the 3.33 million Americans currently institutionalized increasingly have the ability to both make consumer decisions, as well as to engage in a variety of consumption activities. In fact, these individuals may have as many, if not more, consumption alternatives at a macro level (c.f. Firat 1987) than many non-institutionalized individuals, particularly the inner-city poor, who themselves have been characterized as no less than prisoners of their own surroundings (Alexis, et al. 1972). Unfortunately, the consumer behavior of institutionalized individuals is not well documented. Likewise, the ramifications of the rapid changes currently taking place within institutionalized environments are not fully understood. Clearly, however, there are substantial unmet consumer needs among the institutionalized which should be addressed only after first gaining a more thorough understanding of the complex relationships among social, financial, psychological, and physical dependence.

Not only does the current institutionalized population warrant consideration as a viable consumer segment, but with this population increasing in size while at the same time having higher levels of consumption choice, its recognition as such in the future appears all the more appropriate. This assertion, supported by our exploratory research findings, has direct and significant implications for both marketing practitioners and consumer researchers alike. For the practitioner, there is the opportunity to develop product and service offerings specifically for this growing segment of the American population. More importantly, however, is the fact that the vulnerability of institutionalized and post-institutionalized consumers necessitates that both marketers, as well as consumer researchers, pay greater attention to the social responsibility of these offerings and their promotion. Specifically, in regard to consumer researchers, the study of institutionalized consumers represents an opportunity to apply the principles of "critical theory," as suggested by Murray and Ozanne (1991), in an attempt to assist disadvantaged societal members in breaking free of potentially harmful societal constraints.

Future research into the consumer behavior of current and former institutionalized persons should strive to further clarify the findings of our research efforts. For example, research should explore the differences in consumer behavior between different segments of the institutionalized population, especially in consideration of varying levels of social, financial, psychological, and physical dependence. Areas of consumer research theory which hold specific promise in this regard are the continued usage of surrogate consumers and the nature of gift-giving behaviors among post-institutionalized individuals. To accomplish this, studies more longitudinal in nature than the ones conducted here are needed. As a result, the institutionalized population may be better understood to the benefit of all of American society.

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