Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries

Abstract Despite the importance of human behavior in containing a disease outbreak, formal quantitative analyses examining the relationship between measures of trust and COVID-19 outcomes remain limited. We use data from Wave 7 (2017–2022) of the World Values Survey to assess the country-level relat...

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Main Authors: Lillian Rountree, Guangyu Tong, Fan Bu, Megan Ranney, Bhramar Mukherjee
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-09758-6
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author Lillian Rountree
Guangyu Tong
Fan Bu
Megan Ranney
Bhramar Mukherjee
author_facet Lillian Rountree
Guangyu Tong
Fan Bu
Megan Ranney
Bhramar Mukherjee
author_sort Lillian Rountree
collection DOAJ
description Abstract Despite the importance of human behavior in containing a disease outbreak, formal quantitative analyses examining the relationship between measures of trust and COVID-19 outcomes remain limited. We use data from Wave 7 (2017–2022) of the World Values Survey to assess the country-level relationship between trust and COVID-19 outcomes across 61 countries via clustering and regression. After adjusting for country-level confounders, our findings indicate that countries with low trust have significantly greater numbers of COVID-19 deaths (1200.6 more COVID-19 deaths per million, 95% CI [510.92, 1890.3]), significantly greater excess death (2289.1 more excess deaths per million, 95% CI [971.1, 3607.2]), and a lower vaccination rate (16.6 fewer people vaccinated per 100, 95% CI [−27.7, −5.6]) than high trust countries, suggesting a tangible impact of trust on country-level COVID-19 outcomes. We discuss differences between interpersonal and institutional trust and advocate for incorporating trust in disease modeling to better predict country-level outcomes.
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spelling doaj-art-ef1df5a3e0294e849d6a911e81def4d52025-08-20T03:42:52ZengNature PortfolioScientific Reports2045-23222025-07-0115111510.1038/s41598-025-09758-6Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countriesLillian Rountree0Guangyu Tong1Fan Bu2Megan Ranney3Bhramar Mukherjee4Department of Biostatistics, School of Public Health, University of MichiganSection of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine, Yale UniversityDepartment of Biostatistics, School of Public Health, University of MichiganYale School of Public Health, Yale UniversityDepartment of Biostatistics, Yale School of Public Health, Yale UniversityAbstract Despite the importance of human behavior in containing a disease outbreak, formal quantitative analyses examining the relationship between measures of trust and COVID-19 outcomes remain limited. We use data from Wave 7 (2017–2022) of the World Values Survey to assess the country-level relationship between trust and COVID-19 outcomes across 61 countries via clustering and regression. After adjusting for country-level confounders, our findings indicate that countries with low trust have significantly greater numbers of COVID-19 deaths (1200.6 more COVID-19 deaths per million, 95% CI [510.92, 1890.3]), significantly greater excess death (2289.1 more excess deaths per million, 95% CI [971.1, 3607.2]), and a lower vaccination rate (16.6 fewer people vaccinated per 100, 95% CI [−27.7, −5.6]) than high trust countries, suggesting a tangible impact of trust on country-level COVID-19 outcomes. We discuss differences between interpersonal and institutional trust and advocate for incorporating trust in disease modeling to better predict country-level outcomes.https://doi.org/10.1038/s41598-025-09758-6
spellingShingle Lillian Rountree
Guangyu Tong
Fan Bu
Megan Ranney
Bhramar Mukherjee
Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
Scientific Reports
title Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
title_full Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
title_fullStr Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
title_full_unstemmed Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
title_short Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries
title_sort association of covid 19 outcomes with measures of institutional and interpersonal trust an ecological analysis using national data from 61 countries
url https://doi.org/10.1038/s41598-025-09758-6
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