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Trusting the Health System and COVID 19 Restriction Compliance

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  • Costa-Font, Joan
  • Vilaplana-Prieto, Cristina

Abstract

We examine the extent to which exposure to higher relative COVID-19 mortality (RM), influences health system trust (HST), and whether changes in HST explain the perceived ease of compliance with pandemic restrictions during the COVID-19 pandemic. Drawing on evidence from two representative surveys covering all regions of 28 European countries before and after the first COVID-19 wave, and using a difference in differences strategy together with Coarsened Exact Matching (CEM), we document that living in a region with higher RM during the first wave of the pandemic increased HST. However, the positive effect of RM on HST is driven by individuals over 45 years of age, and the opposite effect is found among younger cohorts. Furthemore, we find that a higher HST reduces the costs of complying with COVID-19 restrictions, but only so long as excess mortality does not exceed the average by more than 20%, at which point the ease of complying with COVID-19 restrictions significantly declines, offsetting the positive effect of trust in the healthcare system. Our interpretation of these estimates is that a higher RM is interpreted as a risk signal among those over 45, and as a signal of health-care system failure among younger age individuals.

Suggested Citation

  • Costa-Font, Joan & Vilaplana-Prieto, Cristina, 2023. "Trusting the Health System and COVID 19 Restriction Compliance," Economics & Human Biology, Elsevier, vol. 49(C).
    • Handle: RePEc:eee:ehbiol:v:49:y:2023:i:c:s1570677x23000163
    DOI: 10.1016/j.ehb.2023.101235
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    More about this item

    Keywords

    Healthcare system trust; Mortality; Lockdown; Eurobarometer; Difference in differences; COVID-19; risk signal; health system failure;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • Z1 - Other Special Topics - - Cultural Economics

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