Feeling Blue Over the Economy, Will You Pull Down Your Face Mask? Economic and Psychological Well-Being and Preventive Health Behavior

This study investigates what predicts the uptake of preventive health behaviour (PHB) during COVID-19, bringing to the fore economic and psychological determinants. We provide novel evidence that through affecting psychological well-being, economic well-being can affect PHB. Exploiting a panel survey dataset of four North African countries for November 2020–August 2021, we construct a psychological well-being index and develop a structural equation model that addresses endogeneity in the PHB, economic and psychological well-being, and COVID-19 risk perception relationships. Our estimates reveal vast heterogeneity in individual responses to different PHB determinants across countries and by behaviour type. Psychological well-being had the strongest positive effect on the likelihood of physical distancing in Egypt and Sudan and of wearing masks in Morocco, Sudan, and Tunisia. Psychological well-being in turn was negatively affected by decreased food consumption and higher economic anxiety in all four countries. Psychological well-being was also lower for unpaid family workers in Egypt and Sudan and the unemployed in Egypt, Morocco, and Tunisia. Handwashing, a less publicly visible practice, was directly related to the perceived risk of COVID-19 and neighbourhood compliance. Gender, age, and education effects varied across countries and by PHB type.