Who is willing to stay sick for the collective? – Individual characteristics, experience, and trust

This paper deals with the collective action dilemma of antibiotic resistance. Despite the collective threat posed by antibiotic resistance, there are limited incentives for individuals to consider the contribution of their decisions to use antibiotics to the spread of resistance. Drawing on a novel survey of Swedish citizens (n=1,906), we study factors linked to i) willingness to accept a physician’s decision not to prescribe antibiotics and ii) willingness to limit personal use of antibiotics voluntary. In our study, 53 percent of the respondents stated that they would be willing to accept the physician’s decision despite disagreeing with it, and trust in the healthcare sector is significantly associated with acceptance. When it comes to people’s willingness to voluntarily abstain from using antibiotics, a majority stated that they are willing or very willing not to take antibiotics. The variation in willingness is best explained by concerns about antibiotic resistance and experience of antibiotic therapy, especially if a respondent has been denied antibiotics. Generalized trust seems to be unrelated to willingness to abstain, but the perception that other people limit their personal use of antibiotics is linked to respondents’ own willingness to do so. Few of the individual characteristics can explain the variation in that decision.