Association between Social Capital and Culture of COVID-19 Preventive Behaviors: Country-Level Ecological Study

Background: The association between social capital and preventive behaviors against COVID-19 spread remains controversial. In this study, we examined the association between social capital and culture of preventive behaviors against COVID-19 spread at country level.Methods: The data on social capital (i.e., social trust, group affiliations, civic responsibility, and confidence in state institutions) was obtained from a World Value Survey. Culture of preventive behaviors were calculated as the percentage of people who took COVID-19 preventive behaviors (i.e., physical distancing, hand hygiene, and the use of face mask) from an international survey of Facebook users in 23 countries, selected according to the Facebook coverage, every two weeks from July to October 2020. The score on social capital was standardized and the association with COVID-19 preventive behaviors was investigated with multilevel linear regression analysis.Results: High civic responsibility (per 1 standard deviation, SD) was associated with low percentage points of physical distancing (β = -5.39, 95% confidence interval, CI: -8.24, -2.54), hand hygiene (β = -2.65, 95% CI: -3.76, -1.54) and the use of face mask (β = -3.28, 95% CI: -4.51, -2.04). Group affiliations and confidence in state institutions were associated with high percentage points of the use of face mask (β =1.34, 95% CI: 0.17, 2.52). Social trust had no significant association with culture of preventive behaviors after adjusted for time of survey.Conclusions: The inverse association between civic responsibility and COVID-19 preventive behaviors suggests that personal preventive behaviors should be encouraged in countries with high civic responsibility.