Ideology and Compliance With Health Guidelines During the COVID-19 Pandemic: A Comparative Perspective

Objective: We measure the prevalence of non-compliance with public health guidelines in the COVID-19 pandemic and examine how it is shaped by political ideology across countries. Methods: A list experiment of non-compliance and a multi-item scale of health-related behaviors were embedded in a comparative survey of 11,000 respondents in nine OCED countries. We conduct a statistical analyses of the list experiment capturing degrees of non-compliance with social distancing rules and estimate ideological effect heterogeneity. A semiparametric analysis examines the functional form of the relationship between ideology and the propensity to violate public health guidelines. Results: Our analyses reveal substantial heterogeneity between countries. Ideology plays an outsized role in the United States. No association of comparable magnitude is found in the majority of the other countries in our study. In many settings, the impact of ideology on health-related behaviors is non-linear. Conclusion: Our results highlight the importance of taking a comparative perspective. Extrapolating the role of ideology from the United States to other advanced industrialized societies might paint an erroneous picture of the scope of possible non-pharmaceutical interventions. Heterogeneity limits the extent to which policy-makers can learn from experiences across borders.