Abstract
The article article demonstrates the diverse levels of apprehension regarding the virus and its behavioural impact across various regions, with a specific focus on comparing the United States and Western Europe. Findings illuminate substantial regional disparities in concern levels, notably revealing a consistent trend of heightened apprehension for family members compared to oneself. The study emphasises the imperative for tailored public health strategies capable of addressing these nuanced regional perceptions and fostering trust amidst diverse communities.
Introduction
In early 2020, the rapid escalation of the novel coronavirus (COVID-19) into a global pandemic spurred unprecedented public health responses worldwide. Beyond its immediate health implications, the pandemic profoundly impacted economic, social, and psychological aspects of life globally. Within this context, comprehending public perceptions, concerns, and trust in government responses became paramount for policymakers and public health officials.
To capture these sentiments, a survey spanning multiple countries was meticulously designed and implemented. Its primary objective was to gauge the level of concern among the global population regarding the risk of contracting COVID-19, as well as concerns for the well-being of family members. Additionally, the survey sought to assess public trust in government actions and communication during the crisis, probing how these perceptions influenced individuals’ attitudes and behaviours in response to the pandemic.
Conducted in late March 2020, amidst the initial wave of the pandemic and its accompanying uncertainties, the survey aimed to capture a snapshot of public sentiment during these early stages. This period marked a critical juncture in the global response to COVID-19, with governments worldwide implementing various measures to curb the virus’s spread.
The timing of the survey was pivotal, offering insights into public perceptions and attitudes at a moment when public health strategies and government interventions were rapidly evolving. Through its timely execution, the survey yielded valuable data on the psychological and emotional responses of individuals facing the immediate impacts of the pandemic. These insights contribute to a nuanced understanding of the global community’s adaptability and resilience in the face of adversity.
The survey’s findings serve to inform public health strategies and communication efforts, pinpointing areas where trust could be fortified and concerns more effectively addressed. As the world continues to grapple with the challenges posed by COVID-19, recognizing and comprehending the public’s perspective remains a crucial component in the global response to the pandemic.
Literature Review
Public Perception in Health Crises: Public perception during health crises is a critical factor influencing the effectiveness of response strategies. Existing literature suggests that public behavior and compliance with health directives are predominantly driven by the population’s trust in authorities and their comprehension of associated risks (Siegrist & Zingg, 2014). The Health Belief Model (Rosenstock, 1974) posits that engagement in health-promoting behaviors is contingent upon individual beliefs about health concerns, perceived benefits, and barriers to action.
Trust in Government Responses: Trust in government responses to pandemics plays a pivotal role in public adherence to health advisories (Larson et al., 2009). Studies on the H1N1 pandemic response revealed that trust in health information disseminated by government bodies correlated with greater willingness to adopt preventive behaviors (Rubin et al., 2009). Conversely, mistrust can breed skepticism and resistance to public health measures, as evidenced during the Ebola outbreak (Calnan & Rowe, 2006).
Lessons from Previous Pandemics: Historical pandemics underscore the importance of timely and transparent communication in building public trust. During the SARS outbreak, initial lack of immediate, transparent communication from health authorities led to public panic and confusion (Person et al., 2004). Effective communication strategies that emerged later were instrumental in managing public fear and fostering cooperative behavior (Deurenberg-Yap et al., 2005).
COVID-19 Pandemic: The novel coronavirus (COVID-19) pandemic has presented unprecedented challenges. Early research on COVID-19 has highlighted similar themes, with public perception being influenced by trust in government actions, communication clarity, and perceived threat severity (Bavel et al., 2020). Studies have commenced exploring how varying levels of trust across different countries affect the public’s adherence to COVID-19 guidelines and their uptake of preventive measures (Plohl & Musil, 2021).
The literature consistently emphasizes the symbiotic relationship between public perception, trust in government, and the success of public health interventions during pandemics. As the world navigates the recovery from the COVID-19 crisis, continual assessment and understanding of these dynamics are imperative to inform ongoing and future public health strategies.
Data & Methodology:
The study’s analysis reveals a consistent trend: concern for family and loved ones significantly outweighs personal concern across all regions. Notably, regions in the USA exhibit the highest levels of self-concern, with six out of seven regions surpassing the global average (refer to Chart 1).
For countries and states within each region please refer to Appendix 1. For a complete summary statistic table: mean, median, mode, standard deviation and counts for each region for both self and family concern please refer to Appendix 2.

These findings were statistically supported by ANOVA tests, indicating significant differences across regions for both personal concern (F-Statistic = 3.52, p-value ≈ 0) and family concern (F-Statistic = 2.3, p-value = 0.0133). This underscores the acute awareness and concern among US respondents, particularly in the South Atlantic, compared to those in Western Europe, emphasizing the critical need for nuanced public health strategies and interventions tailored to these regional sentiments.
Follow-up Tukey HSD tests further identified specific regions with significant differences, highlighting notably higher concern levels in the USA regions. This nuanced understanding of regional disparities in concern levels can inform targeted public health messaging and interventions.
Key findings from the Tukey HSD tests include:
- Northern Europe has a lower level of concern for self than:
- USA – South Atlantic
- Western Europe has a lower level of concern for self than:
- Southern Europe
- USA – Pacific
- USA – Mid Atlantic
- USA – South Atlantic
In terms of concern for family/loved ones, the significance across regions was less pronounced. Significant differences for family/loved ones concern from the Tukey HSD tests include:
- Western Europe has a lower level of concern for family members becoming infected than:
- USA – Pacific
- USA – South Atlantic
Conclusion
The study unveils significant regional differences in COVID-19 concern levels, with a pronounced higher concern in US regions compared to Western Europe. Notably, the concern for family and loved ones universally surpasses personal concern, highlighting the need for public health strategies that consider regional sentiment nuances. These findings enrich our understanding of public perceptions during the pandemic, suggesting future research should delve into the drivers of these regional disparities and their impact on public health initiatives and communication strategies.
In this issue, additional articles cover:
- Variations in risk perception across different age groups and employment sectors.
- The relationship between trust in government and levels of concern among the public.
- The influence of media perspectives on public concern regarding the pandemic.
- The effects of COVID-19 on government policy and action.
- An evaluation of global powers’ efforts to combat the pandemic and its potential impact on international relations.
References
Bavel, J. J. V., Baicker, K., Boggio, P. S., Capraro, V., Cichocka, A., Cikara, M., … & Druckman, J. N. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4(5), 460-471.
Calnan, M., & Rowe, R. (2006). Trust matters in health care. Open University Press.
Carpenter, C. J. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25(8), 661-669.
Deurenberg-Yap, M., Foo, L. L., Low, Y. Y., Chan, S. P., Vijaya, K., & Lee, M. (2005). The Singaporean response to the SARS outbreak: Knowledge sufficiency versus public trust. Health Promotion International, 20(4), 320-326.
Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics. Sage.
Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A decade later. Health Education Quarterly, 11(1), 1-47.
Larson, H. J., Cooper, L. Z., Eskola, J., Katz, S. L., & Ratzan, S. (2009). Addressing the vaccine confidence gap. The Lancet, 374(9690), 526-535.
Person, B., Sy, F., Holton, K., Govert, B., Liang, A., & National Center for Influenza Preparedness, Team S. (2004). Fear and stigma: the epidemic within the SARS outbreak. Emerging Infectious Diseases, 10(2), 358.
Plohl, N., & Musil, B. (2021). Modeling compliance with COVID-19 prevention guidelines: The critical role of trust in science. Psychology, Health & Medicine, 26(1), 1-12.
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335.
Rosenstock, I. M. (1974). The Health Belief Model and preventive health behavior. Health Education Monographs, 2(4), 354-386.
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175-183.
Rubin, G. J., Amlôt, R., Page, L., & Wessely, S. (2009). Public perceptions, anxiety, and behavior change in relation to the swine flu outbreak: cross-sectional telephone survey. BMJ, 339.
Appendix 1
Countries included in each region:
Northern Europe | Western Europe | Southern Europe | Eastern Europe | Oceania | Asia |
Denmark | Austria | Albania | Azerbaijan | Australia | Bangladesh |
Estonia | Belgium | Croatia | Belarus | New Zealand | China |
Finland | France | Greece | Bulgaria | Hong Kong | |
Iceland | Germany | Italy | Cyprus | India | |
Ireland | Luxembourg | Spain | Czechia | Israel | |
Latvia | Netherlands | Hungary | Japan | ||
Lithuania | Switzerland | Moldova | Jordan | ||
Norway | Poland | Pakistan | |||
Sweden | Romania | Philippines | |||
United Kingdom | Russia | Republic of Korea | |||
Serbia | Singapore | ||||
Slovakia | Taiwan | ||||
Slovenia | Thailand | ||||
Turkey | United Arab Emirates | ||||
Vietnam |
US Regions/States:
USA – Pacific | USA – Mountain | USA – Midwest | USA – South Central | USA – Mid Atlantic | USA – North Atlantic | USA – South Atlantic |
California | Colorado | Ohio | Kentucky | Pennsylvania | New York | Florida |
Washington | Arizona | Illinois | Texas | Virginia | Massachusetts | Georgia |
Oregon | Nevada | Michigan | Tennessee | Maryland | New Jersey | North Carolina |
Alaska | Idaho | Wisconsin | Alabama | District of Columbia | Connecticut | South Carolina |
Hawaii | Utah | Minnesota | Arkansas | West Virginia | Maine | |
New Mexico | Missouri | Mississippi | Massachusetts | |||
Montana | Indiana | New Hampshire | ||||
North Dakota | Nebraska | Vermont | ||||
Wyoming | Iowa | |||||
Kansas |
Appendix 2
Summary Statistics Table
Concern | Region | Mean | Median | Mode | Standard Deviation | Count |
Rate your level of concern that any of your family members/ loved ones may become infected with the novel coronavirus (COVID-19)? | Northern Europe | 7.465 | 8 | 10 | 2.32253 | 99 |
Western Europe | 6.740 | 7 | 7 | 2.473026 | 77 | |
Southern Europe | 7.603 | 8 | 10 | 2.504926 | 121 | |
Eastern Europe | 6.938 | 8 | 9 | 2.839099 | 32 | |
Oceania | 7.152 | 8 | 8 | 2.170176 | 46 | |
Asia | 7.375 | 8 | 8.00a | 2.419677 | 32 | |
Canada | 7.250 | 8 | 10 | 2.494438 | 64 | |
Otherworld Regions | 7.241 | 8 | 8 | 2.515289 | 58 | |
USA – Pacific | 8.097 | 8 | 10 | 1.927686 | 103 | |
USA – Mountain | 7.589 | 8 | 8 | 2.078258 | 56 | |
USA – Midwest | 7.310 | 8 | 9 | 2.465109 | 116 | |
USA – South Central | 7.192 | 7.5 | 7 | 2.352438 | 78 | |
USA – Mid Atlantic | 7.734 | 8 | 10 | 2.117517 | 64 | |
USA – North Atlantic | 7.730 | 8 | 8 | 2.343187 | 63 | |
USA – South Atlantic | 8.188 | 9 | 10 | 2.053839 | 64 | |
Total | 7.477 | 8 | 10 | 2.351502 | 1073 | |
Rate your level of concern that you may become infected with the novel coronavirus (COVID-19)? | Northern Europe | 5.121 | 5 | 7 | 2.623569 | 99 |
Western Europe | 4.675 | 4 | 3 | 2.386594 | 77 | |
Southern Europe | 5.983 | 6 | 7 | 2.623558 | 121 | |
Eastern Europe | 5.469 | 6 | 3.00a | 2.577626 | 32 | |
Oceania | 5.000 | 5 | 6 | 2.180724 | 46 | |
Asia | 5.469 | 6 | 6 | 2.994451 | 32 | |
Canada | 5.234 | 5 | 2.00a | 2.909984 | 64 | |
Otherworld Regions | 5.448 | 6 | 6.00a | 2.74771 | 58 | |
USA – Pacific | 6.107 | 6 | 5 | 2.562599 | 103 | |
USA – Mountain | 5.911 | 6 | 8 | 2.466332 | 56 | |
USA – Midwest | 5.672 | 6 | 7 | 2.441581 | 116 | |
USA – South Central | 4.833 | 5 | 3.00a | 2.50929 | 78 | |
USA – Mid Atlantic | 6.188 | 6 | 5.00a | 2.322253 | 64 | |
USA – North Atlantic | 5.952 | 6 | 8 | 2.43912 | 63 | |
USA – South Atlantic | 6.688 | 7 | 7 | 2.329078 | 64 | |
Total | 5.607 | 6 | 7 | 2.580429 | 1073 | |
a. Multiple modes exist. The smallest value is shown |