Association of COVID-19 outcomes with measures of institutional and interpersonal trust: an ecological analysis using national data from 61 countries.

Publication date: Jul 21, 2025

Despite the importance of human behavior in containing a disease outbreak, formal quantitative analyses examining the relationship between measures of trust and COVID-19 outcomes remain limited. We use data from Wave 7 (2017-2022) of the World Values Survey to assess the country-level relationship between trust and COVID-19 outcomes across 61 countries via clustering and regression. After adjusting for country-level confounders, our findings indicate that countries with low trust have significantly greater numbers of COVID-19 deaths (1200. 6 more COVID-19 deaths per million, 95% CI [510. 92, 1890. 3]), significantly greater excess death (2289. 1 more excess deaths per million, 95% CI [971. 1, 3607. 2]), and a lower vaccination rate (16. 6 fewer people vaccinated per 100, 95% CI [-27. 7, -5. 6]) than high trust countries, suggesting a tangible impact of trust on country-level COVID-19 outcomes. We discuss differences between interpersonal and institutional trust and advocate for incorporating trust in disease modeling to better predict country-level outcomes.

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Semantics

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