The impact of national culture on COVID-19 pandemic outcomes

Purpose - This study aims to uncover the extent to which cultural traits may explain the puzzling international divergence in COVID-19 outcomes, and how those traits interact with state action to produce compliance with pandemic health policy. Design/methodology/approach - A theoretical framework illustrates the surprising possibility that culture and state action may not reinforce each other but rather act as substitutes in eliciting anti-pandemic behavior. This possibility is tested empirically in two specifications: a cross-sectional regression that includes several novel COVID-related measures, and a panel model that controls for contemporaneous disease burden. Across these models, we use the measures of national culture developed by Hofstede (1984) and a newer metric developed by Schwartz (1990). Findings - Individualism and egalitarianism have a positive effect on disease prevalence, while cultural heterogeneity was associated with a more robust public health response. Consistent with our model, we find that culture and state action served as substitutes in motivating compliance with COVID-19 policy. Practical implications - The results of this study imply that culture and state interact in determining the effectiveness of public health measures aimed at combating COVID-19; these results recommend culturally aware state intervention when combating pandemics. Originality/value - This study offers several new contributions. First, it proposes a model to help contextualize the empirical analysis. Second, it examines a wider range of traits than previous studies, including cultural homogeneity and the Schwartz variables. Third, it employs a richer econometric specification that explores the interaction between state and culture in a panel context.