Reactions to a Public Health Crisis: National Identity and Prevention

The World Health Organization declared the COVID-19 outbreak a pandemic on 11 March 2020. As we look back on two years of the disruption and devastation the coronavirus has caused, we look also to the lessons the world can glean from it.

Timely and Personal

Darden Professor Luca Cian’s research investigating what motivates people to follow COVID-19 prevention is both timely and deeply personal.

“We started [the research] a few months after the pandemic began, and my hope was to contribute — in any way I could — to improve the situation,” he says. “It felt very close to me, as the pandemic, at the beginning, had a catastrophic effect on Italy, my home country.” Cian lost a beloved friend, a man who’d helped raise him as surrogate grandfather, to COVID.  

The work, “National Identity Predicts Public Health Support During a Global Pandemic,” published in Nature Communications, is likely one of the largest health psychology studies ever: More than 250 researchers worldwide collected data from nearly 50,000 people across 67 countries.

The research group found that having a sense of national identity — characterized by a sense of solidarity with one’s fellow citizens — correlated with greater willingness to follow protocols (masking, hand-washing and social distancing) that reduced the spread of COVID-19. As of February 2022, nearly 6 million people have died from the disease, making it one of humanity’s largest crises in recorded history.

Identifying With a Group and Cooperation

“Identifying with a group is associated with mutual cooperation and adherence to its norms, motivation to help other members of their group and a willingness to engage in collectively oriented actions aimed at improving the group’s welfare,” Cian and his co-authors write.

They found that national identity was “significantly and positively related to all public health measures.” Individuals who felt stronger national identity than others within the same nation reported “stronger support for increasing spatial distance and improving physical hygiene,” the report observes.

People who felt a strong sense of national identity were also much more willing to endorse COVID-19 public health policies, such as closing restaurants or mask mandates.

The study is careful to distinguish between national identity — a sense of belonging to one’s nation and of responsibility to your fellow citizens — and nationalism or national narcissism, which is a belief that your home nation is superior to others.

The Perils of Identity Politics

Drawing the distinction, Cian observes, “one could believe it is important to be an American (national identity) without necessarily believing Americans are superior to others (nationalism).”

National narcissism was correlated with a greater willingness to follow COVID protocols, but the research group cautions that “these effects were much smaller than those for national identity and depended on the context.”

Research has shown that national narcissism might work against meaningful collective action: Those high in collective narcissism may have “a greater preoccupation with maintaining a positive image of the nation than with the well-being of fellow citizens,” Cian and his co-authors write. They “may prefer to invest in short-term image enhancement rather than in the sorts of long-term solutions that are necessary to sustain public health during a long pandemic.”

In addition, some political party affiliations have recently been shown to “undercut public health,” Cian and co-authors write, citing a geo-tracking study on 15 million U.S. smartphones. “Counties that voted for a Republican (Donald Trump) over a Democrat (Hillary Clinton) exhibited 14 percent less spatial distancing during the early stages of the pandemic,” they write. “These partisan gaps in distancing predicted subsequent increases in infections and mortality in counties that voted for Donald Trump.”

But in countries in which leaders across the political spectrum endorsed the same public health messages, there was far greater compliance to COVID prevention strategies. Both Canada and Italy demonstrated such nonpartisan national solidarity in the early phases of the pandemic and were initially able to combat disease spread and/or quickly reduce new cases.

Insights for Social Change

In a world that can seem increasingly polarized, Cian’s work suggests important ways leaders can inspire collective action by creating a sense of national unity and common identity.

“Vaccines and medication are indubitably the most important things,” Cian says. “But it’s clear that responses to vaccines, masks and policy are affected by political orientation, personal beliefs and other social phenomena, such as ‘fake news.’ As such, social sciences are important to understand how people react to a public health crisis and its preventative measures, as well as how to generate social change.”

Luca Cian co-authored “National Identity Predicts Public Health Support During a Global Pandemic,” which appeared in Nature Communications.