Frontiers in Public Health 2022 (1) (2022)

Background: According to Gelfand et al., COVID-19 infection and case mortality rates are closely connected to the strength of social norms: “Tighter” cultures that abide by strict social norms are more successful in combating the pandemic than “looser” cultures that are more permissive. However, countries with similar levels of cultural tightness exhibit big differences in mortality rates. We are investigating potential explanations for this fact. Using data from Germany and Japan—two “tight” countries with very different infection and mortality rates—we examined how differences in socio-demographic and other determinants explain differences in individual preventive attitudes and behaviors. Methods: We compared preventive attitudes and behaviors in 2020 based on real-time representative survey data and used logit regression models to study how individual attitudes and behaviors are shaped by four sets of covariates: individual socio-demographics, health, personality, and regional-level controls. Employing Blinder-Oaxaca regression techniques, we quantified the extent to which differences in averages of the covariates between Japan and Germany explain the differences in the observed preventive attitudes and behaviors. Results: In Germany and Japan, similar proportions of the population supported mandatory vaccination, avoided travel, and avoided people with symptoms of a cold. In Germany, however, a significantly higher proportion washed their hands frequently and avoided crowds, physical contact, public transport, peak-hour shopping, and contact with the elderly. In Japan, a significantly higher proportion were willing to be vaccinated. We also show that attitudes and behaviors varied significantly more with covariates in Germany than in Japan. Differences in averages of the covariates contribute little to explaining the observed differences in preventive attitudes and behaviors between the two countries. Conclusion: Consistent with tightness-looseness theory, the populations of Japan and Germany responded similarly to the pandemic. The observed differences in infection and fatality rates therefore cannot be explained by differences in behavior The major difference in attitudes is the willingness to be vaccinated, which was much higher in Japan. Furthermore, the Japanese population behaved more uniformly across social groups than the German population. This difference in the degree of homogeneity has important implications for the effectiveness of policy measures during the pandemic.
Keywords COVID-19, Preventive health behavior, Vaccination, vaccine mandates, social norms, Japan, Germany, mandatory vaccination, SARS – CoV – 2
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