Gender and Trust in Government Modify: The association between Mental Health and Stringency of Public Health Measures to reduce COVID-19

Abstract

Introduction: Trust in government to take care of its citizens may affect mental health outcomes such as anxiety and depression, particularly as measures become more stringent. The study aimed to investigate the associations between stringency of COVID-19 social distancing policies and mental health outcomes, and the moderating effects of trust in government and gender. Methods: The study consisted of secondary analysis of publicly available cross sectional data from a global online survey COVID-19 survey conducted between 20 March and 7 April 2020. There were 106,497 adult participants (18 years of age and over) from 58 countries. The main outcome measures were indices for depression and worries. The exposure measure was the stringency index. The effect modifier measures were gender and trust in government. Multivariable regression was conducted to determine the three-way interaction between the exposure, modifier and outcome measures, adjusting for age, income and education. Results: The median age of participants (56.4% women) was 37 years. Women had higher worries and depression than men. The proportion of people trusting (44%) and distrusting (45%) the government was almost the same. Among those who strongly trusted the government, an increase in policy stringency was associated with an increase in worries. Among men who distrusted the government, an increase in policy stringency was associated with an increase in depression, but in distrusting women there was an inversed Ushaped association between policy stringency and both worries and depression. Once policies exceeded the 50-point mark on the stringency index, women benefited from the most stringent policies, yet men did not, particularly men who strongly trust or distrust the government. Conclusion: As the stringency of public health measures increases, so too do depression and worries. For safe and effective public health measures, governments should develop strategies to increase trust in their actions.

The Interplay Between Quality of Life and Resilience Factors in Later Life: A Network Analysis

“…The lack of an effect of the stringency of the COVID-19 policies on QoL may be explained by the fact that our study took place during the second wave of the pandemic. Previous studies that were conducted during the initial phase, or its aftermath (summer 2020), have reported either negative ( O’Hara et al, 2020 ; Lee et al, 2021a ; Voss et al, 2021 ), or positive effects on individuals’ mental health ( Kim and Jung, 2021 ; Lee et al, 2021b ; Long et al, 2021 ). Hence, current findings may indicate that, over time, individuals became more resistant to fluctuations in policies and restrictions, possibly because they had become accustomed to the uncertainty and frequent policy changes.…”

The mediating role of psychological distress on the link between socio‐ecological factors and quality of life of Filipino adults during COVID‐19 crisis

“…This suggests that Filipinos who believe that the public institutions are capable of responding effectively to the COVID‐19 crisis are less likely to experience emotional distress, which, in turn, can lead to a better quality of life. Indeed, recent transnational research involving participants from 58 countries showed that individuals who have higher trust in their government reported lower depression and anxiety during the COVID‐19 crisis (O'Hara et al, 2020 ). Consistent with our findings on distress as an underlying mechanism predicting quality of life, facing emotional distress during the COVID‐19 pandemic was found to lead to a significant decrease in quality of life among Vietnamese with suspected COVID‐19 symptoms (Nguyen et al, 2020 ), and among COVID‐19 patients, frontline nurses, and residents in China (An et al, 2020 ; Ma et al, 2020 ; Zhang & Ma, 2020 ).…”

“…This study indicates that since policies and measures in responding to the COVID‐19 pandemic in the Philippines are created and implemented by public institutions, Filipinos' perceived effectiveness of public institutions' crisis response protocol is a critical protective factor against psychological distress and poor quality of life in the days of a global pandemic. Indeed, building safety and trust could alleviate distress and promote recovery (Li et al, 2011 ; O'Hara et al, 2020 ) and may serve as a building block for a better quality of life (Zhang & Ma, 2020 ).…”

“…Studies showed that experiencing a greater sense of safety at home during the COVID‐19 pandemic was associated with lower levels of emotional distress among adult Filipinos (Aruta, 2021 ) and Israeli Jews (Kimhi, Eshel, et al, 2020a ). Moreover, TPIs serves as a protective factor against emotional distress in people across 58 countries during the COVID‐19 crisis (O'Hara et al, 2020 ). Furthermore, people who faced financial difficulties due to COVID‐19 reported higher levels of psychological distress (Aruta, 2021 ; Kimhi, Marciano, et al, 2020b ).…”

Public Health Information Seeking, Trust, and COVID-19 Prevention Behaviors: Cross-sectional Study

“…Finally, we included individuals’ perceptions of how likely they were to contract COVID-19 and 2 interaction terms: gender and the level of trust in PHAs; and age and the presence or absence of a preexisting condition that increases COVID-19 vulnerability. We hypothesized from previous literature that women would be more likely than men to take precautions if they had a high level of trust in PHAs [ 27 , 28 ] and that older adults with preexisting conditions would be more likely to take precautions than their younger counterparts [ 29 ]. All of these variables and their levels of measurement are described in the beginning of the Results section below.…”