Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States
Abstract According to the parasite-stress theory, collectivism serves as a trait of ingroup assortative sociality, providing defense against infectious diseases. This study investigated the association between cultural collectivism and COVID-19 severity at the state (Study 1: N = 51), county (Study...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-16384-2 |
| _version_ | 1797555888497623040 |
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| author | Mac Zewei Ma Sylvia Xiaohua Chen |
| author_facet | Mac Zewei Ma Sylvia Xiaohua Chen |
| author_sort | Mac Zewei Ma |
| collection | DOAJ |
| description | Abstract According to the parasite-stress theory, collectivism serves as a trait of ingroup assortative sociality, providing defense against infectious diseases. This study investigated the association between cultural collectivism and COVID-19 severity at the state (Study 1: N = 51), county (Study 2: N = 3,133), and daily (Study 3: N = 52,806) levels from the beginning of 2020 to the end of 2022. State-level collectivism was assessed using two distinct measures: the U.S. collectivism index, focusing on social interconnectedness and interdependence, and the subjective-culture individualism-collectivism index (reversed), capturing attitudes and beliefs related to religion, abortion, and same-sex marriage. By employing random-intercept multilevel models, the results demonstrated significant and negative effects of state-level collectivism, as measured by the U.S collectivism index, on COVID-19 cases per million, COVID-19 deaths per million, and composite COVID-19 severity index, after controlling for confounding factors, such as socioeconomic development, ecological threats, disease protective behaviors, cultural norms, and political influences. A mini meta-analysis (Study 4: N = 9) confirmed the significance of these effects across studies. These findings supported the proactive role of collectivism in defending against the novel coronavirus in the United States, aligning with the parasite-stress theory of sociality. However, the subjective-culture individualism-collectivism index (reversed) did not exhibit a significant relationship with COVID-19 severity when confounding factors were considered. The high correlation between the subjective-culture individualism-collectivism index (reversed) and the controlled variables suggested shared variance that could diminish its impact on COVID-19 outcomes. Accordingly, the present findings underscore the significance of accounting for confounding factors when examining the association between collectivism and COVID-19 severity at population level. By considering relevant confounding factors, researchers could gain a comprehensive understanding of the complex interplay between cultural collectivism and its influence on COVID-19 severity. Overall, this research contributes to our understanding of how cultural collectivism shapes the COVID-19 pandemic in the United States, emphasizing the importance of adjusting for confounding effects in population level studies. |
| first_indexed | 2024-03-10T16:54:55Z |
| format | Article |
| id | doaj.art-5e8a2a02e6624c09a3bf75340b079427 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-10T16:54:55Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-5e8a2a02e6624c09a3bf75340b0794272023-11-20T11:11:09ZengBMCBMC Public Health1471-24582023-08-0123112110.1186/s12889-023-16384-2Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United StatesMac Zewei Ma0Sylvia Xiaohua Chen1Department of Applied Social Sciences, The Hong Kong Polytechnic UniversityDepartment of Applied Social Sciences, The Hong Kong Polytechnic UniversityAbstract According to the parasite-stress theory, collectivism serves as a trait of ingroup assortative sociality, providing defense against infectious diseases. This study investigated the association between cultural collectivism and COVID-19 severity at the state (Study 1: N = 51), county (Study 2: N = 3,133), and daily (Study 3: N = 52,806) levels from the beginning of 2020 to the end of 2022. State-level collectivism was assessed using two distinct measures: the U.S. collectivism index, focusing on social interconnectedness and interdependence, and the subjective-culture individualism-collectivism index (reversed), capturing attitudes and beliefs related to religion, abortion, and same-sex marriage. By employing random-intercept multilevel models, the results demonstrated significant and negative effects of state-level collectivism, as measured by the U.S collectivism index, on COVID-19 cases per million, COVID-19 deaths per million, and composite COVID-19 severity index, after controlling for confounding factors, such as socioeconomic development, ecological threats, disease protective behaviors, cultural norms, and political influences. A mini meta-analysis (Study 4: N = 9) confirmed the significance of these effects across studies. These findings supported the proactive role of collectivism in defending against the novel coronavirus in the United States, aligning with the parasite-stress theory of sociality. However, the subjective-culture individualism-collectivism index (reversed) did not exhibit a significant relationship with COVID-19 severity when confounding factors were considered. The high correlation between the subjective-culture individualism-collectivism index (reversed) and the controlled variables suggested shared variance that could diminish its impact on COVID-19 outcomes. Accordingly, the present findings underscore the significance of accounting for confounding factors when examining the association between collectivism and COVID-19 severity at population level. By considering relevant confounding factors, researchers could gain a comprehensive understanding of the complex interplay between cultural collectivism and its influence on COVID-19 severity. Overall, this research contributes to our understanding of how cultural collectivism shapes the COVID-19 pandemic in the United States, emphasizing the importance of adjusting for confounding effects in population level studies.https://doi.org/10.1186/s12889-023-16384-2COVID-19CollectivismBehavioral immune system theoryParasite-stress theoryMultilevel analysisCovariates |
| spellingShingle | Mac Zewei Ma Sylvia Xiaohua Chen Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States BMC Public Health COVID-19 Collectivism Behavioral immune system theory Parasite-stress theory Multilevel analysis Covariates |
| title | Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States |
| title_full | Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States |
| title_fullStr | Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States |
| title_full_unstemmed | Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States |
| title_short | Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States |
| title_sort | beyond the surface accounting for confounders in understanding the link between collectivism and covid 19 pandemic in the united states |
| topic | COVID-19 Collectivism Behavioral immune system theory Parasite-stress theory Multilevel analysis Covariates |
| url | https://doi.org/10.1186/s12889-023-16384-2 |
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