Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia
Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia
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DOI：
10.1016/j.socscimed.2016.11.016
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发表时间：
2017-01-01
影响因子：
5.4
通讯作者：
Tsai, Lily L.
中科院分区：
文献类型：
--
作者：
Blair, Robert A.;Morse, Benjamin S.;Tsai, Lily L.
长期以来，对政府的信任一直被视为公民遵守公共卫生政策的重要决定因素，尤其是在危机时期。然而，关于这种关系的证据仍然很少，特别是在发展中国家。我们利用 2014-15 年利比里亚蒙罗维亚埃博拉病毒病 (EVD) 流行期间进行的一项代表性调查的结果来评估对政府的信任与遵守埃博拉病毒病控制干预措施之间的关系。我们发现，对政府信任度较低的受访者不太可能在家中采取预防埃博拉病毒病的预防措施，也不太可能遵守政府规定的旨在遏制病毒传播的社会疏远机制。他们也不太可能支持可能引起争议的控制政策，例如“安全埋葬”埃博拉病毒病感染者的尸体。与刻板印象相反，我们没有发现任何证据表明不信任政府的受访者或多或少可能了解埃博拉病毒病的症状和传播途径。这些结果虽然只是相关性，但表明拒绝遵守的受访者这样做可能不是因为他们不了解埃博拉病毒病是如何传播的，而是因为他们不相信政府机构建议预防措施和实施减缓埃博拉病毒病传播的政策的能力或诚信。我们还发现，在疫情期间经历过困难的受访者对政府的信任度低于没有经历过困难的受访者，这表明不信任、不遵守、困难和进一步不信任之间可能存在恶性循环。最后，我们发现信任国际非政府组织（INGO）的受访者不太可能支持或遵守埃博拉病毒病控制政策，这表明虽然国际非政府组织可以为应对危机做出不可或缺的贡献，但它们不能取代公民眼中的政府机构。最后，我们讨论了我们的研究结果对未来公共卫生危机的影响。 (C) 2016 Elsevier Ltd. 保留所有权利。
Trust in government has long been viewed as an important determinant of citizens' compliance with public health policies, especially in times of crisis. Yet evidence on this relationship remains scarce, particularly in the developing world. We use results from a representative survey conducted during the 2014-15 Ebola Virus Disease (EVD) epidemic in Monrovia, Liberia to assess the relationship between trust in government and compliance with EVD control interventions. We find that respondents who expressed low trust in government were much less likely to take precautions against EVD in their homes, or to abide by government-mandated social distancing mechanisms designed to contain the spread of the virus. They were also much less likely to support potentially contentious control policies, such as "safe burial" of EVD-infected bodies. Contrary to stereotypes, we find no evidence that respondents who distrusted government were any more or less likely to understand EVD's symptoms and transmission pathways. While only correlational, these results suggest that respondents who refused to comply may have done so not because they failed to understand how EVD is transmitted, but rather because they did not trust the capacity or integrity of government institutions to recommend precautions and implement policies to slow EVD's spread. We also find that respondents who experienced hardships during the epidemic expressed less trust in government than those who did not, suggesting the possibility of a vicious cycle between distrust, non-compliance, hardships and further distrust. Finally, we find that respondents who trusted international non-governmental organizations (INGOs) were no more or less likely to support or comply with EVD control policies, suggesting that while INGOs can contribute in indispensable ways to crisis response, they cannot substitute for government institutions in the eyes of citizens. We conclude by discussing the implications of our findings for future public health crises. (C) 2016 Elsevier Ltd. All rights reserved.