Social distancing attitudes, national context, and health outcomes during the COVID-19 pandemic: Findings from a global survey

This study analyzes global health consequences of the new coronavirus disease by focusing on the roles of normative beliefs on social distancing and country-level factors, i.e., mobility estimate and globalization index. We fitted mixed effects models to examine the associations between two outcome measures, depression and self-rated health, and their multilevel determinants using a subset of Global Behaviors and Perceptions in the COVID-19 Pandemic, an online survey consisting of more than 100,000 participants from 67 nations. Results show that both personal beliefs and general beliefs significantly predict depression and poor health. There is also a contextual effect of globalization on depression. In addition, the relationship between general beliefs and depression is stronger in countries with lower rates of mobility. With respect to poor health, the effect of general beliefs similarly varies inversely with the level of globalization. Our study indicates that one's own beliefs and the perception of others' regarding social distancing, along with contextual factors (measures of mobility and globalization), critically shape mental and physical health. Subjective and objective factors should be considered, in other words, in properly understanding the differential impact of COVID-19 across the world.