Public Health and Public Trust: Evidence from the Ebola Virus Disease Epidemic in Liberia

52 Pages Posted: 4 Nov 2016 Last revised: 17 Apr 2018

See all articles by Robert Blair

Robert Blair

Brown University; Brown University - Watson Institute for International and Public Affairs

Benjamin Morse

Massachusetts Institute of Technology (MIT), Department of Political Science

Lily Tsai

Massachusetts Institute of Technology (MIT) - Department of Political Science

Date Written: November 3, 2016

Abstract

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.

Keywords: Ebola Virus Disease, trust in government, Liberia, household surveys, epidemics

Suggested Citation

Blair, Robert and Morse, Benjamin and Tsai, Lily, Public Health and Public Trust: Evidence from the Ebola Virus Disease Epidemic in Liberia (November 3, 2016). MIT Political Science Department Research Paper No. 2018-6, Available at SSRN: https://ssrn.com/abstract=2864029 or http://dx.doi.org/10.2139/ssrn.2864029

Robert Blair (Contact Author)

Brown University ( email )

Box 1860
Providence, RI 02912
United States

Brown University - Watson Institute for International and Public Affairs

111 Thayer Street
Box 1970
Providence, RI 02912-1970
United States

Benjamin Morse

Massachusetts Institute of Technology (MIT), Department of Political Science ( email )

77 Massachusetts Avenue
E53-406
Cambridge, MA 02139
United States

Lily Tsai

Massachusetts Institute of Technology (MIT) - Department of Political Science ( email )

77 Massachusetts Avenue
Cambridge, MA 02139
United States

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