Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
BMC Public Health. 2023 Aug 9;23(1):1513. doi: 10.1186/s12889-023-16384-2.
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.
根据寄生虫压力理论，集体主义是内群体社交性的特征之一，可提供对传染病的防御。本研究调查了文化集体主义与 2020 年初至 2022 年底期间州（研究 1：N=51）、县（研究 2：N=3133）和每日（研究 3：N=52806）层面 COVID-19 严重程度之间的关联。州级集体主义使用两种不同的措施进行评估：美国集体主义指数，侧重于社会相互联系和相互依存；以及主观文化个人主义-集体主义指数（反转），捕捉与宗教、堕胎和同性婚姻相关的态度和信仰。通过随机截距多水平模型，结果表明，在美国集体主义指数衡量的州级集体主义对每百万例 COVID-19 病例、每百万例 COVID-19 死亡病例和综合 COVID-19 严重程度指数具有显著的负效应，控制了社会经济发展、生态威胁、疾病保护行为、文化规范和政治影响等混杂因素。一项小型荟萃分析（研究 4：N=9）证实了这些研究之间的效应显著。这些发现支持了集体主义在美国新型冠状病毒防御中的积极作用，与社会寄生虫压力理论一致。然而，当考虑混杂因素时，主观文化个人主义-集体主义指数（反转）与 COVID-19 严重程度之间没有显著关系。主观文化个人主义-集体主义指数（反转）与控制变量之间的高度相关性表明存在共享方差，这可能会降低其对 COVID-19 结果的影响。因此，本研究强调了在人群水平上研究集体主义与 COVID-19 严重程度之间的关联时，考虑混杂因素的重要性。通过考虑相关混杂因素，研究人员可以全面了解文化集体主义及其对 COVID-19 严重程度的影响之间的复杂相互作用。总体而言，本研究有助于我们理解文化集体主义如何塑造美国的 COVID-19 大流行，强调了在人群水平研究中调整混杂效应的重要性。
