COVID-19 Healthcare HR/People/Culture Learning - Function

Coronavirus: What makes people defy orders during a pandemic?


We are within the midst of an unequaled juncture in history, one during which we discover ourselves primarily armed with the power to distance ourselves physically from each other. In countries like USA, we’ve got observed on multiple occasions over the past several weeks how some citizens have chosen to defy social distancing guidelines from the Centers for Disease Control and Prevention (CDC). a touch while back, there have been reports of churches violating these guidelines so as to carry in-person church services.

There’s a specific moral and cultural complex associated with the matter of spiritual observances during a plague, which mustn’t be understated. Despite this dilemma, many churches navigated the difficulty by providing long-distance services, which adhered to the CDC’s guidelines on public gatherings. While some, even without reasons of religion, chose to go out and head on beaches, clubs, bars and ignore that there’s a pandemic.

Given the drastic difference within the choices some people made versus others across the planet, many people are likely left with the identical basic question: What makes people go against the grain and risk potential infection?

There is over one explanation for this behavior, including distrust in institutions, the psychological consequences of quarantine, and aversion to freedom-limiting solutions. However, providing we are within the throes of coping with SARS-CoV-2, perhaps one among the foremost helpful concepts to know all of this is often the health belief model (HBM). Originating from social and psychological science principles, public health experts have used the HBM since the 1950s to explore health-related behaviors and describe patterns in people’s actions that influence risks of and protections against adverse health outcomes. While the model has been applied extensively to health risk behaviors like combustible tobacco use, it’s also been applied to scenarios involving infectious diseases, not unlike COVID-19.

The HBM holds that people’s health-related actions arise from their assessments of an adverse health outcome sort of a disease and therefore the upstream factors related to it.


These assessments of the end result encompass five main considerations:

1. How likely am I to develop this disease? (Perceived susceptibility)

2. How bad wouldn’t it be if I did develop this disease? (Perceived severity)

3. How motivated am I to form the changes necessary to stop the disease? (Health motivation)

4. What are the potential benefits of taking this preventive action? (Perceived benefits)

5. What barriers do I face in taking this action? (Perceived barriers)


In addition to those five considerations, a part often said because the cue to action is the impetus for somebody to act. This cue might be something sort of a bureau issuing a recommendation or a loved one or religious person, suggesting that someone do something to learn his health, like undergoing colonoscopy. It stands to reason that someone is more likely to act during a desirable way if he believes that a specific outcome could be a major threat to him (i.e., there’s high perceived susceptibility and severity), he’s motivated to form the mandatory changes, and if the pros outweigh the cons (i.e., the perceived benefits outweigh the perceived barriers). By the identical token, it’s equally reasonable that somebody would act contrary to what’s recommended if these considerations were all reversed, which could describe the thought process of these who go against social distancing for whatever reason.

One of the foremost powerful uses of the HBM involves guiding health promotion efforts and introducing targeted interventions to manage the speed at which individuals develop a disease or, worse, expire from it. Mass violation of a vital public health measure—willful or otherwise—requires further investigation by local public health officials and community leaders like mayors and governors. The distinct advantage of using the HBM at the community level is that it provides an actionable roadmap to both diagnose and treat the underlying problem. this enables individual communities to tailor their approaches and mobilize the proper resources to deal with the proper issue.

Although the HBM could be a robust tool for identifying patterns in health-related behaviors, it’s limited in its ability to characterize the intricate social and cultural factors that modify one’s assessment of a negative health outcome. Fortunately, years of gathering empirical evidence on human behavior have generated a complementary framework to the HBM: social cognitive theory (SCT). Commonly seen publically health research, SCT helps to clarify both adoption of and deviation from behaviors like social distancing within the context of the individual, her behaviors, and her environment. SCT states that the individual does things that influence the planet round her which the planet reciprocally influences the way the individual acts.

Why is that this important when it involves people not following the CDC guidelines? in line with SCT, someone who sees instances of others seemingly getting off scot-free after not practicing adequate social distancing is more likely to adopt this behavior because it’s less restrictive. Particularly within the context of confirmation bias, people might see this as a victory over the danger of infection and opt to push their luck by downplaying the threat to themselves et al., overemphasizing the barriers, and undervaluing the advantages. What this implies is that somebody experiencing this cycle of interactions between the individual, behavior, and environment will likely be more recalcitrant when told to form compromises for the public’s well-being, which might trigger a potentially dangerous sequence of maladaptive social learning.

In every community where there are people not adhering to national recommendations, it’d behoove local officials to use these concepts when addressing their residents to obviously define the obstacle to appropriate action. Sadly, evidence demonstrates that a top-down (i.e., from the federal perch) approach to influence health behavior only has the most reach and isn’t sufficient alone; the last word success relies on community leaders carrying the torch the remainder of the way. We cannot afford to become lax on the rules timely lest we cause COVID-19 incidence rates to spike.


Ashten Duncan is a medical student.

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