Global report tracks changing health behaviours and attitudes over the past year

A new report has published a year of survey data from half a million global citizens to understand how populations have responded to the pandemic.

Led by Imperial College London’s Institute of Global Health Innovation, the report shares insights from an ongoing international survey established in partnership with YouGov, which is tracking COVID-19 related behaviours and attitudes.

"This programme helps ensure that responses to COVID-19 are successful." Dr David Nabarro Institute of Global Health Innovation

The report focuses on preventative behaviours, life satisfaction, and trust in governments and coronavirus vaccines. While face mask use has increased across all countries surveyed, people’s willingness to self-isolate has decreased over time. Life satisfaction has also decreased in half of surveyed countries, and nations’ attitudes on how their governments are handling the situation has also worsened.

While COVID-19 vaccine hesitancy has decreased across almost all countries, coupled with a fall in worry over side-effects, since the start of the year willingness to take a vaccine has started to decline in some European countries.

Dr David Nabarro, co-director of the Institute of Global Health Innovation, said: “This programme helps ensure that responses to COVID-19 are successful. It recognises that people are at the heart of every response, changing how they behave to reduce the impact of the virus (and its variants) on their health. It helps them adapt so as to be more effective: responding to citizens’ needs and concerns, reacting to data about virus movements, reviewing evidence on risks, and redesigning responses, on a regular basis.”

Of the 29 countries* surveyed since the launch of the programme, 14** offer mostly uninterrupted data from the weekly/bi-weekly surveys, between April 2020 and April 2021, and are included in this report. Click here to download the report.

How well are people sticking to government guidance?

Face mask use has increased across all countries surveyed. As of April 2021, in each country over 70% of people report that they always or frequently wear one when they leave home, except for Australia and Sweden where under half report doing so.

But while Sweden and other Nordic countries have continually had the lowest rates of face mask use, these nations also saw the biggest rise in the proportion of people wearing one, from 6% to 36% in Sweden, 6% to 80% in Denmark, and 10% to 74% in Norway.

In contrast to an increase in this protective behaviour, today more people are returning to work outside the home and a greater number of people are going out in general. People’s willingness to self-isolate if advised to do so by a healthcare professional has also waned over time. While over 68% of people in all countries state that they would do so, the proportion of people who said that they’d be unwilling to self-isolate has increased since April 2020, despite the fact that people’s ability to do so appears to remain unchanged.

The pandemic’s toll on wellbeing

Compared with May 2020, respondents report their current happiness to be worse or unchanged. In half of the 14 countries, life satisfaction has decreased over time, most notably in South Korea ,which has remained the unhappiest nation. The only country that experienced an apparent increase in life satisfaction is the Netherlands.

"It's thanks to the partnerships we've developed that we've been able to dig deeper and help uncloak the pandemic’s far-reaching impacts on people’s wellbeing, on their lives and society more broadly.” Sarah P. Jones Institute of Global Health Innovation

In September 2020 the survey also collected data on wellbeing as measured by the World Health Organization-Five Well-Being Index (WHO-5). Low-middle-income countries tended to report higher wellbeing scores than high-income ones. India, Indonesia and the Philippines had the highest reported wellbeing, while South Korea and Japan had the lowest. Across surveyed European countries, the Netherlands had the highest wellbeing while the UK reported the lowest.

Sarah P Jones, project co-lead at the Institute of Global Health Innovation, said: “The pandemic is changing the way that research is done in a hugely positive way, with greater openness and collaboration enabling science to progress at rates previously unimaginable.

"Our programme is no exception and it is thanks to the public-private partnerships we have developed that we have been able to dig deeper and help uncloak the pandemic’s far-reaching impacts on people’s wellbeing, on their lives and society more broadly.”

Trust in government, health systems and vaccines

Although respondents have generally had more confidence in their health systems than in their government, their views on how both have handled the pandemic have worsened over time in almost all countries. Fewer people today think that the situation has been handled well by their government, except for Singapore and the UK. These were also the only countries, alongside Sweden, where confidence in their health systems’ ability to respond to an outbreak increased.

"We're proud to have contributed to the evidence base that is helping governments and health systems better understand the needs of their citizens and adapt to emerging challenges.” Melanie Leis Institute of Global Health Innovation

The survey has also been tracking people’s views on coronavirus vaccination since early November 2020, shortly before the first approval of a COVID-19 vaccine. Across all countries except Australia, willingness to get vaccinated has risen over time, although this has dipped in several European countries since January 2021. Currently more than half of all respondents said they would take one if offered, except France where only 39% are willing. The UK has remained the most willing throughout the study, currently at 67%.

The increase in willingness has been coupled with a decrease in worry about vaccine side-effects, seen in 12 of the 14 countries. However since the start of the year, concern has started to rise in several countries including Norway, Denmark and Australia.

Although vaccine hesitancy has broadly decreased, the report highlights important issues with access. In 7 of the 14 countries, reported difficulty in accessing a COVID-19 vaccine increased between January and April. And in Italy and France, as of April nearly half of respondents said that vaccines weren’t yet available to them.

Melanie Leis, project co-lead at the Institute of Global Health Innovation, said: “When we established this programme, our ambition was to amass timely, relevant data that leaders could use to shape their ongoing responses and help bring the pandemic under control.

"As we share this review, we are proud to have contributed to the evidence base that is helping governments and health systems better understand the needs of their citizens and adapt to emerging challenges.”

"The pandemic is far from over and we will continue to provide data to public health bodies to help them steer countries across the world through these tumultuous times.” Marcus Roberts YouGov

Marcus Roberts, Head of Public Data at YouGov, said: “As a global public opinion organisation, YouGov is privileged that so many people around the world share their views and behaviours with us every day. Since the pandemic started, we’ve focused on gathering information about COVID-19, asking people to share their experiences and using that unique insight to provide health organisations with data that helps them understand and fight the spread of the virus.

“In that time we have seen great movements in public sentiment – from handwashing early on, to the surge in face mask usage and now when it comes to attitudes towards vaccination. As international news shows on a daily basis, the pandemic is far from over and we will continue to provide data to public health bodies to help them steer countries across the world through these tumultuous times.”

About the programme

Launched across 29 countries in April 2020, the programme was designed to track people’s changing behaviours and attitudes in relation to COVID-19 and help governments, international health organisations and researchers better understand whether public health strategies were effectively curbing the spread of the virus.

Over 540,000 people have taken part to date, offering novel insights into how people’s adherence to guidelines such as face mask use and self-isolation has changed over time, while also unravelling the pandemic’s impacts on individuals’ wellbeing and quality of life. The report also contains recent data on people’s confidence in COVID-19 vaccines and their health systems’ ability to handle the crisis.

By combining long-term trends, robust methods and global reach, the programme has become an important mainstay of publicly available global COVID-19 monitoring.

Notes

* The full list of 29 countries, areas and territories is: Australia, Brazil, Canada, China, France, Germany, India, Italy, Japan, South Korea, Spain, Sweden, UK, USA, Denmark, Finland, Hong Kong, Indonesia, Malaysia, Mexico, Netherlands, Norway, the Philippines, Saudi Arabia, Singapore, Taiwan, Thailand, the UAE and Vietnam.

** The 14 countries highlighted in this report are: Australia, Canada, Denmark, France, Germany, Italy, Japan, South Korea, the Netherlands, Norway, Singapore, Spain, Sweden, UK.

Click here to visit the open data dashboard.

Researchers can access the anonymised data through GitHub. Click here to access the data.