Cultural differences account for starkly different responses to COVID-19

Hello Kitty has eyes but no mouth. The unique anatomy of the world-famous Japanese cartoon girl, who appears to be a cat, reflects an important aspect of her nation’s cultural norms—she doesn’t need a mouth because in Japan, it is more important to read the feelings of others than to broadcast your own. This tendency likely contributed to the easy adoption of mask-wearing among Japanese people during the COVID-19 pandemic, especially when compared to Americans who are averse to covering the facial feature most used to express their unique thoughts and feelings. 

This issue of Psychological Science in the Public Interest explores the cultural differences between the United States and East Asian countries that contributed to divergent COVID-19 outcomes. APS William James Fellow Hazel Markus of Stanford University and her team illustrate how cultural defaults—or common-sense ways of thinking and feeling in a particular culture—account for the starkly different responses to the COVID-19 pandemic. 

A preference for social choice, a willingness to wait and adjust, and a calm attitude are some of the cultural factors that led to a more effective response to the virus in the East Asian countries of Japan, Taiwan, and South Korea. In the United States, by contrast, individuals leaned toward personal choice, an attitude of control, and a tendency to become angry or experience other high arousal emotions.  

These different cultural responses likely contributed to massive variations in the number of COVID-related deaths in each country. By March 2023, 1.1 million people had died in the United States, 73,000 in Japan, 17,700 in Taiwan, and 34,100 in South Korea.  

“While variation in the number of COVID-19 deaths indicates that some nations were indeed better equipped to respond to this particular crisis than others, we do not suggest that one set of cultural defaults is generally ‘better’ or ‘worse’ than another,” wrote the authors. “Both default profiles outlined here carry historically derived cultural wisdom and have been adaptive and useful across a wide range of situations in the past.” 

Markus’s coauthors include APS Fellow Yukiko Uchida (Kyoto University) and APS Fellow Jeanne Tsai, Angela Yang, and Amrita Maitreyi of Stanford. 

The team synthesized literature from mainstream media, reports, quotes from high-level public figures, and analyses from journalists, academics, and other commentators to demonstrate how cultural defaults were apparent in the public messaging of each country’s COVID response.  

“We demonstrate why particular pandemic behaviors were rational and made sense in one cultural context but were much less so in another,” the authors wrote. “Our argument is that these cultural defaults, especially when considered together, could have forecast many of the striking differences in pandemic responses and outcomes between the U.S. and the East Asian countries that are the focus here.”  

In the final section of the paper, Markus and colleagues address how policymakers can identify and consider cultural defaults when planning how to respond to urgent global crises such as climate change.  

“The need to understand not only that culture matters but also how and why it matters to everyday lived experience is in the immediate public interest and more pressing now than ever,” Markus and colleagues wrote.  

In a commentary published alongside the report, Sara Cody considered her own role as director of public health for the Santa Clara Public Health Department in California during the pandemic.  

“Many of the challenges we faced as the pandemic wore on likely reflect the cultural defaults related to individualism and/or independence as described in the paper,” she wrote. “I also recognize that many of the actions that I took and the way we saw our work in our Emergency Operations center also reflect cultural defaults very particular to the U.S.” 

A second commentary from Ichiro Kawachi, a professor of social epidemiology at Harvard University, describes the paper as an important step forward in our understanding of the public health response to pandemic. Kawachi points out that cultural defaults do not operate in a vacuum but are constantly reinforced and manipulated by vested interests. 

“Instead of resigning ourselves to the inexorable power of cultural defaults in influencing public opinion and decision-making, preparing ourselves for future crises demands that we take purposeful action to expose the manipulation of public discourse by vested interests and to educate the polity to resist ingrained habits of thinking, feeling, and acting,” he wrote. 

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References 

Cody, S. (2024). COVID and cultural defaults: A public health officer’s perspective. Psychological Science in the Public Interest, 26(1). 

Kawachi, I. (2024). Culture as a social determinant of health. Psychological Science in the Public Interest, 26(1). 

Markus, H. R., Tsai, J. L., Uchida, Y., Yang, A. M., & Maitreyi, A. (2024). Cultural Defaults in the Time of COVID: Lessons for the Future. Psychological Science in the Public Interest, 25(2), 41-91. https://doi.org/10.1177/15291006241277810