Why Mask Compliance Differed in the United States and Taiwan During the COVID-19 Pandemic: How Individualist vs. Collectivist Cultures Respond in Uncertain Times

Abstract

This paper investigates why the mask compliance rates were significantly higher in Taiwan than in the United States during the COVID-19 pandemic. This distinction can primarily be represented by an individualist vs. collectivist mindset, associated with Western and Eastern countries, respectively. Mask wearing was influenced by collectivism; Taiwan’s proximity to the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic and the subsequent policies implemented; cultural norms; psychological factors including higher risk attitude, sensitivity to social norms, and compliance with personal surveillance; and demographics including race, political ideology, and social class. Mask wearing is negatively associated with infection rates but is not fact based or logical: multiple psychological and cultural factors contribute to this compliance variability. Therefore, those that don’t comply are not purely defiant; individualists and collectivists just have a different belief system in what they value and how they behave. As a paper that explores reasons for noncompliance, from a public policy perspective, the message in compliance requests must be tailored to a specific belief system that serves an individual and group’s best interest while respecting personal values.

Keywords: COVID-19, mask-wearing, culture, individualist vs. collectivist, psychological factors

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Why Mask Compliance Differed in the United States and Taiwan During the COVID-19 Pandemic: How Individualist vs. Collectivist Cultures Respond in Uncertain Times

COVID-19, a disease caused from SARS-CoV-2 virus, first detected in Wuhan, China, in December 2019, has been a test of responding to health regulations. Common symptoms include cough, fever, chills, loss of taste and smell, just to name a few. Most cases are mild, with symptoms persisting a few days, but some cases are very severe, requiring hospitalization. The virus has ravaged through borders and taken the lives of millions worldwide. Even though the severity of the pandemic varied by country and demographics, the COVID-19 pandemic was an experience that everyone dealt with. However, the responses, attitudes, and behaviors of the citizens of different countries shed light on how people deal during times of uncertainty. Two contrasting examples include the United States and Taiwan. These two countries have significant differences in mask wearing compliance, defined as wearing a mask when in close contact (within 6 feet) of non household members (Key, 2021).

In a literature search of studies on the mask compliance rates between Eastern and Western cultures, there were multiple studies on the compliance rates and reasoning behind this behavior in Western countries, but limited studies in Eastern countries. This would suggest that because the compliance rates are so high in Eastern countries, researchers aren’t conducting studies on why people complied or how to get people to comply, instead they’re more interested in why people DON’T comply.

According to a study conducted by the University of Southern California’s Dornsife Center for Economic and Social Research, approximately 83% of Americans agree that masks are an effective way to protect themselves from contracting Americans report actually wearing masks when in public places or in close contact with members not of the same household (Key, 2021). Another study found that 64% of Americans that report not wearing a mask responded, “It is my right as an American to not wear a mask” or “It is uncomfortable.” (Vargas & Sanchez, 2020).

The Taiwanese government, on the other hand, instituted a mask mandate with a fine between $100-500 USD for noncompliance (Ministry of Health and Welfare, n.d.; Ministry of Health and Welfare, n.d.). However, there were some reports of non-compliance in some cities in Taiwan. For instance, 604 fines were given in Kaohsiung within 1.5 days (Zheng, 2021) and 848 fines given in Taichung within 2 months (Hong, T. & Lǚ, Z., 2021). Both cities have a population of around 2.7 million, so based on this statistic it can be speculated that the non-compliance rate in Kaohsiung and Taichung is about 0.02% which is still significantly lower than the approximately 50% noncompliance rate in the United States. This finding raises questions on why there is such a big disparity.

The United States has over 330 million people with diverse backgrounds, socioeconomic levels, and beliefs. When the pandemic hit, those outside of the United States saw how a high-income country like the United States dealt with unprecedented circumstances. As of October 2021, the US has over 43 million confirmed cases and 688,000 deaths (World Health Organization, 2021).

Conversely, Taiwan is a densely populated island off the coast of Mainland China with over 23 million people. Due to its proximity to China, where the virus originated, and constant air travel to and from, Taiwan was expected to have the 2nd highest number of cases. However, this was proved to be incorrect. Taiwan along with other countries like Singapore and New Zealand were able to implement policies and community-based preventative measures to slow the rate of transmission and infection rates. By April 2020, the local transmission was at zero (The Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, 2021).It stayed that way for about a year. When comparing infection and mortality rates, as of October 2, 2021, the confirmed cases per million people in Taiwan and the United States is 680 and 131,020, respectively. The confirmed number of deaths per million people in Taiwan and the United States in 35 and 2,103, respectively (Ritchie et al., 2020). These statistics illustrate the significant contrast in the severity of the pandemic in these two countries with the US infection rate about 200 times that of Taiwan and the US mortality rate about 60 times that of Taiwan. Why is there such a major difference? How did this happen? What lessons can other countries learn and what do the actions by Taiwan tell us about their attitudes and cultural norms?

Specific factors that can explain why the Taiwanese and Americans responded differently to the pandemic lie mainly in cultural differences. These distinctions include Taiwan’s past experience with SARS, established social norms, different healthcare systems and access to resources, an individualist vs. collectivist mindset that serves as the foundation for psychological factors, and diversity in the population.

Past Experience with SARS: Proximal vs. Distal Threat

Taiwan had a greater proximal distance than the United States did to the SARS epidemic in 2003. General psychological principles suggest that first-hand experience has a greater impact on someone than watching from far away. From Taiwan’s experience with SARS, the government put policies in place for controlling another global health crisis, such as universal mask-wearing, quarantine requirements instituted in February 2020, closing down borders to foreigners in March 2020, and contact tracing systems after the first identified case in China (Taiwan Centers for Disease Control, 2020). However, Americans had no prior experience with a pandemic to this level. Given Taiwan’s past experience in dealing with a health care crisis, the Taiwanese were more familiar than Americans were with healthcare recommendations when these preventative measures were put in place to curb the spread of COVID-19. Additionally, in the beginning of the pandemic, Americans were not directly involved or affected by the pandemic because of its origin in China. This feeling was bolstered by Trump’s rhetoric calling COVID-19 the China virus, resulting in some Americans believing that they could not get the virus because they had limited a relationship with China. For instance, they weren’t Chinese or planning on visiting China soon.

Differences in the Governmental Leadership

Health Care Services

Another reason is the difference in access to health care services. In the United States, there is no universal health care. Universal health care ensures that all citizens have access to health care services when they need it without financial burden. About 8% of the US population is uninsured (Keisler-Starkey & Bunch, 2020). Given the dozens of insurance companies, including in the public and private sectors, Americans pay different fees, resulting in the fragmented health care system that provides them varying degrees of access to certain medical services. The average annual health insurance in the United States is $5,940. This number fluctuates given location and different insurance tiers. Some plans can reach an upward annual cost of $8000 (Price, 2021).

Taiwan, on the other hand, has the National Health Insurance (NHI) System which provides universal health care to 99% of the population. The NHI provides citizens with “SMART” cards, which store a patient’s medical history and records.

After the first confirmed COVID case was identified in China, Taiwan took strict actions to prevent the transmission to its island, given the frequent flights between Mainland China and Taiwan. Taiwan already had a public health agency, the Central Epidemic Command Center (CECC), instituted after Taiwan’s experience with SARS in 2003. The CECC responded to the COVID-19 outbreak and followed pre-established protocols to control a pandemic and had access to other data from various government agencies.

On January 20, 2020, when the CECC was activated, patients’ medical history from the “SMART” cards was integrated with their travel history and data. From there, a system categorized each citizen into high risk or low risk for contracting the virus. High-risk individuals were those who had traveled to high-risk areas, such as Wuhan, and low-risk individuals included those who had not traveled abroad and had no preexisting health condition. After this integrated information was stored on a citizen’s “SMART” card, low-risk individuals were ordered to buy a week’s worth of masks and could live normal lives. High-risk individuals, on the other hand, were sent into a two-week quarantine after which they could join everyone else (Wang et al., 2020; Vox, 2021). Quarantines as such were effective because it controlled the spread and didn’t rely on quarantining only symptomatic individuals, as asymptomatic individuals have a high chance of transmitting the virus before developing symptoms, if they develop symptoms (Summers et al, 2020).

Taiwan also banned foreigners from entering and in March 2020, the CECC categorized everyone flying into Taiwan to be considered high risk so they all had to undergo isolation quarantine. To make sure no citizens left their quarantine facility, the CECC tracked people’s location using cell phone data. There were also daily phone call check-ins to monitor any possible symptoms as well as occasional in-person check-ins (Vox, 2021).Taiwan also instituted a fine between NT $200,000 and NT $1,000,000 (approximately $7000 USD and $36,0000 USD) for breaking quarantine rules (Ministry of Health and Welfare, 2020).

However, studies have shown that only relying on case-based preventative measures such as quarantine and contact tracing wouldn’t have been sufficient for controlling the pandemic. Instead, population-based measures, such as wearing masks and social distancing, were useful in the initial containment of the virus (Ng et al., 2020). Taiwanese attitudes towards wearing masks and having a collectivist mindset, discussed later in the paper, also helped enforce these measures. Additionally, the then Vice President of Taiwan, epidemiologist Chen Chein-Jen, had broadcast announcements to assist citizens in population based measures such as mask wearing, frequent hand washing, and preventing mask hoarding. Similarly, the CECC set a fixed price for masks and used funds and the military to increase mask production. By January 20, 2020, when the CECC was activated, the government had 44 million surgical masks and 1.9 million N95 masks (Wang et al., 2020).With an integrated health insurance system, quarantine requirements, and resource allocation for mask production, Taiwan was organized and prepared to contain the virus.

U.S. Response to COVID-19

Compared to Taiwan’s approach, the United States’ response to the pandemic was completely different. To start off, the federal government put the responsibility of controlling the pandemic onto the state and local governments. This led to a divided nation, with different states instituting different policies, resulting largely from political ideology (Lewis, 2021).

Additionally, during the beginning of the pandemic, there was limited testing and even so, testing criteria was too high, mainly for symptomatic individuals admitted to hospitals, likely to have COVID-19 (Lewis, 2021). The Centers for Disease Control and Prevention (CDC) also released a flawed test, reporting that it could fail 33% of the time (Temple-Raston, 2020). Furthermore, the CDC reported that the spread of COVID-19 likely started in January/February 2020. However, the surveillance systems for detecting the virus and reports of flu-like symptoms were insufficient allowing the virus to spread undetected for more than a month (Jorden et al., 2020).

There was also mixed information from then-President Trump, government agencies including the CDC and the World Health Organization (WHO), and the behaviors from local officials. Examples include Trump’s denial of the seriousness of the virus as well as government agencies changing their message for mask guidance in part due to medical supply shortages for hospitals and health care workers (Molteni & Rogers, 2020; World Health Organization, 2020). The mask guidance during the beginning of the pandemic sent confusing messages for further encouragement of mask-wearing. Until April 2020 for the CDC and June 2020 for the WHO, these agencies only recommended masks for those experiencing symptoms, but it has now been established that the virus can also spread from asymptomatic individuals. Consequently, it creates confusing mask guidance as well as making it hard to know who and which government agency to trust.

Lastly, the US had insufficient contact tracing and quarantine policies put in place, which seen from other countries, such as Taiwan and New Zealand, had a role in attenuating the transmission (Lewis, 2021).

Individualist vs. Collectivist

One way to further understand the striking difference between these two countries is by looking at contrasting social and cultural norms. These perspectives can differ broadly and are learned distinctions in behavior imposed by cultures, through family, friends, classmates, and more. Psychologists that study cultural differences have found a distinction between Eastern and Western culture which provides insight into the difference in pandemic responses. This distinction can be represented by an individualist vs. collectivist mindset, ideas put forth by Markus and Kitayama. An individualist mindset, associated with many Western countries, puts the individual or self above the group. These individuals value and have personal independence. Collectivists, on the other hand, associated with many Eastern countries, have strong social ties and a sense of belonging to their group. Collectivists are more likely to agree that they are willing to sacrifice their own self-interests for the well-being of the group and that their happiness depends largely on the happiness of those around them. Individualists are more likely to agree that they often do their own thing and that whatever happens to them is their own doing, emphasizing the responsibility for personal well-being (Lu et al., 2021).

To illustrate the prevalence of individualist vs. collectivist cultures, in collectivist cultures, it’s more normal to see families of multiple generations living together. In the United States, a record-breaking 64 million Americans live in multi-generational households, including sizable immigrant collectivist populations. Asian and Hispanic populations, many of which are considered collectivist countries, are rapidly increasing in the US. Asians and Hispanics are more likely than whites to live in a multi-generational household, with approximately 29% of Asians and 27% of Hispanics doing so (Cohn & Passel, 2018). This sense of belonging and community from collectivist beliefs, carried over into the United States, include taking care of elderly and 1 putting others’ interests before theirs, such as potentially sacrificing personal health, commitments, or time to help out. Research suggests that collectivists are more likely to care for elderly family members as a means to strengthen family ties whereas individualists are more likely to limit caregiving and use formal social services as a means of support (Pyke & Bengtson, 1996).

This individualist and collectivist mindset can be used to understand how individual and group rights and responsibilities influenced behavior during the pandemic. For example, individual rights include the personal freedom of choosing whether or not to wear a mask and take the vaccine. To further illustrate, an individualist is more likely to say that they don’t want to wear a mask because it’s uncomfortable whereas a collectivist is more likely to agree that discomfort is not a valid excuse for going against group norms. Individual responsibility entails taking care of one’s health, through social distancing and wearing a mask. For instance, an individual wearing a mask for their personal health and not contracting COVID.

Group rights mean that being part of a collective gives access to specific privileges: a right to health care and access to masks and vaccines. Being a member of a group also implies specific behavior expectations. This can include taking the vaccine and following policies such as travel restrictions, quarantine, social distancing, mask mandates, to prevent others from possibly contracting the virus. These important distinctions highlight the different reasons individuals give in mask behavior, with individualists more likely to put themselves before the group and collectivists prioritizing group needs.

Cultural Norms

Even before policies for stopping the spread of the virus were implemented, Taiwan and many other Eastern countries had a norm for wearing surgical masks when experiencing the common cold or similar viruses to protect others and for taking care of the elderly or groups that were at higher risk (Jennings, 2021). So during a pandemic, it seemed normal if not obvious to be wearing masks in public places, on public transportation, and walking around. This mindset and behavior echoes a collectivist mindset present in many Eastern cultures.

For Americans, on the other hand, the preventative measures seemed unusual and unprecedented, since they’ve never experienced a global health crisis to this scale before. Consequently, the pandemic was an anxiety-provoking experience with changes in daily routine, with economic, financial, and health threats, as well as immense uncertainty: lots of unknowns from long-term COVID-19 effects, how to deal with variants, and confusing guidance on preventative measures from government officials and agencies. As a result, the link between behavior and curbing COVID-19 transmission might not have been as straightforward for Americans as it was for the Taiwanese based on different experiences and how the pandemic was handled. Along with the diverse backgrounds of its citizens, the United States found itself divided. As policies such as mask mandates and isolation requirements slowly rolled in, some Americans refused to follow these rules.

Collectivism Predicts Mask-Wearing

It has been well established that masks are an effective way to slow the transmission of COVID-19. Studies have also shown that there is a negative correlation between mask wearing and infection rates. As stated earlier, a USC study reported an approximate 50% mask noncompliance rate in the United States and reports of noncompliance in Taiwan predict an approximate 0.02% noncompliance rate (Key, 2021; Zheng, 2021; Hong, T. & Lǚ, Z., 2021).

Furthermore, studies have also shown that collectivism is positively correlated with mask-wearing. This holds true not only to illustrate the Taiwan vs. United States distinction, but also amongst many individualist and collectivist countries. Countries that scored higher on a reserve-coded scale of Hofstede’s individualism index (represented as a collectivism scale) such as the Philippines, Indonesia, and Thailand, had higher mask compliance rates than individualist countries that scored lower on the scale such as Sweden, The Netherlands, and Finland. These results are after controlling for other factors (e.g., political affiliation and government stringency) (Lu et al., 2021).

This is true not only when comparing the United States to other countries but stays consistent in the United States, with people in more collectivist regions (states and counties) more likely to wear a mask. For instance, states such as New Jersey, California, and Maryland scored higher on the state-level collectivism scale sourced from Vandello and Cohen (1999) and in mask compliance compared to states such as Arizona, Ohio, and Wisconsin, which scored lower on both the state-level collectivism scale and in mask compliance (Lu et al., 2021).

Masks can create physical inconvenience and be uncomfortable. As said earlier, one study found that 64% of Americans that report not wearing a mask responded, “It is my right as an American to not wear a mask” or “It is uncomfortable.” (Vargas & Sanchez, 2020). These actions follow an individualist mindset of protecting personal choice and freedom, but disregard that their actions can affect others (Stewart, 2020). Conversely, collectivists are more willing to put aside their personal inconvenience for the collective welfare and well-being (Biddlestone et al., 2020).

As mentioned previously, there is a $100-500 USD fine for not complying with mask mandates in Taiwan, along with limited reports of noncompliance (Ministry of Health and Welfare, n.d.; Ministry of Health and Welfare, n.d.). In collectivist cultures, the rules are more strict, with hefty consequences for non compliance, because the norm is an expectation to follow the policies implemented. In individualist cultures, on the other hand, the mandates are less strict and more complex and ambiguous because individualists are less likely to comply with rules that sacrifice personal freedom for the well-being and welfare of others. Cultural and personal beliefs can influence how rules are put into place and how people respond.

Additionally, in the US, there is a large divide between democrats and republicans based on their political ideology. Republicans can be seen as more individualist because they value personal freedom and limited government interference in daily personal matters whereas democrats can be seen as more collectivist because they value greater government intervention in economics affairs and a balance between orderly society and liberty. When looking at the difference between mask compliance in democrats and republicans, a striking difference is revealed. Democratically leaning Americans, aligned with collectivist values, have a higher mask-compliance rate than republican leaning counterparts, aligned with more individualist values, have a lower rate of mask compliance (Xu & Cheng, 2020).

To conclude, it is crucial to note that lower mask compliance rates in the United States is not because of Americans being defiant against preventative behaviors, but because of contrasting belief systems and pandemic unpredictability. These findings do not suggest that Americans are associated with various personality traits but instead shed light on the distinct cultural norms affecting behavior.

Psychological Factors

Personal Freedom and Surveillance

Psychological factors, supported by an individualist and collectivist mindset, can also influence mask wearing behavior. The first factor is the idea of personal surveillance. Collectivists are more likely to agree that groups can intrude on an individual’s privacy, especially if it’s for the greater good, since collectivists are more likely to sacrifice their personal freedom for the collective (Bellman et al., 2004). Individualist cultures are more likely to put themselves before the collective to protect their personal freedom, a value that the nation was founded on. This can be seen through the reactions that Americans had towards tracking devices. Before the pandemic, tech companies shared consumer location data with the government to make it easier to track the location of Americans. According to results from a survey in December 2020 conducted on American adults, 42% of the men who responded and 52% of women who responded were very uncomfortable with this (Johnson, 2020). During the pandemic, other companies, such as Google and Apple, used consumer data to track potential exposure to COVID-19. Over 60% of US adults found this COVID-19 exposure tracking tool to be very or somewhat concerning for their privacy (Johnson, 2020).

In South Korea, a collectivist country, government surveillance and tracking has been implemented even before the pandemic. For example, the government has access to credit and bank transaction records to prevent fraud. This system was then repurposed during the pandemic to track where people went, from restaurants to subways. Additionally, because 95% of adults own a smartphone, data location, which was originally used in criminal investigations, is now used for contact tracing. Surveillance footage utilized for investigative purposes and can now provide real time, to the minute, tracking of someone’s location. Koreans can also get sent text messages for outbreak updates. The use of South Korea’s established government surveillance network made it easier to ensure public health safety. Even though there was some talk about privacy concerns, there are limited reports on noncompliance, emphasizing the collectivist tendency to allow personal surveillance for public health purposes (Fendos, 2020).

Risk Attitude

Risk attitude is another psychological factor that affects mask wearing and can be explained through the individualist vs. collectivist mindset. Recent studies show that risk aversion, defined as less likely to engage in risky behaviors, was correlated with compliance to engage in protective behaviors during the pandemic. This was not only true in a pandemic setting but in general, with individuals that have higher levels of risk aversion less likely to smoke or engage in heavy drinking. (Xu & Cheng, 2021).

During a study conducted on Italians, results revealed that emerging adults were more concerned with their relatives and other individuals/community members contracting COVID-19, potentially through them being an asymptomatic carrier, than testing positive for COVID-19 themselves. This collectivist mindset was correlated with a higher perceived risk of infection (Germani et al., 2020). This perceived risk was positively associated with engaging in protective behaviors such as mask wearing and social distancing, a US study found (Duong et al., 2021).

Mask-wearing behavior has similarly been observed and studied in many Asian countries, including Taiwan’s long-standing cultural norm of wearing surgical masks when experiencing symptoms, such as a sore throat and runny nose, as a means to protect others, mentioned earlier (Jennings, 2021).The collectivist mindset and risk perception associated with mask-wearing in different regions can help to support the reasoning behind the Taiwanese mask compliance.

Additionally, as said earlier, amongst the Americans that report not wearing masks, 64% of those Americans said that they didn’t wear a mask because it was uncomfortable or that it’s their right as an American to choose not to wear a mask (Vargas & Sanchez, 2020). An individualist mindset provides reason for these attitudes and behaviors present in some individuals.

Sensitivity Towards Social Norms

The Taiwanese have strong responsiveness to social norms. There is a sense of pressure for wearing masks in subways and public areas. The community will also shame those for non-compliance. For instance, this mentality towards social norms is epitomized in what one Taiwanese said in a CNBC article, “We have this phrase in Taiwan that roughly translates to, ‘This is your country, and it’s up to you to save it’” (Farr, 2020).The government policies also add to this, with hefty fines, up to $500, for non-compliance (Ministry of Health and Welfare, n.d.; Ministry of Health and Welfare, n.d.).

These distinctions can again be supported by an individualist vs. collectivist mindset, in terms of emotional reactions. For example, one study conducted by Matsumoto, Kudoh, Scherer, and Wallbott (1988) found that Americans and Japanese experienced similar emotional reactions but Americans experienced emotions longer, with greater intensity and more bodily symptoms such as verbal reactions, lumps in the throat, breath changes. To conclude the study, more Japanese agreed that acting on these events when coping with these emotional situations was unnecessary, showing a weaker association between emotion and behavior (Scherer, Matsumoto, Wallbot, & Kudoh, 1988). The findings can be expanded out and offer an explanation to how individualists vs. collectivists in the US and Taiwan behaved in mask compliance. The Taiwanese held each other accountable and were less likely to act on their emotions if they didn’t fully agree/want to wear a mask. Americans were more likely to act and go against these mandates, as can be seen through countless protests across many states, even if they had felt similar levels of emotion towards masks as some Taiwanese did.

One of the possible explanations for this is that many of the emotions experienced are ego-focused emotions, meaning they mainly concern the individual’s internal attributes or characteristics. Some examples include anger, frustration, and pride. Therefore, it is logical that individualists are more likely to attend to and act on these emotions than collectivists are, say if they feel their personal freedom is being violated, because these ego-focused emotions are at the heart of an independent self (Markus & Kitayama, 1991). Through the exploration of how psychological factors influenced mask compliance, the prevalence of an individualist vs. collectivist mindset underscores the application to attitudes and behaviors.

Differences in Diversity among Populations

The United States has great diversity with Americans having their own distinct identity, from various demographics, gender, race, ethnicity, and social groups. The United States is rapidly becoming more complex, with data estimates from the US Census Bureau showing that nearly 4 of 10 Americans identify with a race or ethnic group other than white (Frey, 2020; US Census Bureau, 2021). Some Americans then form subgroups with those of similar demographic identities, and base social behavior off of their beliefs and backgrounds.

One way of measuring ethnic diversity is based on an analysis of ethnic fractionalization, the probability that two random individuals from the same country are not from the same group (race, ethnicity, or other criteria). This can be done through Fearon’s analysis in which ethnic fractionalization is on a scale from 0 to 1, with 1 being the most ethnically diverse. When comparing the numbers on Fearon’s analysis, the United States is 0.49 and Taiwan is 0.274 (Alesina et al., 2002; Fisher, 2019).

Diversity is a descriptive factor in the individualist vs. collectivist mindset, with individualism associated with more heterogeneous cultures and collectivism associated with more homogeneous cultures. This diversity in mindset can explain why some states have higher mask compliance rates, as mentioned in the “Collectivism Predicts Mask Wearing” section (Lu et al., 2021).

]From a racial perspective, in a study conducted by USC, the group that was least likely to consistently wear a mask when in close contact with non-household members were whites, with a compliance rate of 46%. Compared to whites, other races including latinos, blacks, and others had higher compliance rates with 63%, 67%, and 65%, respectively (Key, 2021). Diversity in all demographics, from race, locale, and ethnicity, had significant contributions the way individualists and collectivists engaged in mask wearing. This emphasizes the dynamic intricacies of various societies in which no single factor can predict mask wearing.

Conclusion

Culture is an important factor in behavior that has intrigued me as someone who is mixed and spends time with those of various ethnicities, races, and social groups. When the pandemic hit, I spoke to many family and friends that had completely different views on how the virus affected them and what appropriate measures they believed should be taken. At times it was overwhelming and I sought to understand if there was an underlying cultural factor at the root of different attitudes and behaviors. I found that my relatives in Taiwan had one of the most striking contrasts compared to my relatives in the United States in the way they viewed how the government and our societies should be responding.

Since the onset of the pandemic, the infection and mortality rates have been significantly higher in the United States: the US infection rate is about 200 times that of Taiwan and the US mortality rate is about 60 times that of Taiwan (Ritchie et al., 2020). I chose mask wearing as my control factor because it is a universal way to lower the rate of transmission. From talking with my family and friends, I observed that mask-wearing was one of the most heavily debated topics.

The mask compliance rates are significantly higher in Taiwan than in the United States. Through my literature search, I found multiple demographic, cultural, and psychological factors, influenced by an individualist vs. collectivist mindset, that predicted mask wearing. Taiwan’s proximal distance to SARS in 2003 resulted in public health regulations that gave public health agencies access to patient medical and travel records for contact tracing and testing. Along with this, Eastern countries have norms for wearing masks to protect others. Race, locale, and political ideology was associated with mask wearing. Psychological factors involving higher risk attitude, sensitivity to social norms, and personal surveillance compliance were affected by a collectivist mindset. As a caveat, individualism tends to be correlated with Western countries but there is still a large percentage of Americans that do not associate with an individualist mindset. This results in greater diversity within the United States and Americans having differing views of cultural beliefs. Further, Taiwan’s cultural norms and policy preparedness proved to be significant in Taiwanese compliance with preventative measures.

At the heart of a collectivist is having compassion and taking in another perspective by wearing a mask to protect others. On the other hand, a reason individualists are not complying with mask mandates is not because of pure defiance but because they have a different belief system. For instance, for some individualists, it may be harder to conceptualize that they’re part of a collective and that their individual behavior is affecting the group.

These findings are important because it provides insights into how people react to governmental health regulations during times of uncertainty. Neither individualists nor collectivists are “better” than the other. There are specific attributes of each that may better serve during specific circumstances, such as a global health crisis, but I am not stereotyping individualists or collectivists with specific personality traits. I am not here to convince anyone to change their belief system but in global health crises it may be useful to adopt more collectivist actions while also taking steps to protect themselves. This can be achieved without taking away key components of identity and protecting personal values. One big question is how can we get people to comply without making them change their belief systems?

This paper explores the reasons behind noncompliance, so we can get insight into how to frame compliance requests for individualists and collectivists in different manners with the goal of showing that mask-wearing benefits the health of the public. For collectivists, explaining how mask-wearing benefits the group. Ironically, individualists that are not complying with mask mandates are presenting potential health risks to themselves and the group; these individuals are more likely valuing personal freedom over health. When framing compliance requests for individualists, it may help to emphasize that wearing masks acts in their own interests as well as establish the link between individual behavior and group health. These changes in reframing requests appeal to the individualist and collectivist belief systems while respecting personal values.

It is also important to note that extreme collectivism and extreme individualism can also harm self-interest. To further illustrate, extreme collectivism is primarily not taking into account individual needs and extreme individualism is solely focused on personal desires. Neither of these extremes act in one’s best interest because it fails to take into account other perspectives and people.

To conclude, in everyday experiences, it’s good to find some common ground. That way different perspectives can be acknowledged to create a more informed and dynamic view of the world. Sometimes it’s better to be an individual, sometimes it’s better to be a collectivist. In general, it’s hard to change belief systems to adopt other views but being able to empathize and understand why people are the way they are is beneficial not only in a pandemic, but in daily life.

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