Trust in Institutions, Not in Political Leaders, Determines Compliance in COVID-19 Prevention Measures within Societies across the Globe.

A core assumption often heard in public health discourse is that increasing trust in national political leaders is essential for securing public health compliance during crises such as the COVID-19 pandemic (2019-ongoing). However, studies of national government trust are typically too coarse-grained to differentiate between trust in institutions versus more interpersonal trust in political leaders. Here, we present multiscale trust measurements for twelve countries and territories across the West, Oceania and East Asia. These trust results were used to identify which specific domains of government and social trust were most crucial for securing public health compliance (frequency of mask wearing and social distancing) and understanding the reasons for following health measures (belief in effectiveness of public health measures). Through the use of linear regression and structural equation modeling, our cross-cultural survey-based analysis ( = 3369 subjects) revealed that higher trust in national and local public health institutions was a universally consistent predictor of public health compliance, while trust in national political leaders was not predictive of compliance across cultures and geographical regions. Institutional trust was mediated by multiple types of transparency, including providing rationale, securing public feedback, and honestly expressing uncertainty. These results highlight the importance of distinguishing between components of government trust, to better understand which entities the public gives the most attention to during crises.