Unveiling Culture through COVID-19 Policy: A Literature Review

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Abstract

The COVID-19 pandemic was met with various responses by governments around the world. Two major countries that set examples for many of the responses of other countries were China and the US. China and the U.S. were chosen due to their vast differences in culture, as well as their positions of global power. Because of their global stature, literature surrounding the two countries will be more abundant and accessible compared to other countries. There is a need to understand culture and how it plays a role in public health policy, especially to equip governments for future crises. This paper explores the responses of China and the U.S. and analyzes the effect that different cultural qualities had in steering their responses and how the COVID-19 pandemic may have altered cultural norms and practices through a literature review. This paper found that culture steered government responses in specific directions and limited their options in many ways. Prominent aspects of culture that affected policy include individualism, collectivism, political culture, federalism, and more. Chinese and American responses to the COVID-19 pandemic differed in methodologies and results. The COVID-19 pandemic altered many cultural practices in China and the U.S. that were prevalent before the pandemic. Efficient policies will consider public perception based on culture, and these findings will help analyze the compatibility of specific policies given diverse cultural landscapes.

Introduction

The COVID-19 pandemic has upheaved every aspect of our lives and has highlighted the importance of a government’s ability to respond successfully to public health crises. The vastly diverse set of values and norms within our societies has affected our ability to collectively engage in behaviors to prevent the spread of COVID-19, such as wearing masks, social distancing, and limiting social gatherings. With millions of lives lost worldwide, ensuring that policies are observed and implemented effectively is essential for future pandemics.

The two global leaders that have set the example for responses and strategies for COVID-19 have been China and the U.S. While at times conflicting in their views and policies, China and the U.S. have shaped COVID-19 perceptions, research, and outcomes across the globe. These two countries had two very different approaches when handling COVID-19, which can be explained in part by disparate cultural norms. Whilst the presence of individualism appeared to take center stage in America’s battle against COVID-19, collectivism seemed to influence China’s public health response to the pandemic. The fundamental difference in cultural values and standards seemed to steer the responses of these two countries.

Recognizing the importance of culture in shaping health and medicine, this paper aimed to understand how cultural differences shaped China’s and the U.S.’s response to the COVID-19 pandemic. This paper is a literature review that analyzes individual, community, and national-level cultural standards that impact the willingness of individuals to comply with COVID-19 prevention measures in the two aforementioned countries. This paper seeks to answer the question: “How does culture impact the public health outcomes of certain countries and their abilities to implement policies to address public health crises?”. China and the U.S. were chosen due to their vast differences in culture, as well as their positions of global power. Because of their global stature, literature surrounding the two countries will be more abundant and accessible compared to other countries. These two countries can inform us of trends that occur in countries with similar cultural climates. Additionally, this paper looks at how cultural factors affected the secondary impacts of COVID-19, such as mental health and psychological well-being. The paper is conducted with the understanding that culture plays a role in policy-making, as well as the reception of policies. It is currently unclear how countries can utilize culture to inform their policy choices.

Culture has been found by many research studies to affect compliance in certain COVID-19 policies, and to have affected certain psychological outcomes in citizens. Governments that implemented policies that are compatible with their country’s culture exhibit lower COVID-19 cases. Culture impacts the speed of a government’s response, and specifically individualism causes discrepancies among policy responses, undermining efforts to mitigate COVID-19. This may inform the necessity of the US to impose more systems beforehand in which the safety of its citizens are prioritized, and can also highlight the influence of culture in limiting policy choices. Zooming out, this literature review addresses how broader socio-political and geopolitical factors collide with national culture to shape global responses to the pandemic. In the future, governments can take a different approach to policy-making, further including culture to inform their policies. Ultimately, this paper identifies how culture intersected with COVID-19 and how we can use culture to improve our responses in the future. The paper also seeks to establish the definitions of culture and how they can be applied in government policy. These can help us establish a wider understanding of culture and their applications in public health policy.

Background

Culture can mean different things to different people. One’s understanding of culture is likely shaped by their own culture. Cultural behaviors result from social norms, broader social structures, and other factors that make the word difficult to define. The practices and values permeating our lives vastly differ in China and the US. While there is nuance in defining culture, in the context of this paper, culture refers to the shared set of values and norms within a group. It is the force holding together a community and guides social interactions and relationships. Cultural norms and values influence individual behavior, and certain behaviors of Chinese and U.S. culture can be attributed to the characteristics of their cultural values. The mentioning of political culture, cultural norms and other terms is applied in this way, and the specific characteristic of a culture referenced is related to the result discussed.

While COVID-19 is the same disease across the globe, how each country responded to the pandemic significantly differed. Many countries imposed quarantines and stay-at-home orders to some extent to mitigate the spread of the disease. Their methods, however, varied in coverage and strictness, which was influenced by multiple sociopolitical and cultural factors. The two countries analyzed in this paper, China and the United States, took two different approaches to handling COVID-19, which yielded two very different outcomes. Although the virus originated in China, the country was able to impose countermeasures that initially proved efficient at stopping the disease. The spread of COVID-19 strained China’s public health system, but by June 2020, the government had halted the spread of the disease by utilizing a “zero COVID-19 policy”1. When China lifted “zero covid,” cases skyrocketed as China once again struggled to preserve public health.

China was one of the strictest countries when it came to testing, tracing, and stopping the spread of COVID-192. They imposed many stay-at-home orders, restricted international travel, and were very thorough in tracing the spread of the disease. In contrast, the United States took a relatively lenient approach to tracing and stopping the spread of COVID-19. In addition, the United States mostly did not track travel history when tracing the spread of COVID-193. Critically, the presence of federalism in the U.S. diffused the power to make public health decisions to states which made a holistic approach to stopping the spread of COVID-19 difficult. State policies clashed with federal policies around issues such as shutting down schools, businesses, which made it difficult for the U.S. government to contain the virus. It also prevented any policies that were observed by states from having a substantial effect, as neighboring states who did not observe said policies could facilitate the spread of the disease to states who did.

Numerous countries emulated the methods of the U.S. and China. For example, the Japanese response to COVID-19 was similar to China’s in restrictions on international travel, mask mandates, and other strict regulations3. Many Western countries emulated the United States in their response to COVID-19. These two different methods of handling this public health crisis are reflected in the vast difference in cases and deaths in China and the United States. COVID-19 cases in the United States vastly outnumbered those in China, which put a large strain on the healthcare system. By February 2021, 26.7 million COVID-19 cases were reported in America4). COVID-19 was the third largest cause of death in the United States.

In contrast, COVID-19 cases were relatively few in China, numbering only 100 thousand by February 2021. Although their citizens had less freedom than in the United States, Chinese society could still function even with the stringent guidelines imposed by the government. However, the United States vaccination rate was much higher than China as of March 2021, with 30% of the US population vaccinated compared to under 10% in China5. This indicates that the US was quicker than China in achieving herd immunity and halting the spread of the virus after the initial waves.

Methods

The research method for this paper will be a literature review. The literature review will be based on strict selection criteria. Firstly, the selected papers must be written in the English language to ensure proper comprehension. Non-english papers will not be included because the researchers cannot read college-level literature not in English. Secondly, to ensure the selected literature is relevant to the topic, the time frame of 2020-2023 will be used. The COVID-19 pandemic started in 2020, so data collected about the COVID-19 pandemic and its effects will only be considered after that point in time. Reliable databases such as Google Scholar and PubMed will be used to ensure that only peer-reviewed publications are included in the review. Only papers that discuss China and/or the USA will be included. The literature search will be based on keywords such as “culture,” “COVID-19,” “China,” “USA,” “cultural norms,” “public health,” and “cultural practices,” will be used. Papers will be included/excluded first by initial screening of titles. Papers that can provide evidence to answer the research question: “How do cultural factors influence a government’s policy choice and public health outcome?” will be included. A full-text screening that verifies the topics discussed are related to culture and its impact on COVID-19 public health policy is conducted. Once identified, papers will be downloaded, cataloged in Excel, and analyzed for the final review. Reliability and validity were ensured by using a variety of combinations of keywords. This guarantees a wide variety of research studies and eliminates bias that can arise in specific language use.

Results

Factors Impacting Government Response to COVID-19

Clashes between conservative and liberal political cultures in America affected how the government understood its obligations to the health and well-being of citizens6. These differing values shape policy debates that impact access to health care and funding for government healthcare programs. Conservative political culture, which emphasizes limited government intervention and individual responsibility, has caused resistance to government-funded healthcare programs, while liberal political culture has produced the opposite outcome. This political culture polarization reflects American culture’s complexity and how it affects public health policy. Chinese political culture does not have such bipartisan issues. Chinese politics centers around a single party with no opposition, so changes in public health policy are not met with opposition, unlike in the United States.

Responses of US states were also affected by political culture and current events. For example, the federal government largely underfunded New York State’s mitigation efforts, reflecting individualism through the conflict between President Trump and the current New York governor6. The politicization of the COVID-19 response combined with a decentralized government caused disparate COVID-19 outcomes and risk behaviors across the U.S. Because of individualism, multiple political figures are prominent in American culture, and their actions can sometimes conflict, affecting policies and funding. Chinese culture does not create this issue, as their authoritarian government can effectively mobilize resources, make policy changes and take more preventative measures in crises. Their citizens also take preventative measures as a group due to the cohesion of their culture. The speed of a government’s response is informed by cultural factors, such as their political culture.

The existence of federalism caused discrepancies in policies regarding preventative measures in different states2. Although it was recommended to wear masks and stay at home, only 72% of states required using masks in public at the start of the pandemic. In addition, a lack of consistency in policies caused citizens to question the legitimacy of the mandates. Only 59% of US citizens wore masks when going outside, and significant geographic differences reflected the inconsistency in policy. In addition, the emphasis on individualism in the US’s political culture gave most local governments autonomy to impose their restrictions. This paired with the high individualism within the US led the US government to impose more lax restrictions on civil liberties, limiting their ability to heavily restrict these liberties7.

Consequently, it was hard for the nation to mobilize enough resources because all local governments made the decisions themselves and also had to request funding from the federal government, which would create a time lag6. This is crucial when considering a pandemic of this scale and hinders the effectiveness of policies implemented by the United States. It was also more costly to change policies due to this lag as the pandemic continued.

In contrast, the collective culture of China has allowed its authoritarian government to implement policies and mobilize resources with less backlash and lag3. They implemented mask mandates and quarantine policies nationwide and funded local governments in tracing and testing for COVID-19. They also mobilized large amounts of medical personnel and constructed large hospitals in order to support the provinces hit the hardest. This contributed to China being able to contain the disease quickly when the pandemic was at its peak. However, easing the “zero-covid” policy caused a rise in cases, straining the Chinese healthcare system. The US did not have this problem after the initial waves as they had already recovered mainly from the COVID-19 pandemic due to vaccines and herd immunity.

Factors Influencing Citizen Response to COVID-19

Social Culture

Social culture is found to play a large role in limiting a government’s response to public health crises. The presence of individualism and collectivism within China and the US has been found to play a role in the community’s compliance with COVID-19 restrictions and vaccines7. The United States has been known to emphasize individualism in some areas, while China’s culture centers around collectivism, which emphasizes the collective good over the individual. These contrasting cultural norms affect how compliant citizens are with upholding certain mitigative behaviours and how much the government can intervene in the lives of the citizens. Studies find that individualism varies across the United States, but holistically the US has a higher level of individualism than most countries7. The study also found that countries with more individualism were less compliant with lockdown measures from the government, while collectivism positively affected compliance. This difference in compliance was found to be quite significant. Other studies found that, in general Chinese citizens were much more compliant with COVID-19 regulations as a result of higher social cohesion.

Individualism versus collectivism affected trust in the government’s ability to handle public health crises. U.S. respondents had a low trust in the government, which can be explained by the emphasis on individualism in U.S. culture8. U.S. citizens look to individuals to solve problems rather than a collective organisation like the government, which is why they distrust the government. In contrast, Chinese citizens had a higher trust in the government, mainly due to the emphasis on collectivism in Chinese culture. Chinese citizens focus their behaviours on the collective and are also more reliant on the collective, relying on the government. This trust determines how much a government can intervene in its citizens’ lives. Consequently, the Chinese government can implement more policies due to it being more trusted by the public.

In addition, willingness to vaccinate was also vastly different between the US and China9. China was found to have a higher willingness to vaccinate than the US. This was indicated due to Chinese citizens having a higher sense of responsibility to protect others by getting vaccinated, tracing back to collectivism. However, culture was not the only significant factor that indicated whether someone would be willing to vaccinate. For example, younger age or lower social status was significant in predicting willingness and trust in the health care system. Risk perception and infectability were also crucial in predicting one’s vaccination willingness. Specifically in China, marital status was also found to be an essential predictor of willingness. These factors can inform us on whether a government’s effort to vaccinate its population will prove fruitful.

Cultural disparities did play a role in one’s perception of vaccines. Semantic analysis of media platforms found that the Chinese generally had a more positive outlook on vaccines and often put their trust in authority groups10. Both China and the US overlapped in concerns for domestic vaccination policies as well as priority groups and the global pandemic situation. However, Americans expressed their sentiments and concerns more often, including personal experiences in the mix. Americans were more vocal with anti-vaccine attitudes, which reflects the individualism in U.S. culture. On the other hand, the Chinese were found to be less likely to share personal stories, as they are more likely to follow communal rules rather than their sentiments due to a desire to conform to society.

China exhibited more individualism in the face of the COVID-19 pandemic compared to the United States11. Chinese citizens had higher risk perception and behavioral intentions due to cultural aspects but found that each individual cared more about personal goals and safety throughout the pandemic. Although Chinese culture centers around collectivism, it may have been that the perception of COVID-19 affected Chinese citizen’s ability to prioritise others. Compliance may have been affected by collectivism and a desire to protect oneself by taking preventative measures. China’s government’s response was better perceived by the citizens than by the US government8. China’s government reported cases daily and coordinated action and reports to gain citizen trust and maintain consistency. They used epidemic data to make informed policy decisions, which resulted in higher trust from the public and ultimately allowed the government to take more restrictive actions. However, in the US, the most used source of public health data was not the government but rather the mass media. In addition, contrasting and sometimes conflicting views from political figures caused the government to lose popularity and trust. One example would be when President Donald Trump downplayed the severity of the pandemic, causing public distrust and backlash6. Chinese emphasis on collectivism and trust in institutions correlates with a better perception of the government’s actions. This perception is what allows governments to impose more restrictions without public backlash.

Various psychological factors affect citizen response and wellbeing, and these psychological factors are helpful in gauging how many restrictions a government can impose. Despite the widespread disaster of COVID-19, numerous citizens are still hopeful for the future, and analysis of the psychological responses of Asian and Euro-Canadian students was conducted. This research was motivated by past work revealing that culture plays a role in how citizens respond to “highly aversive events” such as COVID-19. During the COVID-19 pandemic, it was found that the Chinese may have reacted more positively in terms of well-being, meaning in life, and optimism when compared to Euro-Canadians11. Other psychological trends were found, such as higher risk perception, seriousness, and preventative intentions during the COVID-19 pandemic.
This research tackled how optimism toward the future has changed during the COVID-19 pandemic. In the past, optimism has been seen as static and unchanging over time. However, with recent findings, this assumption has been challenged through data gathered throughout the COVID-19 pandemic. Optimism is now seen as dynamic, influenced by environmental cues, and may be impacted by events such as the COVID-19 pandemic. Different cultural factors also impact how citizens stay optimistic in hard times and how they respond to adverse events.

Optimism has been shown to influence a person’s responses to adverse events. For example, more optimistic people are less likely to succumb to alcoholism and have been shown to respond with favorable emotional and behavioral patterns when more optimistic. Results have shown that Asian students had a higher level of optimism at various points than their Euro-Canadian counterparts, which has been speculated to be influenced by several cultural factors. Optimism has been connected to the non-linear theory of change and naïve dialecticism, which is prevalent in many Asian cultures. Non-linear theory of change is the idea that events are constantly transforming between negativity and positivity, such as the tides, and the seasons, which explains why Asian students are able to anticipate positive events in the future despite a bleak present. Studies in the past have shown that Chinese citizens were more likely to think non-linearly and had a higher level of optimism regarding the 2002 SARS outbreak compared to Euro-Canadians. Naïve dialecticism is the idea that life exists with contradictions, and it is always suitable within bad, and vice versa. This, coupled with non-linear thinking, has made Chinese students more optimistic when facing adverse events such as the COVID-19 pandemic.

Chinese participants have also been shown to have better well-being12. This can be linked back to optimism due to the fact that if you are more optimistic about the future, it contributes to a more relaxed state of mind. Studies have shown that optimism at an early age is a significant factor in well-being throughout life12. Although Chinese participants generally reported lower life satisfaction, they experienced more positive affect and fewer negative affect than Euro-Canadian participants. This may also be influenced by Asian culture, as there is a link between typical well-being and awareness of social contexts, which Asian participants exhibit more clearly. Asian participants are also known for being able to perceive affective experiences as ever-changing and non-linear, which helps them to “find the good in the bad”. Finding meaning in life can also contribute to a heightened sense of optimism. Asian participants were also found to have a higher sense of meaning in life than Euro-Canadians throughout the COVID-19 pandemic.

Risk perception and seriousness were important psychological factors during the COVID-19 pandemic12. Chinese citizens were found to have a higher risk perception for COVID-19. This means they took the pandemic more seriously than Euro-American participants. From this, the Chinese government can implement more restrictive policies because Chinese citizens already understand how much of a threat the pandemic is.

Differences in optimism and other psychological factors can be explained through cultural differences between Asian and Western cultures12. This is important to note as citizens’ responses impact the response of a government and limit the policies they can place without becoming unpopular with the masses. More optimism in a nation can allow the government to implement new policies without losing the public’s trust or support. Culture ultimately influences a citizen’s psychological response to public health crises and affects their perception of it, which in turn impacts how strict a government can be when responding to health crises.

Understanding how citizens respond to public health crises can inform governments on how to best approach policy changes. The different cultural factors that impact compliance can be used to understand a government’s ability to impose restrictions on civil liberties. The speed of a government’s response can at times highlight the necessity of systems that can mitigate public health crises without the need of government response. The psychological well-being of citizens, which is also tied to culture, can further inform the policy choices of governments

Discussion & limitations

Culture was not the only factor that affected COVID-19, but it was necessary in influencing public health policy. Other factors, such as flaws in the public health system or failure of political figures, also play essential roles in public health crises. Governments could have enforced certain policies differently, which would yield different results. It is essential to keep these factors in mind, but culture remains an easily recognizable factor that can explain specific differences in nationwide response to COVID-19. Culture is also fluid and can change over time, which is why at times, there needs to be a reevaluation of our research in order to predict public health crises. Cultural factors on an individual level can be used to explain certain decisions and behaviors, however, the discussion of cultural factors was generalized to a national level, which may not be accurate. Certain cultural norms and values may not be generalizable on a national scale.

The research found that culture played a role in numerous aspects of the COVID-19 pandemic, including; government public health policy, short and long-term COVID-19 outcomes, social compliance, and the psychological and physical well-being of individuals and communities. Diverging political cultures and a centralized vs decentralized approach to policy in China and the US, respectively led to different rates of COVID-19 policy implementation and resource mobilization. Federalism and bipartisanship in America restricted their ability to implement policy changes nationwide as well as keep consistent attitudes towards the crisis, causing public distrust. Conflicting views from political figures also broke apart the collective effort to contain the virus. China was initially able to implement policies with ease and also maintain public trust through a consistent flow of information and attitudes due to an “authoritarian” political system. This allowed them to set stricter policies than the United States at the start of the pandemic. However, as the pandemic continued, public distrust grew, and the government was not able to maintain its “zero-covid” policy. The differences in political culture and political norms can severely limit the choices a nation makes in response to public health crises. The speed of a government response is also impaired by this difference, making it crucial for countries like the US, that exhibit federalism and decentralized political structures, to implement policies and systems beforehand in order to protect from public health crises. This is to ensure that roadblocks during the crises are mitigated as much as possible. As much as possible, countries should strive to prepare for public health crises well in advance.

Beyond political tradition and culture, this paper also found that culture shaped the boundaries of a government’s ability to impose strict policies regulating individual behaviors. Cultural diversity in America caused policies to vary with what the local population felt was permissible, which led to different outcomes within America itself. Cultural diversity is important when considering different government policy changes. In a highly culturally diverse country like America, no matter what types of policies you implement, they must be less severe in comparison to highly cohesive cultures because clashes of ideals are inevitable. Governments with culturally diverse populations should be cautious with policy changes and make gradual changes in order to not provoke their citizens. The protests that occurred in China may have been caused partly because their population was becoming increasingly diverse in ideals and values, which the government’s policies did not take into account. Though public response is not only dictated by cultural factors. Adverse events and psychological factors may play a role in citizens’ response, so governments should not solely take culture into account when changing policies.

Culture also affects the psychological response of citizens in many ways. Citizens were found to be more positive, tense, or serious throughout the pandemic. These emotions can affect their response to government policy changes. Chinese citizens reacted more positively to the COVID-19 pandemic due to various cultural aspects such as naive dialecticism and non-linear thinking, meaning they were more likely to be compliant with government regulations. Chinese participants generally took the pandemic more seriously than and generally had a more relaxed state of mind which would aid the government response. Response in America was not influenced by a single culture but remained generally mixed due to the cultural diversity in America. Understanding their psychological response can guide a government in navigating a public health crisis. These psychological responses can aid a government and can also be influenced accordingly through policy changes. Thus it is crucial for governments to consider the psychological response of citizens to cater to their policies.

COVID-19 may have also changed cultural norms and transformed cultures around the world. Specifically, a lack of social interaction may have changed cultural practices relating to visiting relatives from overseas, which may have diminished the connection between generations both in Asian and Western cultures11. Kinship networks are, in general, tighter and have more practices in China, but America also has practices that are affected by COVID-19. Kinship networks may have changed due to COVID-19, but familial and interpersonal relationships stayed relatively the same. The foundation of all cultures is unlikely to have changed, but one example of cultural change could be found in an increase in individualism in China. Modern China’s high individualism in recent times can be explained by the COVID-19 pandemic11. COVID-19 may have caused an increase in individualism in China due to citizens being more inclined to prioritize their own health over the collective good, which would change the cultural landscape of China to a certain degree. This is supported by the fact that many protests broke out in China as a result of the “zero-covid” policy, showing their individualistic values. Collectivism is still present in China and affects the political and social culture, but there has been some cultural change due to COVID-19, especially as more outside factors clash and interact with Chinese culture.

There are a number of limitations in the literature review. Research could have been more complete if papers not written in English were considered. Papers written in English may have been influenced by certain factors that make them biased or incomplete in some way, and papers not written in English could help provide different perspectives. Taking into account papers written in Chinese or other languages could’ve made this paper more complete. Not all literature comparing surrounding culture and public health was considered, and not all research databases were used to research. Due to limited resources and time, findings analyzing a country’s culture and public health outcomes may have inaccuracies. Problems regarding media and China may distort the citizen’s perception of the government’s actions as well as the data collected from China. Some data regarding COVID-19 cases may be distorted or unreported for a number of reasons. Cultures may have been misrepresented in some ways in the research, as it is hard to correctly identify culture with all its complexities and contradictions. Especially in countries like the US, cultural diversity may cause inaccuracies in findings and not holistically represent a country’s culture. Cultural norms may also be misrepresented, as they may differ between households. In addition, the findings presented did not include the context and research methods of each individual study, which may misrepresent the data they found. The context may not align with this paper’s purpose, and data may not ultimately reflect a culture.

Overall, the differences in culture in the U.S. and China caused different outcomes, both of which had positive and negative outcomes. Holistically, it is hard to say whether one country was “better,” but both countries had varying degrees of success in achieving their goals. While China overall had fewer cases throughout its “zero-covid” policy compared to the U.S., it had to sacrifice its citizens’ personal and economic freedoms. This caused protests and discontent with the government, as seen in late 2022 with the COVID-19 protests. It also harmed the Chinese economy as they had to halt production and limit business events to maintain public health policy. America may have had more COVID-19 casualties throughout the pandemic, but their more relaxed policies allowed interpersonal relationships to thrive and their economy to grow more so than China. Regarding public health, China seems to have contained the virus more effectively than the US. This was because their policies were more compatible with their culture to achieve this goal. The US had a more relaxed approach to COVID-19 because restrictive policies were incompatible given their cultural landscape. The lack of restrictive policy in America may have endangered citizens, but it also allowed them to interact and connect, which did not happen in China. Neither country could have undertaken an approach fundamentally different because of culture.

Understanding culture is essential in navigating future public health policies and for predicting the actions that a government may take in order to combat crises. A government’s options are limited by culture, and efficient policies take compatibility with the culture into account. It is crucial to understand how successful policies will be in achieving their goals, especially when considering public opinion. Local governments can tailor COVID-19 policies to their communities by analyzing the cultural landscape and how their policies will affect their culture. Other factors, like the psychological well-being of citizens, may also come into play during public health crises, and it is vital to keep these in mind before implementing policy changes. Policies that clash too much with culture can hurt a government’s public image and limit its actions in the future, so one needs to understand their community and culture. Since culture is such a subjective area, governments should put in place proper data collection and empirical methods for justifying their policy choices. Inaccurate assumptions may cause governments to lose legitimacy among their population, and if highly influential figures are able to decide on their own what the culture is like, then it could pave the way for corruption to take hold in policy reform. In order to ensure objectivity and validity, governments should base their policy choices on evidence and statistics.

Acknowledgments

I thank Lumiere Education, Tanvika Parlikar, Khushi Malde, Mary Tate, Taylor Futnam, and Manas Pant for their guidance and assistance in my research paper.

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