Social capital dimensions are differentially associated with COVID-19 vaccinations, masks, and physical distancing

Background
Social capital has been associated with health outcomes in communities and can explain variations in different geographic localities. Social capital has also been associated with behaviors that promote better health and reduce the impacts of diseases. During the COVID-19 pandemic, social distancing, face masking, and vaccination have all been essential in controlling contagion. These behaviors have not been uniformly adopted by communities in the United States. Using different facets of social capital to explain the differences in public behaviors among communities during pandemics is lacking.

Objective
This study examines the relationship among public health behavior—vaccination, face masking, and physical distancing—during COVID-19 pandemic and social capital indices in counties in the United States.

Methods
We used publicly available vaccination data as of June 2021, face masking data in July 2020, and mobility data from mobile phones movements from the end of March 2020. Then, correlation analysis was conducted with county-level social capital index and its subindices (family unity, community health, institutional health, and collective efficacy) that were obtained from the Social Capital Project by the United States Senate.

Results
We found the social capital index and its subindices differentially correlate with different public health behaviors. Vaccination is associated with institutional health: positively with fully vaccinated population and negatively with vaccination hesitancy. Also, wearing masks negatively associates with community health, whereases reduced mobility associates with better community health. Further, residential mobility positively associates with family unity. By comparing correlation coefficients, we find that social capital and its subindices have largest effect sizes on vaccination and residential mobility.

Conclusion
Our results show that different facets of social capital are significantly associated with adoption of protective behaviors, e.g., social distancing, face masking, and vaccination. As such, our results suggest that differential facets of social capital imply a Swiss cheese model of pandemic control planning where, e.g., institutional health and community health, provide partially overlapping behavioral benefits.