A study found that older Europeans are more likely to stick to pandemic rules if they think they are unhealthier than they actually are.

Researchers studying self-reported health and physicality survey results from over 24,000 European residents aged 50 or more have found that those who underestimate the state of their health are more likely to adapt their behavior in the face of COVID-19 concerns.

But, the researchers warn, this group could possibly face increased social isolation and feelings of loneliness as a result. The Open Access paper from their study has been published in the European Journal of Public Health.

The severity and longevity of the worldwide COVID-19 pandemic will likely be dependent on how people follow rules and guidelines aimed at controlling the spread of current and future variants of the novel SARS-CoV-2 virus, so the research team set out to better understand factors that might make the higher-risk older generations accept or reject these conditions.

Lead author, Sonja Spitzer from the Wittgenstein Centre for Demography and Global Human Capital, a collaboration between IIASA, the Austrian Academy of Sciences (OeAW), and the University of Vienna, says the study was aimed at discovering if the self‑perceived health status of older citizens affects their pandemic rule following.

"We rely on individuals sticking to the rules to reduce the harm this COVID-19 pandemic inflicts on society, so we were interested to know what effect self-perceptions of health have in this regard," she explains.

The study drew on data from self-reported impressions of health compared with physical performance tests in the most recent Survey of Health, Ageing and Retirement in Europe (SHARE) using polling data from respondents in 13 European countries.

"We discovered that survey respondents who believed they were less healthy than was actually the case more often reduced their mobility to comply with rules aimed at shortening the pandemic," notes study coauthor and IIASA researcher Daniela Weber.

"There can however also be a downside: while those with a heightened perception of susceptibility to the disease help prevent transmission through fewer shopping trips and staying home instead, this group could potentially face increased isolation and loneliness," she adds.

On the other hand, those who think they are healthier than they are did not appear more likely to disregard the rules.

"Early in the COVID-19 pandemic there was some shaming of older individuals under the belief that they were not following pandemic rules, but our results show that this popular perception was not accurate," says Spitzer.

The researchers hope that their study can help to inform policymakers on how to better connect with the public in future pandemic communication. In addition, the researchers point out that future health literacy campaigns could consider differences in health perception among people, its effect on health behavior, and how to tackle biased beliefs in one's own health. The findings could also help form better public messaging in the current crisis.

"When we started working with this idea it was generally considered that the vaccines would render the pandemic essentially over, but now, with cases in Europe rising again and some people not wanting to get vaccinated, it's still important that people follow pandemic advice. That makes it really valuable for us to know who follows pandemic advice, who doesn't, and why," adds Spitzer.

The team hope to extend this line of enquiry.

"For the future, it would be very useful to examine this concept of self-perceptions of health in terms of people getting vaccinated, particularly for vaccination take-up in people who overestimate the state of their health. We will definitely follow up on that if we can find data to use," Spitzer concludes.


Spitzer S., Shaikh M., Weber D. (2022). Older Europeans' health perception and their adaptive behavior during the COVID-19 pandemic. European Journal of Public Health, DOI: 10.1093/eurpub/ckab221 [pure.iiasa.ac.at/17733]


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