"Apples and Oranges": Examining Different Social Groups’ Compliance With Government Health Instructions During the COVID-19 Pandemic

Background: The coronavirus outbreak has demonstrated the crucial effect of the public’s compliance with the government’s health instructions on the population’s health. However, evidence shows that some communities are less likely to comply with such instructions than others. This study highlights the factors related to intentions to comply with newly issued health directives during an ongoing extreme crisis, such as the current pandemic. In addition, it compares the impact of these factors on different minority groups and the general population in Israel. Methods: Using an online survey (N=1005), we examined the impact of compliance-related factors on compliance intentions with newly issued health directives in two minority groups in Israel: the ultra-Orthodox Jewish community (N=323) and the Arab community (N=361), as well as in the general population (N=321), during the first outbreak of coronavirus disease 2019 (COVID-19). Participants were presented with a new made-up COVID-19-related instruction simulated to be issued by the Israeli Ministry of Health. Compliance intentions and compliance-related factors were measured. Results: The Arab minority expressed greater intentions of complying with the instructions than the other groups. Perceptions on risk and the effectiveness of the instruction were the only two significantly associated factors with compliance intentions in all of the social groups. Additional factors affected different groups to different extents. Trust in government was related to compliance intentions only in the Arab minority. Conclusion: Intentions to comply with health instructions during a crisis differ in various minority groups and in comparison to the general population, both in their levels and in the factors related to them. Policy-makers and health authorities should consider providing information about the risks and negative outcomes of the crisis as well as the expected effectiveness of the recommended behaviors. Future research should examine other minority groups and other types of instructions in different stages of a crisis.