Ethnic Marginalization and (Non)Compliance in Public Health Emergencies

Abstract

Health crises can reveal the inability of governments to induce compliance with policy interventions. While lack of compliance is conventionally attributed to individual mistrust in government, resistance to such interventions is often found clustered among entire communities, particularly in ethnically divided societies. We account for such patterns by explaining how citizens adjust their responses to state authority according to their shared ethnicity with those in power. We assess the effect of ethnicity on citizen compliance with a public health advisory on HIV/AIDS issued by different authority types through a survey-based field experiment in the West African country of Guinea. Members of a politically marginalized ethnic group, the Peul, are significantly less likely to comply with a public health advisory from a national government representative, the president, when compared to local or religious leaders. We show that perceived ethnic discrimination conditions both trust in and compliance with different authority types.