Societal volunteering and COVID-19 mortality in high-income countries: a cross-sectional study

Abstract

Objectives: This study aims to quantify the relationship between societal volunteering and the impact of COVID-19 in that society.

Design: Cross-sectional study.

Setting, participants and outcome measure: Data on societal volunteering were collected for 32 high-income countries (international analysis) and 50 US states (US analysis). Using regression analysis, the ability of this variable to explain COVID-19 mortality was compared with other variables put forward in the public debate (eg, vaccination rate, obesity, age). COVID-19 mortality was measured as the number of deaths due to COVID-19 per million inhabitants, from January 2020 until January 2022.

Results: Societal volunteering explains 43% (resp. 34%) of observed variation in COVID-19 mortality (R²) in the international (resp. US states) analysis. Compared with other variables, societal volunteering better explains the variation in COVID-19 mortality across countries and US states, with only the prevalence of smokers displaying a higher R² in the international analysis.

Conclusions: Countries and states with more societal volunteering have been less impacted by COVID-19, even after accounting for differences in demographics, gross domestic product, healthcare investments and vaccination rates. Although this evidence is not causal, our findings suggest that factors beyond the public-private debate might impact the resilience of societies to a pandemic, with societal volunteering being one such factor.

Keywords: COVID-19; Organisation of health services; PUBLIC HEALTH.

Figure 1

Societal volunteering and COVID-19 mortality. N=32 for international comparison and N=50 for comparison of US states; r = Pearson correlation coefficient. ILO, International Labor Organization. International comparison: AUS, Australia; AUT, Austria; BEL, Belgium; BGR, Bulgaria; CAN, Canada; HRV, Croatia; CZE, Czechia; DNK, Denmark; FIN, Finland; FRA, France; DEU, Germany; GRC, Greece; HUN, Hungary; ISL, Ireland; ISR, Israel; ITA, Italy; NLD, Netherlands; NZL, New Zealand; NOR, Norway; POL, Poland; PRT, Portugal; ROU, Romania; RUS, Russia; SAU, Saudi Arabia; SRB, Serbia; SVK, Slovakia; ZAF, South Africa; ESP, Spain; SWE, Sweden; CHE, Switzerland; GBR, United Kingdom; USA, United States; Comparison of US states: AK, Alaska; AL, Alabama; AR, Arkansas; AZ, Arizona; CA, California; CO, Colorado; CT, Connecticut; DE, Delaware; FL, Florida; GA, Georgia; HI, Hawaii; IA, Iowa; ID, Idaho; IL, Illinois; IN, Indiana; KS, Kansas; KY, Kentucky; LA, Louisiana; MA, Massachusetts; MD, Maryland; ME, Maine; MI, Michigan; MN, Minnesota; MO, Missouri; MS, Mississippi; MT, Montana; NC, North Carolina; ND, North Dakota; NE, Nebraska; NH, New Hampshire; NJ, New Jersey; NM, New Mexico; NV, Nevada; NY, New York; OH, Ohio; OK, Oklahoma; OR, Oregon; PA, Pennsylvania; RI, Rhode Island; SC, South Carolina; SD, South Dakota; TN, Tennessee; TX, Texas; UT, Utah; VA, Virginia; VT, Vermont; WA, Washington; WI, Wisconsin; WV, West Virginia; WY, Wyoming

Figure 2

Per cent of variation in COVID-19 mortality explained by different variables. GDP, gross domestic product.