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Perception of General Health Risks About
COVID-19 Among Members of Opposing
Political Parties in North Macedonia
Ljupcho Efremov,1
Liberal Arts Department, American University of the Middle East, Kuwait
ORCiD ID: Ljupcho Efremov https://orcid.org/0000-0002-2660-4422
Abstract. COVID-19 pandemic unexpectedly created many health risks when it
appeared at the end of 2019 and beginning of 2020. The aim of this paper is to
examine perception of general health risks during the second wave of Pandemic
(October 2020 to December 2020). For this purpose, a questionnaire that explores
different risks during COVID was created. The study included a survey with a
specific target group which was chosen purposefully from members of opposing
political parties in N. Macedonia in order to explore potential differences. 100
respondents in total were included in the sample, consisting of 50 respondents from
two main political parties (VMRO-DPMNE and SDSM) in the country. The
findings show that were no differences between members of opposing political
parties when it comes to aspects related to general health risks during COVID. The
conclusion stated that results are related to beliefs of members of political parties in
the efficacy of well-known measures. The findings provide excellent background
for creating strategies for management of public perception in situations with health
risks.
Keywords. Health risks; Perception; Covid-19; Party membership
1. Introduction
Prior to March 2020 people didn’t worry about getting sick or facing different health
risks in public [1]. The initial cases of COVID-19 became public on December 31, 2019,
when China first reported registered cases of pneumonia of unknown etiology [2]. The
disease soon spread globally as a result of human migration and close contact, fueling
public panic. Like most countries, N. Macedonia was not able to avoid COVID-19 and
in late February 2020, the Ministry of Health registered the first case of COVID-19 [3].
Intercepted by the leadership of the technical government at that time, the copying
mechanisms emphasized the bypassed constructive cooperation, and determined the
already opposing positions of the two largest parties, Socijal Demokratski Sojuz na
Makedonija (SDSM) and VMRO-Demokratska Partija za Makedonsko Nacionalno
Edinstvo (VMRO-DPMNE), which could not ensure a common consensus regarding
1 Corresponding Author, Ljupcho Efremov, Liberal Arts Department, American University of the Middle
East, Egaila, Kuwait e-mail: Ljupcho.efremov@aum.edu.kw
Modern Management based on Big Data V
A.J. Tallón-Ballesteros (Ed.)
© 2024 The authors and IOS Press.
This article is published online with Open Access by IOS Press and distributed under the terms
of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).
doi:10.3233/FAIA240240
30
decision-making and implementation of measures [4]. Instead, a convenient ideological
scenario for crisis management entrenched party interests.
Three weeks after the appearance of the first case [3], that is, on March 13, 2020,
President Stevo Pendarovski declared a state of emergency in the territory of the entire
country, initially for 30 days, which was later extended [5]. The state of emergency
implies strict restrictive measures that abruptly stopped the linear flow of life habits and
caused a great impact on social, economic and political aspects. A day later on March
14, 2020, the Government established the coordination crisis headquarters [6], where
Government officials stepped into the role of communicators and coordinators to respond
to this challenge by introducing various policies in an attempt to control the transmission
of the virus. Under the many uncertainties surrounding the coronavirus, the public has
needed to rely on the Government, political leaders, scientists and the media to obtain
information about the pandemic.
The subject of this research is perception of general health risks that occurred
among members of opposing parties in the period October 2020 to December 2020. This
period is referred to as the second wave of the pandemic. The research question examines
whether there is a difference in perception of general health risks that occurred among
members of opposing parties. The research is important for creating strategies that can
be used in emergency planning and when public faces health risks. The contribution to
knowledge lies in the usage of specific information, while the intended outcome is
knowledge which specific risks to communicate and address in the future in uncertain
situations in a highly polarized society.
2. Risk Perception as a Social Construction
The public faces risks on a daily basis [7]. Some of those risks are individual, while
others are on a societal level. The common factor is that some of them are overestimated,
while other risks are underestimated. Some researchers argue that risk is not a definitive
entity because the public tends not to respond to the physical impact of measurable and
quantifiable risks [8]. Others emphasize the need to focus on the significance of the
psychological, social, and cultural contexts associated with risk [9]. This means that the
public is subject to a different risk assessment, which depends on a complex layer of
elements that influence the acceptance, rejection, reduction, avoidance, or control of the
occurrence of the risk. In the case of COVID [1] the members of the public must protect
themselves both from the virus and fear in the same moment. The responsibility is
individual because the fear response will grow if a person overestimates the risk. The
study of risk perception attributes behaviors and different exposures that people face in
relation to their beliefs, knowledge, values, and attitudes [9].
The general public experiences the risk of Covid-19 indirectly and directly [10].
Direct exposure and negative effects of the virus encourage increased perception. On the
other hand, those who do not have direct experience rely on the scientific community
and government recommendations to assess and protect against the threat. Those
audiences who do not experience it directly and cannot make personal relationships only
have a virtual experience with the effects of the risk through the media [11].
Subjective identification with a political party provides reference points of
perspective through which one's (ir)rational behaviors can be explained and makes space
for the creation of social environment through political information and decision-making.
From this point of view, influenced by cultural and social imaginaries, different social
L. Efremov / Perception of General Health Risks About COVID-19 31
groups (defined by ideological affiliation) evaluate differently what a threat is and how
acceptable it is [12]. The abovementioned notion states that there is no such thing as an
objective risk, but socio-cultural contexts in which they are constructed and perceived.
Risk assessment is rarely unanimous, as the social construction of risk cannot
escape the dynamics of democratic pluralism. Political conflicts and moral debates
greatly influence risk assessment. In a mediatized society [13] in which new dangers
emerge, their centrality can only increase. The strong influence that political ideology
has on people's preferences and descriptive beliefs about the world is done in part by
influencing the way people seek information. In turn, the ways in which individuals
acquire and evaluate information shape their political views. Researchers consistently
find that party loyalty strongly colors citizens' views of political candidates, policy issues,
and “objective facts” [14]. In other words, individuals' commitments to a particular party
identity come first and strongly influence what individuals believe about descriptive and
normative facts, as well as what public policies they prefer.
The cognitive-cultural is a model of risk perception that distinguishes two ways
in perceiving risk [15]. The first way is a reflection from or towards the group of
belonging. It is important to note that there is a reflective function in this relationship. A
reflective effect occurs because individuals with similar values will have similar attitudes
that correspond to shared values. Thus, in-group versus out-group perceptions of party
ideology tend to emphasize the complex nature of how risks are perceived and how those
perceptions may be rooted in the ideology associated with group membership. Another
way individuals perceive risk is according to what reinforces their commitments to the
group to which their views belong [16]. This perception could be independent from the
best available evidence and sometimes in conflict with it [17]. The second way relates to
the cultural-cognitive aspect of risk perception and explains why groups with opposing
political views tend to disagree on important social topics. At the level of party
memberships, there is an internal categorization of affiliation that assesses the
interconnectedness and thus the groups have different norms of behavior. One study [18]
explored differences among opposing party members in perception of media headlines
from opposing political actors. He found a difference in the perception of political
communication related to COVID-19 which is in favor of own political affiliation.
Disagreements about risks, whether concerning the magnitude or meaning that
the risk produces, arise not only from a lack of rational consensus, but also from
subjective experience in which past impressions, evaluations, and knowledge are
generated. In other words, the coronavirus pandemic cannot be fully understood if the
emotional aspects are not taken into account, i.e. fear, panic, hope, etc. Certain authors
[19] point out that social psychologists have long considered emotion an important
component of cognitive processing that can produce an emotional response if influenced
by political messages. Also, emotions should be taken into account, because it is not easy
to know which of them will prevail in a given situation. Findings from another study [20]
suggest that emotions have influence in occupational context regarding attitudes in
organization.
3. Methodology
The study involved surveying 100 individuals, 50 from the VMRO-DPMNE opposition
party and 50 from the ruling SDSM party, all aged 18 or above. For this purpose, a
questionnaire was created on Google Forms, and the survey link was emailed to members
L. Efremov / Perception of General Health Risks About COVID-1932
of the two major Macedonian political parties: VMRO-DPMNE and SDSM. The sample
was purposive, and the approach involved reaching out to people in local party groups
through mutual connections of the author. Approximately half of the participants from
both parties were women. Data collection took place between March 2021 and June 2021.
Participation in the survey was voluntary and completely anonymous. All variables,
except demographics, were measured using a self-evaluation scale corresponding to a
Likert scale ranging from 1 to 5 where 1 = strongly disagree and 5 = strongly agree or 1
= not at all concerned and 5 = I am very worried. Questions about risks (different aspects)
were formulated based on different government recommendations [4] and
recommendations of organizations [1,5]. The aspects are shown in table 1 in the section
results.
Having in mind the goals of the research, the hypothesis claims that there are no
differences in general health risks between members of the party in power and members
of the opposition party. The prediction is based on the premise that when it comes to own
health, members of different political parties will adhere to general recommendations
issued by the government, although for example members of the opposing party don’t
agree with some of the recommendations. In order to test the proposed hypothesis, a t-
test for independent groups was used and the analysis consisted of comparison of
perceptions of health risks between members of opposing parties.
4. Results
The results present the analysis of differences in general health perception (table 1).
Table 1. Comparison between members of SDSM and VMRO-DPMNE about perceived general health risks.
Aspects
Average of
SDSM
members
SD
Average of
VMRO
-
DPMNE
members
SD
t value
P value
1. How concerned are you that you could be
exposed to Covid
-19?
3.32
0.19
2.92
0.16
0.36
p>0.05
2. I am afraid that I will get sick from Covid-19
2.98
0.14
2.85
0.16
0.36
p>0.05
3. I think I will hardly survive if I become
positive for Covid
-19
1.98
0.16
1.99
0.19
0.92
p>0.05
4. I am afraid that I would pass Covid-19 to
someone close to me
3.87
0.22
3.27
0.18
0.04
p<0.05
5. I am worried that I or someon e close to me
will lose my job
2.62
0.13
2.6
0.12
0.85
P>0.05
6. It really worries me when som eone around
me sneezes or coughs without covering their mouth
3.27
0.18
3.14
0.14
0.24
p>0.05
7. The more the virus spreads the more likely I
am to get it
3.63
0.24
3.21
0.16
0.12
p>0.05
8. I feel free to share a bottle of water with a
friend
1.53
0.17
1.73
0.15
0.30
p>0.05
L. Efremov / Perception of General Health Risks About COVID-19 33
9. I don't want to write with a pen that someone
else has obviously used before me
2.14
0.09
2.49
0.15
0.42
p>0.05
10. Past experience has led me to believe that I
am unlikely to get sick easily even when my lov ed
ones/friends are sick
2.27
0.09
2.26
0.14
0.35
p>0.05
11. I prefer to wash my hands immediately after
greeting someone
3.42
0.13
3.2
0.18
0.22
p>0.05
12. I am generally susceptible to flu, colds and
other infectious diseases
2.07
0.12
2.21
0.18
0.84
p>0.05
13. I am more prone than others around me to
catch a cold, flu or infection
2.11
0.13
2.47
0.20
0.43
p>0.05
14. My hands don't feel dirty after touching
money
1.66
0.17
2.24
0.16
0.01
p<0.05
15. I am not anxious to be around sick people
2.36
0.10
2.6
0.15
0.85
p>0.05
16. How worried are you about the spread of
Covid
-19 in Macedonia?
3.19
0.18
3.46
0.16
0.92
p>0.05
The calculations regarding differences from table 1 show that between members
of SDSM and VMRO-DPMNE there are only two statistically significant differences out
of sixteen perceived general health risks (p>0.05). Namely, the differences exist
regarding “I am afraid that I would pass it on to a close person“. In this case members of
the political party SDSM agree more as opposed to the political members of VMRO-
DPMNE. Another statement where these two groups differ, is the statement “I do not
feel my hands dirty after touching money”. In this case the members of the political
members of VMRO-DPMNE agree more as opposed to the political members of SDSM.
There was no difference regarding the other fourteen aspects which emphasize the unique
significance in the difference of perceived risk between the two observed groups. The
results confirm the hypothesis that there is no difference in health risk perception.
5. Discussion
The research aimed to examine the perception of general health risks. The results show
that general assumptions can be confirmed e.g. there is no differences when it comes to
general health risks. The hypothesis indicates that the perception of general health risk
of Covid-19 does not mean that it is necessarily equated with political factors, but
emotional and psychological factors prevail. Members of opposing political parties from
the Macedonian political bloc VMRO-DPMNE and SDSM were subjects of the research
thus introducing affiliation differences as reasons for non-compliance with safety
measures and risk perception. This research provided important findings that there is no
significant difference in the perception of general health risks between members of the
party in power and the party in opposition.
The fact that there are no differences in perception of general health risks shows
that this perception does not depend on trust in the Government, but on the strength of
information [10] that covers the news about the pandemic and has an impact on
psychological-emotional values [21]. Also, this can be interpreted in the light of
increasing the motivation to protect from risk [22] and provide greater adherence to
precautions and thus higher risk aversion. In line with the abovementioned results there
L. Efremov / Perception of General Health Risks About COVID-1934
are several studies that focused on measuring differences in attitudes towards Covid-19
over the course of the pandemic. These types of findings accent the fact that belief and
other psychological factors have a big impact on perceived risk. One such finding comes
from research done at the University of Cambridge, which measured how attitudes
towards the coronavirus varied over the 10 months of the pandemic and included more
than 6,000 UK residents [23]. Research results show that people's values and views, and
sense of personal efficacy play a greater role in risk perception compared to more
objective and cognitive factors [23]. The results from this study show that risk perception
is not influenced by their affiliation but by different socio-cultural factors as found in the
Cambridge study. Similar data from Canada given [24] shows that there is a consensus
about trust regarding Covid-19 between political parties and the general public.
Main limitations of the research are that results cannot be generalized and
sample size. Possibility for generalization is limited due to purposive sampling technique
and smaller sample size. Further research should be directed at analysis of general health
risks among the general population and among non-members or non-supporters of
political parties in the country Additionally, future studies can adopt random sampling
techniques and a higher number of respondents.
The results clearly show that there were no differences between members of
opposing political parties when it comes to general health risks. The explanation is
related to beliefs of members of political parties in the efficacy of well-known measures.
The research shows that political affiliation doesn’t play a role in risk perception, but
there are other factors. Another crucial factor is the unity of presented measures across
different media and across different countries. The current findings provide excellent
background for creating strategies about emergency government planning and crises
management. The abovementioned results create knowledge about knowing which
aspects to address in situations when the public faces unpredicted health risks.
References
[1] Flatten the Fear with Facts: What is an Appropriate Level of COVID-19 Worry and the Steps You Can
Take to Reduce Anxiety. [cited 2024 Jan 23]. Anxiety and Depression Association of America, ADAA.
2020. Available from: https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/flatten-fear-
facts-what-appropriate-level-covid
[2] World Health Organization. Archived: WHO Timeline - COVID-19 [Internet]. [cited 2024 Jan 23]. World
Health Organization. 2020. Available from: https://www.who.int/news/item/27-04-2020-who-timeline--
-covid-19
[3] Opportunities for political gain: the instrumentalization of COVID-19 in four Balkan countries [Internet].
Group for Legal and Political Studies. 2020 [cited 2024 Jan 23]. Available from:
http://www.legalpoliticalstudies.org/opportunities-for-political-gain-the-instrumentalization-of-covid-
19-in-four-balkan-countries/
[4] Управување со кризата како одговор на пандемијата со КОВИД-19 во Република Северна
Македонија. [Internet]. [cited 2024 Jan 23]. Available from:
https://www.ndi.org/sites/default/files/NDI%20Crisis%20Management%20%20Assessment%20%281
%29.pdf
[5] OSCE Office for Democratic Institutions and Human Rights Election Observation Mission Republic of
North Macedonia Early Parliamentary Elections 2020. [Internet]. [cited 2024 Jan 23]. Available from:
https://www.osce.org/files/f/documents/3/5/451213.pdf
[6] Анализа на искуствата на институциите за време на вонредната состојба и уредбите со законска
сила.. 2020 . [Internet]. [cited 2024 Jan 23]. Available from:
https://www.pravda.gov.mk/upload/Documents/Анализа%20за%20искуства%20на%20институциит
е%20за%20време%20на%20вонредната%20состојба.pdf
[7] Bodemer N, Gaissmaier W. Risk perception. Los Angeles: California: Sage; 2015. 10-23 p.
L. Efremov / Perception of General Health Risks About COVID-19 35
[8] Burns WJ, Peters E, Slovic P. Risk perception and the economic crisis: A longitudinal study of the
trajectory of perceived risk. Risk Analysis: An International Journal. 2012 Apr;32(4):659-77.
[9] Cori L, Bianchi F, Cadum E, Anthonj C. Risk perception and COVID-19. International journal of
environmental research and public health. 2020 May;17(9):3114.
[10] Wachinger G, Renn O, Begg C, Kuhlicke C. The risk perception paradox—implications for governance
and communication of natural hazards. Risk analysis. 2013 Jun;33(6):1049-65.
[11] Swim JK, Stern PC, Doherty TJ, Clayton S, Reser JP, Weber EU, Gifford R, Howard GS. Psychology's
contributions to understanding and addressing global climate change. American psychologist. 2011
May;66(4):241.
[12] Fragouli E, Theodoulou P. The way people and societies perceive the nature and context of risk is
different, due to psychological and cultural issues. Journal of Economics and Business. 2015;18(1):29 -
46.
[13] Hjarvard S. The mediatization of culture and society. Routledge; 2013.
[14] Achen C, Bartels L. Democracy for Realists: Holding up a Mirror to the Electorate. Juncture. 2016
Mar;22(4):269-75.
[15] Kahan DM. Cultural cognition as a conception of the cultural theory of risk. HANDBOOK OF RISK
THEORY, S. Roeser, ed., Forthcoming, Harvard Law School Program on Risk Regulation Research
Paper. 2008 Apr 21(08 -20).
[16] Kahan DM. The politically motivated reasoning paradigm. Emerging Trends in Social & Behavioral
Sciences, Forthcoming. 2015 Dec 14.
[17] Kahan DM. The politically motivated reasoning paradigm, Part 2: Unanswered questions. Emerging
trends in the social and behavioral sciences: An interdisciplinary, searchable, and linkable resource. 2015
May 15:1-5.
[18] Efremov L. Attitudes Towards Framed Communication of Political Parties in North Macedonia During
Second Wave COVID 19 Through the Lenses of Supporters. Modern Management Based on Big Data
IV: Proceedings of MMBD 2023. 2023 Aug 23;370:257.
[19] Fiske ST, Taylor SE. Social cognition: From brains to culture. Sage; 2013 Jan 15.
[20] Efremov L. Emotions and Attitudes Towards Safety—Relationship Between Affective Commitment and
Safety Attitudes Among Construction Employees in North Macedonia. In Occupational and
Environmental Safety and Health IV 2022 Sep 17 (pp. 395-407). Cham: Springer International Publishing.
[21] Samadipour E, Ghardashi F, Aghaei N. Evaluation of risk perception of COVID-19 disease: a
community-based participatory study. Disaster medicine and public health preparedness. 2023;17:e10.
[22] Okuhara T, Okada H, Kiuchi T. Predictors of staying at home during the COVID-19 pandemic and social
lockdown based on protection motivation theory: A cross-sectional study in Japan. In Healthcare 2020
Nov 11 (Vol. 8, No. 4, p. 475). MDPI.
[23] Schneider CR, Dryhurst S, Kerr J, Freeman AL, Recchia G, Spiegelhalter D, van der Linden S. COVID-
19 risk perception: a longitudinal analysis of its predictors and associations with health protective
behaviours in the United Kingdom. Journal of Risk Research. 2021 Apr 22;24(3-4):294-313.
[24] Merkley E, Bridgman A, Loewen PJ, Owen T, Ruths D, Zhilin O. A rare moment of cross-partisan
consensus: Elite and public response to the COVID-19 pandemic in Canada. Canadian Journal of Political
Science/Revue canadienne de science politique. 2020 Jun;53(2):311-8.
L. Efremov / Perception of General Health Risks About COVID-1936