A growing number of news stories around the world are pointing to declining public trust in government and other institutions as well as interpersonal trust. Such distrust within populations can prompt polarisation, anger and social unrest. But what are the implications of these trends for our ability to cooperate with each other, and for the institutions that must govern and lead in the face of emerging crises?
In our recent article, we look at cooperation around the two different health issues of vaccination and organ donation. Many of the human and emotional elements of cooperation we discuss in these two settings are similar – fairness, trust, reciprocity, empathy, sustained support and occasional incentives are all powerful levers of cooperation. A notable distinction is that vaccination needs widespread, population-level participation to be most effective – sometimes referred to as ‘herd immunity’ – while organ donation and transplantation can be successful at significantly lower, and more achievable, levels of cooperation. The other key area of delineation worth discussing here is that recently vaccination has operated in a highly charged political environment, where organ donation has been free of this dimension in building support. This apolitical space has been a critical element in the opportunity for growth in organ donation when juxtaposed with the environment surrounding vaccination. The COVID-19 pandemic, which became highly politicised in a number of settings, certainly strained our ability to cooperate, with polarisation emerging in those moments that called for a collective resolve.
Clearly cooperation is not a panacea for all circumstances. Sometimes issues seem too important and too time-sensitive to build consensus and the time for dialogue and explanation is deferred in the face of urgency. Other cases, such as vaccination, require a critical level of engagement to be successful.
Evolutionary behavioural science tells us that, in general, people tend to cooperate for the greater good, despite some individuals who may counter the trend for personal belief or political reasons. But it seems that going against cooperation is becoming more of the norm among publics, while examples of genuine cooperation have become the exception.
Are we becoming more dogmatic and less malleable in our ability to cooperate?
The 2023 Edelman Trust Barometer showed worrying findings in its 27-country survey which reported that only 30 per cent of respondents agreed with the statement ‘If a person strongly disagreed with me or my point of view I would help them if they were in need’. The survey findings indicate that within our current social climate these differences of opinion have undermined cooperation and our fundamental moral values of helping each other.
Cooperation around life-saving measures is essential to protect ourselves and others from a potentially fatal virus, unstable political regimes or other existential threats such as climate change. While cooperation may be in peril, and fragile in nature, it is an invaluable asset in working towards the public good.
Cooperation does still exist in many settings. It just depends on how cooperation is defined, and more importantly with whom. Cooperation is more common across groups of like-minded people, but less so outside of those groups, particularly in our current polarised world.
Think of the ‘echo chamber’ effect often referred to in the context of social media conversations whose algorithms cluster individuals and groups with shared sentiments into spaces where their views are endorsed by others with similar beliefs and feelings – amplifying their perception of how many people actually believe what they do. In this echo chamber of groupthink, people are becoming more strongly tied to their in-group identity, instead of thinking critically with a willingness to engage with others who perhaps hold different views and beliefs.
In his famous book Profiles in Courage, John F. Kennedy champions individuals who had the courage to go against the grain of popularity among their constituencies, to make a bold move, risking that in-group popularity, for something that their integrity felt was bigger. The public good.
Kennedy quotes Senator Thomas Hart Benton saying: “I despise the bubble popularity that is won without merit … I sometimes had to act against the preconceived opinions and first impressions of my constituents.”
These dilemmas Benton reflected on in the 1800s are still relevant today. Former California Governor Arnold Schwarzenegger wrote that he tried to maintain as a guiding principle “What is best for the people? Because I always believed you should not be a party servant, you should be a public servant.”
It takes courage to leave the comfort zone of shared beliefs, to step outside the echo chamber, let go of the shore, and be willing to cooperate with others. But such cooperation is needed more than ever. In the age of information, we cannot independently vet all issues, and it becomes easy to default to familiar voices to inform our opinions. And social media funnels us back to our echo chamber to find guidance. We need new norms, incentives and championing of cooperative behaviours. Thousands of years of data tells us that human beings migrate towards incentives, be it financial, reputational or otherwise. Cooperation outside our silos, not within, must be the recognised virtue. Such efforts and large-scale cooperation might even bring back a level of civility to our public discourse and build greater social cohesion.
Heidi Larson is at the London School of Hygiene & Tropical Medicine, UK, and the University of Washington, Seattle, USA.
Alexander H Toledo is at the University of North Carolina at Chapel Hill, USA.
Nurturing, nudging and navigating the increasingly precarious nature of cooperation in public health: the cases of vaccination and organ donation by Heidi J. Larson and Alexander H. Toledo for Global Discourse is available to read open access on Bristol University Press Digital here.
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