{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:44:56Z","timestamp":1784133896993,"version":"3.55.0"},"reference-count":10,"publisher":"National Academy of Sciences","issue":"29","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000088","name":"NSF | Directorate for Social, Behavioral and Economic Sciences","doi-asserted-by":"publisher","award":["SES 342105"],"award-info":[{"award-number":["SES 342105"]}],"id":[{"id":"10.13039\/100000088","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000088","name":"NSF | Directorate for Social, Behavioral and Economic Sciences","doi-asserted-by":"publisher","award":["SAP 2149053"],"award-info":[{"award-number":["SAP 2149053"]}],"id":[{"id":"10.13039\/100000088","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005156","name":"Alexander von Humboldt-Stiftung","doi-asserted-by":"publisher","award":["Experienced researcher fellowship"],"award-info":[{"award-number":["Experienced researcher fellowship"]}],"id":[{"id":"10.13039\/100005156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2025,7,22]]},"abstract":"<jats:p>The COVID-19 pandemic has renewed attention to the far-reaching social implications of emerging infectious diseases, an issue with historical parallels in the transformative effects of the Black Plague and Spanish Flu. However, the potential for epidemics to reshape political trust and fuel instability has remained underexplored. This study leverages a novel dataset on zoonotic disease outbreaks\u2014including Ebola, Marburg, H1N1, and the Black Plague\u2014and geolocated Afrobarometer survey data from dozens of African states to investigate whether exposure to these deadly outbreaks alters public confidence in political institutions. Estimating the average-treatment-effect-in-the-treated with coarsened exact matching, we find that individuals with an infectious disease outbreak experience significant declines in trust toward the political establishment, especially the president, parliament, and ruling party (reductions of 0.2, 0.18, and 0.22 points, respectively, on a four-point scale). These findings, consistent across various spatial and temporal windows, provide robust empirical evidence that deadly infectious disease outbreaks can exacerbate political polarization and undermine political stability. The study emphasizes the critical need for policy strategies that integrate public health preparedness with efforts to preserve and rebuild institutional trust during outbreaks.<\/jats:p>","DOI":"10.1073\/pnas.2506093122","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T17:51:53Z","timestamp":1752774713000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":4,"title":["Infectious disease outbreaks drive political mistrust"],"prefix":"10.1073","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9011-1510","authenticated-orcid":false,"given":"Ore","family":"Koren","sequence":"first","affiliation":[{"name":"Department of Political Science, Tobias Center for International Development, Ostrom Workshop in Political Theory and Analysis, Indiana University Bloomington","place":["Bloomington"]},{"name":"Department of Politics and Public Administration, University of Konstanz","place":["Konstanz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-4913","authenticated-orcid":false,"given":"Nils B.","family":"Weidmann","sequence":"additional","affiliation":[{"name":"Department of Politics and Public Administration, University of Konstanz","place":["Konstanz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctvjghwgp"},{"key":"e_1_3_3_2_2","volume-title":"The Pandemic Century: A History of Global Contagion from the Spanish Flu to COVID-19","author":"Honigsbaum M.","year":"2020","unstructured":"M. Honigsbaum, The Pandemic Century: A History of Global Contagion from the Spanish Flu to COVID-19 (Random House, 2020)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-polisci-051120-014707"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-024-01929-1"},{"key":"e_1_3_3_5_2","unstructured":"Afrobarometer Afrobarometer round 7: Survey data (2021). https:\/\/www.afrobarometer.org."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abc2717"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022002716628281"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0020818320000338"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0032321720980900"},{"key":"e_1_3_3_10_2","unstructured":"O. Koren N. B. Weidmann Infectious disease outbreaks drive political mistrust [online supplemental material]. Open Science Framework. https:\/\/osf.io\/fp5y4\/files\/osfstorage. Deposited 23 June 2025."}],"container-title":["Proceedings of the National Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.2506093122","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.2506093122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T17:52:37Z","timestamp":1752774757000},"score":1,"resource":{"primary":{"URL":"https:\/\/pnas.org\/doi\/10.1073\/pnas.2506093122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":10,"journal-issue":{"issue":"29","published-print":{"date-parts":[[2025,7,22]]}},"alternative-id":["10.1073\/pnas.2506093122"],"URL":"https:\/\/doi.org\/10.1073\/pnas.2506093122","relation":{},"ISSN":["0027-8424","1091-6490"],"issn-type":[{"value":"0027-8424","type":"print"},{"value":"1091-6490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,17]]},"assertion":[{"value":"2025-03-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2506093122"}}