What Factors Led to the Adoption of Stay-at-Home Orders, and Did They Change Public Behavior?

by Philip Gigliotti, MPA, and Erika Martin, PhD, MPH


As the COVID-19 pandemic accelerated in March 2020, US states adopted “stay at home” orders (SHOs) to limit their residents’ movements away from home and slow the spread of the virus. However, this public health intervention became politically polarized as many Democratic governors rushed to adopt SHOs, while many Republican governors resisted until the issue of White House recommendations on March 29. A new study published in the Journal of Public Health Management and Practice finds that early and late SHO adopters differed politically, as well as in other important ways, including outbreak severity, availability of public health resources, and demographic composition.

Even after adjusting for outbreak severity, Republican governors were significantly less likely to adopt a SHO. However, higher per capita COVID-19 diagnoses and lower hospital capacity were also strong predictors of SHO adoption. The presence of a SHO was significantly associated with reductions in population mobility. However, states with high support for President Trump had smaller reductions in population mobility after adjusting for the presence of a SHO. The infographic below illustrates state-level distributions of SHOs and three associated measures. (Click the infographic to view a larger image or to download a PDF.)

Click the infographic to view a larger image or to download a PDF.

In conclusion, this study provides evidence of political polarization, but also suggests that governors are responsive to public health dynamics in their COVID-19 response. As the pandemic expands across the US, we hope that the importance of evidence-based public health remains salient in the policy-making process.

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Philip Gigliotti, MPA

Philip Gigliotti, MPA, is a PhD Candidate in Public Administration and Policy at the Rockefeller College of Public Affairs and Policy, University at Albany, SUNY. His research uses causal inference methods to evaluate interventions in public organizations. His dissertation evaluates performance management reforms in public health organizations. Previous work evaluated performance reforms in public education. His research has been published in Economics of Education Review and Research in Higher Education.

 

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Erika Martin, PhD, MPH

Erika Martin, PhD, MPH, is an associate professor in the Department of Public Administration and Policy at University at Albany. As an applied health policy and public health systems researcher, she uses mixed methods to evaluate the allocation of scarce public health resources, the adoption and impact of public health policies, and ways to improve the sustainability and impact of open health data initiatives. She is passionate about translating rigorous evidence-based research into public health practice.