Understanding U.S. COVID-19 Policy Responses Across States Over Time

• In Event: Plural Approaches to Understanding COVID-19 Response

Abstract

The COVID-19 pandemic is one of the worst crises in the past 100 years and poses unprecedented challenges for governance. Due to lack of federal leadership in the U.S. during 2020, state governments were forced to rapidly develop policies and plans for curbing the outbreak, closing and re-opening economies, testing, and vaccine distribution. State policy responses varied dramatically across the 50 states, with some states implementing much more stringent and wide-reaching policies than others. Many of the states adopting more stringent policies also acted earlier than other states to issue COVID-19 policies and kept their policies in place for longer periods of time, even as they made adaptations in response to the evolving public health situation. Understanding how the duration of the crisis influences state policy adoption is critical for advancing knowledge of policy diffusion. This empirical context provides a unique opportunity to analyze how pandemic-related policies were developed, diffused, and adapted across all 50-states over the course of a relatively long period of time, relative to other public health crises. Moreover, we can examine the factors that led some states to act earlier and with more aggressive policy approaches than other states, and how these policies correlate with a host of public health outcomes.

Drawing on the policy diffusion literature, this research examines the factors influencing the adoption and timing of pandemic policy by U.S. states with a focus on COVID-19 policies in 2020. The policy portfolios developed across states vary both in terms of the tools used (i.e., stay-at-home orders, mask mandates, limits on gatherings, business closures) and stringency (i.e., sanctions for failure to abide by new laws, application to various populations or location). This study hypothesizes that internal determinants are important predictors of state policy adoption, including problem severity (state COVID-19 cases per 1,000 people), state political ideology, governor’s party affiliation, and hospital capacity (state estimated inpatient beds occupied per 1,000 people). We also hypothesize that external factors, including participation in a regional compact agreement, competition with neighboring states (proportion of neighboring states that have adopted COVID-19 policies), and the problem severity of nearest neighbors (rates of COVID-19 cases per 1,000 people in nearby states) are important predictors of state policy adoption. We quantitatively test the influence of these internal and external factors on state policy adoption using process tracing event history analysis.

Authors

• Deserai Anderson Crow, University of Colorado Denver

• Manli Zhang, University of Colorado Denver

• Rob A. DeLeo, Bentley University

• Kristin Taylor, Wayne State University

• Elizabeth Koebele, University of Nevada, Reno

• Thomas A. Birkland, North Carolina State University

• Elizabeth Ann Albright, Duke University

• Nathan Jeschke, University of Colorado Denver

• Honey Minkowitz, North Carolina State University