Pandemic policies: CSSS group investigates states’ COVID outcomes
From the beginning of the COVID pandemic in March 2020 through the summer of 2021, a team of UW researchers led by CSSS professor Christopher Adolph provided the public with detailed data on state policies — especially social distancing and mask mandates — that proved critically useful for scientists, mass media, political leaders, and even large business interests.
But as COVID transitioned to an endemic disease and mandates on distancing and masks ended, research shifted from tracking and forecasting the epidemic to analyzing what happened.
What social, racial, or economic factors affected the spread and mortality of COVID? How much difference did mandates make? What role did politics play in the consequences of the pandemic for health, economics, and education?
Drawing on data to learn for future pandemic policy making
To help answer these questions, Adolph’s team — the COVID-19 State Policy Project — joined forces with a large group of contributors at the Institute for Health Metrics and Evaluation (IHME). Their paper in The Lancet, titled “Assessing COVID-19 pandemic policies and behaviours and their economic and educational trade-offs across US states from Jan 1, 2020, to July 31, 2022: An observational analysis,” seeks to disentangle the complex effects of partisanship, demography, and the broad menu of rapidly evolving state policies tracked by Adolph’s team to uncover why some states did better than others, and to suggest what might be done in the case of a future pandemic.
The Lancet study found that all else equal, death rates were highest in states with large Black, Hispanic or Republican-voting populations. States with more risk-reduction mandates had lower rates of infection. Wealthier, more educated people had better outcomes in terms of infection and death, as did people who reported higher levels of interpersonal trust. Access to high quality health care was also associated with fewer infections and deaths. Behaviors associated with lowered infection rates included masking, reduced mobility, and vaccination.
The researchers also investigated some of the social and economic costs of COVID mandates. They did not find a significant relationship between state COVID policies and state GDP or students’ reading test scores. States where more people adopted behaviors to reduce the risk of infection had lower fourth-grade math scores, as did states with more mandates overall – but there did not appear to be a significant association between test scores and school closures specifically.
“US states that mitigated those structural inequalities, deployed science-based interventions such as vaccination and targeted vaccine mandates and promoted their adoption across society were able to match the best-performing nations in minimising COVID-19 death rates,” the study reported. “These findings could contribute to the design and targeting of clinical and policy interventions to facilitate better health outcomes in future crises.”
Collaborating to conduct real-time pandemic policy research
This article is the latest in a series of influential papers building on the data that Adolph’s team provided from the beginning of the pandemic through summer 2021. The work the team did through the pandemic to track policy changes in real time also proved critically important to leaders and health experts throughout the crisis. Producing that work was not easy.
The data project began when Adolph, a political scientist, noticed early in March 2020 that there seemed to be a partisan bias in the willingness of states to mandate social distancing. That surprised him, because although partisan polarization had reached heights not seen for a lifetime, pandemic response didn’t immediately seem to have partisan implications.
At the start of spring break, Adolph turned to four colleagues —Nancy Fullman of IHME and Bree Bang-Jensen, Kenya Amano, and John Wilkerson in political science – and suggested they quickly investigate whether the apparent partisan bias in state’s pandemic response was real, or just an artifact of other factors driving the pandemic.
With the goal of getting a paper written and released before spring quarter, the first order of business was finding data on the actual social distancing policies being enacted across the states. When their research turned up only incomplete reports from the National Governors Association, Wilkerson suggested their small team compile the data themselves.
They started gathering data from state government websites about measures that were taken to address the pandemic. The partisan patterns they found were so striking they decided to post their early findings as a preprint, as many researchers did during the early stages of the crisis. Fullman, a graduate student from health metrics science, also convinced the team to begin publishing their data tracking state policies on a daily basis because of its importance to the public.
The key finding of the team’s March 2020 study, later published in peer-reviewed form in the Journal of Health Politics, Policy and Law, was that “[t]he most important predictor of when states adopted social distancing policies is political: all else equal, states led by Republican governors were slower to implement such policies during a critical window of early COVID-19 response.” The paper, and the group’s ongoing work, immediately received widespread attention, including coverage in Newsweek and The Economist. The Economist even published a piece replicating and confirming the team’s results.
Evolving and growing to meet new research challenges
With the first wave of the epidemic at its height in April 2020, Adolph’s team expected little immediate change in state policies and instead hoped to spend the spring quarter seeking research funding and planning strategies for measuring the eventual easing of mandates. Instead, spurred by President Trump, numerous Republican governors began easing or ending social distancing policies before infections began to fall. Within a few weeks, some Democratic states began easing their mandates as well. Easing turned out to be even more complex than the initial adoption of social distancing, as states frequently revised their mandates and often established different rules for different counties.
Tracking and coding daily changes in policy was now a major undertaking under the leadership of Fullman and Bang-Jensen, but seed funding from CSSS and Political Science was running out. To keep the project alive through the summer would take outside support, which the team eventually secured from the Benificus Foundation, a private philanthropy based in California. With their support, the team was able to hire more researchers to carry out the coding effort over the following year and a half, including political science graduate students Beatrice Magistro, Grace Reinke, Rachel Castellano, Megan Erickson, and Carolyn Dapper, as well as Rebecca Walcott of the Evans School.
The team produced two more influential papers in 2020 and 2021. The first, released in August 2020 as a preprint, provided clear evidence that adoption of statewide mask mandates could be explained by the partisanship of state governors. It was profiled on the front page of the Washington Post and later published in State Politics and Policy Quarterly. The second, published in Perspectives on Politics in 2021, showed that the rate of easing of social distancing policies was as much a function of partisanship and state racial composition as it was infection rates.
Leaving a legacy in data
Adolph is proud of what the team accomplished and considers the heart of the project to be the data on 16,000 different policy decisions made by the states and DC from March 2020 to August 2021. This dataset – permanently available at covid19statepolicy.org – remains a vital resource for understanding the causes and consequences of non-pharmaceutical interventions made in response to the pandemic. It is also a testament to the diligent work of a large team of graduate student researchers who in the midst of a global crisis devoted themselves to what Bang-Jensen called a “lifestyle project.”
