--- title: "Duration of Behavioral Policy Interventions COVID-19 | Sutter Health" description: "Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020" url: "https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Duration of Behavioral Policy Interventions COVID-19 # Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020 _Public Health Reports_ 2021-10-06 ## Abstract Objective:State-issued behavioral policy interventions (BPIs) can limit community spread of COVID-19, but their effects on COVID-19 transmission may vary by level of social vulnerability in the community. We examined the association between the duration of BPIs and the incidence of COVID-19 across levels of social vulnerability in US counties. Methods:We used COVID-19 case counts from USA Facts and policy data on BPIs (face mask mandates, stay-at-home orders, gathering bans) in place from April through December 2020 and the 2018 Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention. We conducted multilevel linear regression to estimate the associations between duration of each BPI and monthly incidence of COVID-19 (cases per 100 000 population) by SVI quartiles (grouped as low, moderate low, moderate high, and high social vulnerability) for 3141 US counties. Results:Having a BPI in place for longer durations (ie, ≥2 months) was associated with lower incidence of COVID-19 compared with having a BPI in place for <1 month. Compared with having no BPI in place or a BPI in place for <1 month, differences in marginal mean monthly incidence of COVID-19 per 100 000 population for a BPI in place for ≥2 months ranged from -4 cases in counties with low SVI to -401 cases in counties with high SVI for face mask mandates, from -31 cases in counties with low SVI to -208 cases in counties with high SVI for stay-at-home orders, and from -227 cases in counties with low SVI to -628 cases in counties with high SVI for gathering bans. Conclusions:Establishing COVID-19 prevention measures for longer durations may help reduce COVID-19 transmission, especially in communities with high levels of social vulnerability. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/36200805/) ![Rashon I Lane, Ph.D, MA](https://dyn.mktgcdn.com/p/YkFrApKCt1azAd9bE9J193lbOK4SG3jv_LeSeAb0yhY/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Rashon I Lane, Ph.D, MA Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/rashon-i-lane-phd-ma-1049681186) ## Research topics - [COVID-19](https://www.sutterhealth.org/research-search-results?query=%22%5C%22COVID-19%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Unreported SARS-CoV-2 Home Testing and Test Positivity](https://www.sutterhealth.org/research/publications/unreported-sars-cov-2-home-testing-test-positivity-1055312922) JAMA Network Open 2023 Jan 23 - Publication ### [Disparities among racially/ethnically marginalized groups in the COVID-19 pandemic persist regardless of statewide shelter-in-place policies: an analysis from northern california](https://www.sutterhealth.org/research/publications/disparities-among-marginalized-groups-in-covid-19-pandemic-1055312827) Kristen M J Azar, Stephen H Lockhart, Zijun Shen, Robert Romanelli, Stephanie Brown, Kelly Smits, Alice R Pressman Am J Epidemiol: kwab191. doi: 10.1093/aje/kwab191. Online ahead of print. 2021 Jul 02 - Publication ### [Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis](https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873) Ethnicity and Health 2023 Mar 12 - Publication ### [Measuring and promoting SARS-CoV-2 vaccine equity: development of a COVID-19 vaccine equity index](https://www.sutterhealth.org/research/publications/measuring-promoting-sars-cov-2-vaccine-equity-1055312863) Alice R Pressman, Stephen H Lockhart, Zijun Shen, Kristen M J Azar Health Equity.;5(1):476-483. doi: 10.1089/heq.2021.0047. eCollection 2021. 2021 Jul 13 - Publication ### [The learning health system in crisis: lessons from the novel coronavirus disease pandemic](https://www.sutterhealth.org/research/publications/lessons-from-the-novel-coronavirus-disease-pandemic-1055312887) Robert J Romanelli, Kristen M J Azar, Sylvia Sudat, Dorothy Hung, Dominick L Frosch, Alice R Pressman Mayo Clin Proc Innov Qual Outcomes. doi: 10.1016/j.mayocpiqo.2020.10.004. Online ahead of print 2020 Oct 29 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Duration of Behavioral Policy Interventions COVID-19"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817#medicalscholarlyarticle","name":"Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020","headline":"Duration of Behavioral Policy Interventions COVID-19","abstract":"Objective:State-issued behavioral policy interventions (BPIs) can limit community spread of COVID-19, but their effects on COVID-19 transmission may vary by level of social vulnerability in the community. We examined the association between the duration of BPIs and the incidence of COVID-19 across levels of social vulnerability in US counties. Methods:We used COVID-19 case counts from USA Facts and policy data on BPIs (face mask mandates, stay-at-home orders, gathering bans) in place from April through December 2020 and the 2018 Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention. We conducted multilevel linear regression to estimate the associations between duration of each BPI and monthly incidence of COVID-19 (cases per 100 000 population) by SVI quartiles (grouped as low, moderate low, moderate high, and high social vulnerability) for 3141 US counties. Results:Having a BPI in place for longer durations (ie, ≥2 months) was associated with lower incidence of COVID-19 compared with having a BPI in place for \u003c1 month. Compared with having no BPI in place or a BPI in place for \u003c1 month, differences in marginal mean monthly incidence of COVID-19 per 100 000 population for a BPI in place for ≥2 months ranged from -4 cases in counties with low SVI to -401 cases in counties with high SVI for face mask mandates, from -31 cases in counties with low SVI to -208 cases in counties with high SVI for stay-at-home orders, and from -227 cases in counties with low SVI to -628 cases in counties with high SVI for gathering bans. Conclusions:Establishing COVID-19 prevention measures for longer durations may help reduce COVID-19 transmission, especially in communities with high levels of social vulnerability.","description":"Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020","keywords":["COVID-19"],"datePublished":"2021-10-06","url":"https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"36200805"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/36200805/"],"isPartOf":{"@type":"Periodical","name":"Public Health Reports"},"about":[{"@type":"DefinedTerm","name":"COVID-19","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22COVID-19%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817#breadcrumblist"}}} ```