Changes in Self-Reported Mask Use After the Lifting of State-Issued Mask Mandates in 20 US States, February-June 2021

Area of Science:

• Public Health
• Epidemiology
• Behavioral Science

Background:

• The US Centers for Disease Control and Prevention (CDC) recommended community masking to curb SARS-CoV-2 transmission.
• Despite evidence supporting mask efficacy, many US states lifted mask mandates in 2021.
• This study investigates the impact of lifting mask mandates on mask-wearing behavior.

Purpose of the Study:

• To examine the association between the lifting of state-issued mask mandates and subsequent mask-wearing behavior.
• To identify specific demographic or geographic groups disproportionately affected by policy changes regarding mask mandates.

Main Methods:

• A difference-in-difference model was employed to compare mask-wearing changes.
• Data from national surveys (N=3459) on self-reported mask use were analyzed.
• State-level mask mandate data were obtained from the CDC and the University of Nevada, Las Vegas.

Main Results:

• Overall mask-wearing behavior was not significantly influenced by the lifting of mask mandates.
• A significant decrease in mask wearing was observed in rural counties following mandate removal.
• Individuals undecided about COVID-19 vaccination also showed a significant decrease in mask use.

Conclusions:

• Policies addressing COVID-19 behavioral mitigation are crucial, particularly in rural areas and among vaccine-hesitant populations.
• Targeted interventions may be necessary to maintain mask-wearing behaviors in communities with low vaccination rates.
• Understanding these dynamics can help reduce the transmission of COVID-19 and other respiratory viruses.