Abstract

RationalePsychological reactance theory was applied to examine the implications of state-level mask mandates in the United States during the COVID-19 pandemic. We evaluated the role of political partisanship and COVID-19 risk on changes in self-reported mask wearing before and after the imposition and removal of state mask mandates. MethodSecondary data from several sources were aggregated about self-reported mask wearing behavior, state mandates, COVID-19 infection rates, and state-level political partisanship. Difference-in-differences tests were performed using logistic regression to evaluate whether change in mask wearing behavior following the imposition or removal of a mandate was greater in states based on state-level political partisanship and COVID-19 infection rates. ResultsAlthough mask adoption generally increased following mandates, the amount of increase was smaller in more Republican states compared to more Democratic states. Mask wearing generally decreased following the removal of mandates, with greater decreases when COVID-19 infection rates were lower. ConclusionThe results collectively offer insights about the nuanced role of contextual factors in the adoption and resistance to masks following state mask mandates. Partisanship was important in responses to the imposition of state mask mandates and COVID-19 risk played a critical role in responses to mandate removal.

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