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State-level Stay-at-home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic

Objective: Social distancing has been one of the primary interventions used to slow the spread of COVID-19. State-wide stay-at-home orders received a large degree of attention as a public health intervention to increase social distancing, but relatively little peer-reviewed research has examined the extent to which stay-at-home orders affected people’s behavior. Method: This study used GPS-derived movement from 2,858 counties in the United States from March 1 to May 7, 2020 to test the degree to which changes in state-level stay-at-home orders were associated with movement outside the home. Results: From the first week of March to the first week of April, people in counties within states that enacted stay-at-home orders decreased their movement significantly more than people in counties within states that did not enact state-level stay-at-home orders. From the first week of April to the first week of May, people in counties within states that ended their stay-at-home orders increased their movement significantly more than people in counties within states whose stay-at-home orders remained in place. The magnitude of change in movement associated with state-level stay-at-home orders was many times smaller than the total change in movement across all counties over the same periods of time in both cases. Conclusions: Stay-at-home orders are likely insufficient to reduce people’s movement outside the home without additional public health actions. Existing research on behavior change would be useful to determine what additional interventions could support social distancing behaviors during the COVID-19 pandemic if becomes necessary to reduce movement in the future.