Hawaii ranks near bottom of report on COVID-19 policy effects

by Kim Jarrett | The Center Square, April 15, 2022

(The Center Square) – Hawaii ranked near the bottom in an analysis from the National Bureau of Economic Research, which measured COVID-19-related outcomes in the states.

The report measured states' pandemic policies based on health outcomes, economic performance and impact on education.

Hawaii is unusual because it is an island state, the report's authors said.

"It ranks last on the economic index and sixth from last on schooling," the authors wrote in the report. "As of March 2022, it ranks first on health. Understood in the context of island nations such as Australia and New Zealand, the experience of Hawaii suggests that island locations can, by sustaining significant economic losses, reduce mortality for a year or more."

Hawaii also ranked low for its economy because it relies heavily on tourism, according to the report. The state implemented a Safe Travels Program that required visitors to show proof of vaccination or a negative COVID-19 test from within three days of arrival. Hawaii was the last state to end its indoor mask mandate.

The authors also cited a report from The Rand Corporation that showed lockdowns did not reduce mortality.

“The correlation between health and economy scores is essentially zero, which suggests that states that withdrew the most from economic activity did not significantly improve health by doing so,” the authors wrote.

Other factors could have played a bigger part in COVID-19-related deaths, according to the report.

"Pandemic mortality was greater in states where obesity, diabetes, and old age were more prevalent before the pandemic. Economic activity was less in states that had been intensive in, especially, accommodations and food," the authors wrote. "Still, much residual variation in both mortality and economic activity remains even after controlling for these factors because the 50 states and D.C.(District of Columbia) took very different approaches to confronting the COVID-19 pandemic."

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A FINAL REPORT CARD ON THE STATES’ RESPONSE TO COVID-19

April, 2022, National Bureau of Economic Research, Cambridge, MA

Introduction

Modern economies like the United States spend considerable resources on health, ranging from hospitals to drugs, to device manufacturing to at-home care. With health very high among the American population’s priorities, it is no surprise that government officials and most citizens were willing to sacrifice income and some of their daily routines and normal freedoms in order to significantly reduce the burden of this new disease.

The COVID-19 pandemic was distinct from other previous health pandemics in the degree to which we saw government interventions in the economy and suspension of individual freedoms – including policies such as lockdowns, curfews, mask and vaccine mandates, mandatory business closures, school shutdowns, and so on.

After the first several months of the pandemic, decisions about the most effective policies to balance health risks and allowing businesses to stay open and workers to go to work, as well as keeping schools, stores, churches and parks open and under what conditions were left to the 50 states. The purpose of this paper is to measure and compare the different economic and health trajectories across the 50 states and DC.

Our measures fall into three categories: the economy, education, and mortality. For economic performance we used two measures: unemployment and GDP by state. For education we used a single metric: the Burbio cumulative in-person instruction percentage for the complete 2020-2021 school year, with hybrid instruction weighted half. For mortality we used two measures: COVID-associated deaths reported to the CDC and all-cause excess mortality.

Of course, even without a pandemic, states populations are heterogeneous and their economies emphasize different industries. And because the pandemic had a much more negative effect on economic output in some industries (such as entertainment, energy production, mining, hotels and food), we adjust unemployment and GDP changes for industry composition. We adjust COVID mortality (through March 5, 2022) for age and “metabolic health,” by which we mean the pre-pandemic prevalence of obesity and diabetes – as these are highly correlated with higher death rates from the virus.

Economy and schooling are positively correlated (correlation coefficient = 0.43), which suggests a relationship between the willingness of the population (or its politicians) to resume normal activity in business and school. MT, SD, NE, and UT are the states highest on the economy score and also among only seven states to exceed 85 percent open schools. The correlation between health and economy scores is essentially zero, which suggests that states that withdrew the most from economic activity did not significantly improve health by doing so.

We should note that Hawaii, as an isolated island, stands out as a special case. It ranks last on the economic index and sixth from last on schooling. As of March 2022, it ranks first on health. Understood in the context of island nations such as Australia and New Zealand, the experience of HI suggests that island locations can, by sustaining significant economic losses, reduce mortality for a year or more. (Australia and New Zealand saw higher outbreaks in later stages of the virus spread.) Interestingly, Maine opened its schools at almost triple the rate as Hawaii did and was able to achieve a health score almost as high.

The economy and education components were likely influenced by decisions made by policymakers, but it is unclear if that is the case for the mortality component. One possible exception is nursing home policies, which may explain why several states, especially New York and New Jersey, performed poorly on mortality metrics. A recent comprehensive global review by Heneghan, et. al. (2021) concluded that COVID-19 disproportionately occurred in nursing homes. Because the states that were transferring COVID patients from hospitals to nursing homes also tended to systematically underreport nursing home deaths so this is a difficult question to examine quantitatively.

Using other methods, several studies have also found little health benefit of closing schools or businesses. Several studies find low COVID-19 transmission rates in schools. Herby, Jonung, and Hanke’s (2022) metaanalysis finds that “lockdowns in Europe and the United States only reduced COVID-19 mortality by 0.2% on average.” Mulligan (2021b) finds that in-person workplaces were often safer, in terms of COVID transmission per person per hour, than households were due to the additional prevention efforts made in workplaces. Several other studies have found that efforts to reduce COVID mortality had costly unintended consequences.

In addition to calculating category-specific indices, we also calculated a single combined score that equally weights the z-scores of the three components and then transforms to a 0-100 scale.

Results

This summary map shows combined scores. The table shows each state’s combined score alongside its components. The outcomes in NJ, NY, and CA were among the worst in all three categories: mortality, economy, and schooling. UT, NE, and VT were leaders in all three categories. The scores have a clear spatial pattern, perhaps reflecting spatial correlations in demographic, economic, and political variables. However, IL, NM, CO, and CA are outliers among their geographic neighbors in the direction of low combined scores. FL, AR, WV, and UT are outliers in the other direction.

LINK: Hawaii Ranks 39th, see page 5

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For our unemployment measure, we looked at the cumulative months of unemployment (total unemployed over the period divided by total labor force over the period) from April 2020 to December 2021 and for each state subtracted the period of the same measure from January 2019 to February 2020. That is the raw unemployment metric. Hawaii and Nevada came in last by far because of the overwhelming impact the global shutdown of tourism had on them, and energy-heavy states similarly had disproportionate unemployment rises with the collapse of global demand. Because we considered these industry factors independent of state performance, we adjusted for industry composition….

Excluding the geographically unusual cases of Hawaii and Alaska to focus on the continental U.S., there is no apparent relationship between reduced economic activity during the pandemic and our composite mortality measure…. 

read … Full Report

WSJ: States of Covid Performance

WT: The verdict on lockdowns: high costs, minimal benefits  

SoR: Hawaii ranks first in health, last in economic well-being in COVID policy analysis