An Intersectional Analysis of Long COVID Prevalence

TL;DR

This study uses intersectional analysis of survey data to reveal disparities in long COVID prevalence and activity limitations across different demographic groups, emphasizing the need for targeted health policies.

Contribution

It introduces an intersectional approach to analyze long COVID prevalence and activity limitations, revealing complex patterns across multiple demographic factors.

Findings

Women, people of color, sexual and gender minorities, and less educated individuals have higher long COVID prevalence.

Prevalence shows a step-like pattern with the lowest in college-educated men and highest in women without college degrees.

Disparities in activity limitations are more evenly distributed but still show distinct patterns across demographics.

Abstract

Background. Long COVID symptoms (which include brain fog, depression, and fatigue) are mild at best and debilitating at worst. Some U.S. health surveys have found that women, lower income individuals, and those with less education are overrepresented among adults with long COVID, but these studies do not address intersectionality. Methods. We use 10 rounds of Household Pulse Survey (HPS) data from 2022 to 2023 to perform an intersectional analysis using descriptive statistics that evaluate the prevalence of long COVID and the interference of long COVID symptoms with day-to-day activities. We also estimate multivariate logistic regressions that relate the odds of having long COVID and activity limitations due to long COVID to a set of individual characteristics and intersections by sex, race/ethnicity, education, and sexual orientation and gender identity. Results. Women, some people of color, sexual and gender minorities, and people without college degrees are more likely to have long COVID and to have activity limitations from long COVID. Intersectional analysis reveals a striking step-like pattern: college-educated men have the lowest prevalence of long COVID while women without college educations have the highest prevalence. Daily activity limitations are more evenly distributed across demographics, but a different step-like pattern is present: fewer women with degrees have activity limitations while limitations are more widespread among men without degrees. Regression results confirm the negative association of long COVID with being a woman, less educated, Hispanic, and a sexual and gender minority, while results for the intersectional effects are more nuanced. Conclusions. Results point to systematic disparities in health, highlighting the need for policies that increase access to quality healthcare, strengthen the social safety net, and reduce economic precarity.