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Objectives <p>Limited evidence suggests possible disparities in COVID-19 across race/ethnicity, metropolitan status, and healthcare access. This study investigated racial/ethnic, metropolitan, and healthcare access disparities in Long COVID among U.S. adults.</p> Methods <p>2022–2023 cross-sectional Behavioral Risk Factor Surveillance System data were analyzed. U.S. adults who had COVID-19 were included, resulting in a final weighted sample size of <i>n</i> = 80,093,998. Logistic regressions examined associations between race/ethnicity, metropolitan status, health insurance and ever or currently experiencing Long COVID and reductions in daily function. Interactions were examined for metropolitan status and health insurance.</p> Results <p>Versus non-Hispanic White (NHW) respondents, a higher odds of Long COVID were observed for Non-Hispanic American Indian/Alaskan Native (ever adj. OR = 1.24, 95% CI: 1.01, 1.53; currently adj. OR = 1.72, 95% CI: 1.39, 2.12) and Other Race/Multiracial (ever adj. OR = 1.41, 95% CI: 1.18, 1.62; currently adj. OR = 1.35, 95% CI: 1.16, 1.58) respondents. Black (ever adj. OR = 0.84, 95% CI: 0.76, 0.93), Asian (ever adj. OR = 0.54, 95% CI: 0.42, 0.70), and Native Hawaiian/Pacific Islander (currently adj. OR = 0.61, 95% CI: 0.39, 0.95) respondents had a lower odds. Non-metropolitan residents had a higher odds (ever adj. OR = 1.16, 95% CI: 1.08, 1.25; currently adj. OR = 1.16, 95% CI: 1.08, 1.24) versus metropolitan residents. Uninsured respondents had a higher odds versus insured respondents (currently adj. OR = 1.24, 95%: 1.08, 1.44). Interactions were statistically significant for metropolitan status (ever p-value = 0.026) and health insurance (ever p-value = 0.006; currently p-value = 0.008).</p> Conclusions <p>Long COVID is experienced unequally across race/ethnicity and metropolitan/non-metropolitan residence. Further research is needed to understand this heterogeneity and the effects of Long COVID.</p>

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Exploring the Role of Race/Ethnicity, Metropolitan Status, and Health Insurance in Long COVID Among U.S. Adults

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Camilo Vargas,
  • Rebeka Moges,
  • Grace Caltabellotta,
  • Lulu David,
  • Nicola Manalili,
  • Marilyn Tseng,
  • Emily C. Marlow,
  • Adrienne B. Lent

摘要

Objectives

Limited evidence suggests possible disparities in COVID-19 across race/ethnicity, metropolitan status, and healthcare access. This study investigated racial/ethnic, metropolitan, and healthcare access disparities in Long COVID among U.S. adults.

Methods

2022–2023 cross-sectional Behavioral Risk Factor Surveillance System data were analyzed. U.S. adults who had COVID-19 were included, resulting in a final weighted sample size of n = 80,093,998. Logistic regressions examined associations between race/ethnicity, metropolitan status, health insurance and ever or currently experiencing Long COVID and reductions in daily function. Interactions were examined for metropolitan status and health insurance.

Results

Versus non-Hispanic White (NHW) respondents, a higher odds of Long COVID were observed for Non-Hispanic American Indian/Alaskan Native (ever adj. OR = 1.24, 95% CI: 1.01, 1.53; currently adj. OR = 1.72, 95% CI: 1.39, 2.12) and Other Race/Multiracial (ever adj. OR = 1.41, 95% CI: 1.18, 1.62; currently adj. OR = 1.35, 95% CI: 1.16, 1.58) respondents. Black (ever adj. OR = 0.84, 95% CI: 0.76, 0.93), Asian (ever adj. OR = 0.54, 95% CI: 0.42, 0.70), and Native Hawaiian/Pacific Islander (currently adj. OR = 0.61, 95% CI: 0.39, 0.95) respondents had a lower odds. Non-metropolitan residents had a higher odds (ever adj. OR = 1.16, 95% CI: 1.08, 1.25; currently adj. OR = 1.16, 95% CI: 1.08, 1.24) versus metropolitan residents. Uninsured respondents had a higher odds versus insured respondents (currently adj. OR = 1.24, 95%: 1.08, 1.44). Interactions were statistically significant for metropolitan status (ever p-value = 0.026) and health insurance (ever p-value = 0.006; currently p-value = 0.008).

Conclusions

Long COVID is experienced unequally across race/ethnicity and metropolitan/non-metropolitan residence. Further research is needed to understand this heterogeneity and the effects of Long COVID.