Prevalence of Long-COVID Among Low-Income and Marginalized Groups: Evidence From Israel

Abstract

Objective: To identify the socioeconomic and demographic factors associated with the prevalence of self-reported long-COVID symptoms.Method: We examined the association between acute-COVID (SARS-CoV-2) and long-COVID symptoms, by a cross-sectional analysis of data obtained on a prospective online-survey, conducted from November to December 2021 on a nationally-representative sample of the Israeli population (N = 2,246).Results: Findings suggest that there is a greater likelihood of experiencing long-COVID symptoms among low-income and among marginalized groups. After controlling for demographic and socioeconomic attributes, those who had moderate/severe acute-COVID were 1.3 (p < 0.05) times more likely to experience a long-term symptom and also reported more long-term symptoms (2.2 symptoms) than those who have not been infected (1.4 symptoms; p < 0.01). Among the low-income group, a larger gap in symptom count was found between those who had moderate/severe acute-COVID (3.3 symptoms) and those who had not been infected (1.8 symptoms, p < 0.05).Conclusion: Our findings highlight the importance of raising awareness of long-COVID among marginalized population groups, and to the therapeutic options available. Such efforts should be tailored and should consider the unique socioeconomic and cultural characteristics, as well as the preexisting low access to healthcare services among these groups.

SARS-CoV-2 and COVID-19: From Crisis to Solution

“…Therefore, the potential consequences of uncontrolled spread go far beyond immediate impacts on hospital capacity and acute mortality. It has also been shown that greater harms are experienced by people of lower socioeconomic status, ethnic minorities, marginalized communities 136,137 and women 138,139 who are affected at a greater rate by post-acute disease. Stigma and discrimination are not limited to those who have prior socio-economic disadvantages, as they can affect post-acute COVID-19 patients in general 140 , which expands the scope of the problem to other socio-economic groups and confounds its accurate assessment.…”

Long COVID in the context of social determinants of health

“…Structural and intermediary determinants may play major roles in how individual seek help, use healthcare resources, and quality of life within the context of long COVID. For example, individuals with low socioeconomic status and low education who suffer from prolonged symptoms may not be aware of the long COVID symptoms or may have limited access to healthcare and social support, and face difficulty returning to work ( 85 , 86 ). Some ethnic minority individuals with long COVID reported feeling stigmatized or dismissed by healthcare providers which contributed to delays in seeking care, inability to obtain disability benefits, and increased financial hardship ( 87 ).…”

Changes in Quality of Life Following SARS-CoV-2 Infection Among Jewish and Arab Populations in Israel: A Cross-Sectional Study

“…Most of the available evidence referring to health inequalities associated with the COVID-19 pandemic, in Israel and elsewhere, investigates the acute effects of the infection or programmatic disparities and are based on infection, admission rate [ 6 ], or vaccination. Evidence suggests that in Israel there is a greater likelihood of experiencing post-acute COVID symptoms among low-income and among marginalized groups [ 13 ]. There is less evidence available on the differential long-term impact of COVID-19 on Health-Related Quality of Life (HRQoL) and its effect on inequalities.…”