Author ORCID Identifier

0009-0003-3697-2282

Date of Award

Spring 5-3-2024

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Yahui Yu, PhD

Second Advisor

Lia Scott, PhD

Abstract

Background: Long COVID is an increasingly recognized public health threat. Numerous studies have demonstrated that females, certain racial/ethnicity groups, and individuals with a severe COVID infection are at higher risk of developing Long COVID. This study aimed to quantify racial disparities in the lifetime prevalence of Long COVID among US females, and to explore the extent to which the disparities were explained by a severe acute COVID infection

Methods: Our study cohort was established using nine waves of data from the US Census Bureau’s Household Pulse Survey, a representative, cross-sectional survey of the US population, and includes adult females with a history of COVID-19 (n = 155,669). Log-binomial regression was used to estimate the disparity of lifetime Long COVID prevalence, comparing Non-Hispanic Black, Hispanic, Asian and others (mixed race/American Indian/Alaskan Native/Pacific Islander) to Non-Hispanic White; overall and stratified by age. Marginal structural models with inverse probability weights were used to estimate the disparity that remained had no individuals experienced a severe COVID infection.

Results: Non-Hispanic Black (PR: 1.06, CI: 1.02, 1.11), Hispanic (PR: 1.16, CI: 1.32), and Other (PR: 1.23, CI: 1.16, 1.31) females experienced a higher lifetime prevalence of Long COVID when compared to Non-Hispanic White females, while Asian females experienced a lower prevalence (PR: 0.70, CI: 0.65, 0.77). When stratified by age, we found that the disparity was more prominent among females ages 30 – 39 and 40 – 49, with some of the greatest disparities among Hispanics 40 – 49 (PR: 1.28, CI: 1.19, 1.38), Others 30 – 39 (PR: 1.27, CI: 1.14, 1.42), and Others 40 – 49 (PR: 1.24, CI: 1.12, 1.37). The exploratory mediation analysis showed that experiencing a severe COVID infection partially explained the racial disparities in Long COVID, especially among Non-Hispanic Black and Others.

Discussion: Among US females, substantial racial disparities in the prevalence of Long COVID exist among Black, Hispanic, and Other individuals. Implementing targeted public health interventions and policies to prevent severe COVID infections can greatly reduce racial disparities in Long COVID. In particular, young and middle-aged Other groups, early middle-aged Hispanics, and early middle-aged Black females should be prioritized for resources such as COVID vaccination, Paxlovid, and monoclonal antibodies.

DOI

https://doi.org/10.57709/36991689

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