Publication date: Feb 07, 2026
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. 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. 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). 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.
| Concepts | Keywords |
|---|---|
| Alaskan | Disparity |
| Healthcare | Long COVID |
| Racial | Metropolitan |
| Non-metropolitan | |
| Race/ethnicity |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Long COVID |
| disease | MESH | COVID-19 |
| disease | MESH | included |