Disparities in Prevalence of COVID-19, Long COVID, Disease Severity, and Mental Health Outcomes among US Adults by Industrial Sector of Employment, September-November 2022

Abstract

Background: The coronavirus disease (COVID-19) pandemic has had a major adverse impact on people’s health and well-being in the United States (US) and globally. Although inequalities in COVID-19 prevalence and to a lesser extent in Long COVID and related mental health impact among US adults have been documented, disparities in COVID-related outcomes by industrial sector of employment, an important social determinant, have not been studied. Using the latest nationally representative data, we examine disparities in COVID-19, Long COVID, and associated mental health impact among US adults aged ≥18 years by industrial sector. Methods: Using three consecutive rounds of the US Census Bureau’s Household Pulse Survey from September 14 to November 14, 2022 (N=148,813), disparities in COVID-related outcomes by industrial sector were modeled by multivariable logistic regression after controlling for race/ethnicity, socioeconomic status, health insurance, and other demographic characteristics. Results: During September–November 2022, an estimated 117 million or 48.7% of US adults reported having been diagnosed with COVID-19; 34.3 million or 29.4% of COVID patients reported developing Long COVID; 14.7 million or 12.6% of COVID patients reported experiencing severe COVID symptoms; 10.7% of COVID patients reported serious depression, and 17.8% reported serious anxiety. Adjusted for covariates, workers in wholesale trade, finance and insurance, educational services, healthcare, social assistance, and accommodation and food services had 30-39% higher odds of being diagnosed with COVID-19 than workers in the agricultural sector. Workers in social assistance, real estate, utilities, construction, and healthcare sectors had 48-102% higher adjusted odds of developing Long COVID than workers in wholesale trade. Conclusion and Implications for Translation: Marked disparities in COVID-related outcomes existed, with workers in employment industries such as healthcare, social assistance, real estate, arts and entertainment, and accommodation and food services being at increased risk of COVID-19 diagnosis, Long COVID, severe COVID symptoms, serious depression, and anxiety. Equitable access to social services and healthcare, including mental and behavioral health services, among workers afflicted with these conditions is critical to reducing inequities in COVID-related health outcomes.