Long COVID and financial hardship: A disaggregated analysis at income and education levels.

Objectives: To examine how long COVID is associated with financial hardship (food insecurity, inability to pay bills, or threat of losing service) across income and education levels, and to assess the role of employment loss or reduced work hours in this hardship.

Data source and study setting: We used nationally representative data on 271,076 adults from the 2022 Behavioral Risk Factor Surveillance System (BRFSS).

Study design: We used multivariable binomial logistic regression models to estimate the average marginal effect of long COVID on financial hardships across multiple income and education groups.

Principal findings: In general, we found a significant positive association between long COVID and the three measures of financial hardships across income and education groups (1-11 percentage points increase, 95% CI 0.00-0.02 and 0.07-0.14, respectively). Mediation analysis showed that lost or reduced hours of employment accounted for a significant portion (6%-20%) of the changes in financial distress.

Conclusions: Long COVID has affected the economic wellbeing of people from all socioeconomic statuses, although at a higher rate for lower income groups. Policy attention is needed to address its economic impacts across income and education levels.