Social Determinants of Health and Long COVID in U.S. Children: A Cross-Sectional Study, 2022--2023
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Objective
We characterized social determinants of health (SDOH) in U.S. children who ever and never had Long COVID.
Methods
We used cross-sectional data from the 2022-2023 National Health Interview Survey (N=14,993 children 0-17 years). Parents reported child- and household-level information. Long COVID was defined as ever experiencing symptoms lasting ≥3 months that were not present prior to having COVID-19. We produced weighted prevalence estimates by Long COVID status for 3 SDOH domains (Social and Community Context, Healthcare Access and Quality, and Economic Stability) and used Rao-Scott chi-squared tests to examine differences.
Results
In Social and Community Context, children who ever had Long COVID more often resided in single parent households (33.2% vs. 20.3%; p<0.0001), with someone with severe depression or mental illness (18.5% vs. 8.3%; p<0.0001) or substance abuse (16.7% vs. 8.1%; p<0.0001) or had a lifetime of being disparaged by adults in the home (9.2% vs. 3.9%; p=0.0009). In Healthcare Access and Quality, children who ever had Long COVID more often had public insurance (e.g., Medicaid) (51.3% vs. 41.6%; p=0.02), higher healthcare use, and difficulty paying medical bills (23.2% vs. 12.2%; p<0.0001). In Economic Stability, children who ever had Long COVID had lower parental education, lower food security, and higher participation in social safety net programs (p<0.01 for all comparisons).
Conclusion
Children who ever had Long COVID more frequently experienced adverse SDOH compared to their peers who never had Long COVID. These findings may help identify children who may benefit from additional resources related to their Long COVID care.
Article Summary
Children who had Long COVID more frequently reported adverse Social Determinants of Health (SDOH) compared to their peers who never had Long COVID.
What’s Known on This Subject
The relationship of SDOH and Long COVID in children has not been well characterized; however, research indicates potential disparities in Long COVID symptoms and severity based on age, sex, race, ethnicity, and socioeconomic characteristics.
What This Study Adds
In a nationally representative sample, we found that U.S. children who had Long COVID more frequently reported adverse SDOH. These results may help identify higher-risk children who may benefit from additional resources related to their Long COVID care.
