Rethinking Risk: Intersectional Inequalities in Long COVID in the United States

Post-acute sequelae of coronavirus disease 2019 (PASC), also known as Long COVID, is a chronic, multisystem condition affecting millions of U.S. adults, with profound social, medical and economic consequences. Despite its widespread impact, disparities in who is most affected remain poorly understood, especially through an intersectional sociological lens. Using a sociological and intersectional framework, this study analyses a national sample (N = 535,300) from the Household Pulse Survey to explain disparities in Long COVID risk across race, gender and socioeconomic status. The analysis demonstrates that socioeconomic advantage does not equally protect all groups; specifically, higher-SES Black women show significantly elevated Long COVID prevalence compared to White counterparts, challenging claims of racial parity in Long COVID rates. Moreover, although women generally show higher Long COVID risk, intersectional analysis uncovers that the gender gap narrows among high-SES White women, suggesting that social privilege can mitigate health risks. These findings emphasise that structural inequalities, rather than biology, may primarily drive Long COVID inequities and highlight the importance of intersectional sociological analyses for understanding health disparities. The results call for equity-focused interventions addressing the unequal social burden of Long COVID and advancing sociological theory on the social determinants of health.