Exploring long COVID diagnostic equity by sex, race and ethnicity, and insurance type

Authors

• Kevin Petranu, Advocate Health - MidwestFollow
• Tiffany Ford, Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
• Denise Henley, Independent Community Partner, Chicago, IL, USA.
• Ebenezer Hammond, Independent Community Partner, Chicago, IL, USA.
• John Henley, Independent Community Partner, Chicago, IL, USA.
• Melvin Crawford, Independent Community Partner, Chicago, IL, USA.
• Zella Coleman, Independent Community Partner, Chicago, IL, USA.
• Jana Hirschtick, Advocate Health - MidwestFollow

Recommended Citation

Petranu K, Ford T, Henley D, et al. Exploring Long COVID diagnostic equity by sex, race and ethnicity, and insurance type. Prev Med Rep. 2026;65:103459. Published 2026 Mar 27. doi:10.1016/j.pmedr.2026.103459

Affiliations

Aurora Sinai

Abstract

Objective: Our study explored Long COVID diagnostic inequity by comparing the demographic profile of patients diagnosed with Long COVID to patients diagnosed with COVID-19.

Methods: Using electronic health record data from Advocate Health-Midwest between March 1, 2020, to November 1, 2023, we compared the proportion of all patients with documentation of Long COVID versus COVID-19 by race/ethnicity, sex, insurance type, and varying combinations of these characteristics.

Results: Relative to COVID-19, a greater proportion of patients diagnosed with Long COVID were female (63.7% vs. 58.0%), non-Hispanic (NH) White (66.4% vs 62.9%), or covered by private insurance (53.8% vs 51.3%), and a lower proportion were Hispanic (12.1% vs. 14.3%) or covered by Medicaid (11.9% vs. 14.3%). Among patients with Medicaid, NH Black patients were underrepresented by 5.4 percentage points in the Long COVID sample vs. COVID-19 (25.2% vs. 30.6%), while NH White patients were overrepresented by 6.7 percentage points in the Long COVID sample compared to COVID-19 (48.2% vs. 41.5%).

Conclusions: Long COVID diagnostic estimates may be skewed towards patients that are more willing and able to seek care, while patients who experience multiple forms of disadvantage may be at risk for underdiagnosis due to compounding barriers to diagnosis.

Document Type

Article

PubMed ID

42004523