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- Title
Association of Severe COVID-19 and Persistent COVID-19 Symptoms With Economic Hardship Among US Families.
- Authors
Hair, Nicole L.; Urban, Carly
- Abstract
Key Points: Question: Are COVID-19 outcomes, including severe COVID-19 and persistent COVID-19 symptoms, associated with economic hardship among US families? Findings: In this cohort study of 6932 families, the odds of reporting economic hardship were higher for families headed by an adult with persistent COVID-19 symptoms and, to a lesser extent, families headed by an adult with previous severe COVID-19 compared with families with no history of COVID-19. Families with lower income before the pandemic were more vulnerable to employment disruptions and earnings losses associated with an adult family member's COVID-19 illness. Meaning: Policy actions to mitigate the household financial hardship of post–COVID-19 conditions merit continued discussion. Importance: Little is known about the association of severe COVID-19 and post–COVID-19 conditions with household finances. Objective: To examine associations between COVID-19 outcomes, pandemic-related economic hardship, and prepandemic socioeconomic status among families in the US. Design, Setting, and Participants: This cohort study used data from the Panel Study of Income Dynamics (PSID), a nationally representative, longitudinal study. Data included 6932 families active in the PSID in both 2019 and 2021. Exposures: Ordinal exposure categories were defined based on whether the reference person or spouse or partner reported a positive COVID-19 diagnosis and (1) persistent COVID-19 symptoms, (2) previous severe COVID-19, or (3) previous moderate, mild, or asymptomatic COVID-19. Families with no history of COVID-19 served as the reference group. Main Outcomes and Measures: Outcomes included whether a resident family member was laid off or furloughed, lost earnings, or had any financial difficulties due to the COVID-19 pandemic. Results: In this cohort study of 6932 families (772 Hispanic families [weighted, 13.5%; 95% CI, 12.4%-14.6%], 2725 non-Hispanic Black families [weighted, 13.1%; 95% CI, 12.3%-14.1%], and 3242 non-Hispanic White families [weighted, 66.8%; 95% CI, 65.2%-68.3%]), close to 1 in 4 (2222 [weighted, 27.0%; 95% CI, 25.6%-28.6%]) reported income below 200% of the US Census Bureau poverty threshold. In survey-weighted regression models adjusted for prepandemic sociodemographic characteristics and experiences of economic hardship, the odds of reporting pandemic-related economic hardship were 2.0 to 3.7 times higher among families headed by an adult with persistent COVID-19 symptoms (laid off or furloughed: adjusted odds ratio [AOR], 1.98 [95% CI, 1.37-2.85]; lost earnings: AOR, 2.86 [95% CI, 2.06-3.97]; financial difficulties: AOR, 3.72 [95% CI, 2.62-5.27]) and 1.7 to 2.0 times higher among families headed by an adult with previous severe COVID-19 (laid off or furloughed: AOR, 1.69 [95% CI, 1.13-2.53]; lost earnings: AOR, 1.99 [95% CI, 1.37-2.90]; financial difficulties: AOR, 1.87 [95% CI, 1.25-2.80]) compared with families with no history of COVID-19. Families headed by an adult with persistent COVID-19 symptoms had increased odds of reporting financial difficulties due to the pandemic regardless of prepandemic socioeconomic status (families with lower income: AOR, 3.71 [95% CI, 1.94-7.10]; families with higher income: AOR, 3.74 [95% CI, 2.48-5.63]). Previous severe COVID-19 was significantly associated with financial difficulties among families with lower income (AOR, 2.59 [95% CI, 1.26-5.31]) but was not significantly associated with financial difficulties among those with high income (OR, 1.56 [95% CI, 0.95-2.56]). Conclusions and Relevance: This cohort study suggests that persistent COVID-19 symptoms and, to a lesser extent, previous severe COVID-19 were associated with increased odds of pandemic-related economic hardship in a cohort of US families. The economic consequences of COVID-19 varied according to socioeconomic status; families with lower income before the pandemic were more vulnerable to employment disruptions and earnings losses associated with an adult family member's COVID-19 illness. This cohort study examines associations between COVID-19 outcomes, pandemic-related economic hardship, and prepandemic socioeconomic status among families in the US.
- Subjects
UNITED States; FAMILIES &; economics; FAMILIES &; psychology; FAMILIES -- United States; DISMISSAL of employees; RESEARCH; COVID-19; ECONOMIC impact; CONFIDENCE intervals; POST-acute COVID-19 syndrome; SELF-evaluation; MULTIPLE regression analysis; AGE distribution; FAMILIES; SEVERITY of illness index; COMPARATIVE studies; INCOME; DISEASE duration; SOCIAL classes; DESCRIPTIVE statistics; RESEARCH funding; POVERTY; STATISTICAL correlation; SOCIODEMOGRAPHIC factors; ODDS ratio; COVID-19 pandemic; LONGITUDINAL method
- Publication
JAMA Network Open, 2023, Vol 6, Issue 12, pe2347318
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.47318