Brief Employment and Material Hardship among Adults with Long COVID in December 2022
Michael Karpman, Olivia Fiol, Susan J. Popkin, Lisa McCorkell, Elaine Waxman, Sarah Morriss
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Millions of US residents have long COVID, a multisystemic condition caused by COVID-19 infection that can involve an array of symptoms, such as chest pains, cough, cognitive impairment, memory loss, fatigue, postexertional malaise, shortness of breath, and muscle and joint pain. Long COVID can affect many aspects of a person’s life, including their ability to work and afford to meet their basic needs, which can affect their recovery and long-term health and well-being. In this brief, we examined experiences with long COVID related to employment and material hardship using a nationally representative December 2022 survey of nonelderly adults.


Long COVID can lead to or exacerbate challenges in meeting basic needs through its effect on employment, the ability to carry out daily activities, and increased health care costs. This is particularly the case for people already experiencing material hardship and who may be at greater risk for developing long COVID, including people with chronic conditions and disabilities. Material hardships may make accessing health care more challenging, as those affected may have to make difficult financial decisions to prioritize basic needs. Fully addressing the long COVID crisis requires a holistic, multidisciplinary, and intersectional lens, both in and beyond medicine, including supporting those who have or will develop long COVID to ensure their basic needs are met.


  • Among adults reporting a prior confirmed or suspected COVID-19 infection, almost 1 in 5 (18 percent) reported experiencing long COVID symptoms lasting four weeks or longer.
  • One in 10 adults with long COVID (10 percent) reported that they stopped working for a period because of their symptoms, and another 5 percent reduced their work hours. In addition, about 1 in 4 (24 percent) reported that they limited activities outside of work—such as social activities, errands, or chores at home—to continue working.
  • Adults with long COVID were less likely to be working than adults who had COVID-19 but did not report current long COVID (65 percent vs. 76 percent) and were also more likely to be out of the labor force for health or disability reasons (11 percent vs. 5 percent).
  • Over 4 in 10 adults with long COVID (42 percent) reported household food insecurity in the past year, with 1 in 4 (25 percent) reporting very low food security.
  • Approximately 1 in 5 adults with long COVID symptoms (20 percent) reported difficulty paying their rent or mortgage in the past year, and nearly 1 in 4 (23 percent) had trouble paying utility bills.

The stark disparities in material hardship between people with and without long COVID suggest that in addition to fast-tracking research and increasing health care access, policymakers must address social determinants of health and bolster the safety net for those who become sick to equitably address the emergence of this new and significant disability.


Our analysis draws on data from the December 2022 round of the Urban Institute’s Well-Being and Basic Needs Survey, a nationally representative internet-based survey of more than 7,500 adults ages 18 to 64 designed to monitor changes in individual and family well-being as policymakers consider changes to federal safety net programs.

Research Areas Health and health care Social safety net Workforce Disability equity policy
Tags COVID-19 Disabilities and employment
Policy Centers Health Policy Center Metropolitan Housing and Communities Policy Center Income and Benefits Policy Center
Research Methods Quantitative data analysis
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