Long COVID Prevalence, Disability, and Accommodations: Analysis Across Demographic Groups.

PURPOSE: This paper examines the prevalence of long COVID across different demographic groups in the US and the extent to which workers with impairments associated with long COVID have engaged in pandemic-related remote work. METHODS: We use the US Household Pulse Survey to evaluate the proportion of all adults who self-reported to (1) have had long COVID, and (2) have activity limitations due to long COVID. We also use data from the US Current Population Survey to estimate linear probability regressions for the likelihood of pandemic-related remote work among workers with and without disabilities. RESULTS: Findings indicate that women, Hispanic people, sexual and gender minorities, individuals without 4-year college degrees, and people with preexisting disabilities are more likely to have long COVID and to have activity limitations from long COVID. Remote work is a reasonable arrangement for people with such activity limitations and may be an unintentional accommodation for some people who have undisclosed disabilities. However, this study shows that people with disabilities were less likely than people without disabilities to perform pandemic-related remote work. CONCLUSION: The data suggest this disparity persists because people with disabilities are clustered in jobs that are not amenable to remote work. Employers need to consider other accommodations, especially shorter workdays and flexible scheduling, to hire and retain employees who are struggling with the impacts of long COVID.

An intersectional analysis of long COVID prevalence.

BACKGROUND: Long COVID symptoms - which include brain fog, depression, and fatigue - are mild at best and debilitating at worst. Some U.S. health surveys have found that women, lower income individuals, and those with less education are overrepresented among adults with long COVID, but these studies do not address intersectionality. To fill this gap, we conduct an intersectional analysis of the prevalence and outcomes of long COVID in the U.S. We posit that disparities in long COVID have less to do with the virus itself and more to do with social determinants of health, especially those associated with occupational segregation and the gendered division of household work. METHODS: We use 10 rounds of Household Pulse Survey (HPS) data collected between June 2022 and March 2023 to perform an intersectional analysis using a battery of descriptive statistics that evaluate (1) the prevalence of long COVID and (2) the interference of long COVID symptoms with day-to-day activities. We also use the HPS data to estimate a set of multivariate logistic regressions that relate the odds of having long COVID and activity limitations due to long COVID to a set of individual characteristics as well as intersections by sex, race/ethnicity, education, and sexual orientation and gender identity. RESULTS: Findings indicate that women, some people of color, sexual and gender minorities, and people without college degrees are more likely to have long COVID and to have activity limitations from long COVID. Women have considerably higher odds of developing long COVID compared to men, a disparity exacerbated by having less education. Intersectional analysis by gender, race, ethnicity, and education reveals a striking step-like pattern: college-educated men have the lowest prevalence of long COVID while women without college educations have the highest prevalence. Daily activity limitations are more evenly distributed across demographics, but a different step-like pattern is present: fewer women with degrees have activity limitations while limitations are more widespread among men without degrees. Regression results confirm the negative association of long COVID with being a woman, less educated, Hispanic, and a sexual and gender minority, while results for the intersectional effects are more nuanced. CONCLUSIONS: Results point to systematic disparities in health, highlighting the urgent need for policies that increase access to quality healthcare, strengthen the social safety net, and reduce economic precarity.

Conversion therapy, suicidality, and running away: An analysis of transgender youth in the U.S.

This study analyzes the relationship between conversion therapy and mental health and wellbeing of transgender youth in the U.S. We create a retrospective panel of transgender youth using the 2015 U.S. Transgender Survey to test how exposure to conversion therapy affects the likelihood of attempting suicide and running away from home. The empirical approach employs a difference-in-differences design. Results indicate that exposure to conversion therapy substantially increases the likelihood a transgender adolescent will attempt suicide and run away. The average treatment effect on treated (ATT) of conversion therapy on having attempted suicide is an increase of 17 percentage points, which amounts to a 55% increase in the risk of attempting suicide, and the ATT on the risk of running away is an increase of 7.8 percentage points, more than doubling the risk of running away. These effects are largest when exposure to conversion therapy occurs at a young age (11-14).

Telework during the pandemic: Patterns, challenges, and opportunities for people with disabilities.

BACKGROUND: Telework has benefits for many people with disabilities. The pandemic may create new employment opportunities for people with disabilities by increasing employer acceptance of telework, but this crucially depends on the occupational structure. OBJECTIVE: We compare people with and without disabilities in the expansion of telework as the pandemic began, and the evolution of telework during the pandemic. METHODS: We use U.S. data from the American Community Survey from 2008 to 2020 and the Current Population Survey over May 2020 to April 2022 period. Prevalence and trends are analyzed using linear probability and multinomial logit regressions. RESULTS: While workers with disabilities were more likely than those without disabilities to telework before the pandemic, they were less likely to telework during the pandemic. The occupational distribution accounts for most of this difference. Tight labor markets, as measured by state unemployment rates, particularly favor people with disabilities obtaining telework jobs. While people with cognitive/mental health and mobility impairments were the most likely to telework during the pandemic, tight labor markets especially favored the expansion of telework for people with vision impairments and difficulty with daily activities inside the home. CONCLUSIONS: Many people with disabilities benefit from working at home, and the pandemic has increased employer acceptance of telework, but the current occupational distribution limits this potential. Tighter labor markets during the recovery offer hope that employers will increasingly hire people with disabilities in both telework and non-telework jobs.

Health insurance coverage and health outcomes among transgender adults in the United States.

This study provides evidence of health and insurance coverage disparities between the cisgender and transgender US populations using repeated cross sections from the 2014-2020 Behavioral Risk Factors Surveillance Systems. The analysis tests whether increasing the incidence of insurance coverage among transgender people could alleviate the health disparity. The empirical approach uses a fuzzy regression discontinuity design that leverages breaks in government health assistance eligibility by age. Results indicate that, for transgender recipients only, insurance coverage meaningfully improves mental health; for cisgender recipients only, insurance coverage reduces difficulties with concentration and memory; and for both the transgender and cisgender populations, insurance coverage contributes to important improvements in physical health, overall health, and healthcare access.

Disability and remote work during the pandemic with implications for cancer survivors.

PURPOSE: This article examines the extent to which employees worked from home because of the pandemic, focusing on differentials between people with and without disabilities with implications for cancer survivors. METHODS: We use data on COVID-19 from the Current Population Survey over the May 2020 to June 2021 period. We present descriptive statistics and the results from regression and decomposition analysis. RESULTS: While workers with disabilities were more likely than those without disabilities to be teleworking before the pandemic, they were less likely to be teleworking as a result of the pandemic. Differences in the occupational distribution account for most of this difference. People with disabilities experienced relatively more pandemic-related hardships as well, compared to people without disabilities, including a greater chance of not being able to work due to their employer losing business and more difficulty in accessing medical care. CONCLUSIONS: Many people with disabilities benefit from working from home, and the pandemic has increased employer acceptance of these arrangements, but the potential is limited by the current occupational distribution. IMPLICATIONS FOR CANCER SURVIVORS: While the CPS dataset does not have information on cancer survivorship, we use other data to impute that the average likelihood of cancer survivorship is 12.6% among people with disabilities, more than double the 6.1% rate among those without a disability. Hence cancer survivorship is partly picked up by the CPS questions on disability, and our results have implications for cancer survivors, especially because increased opportunities for telework have the potential to help cancer survivors maintain economic stability and avoid financial hardship.

Abortion During the COVID-19 Pandemic: Racial Disparities and Barriers to Care in the USA.

This article draws on first-hand experience as well as scholarly research to illuminate how COVID-19 has impacted an already-embattled medical service in the USA, subsequently affecting the reproductive health and experiences of diverse individuals navigating an unfamiliar health and economic environment. COVID-19's introduction into a landscape of abortion restrictions has intensified the barriers that providers and communities already face, with disproportionate impacts on Black and Hispanic abortion seekers. Relaxing existing restrictions on medication abortions and telemedicine delivery models may be one way to ease the tension between keeping people home and getting them the treatment they need.

COVID-19 disparities by gender and income: Evidence from the Philippines.

The COVID-19 pandemic and the resulting containment policies have hit the Philippines harder than most developing countries. The government lockdown is among the strictest in the world, and blanket school closures are the lengthiest. This article uses a novel simulation model to estimate the gendered and regional impacts of these factors on labour, income and poverty, and a case study of school closures points to the losses in employment among private school teachers and in the income of parents with young children. The authors find that the pandemic has had unprecedented implications for economic activity and has disproportionately affected women.

Gender, entrepreneurship, and coping with the COVID-19 pandemic: The case of GoFood merchants in Indonesia.

This paper examines business performance and crisis-mitigation strategies among micro, small, and medium-sized enterprises (MSMEs) in Indonesia during the COVID-19 pandemic. We utilise a new primary dataset based on administrative records, survey data, and follow-up interviews with merchants using the digital application GoFood, an on-demand cooked food delivery service. Three empirical findings emerge: first, the overall employment size of women-owned businesses shrank more than men-owned businesses after the onset of the pandemic; second, women were more likely than men to cut personal expenditures and use government assistance as crisis-mitigation strategies; and third, competition increased sharply as new merchants entered the platform, with the service areas of both incumbents and entrants shrinking over time. These results have implications for policies on women's entrepreneurship, the uptake of business development services, and financing programs for MSMEs.

History and scientific background on the economics of abortion.

BACKGROUND: Approximately one quarter of all pregnancies globally end in abortion, making it one of the most common gynecological practices worldwide. Despite the high incidence of abortion around the globe, the synthesis of known economic outcomes of abortion care and policies is lacking. Using data from a systematic scoping review, we synthesized the literature on the economics of abortion at the microeconomic, mesoeconomic, and mesoeconomic levels and presented the results in a collection of studies. This article describes the history and scientific background for collection, presents the scoping review framework, and discusses the value of this knowledge base. METHODS AND FINDINGS: We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following outcomes: costs, impacts, benefits, and/or value of abortion-related care or policies. Our searches yielded 19,653 unique items, of which 365 items were included in our final inventory. Studies most often reported costs (n = 262), followed by impacts (n = 140), benefits (n = 58), and values (n = 40). Approximately one quarter (89/365) of studies contained information on the secondary outcome on stigma. Economic factors can lead to a delay in abortion care-seeking and can restrict health systems from adequately meeting the demand for abortion services. Provision of post-abortion care (PAC) services requires more resources then safe abortion services. Lack of insurance or public funding for abortion services can increase the cost of services and the overall economic impact on individuals both seeking and providing care. CONCLUSIONS: Consistent economic themes emerge from research on abortion, though evidence gaps remain that need to be addressed through more standardized methods and consideration to framing of abortion issues in economics terms. Given the highly charged political nature of abortion around the world, it is imperative that researchers continue to build the evidence base on economic outcomes of abortion services and regulations.

The microeconomics of abortion: A scoping review and analysis of the economic consequences for abortion care-seekers.

BACKGROUND: The economic consequences of abortion care and abortion policies for individuals occur directly and indirectly. We lack synthesis of the economic costs, impacts, benefit or value of abortion care at the micro-level (i.e., individuals and households). This scoping review examines the microeconomic costs, benefits and consequences of abortion care and policies. METHODS AND FINDINGS: Searches were conducted in eight electronic databases and applied inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined at least one of the following outcomes: costs, impacts, benefits, and value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 230 included microeconomic studies, costs are the most frequently reported microeconomic outcome (n = 180), followed by impacts (n = 84), benefits (n = 39), and values (n = 26). Individual-level costs of abortion-related care have implications for the timing and type of care sought, globally. In contexts requiring multiple referrals or follow-up visits, these costs are multiplied. The ways in which people pay for abortion-related costs are diverse. The intersection between micro-level costs and delay(s) to abortion-related care is substantial. Individuals forego other costs and expenditures, or are pushed further into debt and/or poverty, in order to fund abortion-related care. The evidence base on the economic impacts of policy or law change is from high-income countries, dominated by studies from the United States. CONCLUSIONS: Delays underpinned by economic factors can thwart care-seeking, affect the type of care sought, and impact the gestational age at which care is sought or reached. The evidence base includes little evidence on the micro-level costs for adolescents. Specific sub-groups of abortion care-seekers (transgendered and/or disabled people) are absent from the evidence and it is likely that they may experience higher direct and indirect costs because they may experience greater barriers to abortion care.

The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes.

BACKGROUND: Although abortion is a common gynecological procedure around the globe, we lack synthesis of the known macroeconomic costs and outcomes of abortion care and abortion policies. This scoping review synthesizes the literature on the impact of abortion-related care and abortion policies on economic outcomes at the macroeconomic level (that is, for societies and nation states). METHODS AND FINDINGS: Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined one of the following macroeconomic outcomes: costs, impacts, benefits, and/or value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 189 data extractions with macroeconomic evidence, costs at the national level are the most frequently reported economic outcome (n = 97), followed by impacts (n = 66), and benefits/value (n = 26). Findings show that post-abortion care services can constitute a substantial portion of national expenditures on health. Public sector coverage of abortion costs is sparse, and individuals bear most of the costs. Evidence also indicates that liberalizing abortion laws can have positive spillover effects for women's educational attainment and labor supply, and that access to abortion services contributes to improvements in children's human capital. However, the political economy around abortion legislation remains complicated and controversial. CONCLUSIONS: Given the highly charged political nature of abortion around the global and the preponderance of rhetoric that can cloud reality in policy dialogues, it is imperative that social science researchers build the evidence base on the macroeconomic outcomes of abortion services and regulations.

The feminist political economy of Covid-19: Capitalism, women, and work.

Analysing the pandemic through a feminist political economy lens makes clear how gender, race, and class structures are crucial to the functioning of capitalism and to understanding the impacts of the pandemic. The way capital organises production and reproduction combines with structures of oppression, generating vulnerability among the racialised and gendered populations worst impacted by Covid-19. Using global data, this commentary shows that during the pandemic, women experienced relatively greater employment losses, were more likely to work in essential jobs, and experienced a greater reduction in income. Women were also doing more reproductive labour than men and were more likely to drop out of the labour force because of it. Analyses of capitalism in feminist political economy illustrate how capital accumulation depends on women's oppression in multiple, fundamental ways having to do with their paid and unpaid work. Women's work, and by extension their health, is the foundation upon which both production and social reproduction rely. Recognising the pandemic as endogenous to capitalism heightens the contradiction between a world shaped by the profit motive and the domestic and global requirements of public health.

Critiques, Ethics, Prestige and Status: A Survey of Editors in Economics.

This study examines survey data on the views of editors of economics journals on common critiques of the discipline, ethics and editorial practices, and the role of prestige and status in publishing. We utilize an ordered probit model to investigate whether editors or journal characteristics are systematically related to editors' views, controlling for gender and editorial position. Regression results show that editors from top-ranked journals are less likely to agree with common disciplinary critiques, more likely to support market solutions and less likely to agree with concerns about editorial practices.

The economics of abortion and its links with stigma: A secondary analysis from a scoping review on the economics of abortion.

BACKGROUND: Although abortions are a common aspect of people's reproductive lives, the economic implications of abortion and the stigmas that surround abortion are poorly understood. This article provides an analysis of secondary data from a scoping review on the economic impact of abortion to understand the intersections between stigma and economics outcomes at the microeconomic (i.e., abortion seekers and their households), mesoeconomic (i.e., communities and health systems), and macroeconomic (i.e., societies and nation states) levels. METHODS AND FINDINGS: We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following microeconomic, mesoeconomic, or macroeconomic outcomes: costs, benefits, impacts, and/or value of abortion-related care or abortion policies. Our searches yielded 19,653 items, of which 365 items were included in our final inventory. As a secondary outcome, every article in the final inventory was screened for abortion-related stigma, discrimination, and exclusion. One quarter (89/365) of the included studies contained information on stigma, though only 32 studies included stigma findings directly tied to economic outcomes. Studies most frequently reported stigma's links with costs (n = 24), followed by economic impact (n = 11) and economic benefit (n = 1). Abortion stigma can prevent women from obtaining correct information about abortion services and laws, which can lead to unnecessary increases in costs of care and sizeable delays in care. Women who are unable to confide in and rely on their social support network are less likely to have adequate financial resources to access abortion. CONCLUSIONS: Abortion stigma has a clear impact on women seeking abortion or post-abortion care at each level. Programmatic interventions and policies should consider how stigma affects delays to care, access to accurate information, and available social and financial support, all of which have economic and health implications.

The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems.

BACKGROUND: Despite the high incidence of abortion around the globe, we lack synthesis of the known economic consequences of abortion care and abortion policies at the mesoeconomic level (i.e. health systems and communities). This scoping review examines the mesoeconomic costs, benefits, impacts, and values of abortion care and policies. METHODS AND FINDINGS: Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined at least one of the following outcomes: costs, benefits, impacts, and value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 150 included mesoeconomic studies, costs to health systems are the most frequently reported mesoeconomic outcome (n = 116), followed by impacts (n = 40), benefits (n = 17), and values (n = 11). Within health facilities and health systems, the costs of providing abortion services vary greatly, particularly given the range with which researchers identify and cost services. Financial savings can be realized while maintaining or even improving quality of abortion services. Adapting to changing laws and policies is costly for health facilities. American policies on abortion economically impact health systems and facilities both domestically and abroad. Providing post-abortion care requires a disproportionate amount of health facility resources. CONCLUSIONS: The evidence base has consolidated around abortion costs to health systems and health facilities in high-income countries more than in low- or middle-income countries. Little is known about the economic impacts of abortion on communities or the mesoeconomics of abortion in the Middle East and North Africa. Methodologically, review papers are the most frequent study type, indicating that researchers rely on evidence from a core set of costing papers. Studies generating new primary data on mesoeconomic outcomes are needed to strengthen the evidence base.

Contributing factors to personal protective equipment shortages during the COVID-19 pandemic.

This study investigates the forces that contributed to severe shortages in personal protective equipment in the US during the COVID-19 crisis. Problems from a dysfunctional costing model in hospital operating systems were magnified by a very large demand shock triggered by acute need in healthcare and panicked marketplace behavior that depleted domestic PPE inventories. The lack of effective action on the part of the federal government to maintain and distribute domestic inventories, as well as severe disruptions to the PPE global supply chain, amplified the problem. Analysis of trade data shows that the US is the world's largest importer of face masks, eye protection, and medical gloves, making it highly vulnerable to disruptions in exports of medical supplies. We conclude that market prices are not appropriate mechanisms for rationing inputs to health because health is a public good. Removing the profit motive for purchasing PPE in hospital costing models, strengthening government capacity to maintain and distribute stockpiles, developing and enforcing regulations, and pursuing strategic industrial policy to reduce US dependence on imported PPE will help to better protect healthcare workers with adequate supplies of PPE.

A feminist perspective on COVID-19 and the value of care work globally.

The shared response to the COVID-19 crisis demonstrates that the vast majority of society believes human wellbeing - not economic growth - should be at the centre of policy. COVID-19 exposes the foundational role of care work, both paid and unpaid, to functioning societies and economies. Focusing on 'production' instead of the sustainable reproduction of human life devalues care work and those who perform it. Women's physical and mental health, and the societies that rely on them, are at stake. When these policies are formulated, the field of feminist economics has valuable lessons for mitigating hardships as countries navigate the related economic fallout. A comprehensive response to the COVID-19 crisis must recognize this gendered work as an integral part of the economic system that promotes human wellbeing for all.

Economics of abortion: a scoping review protocol.

INTRODUCTION: Abortion is a common feature of people's reproductive lives. However, the economic implications of abortion and policies affecting abortion provision are poorly understood. This scoping review aims to systematically review social science literature for studies that have investigated the impact of abortion care (ie, un/safe abortion, post-abortion care) or abortion policies on economic outcomes at the micro-levels (ie, abortion seekers and their households), meso-levels (ie, communities and health systems) and macro-levels (ie, societies and nation states). Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline for protocols, this protocol details the scoping review's methodological and analytical approaches. METHODS AND ANALYSIS: This scoping review will utilise the PRISMA extension for Scoping Reviews (PRISMA-ScR) tool. Studies reporting on qualitative and/or quantitative data from any world region will be considered. For inclusion, studies must examine one of the following economic outcomes at the micro-levels, meso-levels and/or macro-levels: costs, benefits, impacts and/or value of abortion care or abortion policies. Searches will be conducted in eight electronic databases. We will conduct the searches and application of inclusion/exclusion criteria according to the PRISMA-ScR flow approach. No assessments of items' quality will be made, as the purpose of this scoping review is to synthesise and describe the coverage of the evidence. After extracting all data, we will inductively develop an economic framework around the economics of abortion. The analysis will synthesise the evidence base and identify knowledge gaps on the costs and benefits of abortion to stakeholders at various levels. ETHICS AND DISSEMINATION: Formal ethical approval is not required, as primary data will not be collected in this study. The findings of this study will be disseminated through peer-reviewed publications, conference presentations, and condensed summaries for key stakeholders and partners in the field.