Austin R Waters, Lauren G Fiechtner, Meghan E Perkins, Man Luo, Michele F Schuckel, Catherine D'Amato, Brittany M Charlton
{"title":"LGBTQ+ Disparities in Food Insecurity, Food Assistance Use, and Barriers to Food Assistance.","authors":"Austin R Waters, Lauren G Fiechtner, Meghan E Perkins, Man Luo, Michele F Schuckel, Catherine D'Amato, Brittany M Charlton","doi":"10.1001/jamanetworkopen.2026.38129","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Food insecurity disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults, yet population-based data on disparities in food assistance use and barriers to accessing services remain limited.</p><p><strong>Objectives: </strong>To estimate the prevalence of food insecurity and food assistance program use among LGBTQ+ adults in Massachusetts from 2022 to 2024 and identify LGBTQ+-specific barriers to assistance.</p><p><strong>Design, setting, and participants: </strong>This repeated cross-sectional analysis used 2022 to 2024 data from the Massachusetts Statewide Food Access Survey, an annual online survey conducted by the Greater Boston Food Bank and Mass General Brigham.</p><p><strong>Exposure: </strong>LGBTQ+ identity, defined using a 2-step measure of sexual orientation and gender.</p><p><strong>Main outcomes and measures: </strong>Food insecurity, measured using the 10-item US Department of Agriculture Food Security Survey Module; food pantry and Supplemental Nutrition Assistance Program (SNAP) use; and barriers to food assistance access. Weighted prevalence estimates and adjusted prevalence ratios with 95% CIs were calculated by LGBTQ+ status.</p><p><strong>Results: </strong>The sample included 9174 Massachusetts adults (10.4%-12.8% LGBTQ+ across survey years). The prevalence of food insecurity increased significantly from 2022 to 2024 among both non-LGBTQ+ adults (29.8% [95% CI, 27.7%-32.0%] to 33.3% [95% CI, 31.3%-35.3%]) and LGBTQ+ adults (43.7% [95% CI, 37.7%-49.9%] to 54.9% [95% CI, 48.5%-61.1%]). Food pantry and SNAP use among LGBTQ+ adults remained stable over time. Among LGBTQ+ nonusers of food pantries in 2024, the most common barriers to use were wanting to be self-reliant (49.4% [95% CI, 41.6%-57.4%]), embarrassment (37.4% [95% CI, 30.1%-45.2%]), and fear of being identified as a pantry user (35.6% [95% CI, 28.6%-43.3%]); all barriers increased over time and were more commonly reported than among non-LGBTQ+ adults. Common barriers to SNAP use among LGBTQ+ adults in 2024 included wanting to be self-reliant (52.7% [95% CI, 43.4%-61.8%]), concern about taking benefits from someone with more need (44.6% [95% CI, 35.8%-53.7%]), and not knowing how to apply (26.0% [95% CI, 18.5%-35.1%]). In 2024, LGBTQ+ adults frequently endorsed grocery gift cards (42.5% [95% CI, 36.6%-48.7%]), home delivery (42.4% [95% CI, 36.4%-48.6%]), and online ordering (34.0% [95% CI, 28.5%-39.9%]) as strategies to increase pantry use.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study of food insecurity in Massachusetts, over half of LGBTQ+ adults experienced food insecurity in 2024, alongside barriers to food assistance use. Findings highlight the need for multilevel, community-co-created interventions to reduce disparities among LGBTQ+ individuals in food insecurity and improve equitable access to food assistance.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"9 10","pages":"e2638129"},"PeriodicalIF":11.7000,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650663/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA Network Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamanetworkopen.2026.38129","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Importance: Food insecurity disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults, yet population-based data on disparities in food assistance use and barriers to accessing services remain limited.
Objectives: To estimate the prevalence of food insecurity and food assistance program use among LGBTQ+ adults in Massachusetts from 2022 to 2024 and identify LGBTQ+-specific barriers to assistance.
Design, setting, and participants: This repeated cross-sectional analysis used 2022 to 2024 data from the Massachusetts Statewide Food Access Survey, an annual online survey conducted by the Greater Boston Food Bank and Mass General Brigham.
Exposure: LGBTQ+ identity, defined using a 2-step measure of sexual orientation and gender.
Main outcomes and measures: Food insecurity, measured using the 10-item US Department of Agriculture Food Security Survey Module; food pantry and Supplemental Nutrition Assistance Program (SNAP) use; and barriers to food assistance access. Weighted prevalence estimates and adjusted prevalence ratios with 95% CIs were calculated by LGBTQ+ status.
Results: The sample included 9174 Massachusetts adults (10.4%-12.8% LGBTQ+ across survey years). The prevalence of food insecurity increased significantly from 2022 to 2024 among both non-LGBTQ+ adults (29.8% [95% CI, 27.7%-32.0%] to 33.3% [95% CI, 31.3%-35.3%]) and LGBTQ+ adults (43.7% [95% CI, 37.7%-49.9%] to 54.9% [95% CI, 48.5%-61.1%]). Food pantry and SNAP use among LGBTQ+ adults remained stable over time. Among LGBTQ+ nonusers of food pantries in 2024, the most common barriers to use were wanting to be self-reliant (49.4% [95% CI, 41.6%-57.4%]), embarrassment (37.4% [95% CI, 30.1%-45.2%]), and fear of being identified as a pantry user (35.6% [95% CI, 28.6%-43.3%]); all barriers increased over time and were more commonly reported than among non-LGBTQ+ adults. Common barriers to SNAP use among LGBTQ+ adults in 2024 included wanting to be self-reliant (52.7% [95% CI, 43.4%-61.8%]), concern about taking benefits from someone with more need (44.6% [95% CI, 35.8%-53.7%]), and not knowing how to apply (26.0% [95% CI, 18.5%-35.1%]). In 2024, LGBTQ+ adults frequently endorsed grocery gift cards (42.5% [95% CI, 36.6%-48.7%]), home delivery (42.4% [95% CI, 36.4%-48.6%]), and online ordering (34.0% [95% CI, 28.5%-39.9%]) as strategies to increase pantry use.
Conclusions and relevance: In this cross-sectional study of food insecurity in Massachusetts, over half of LGBTQ+ adults experienced food insecurity in 2024, alongside barriers to food assistance use. Findings highlight the need for multilevel, community-co-created interventions to reduce disparities among LGBTQ+ individuals in food insecurity and improve equitable access to food assistance.
期刊介绍：
JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health.
JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
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