Inequities in food security by sexual orientation in the United States.

Abstract

To determine if sexual minority (gay, lesbian, bisexual, or another [LGB+] sexual orientation) identity independently contributes to food insecurity while accounting for other social drivers of health (SDoH) like race, education, employment, supplemental nutrition assistance program (SNAP) participation, and mental illness. We performed multivariate logistic regression of 2019-2023 National Health Interview Surveys to determine any relationship between LGB+ identity and 30-day food security scale responses. We included 130,656 participants, representing 235,728,318 Americans by weighted sampling. Among those eligible, there was no difference in SNAP utilization between LGB+ and heterosexual individuals (odds ratio: 1.12, 95 % confidence interval: 0.97-1.30). However, LGB+ individuals had 1.53 times higher odds of very low food security (95 % confidence interval: 1.31-1.79) even after adjusting for SDoH and mental illness. Despite similar SNAP enrollment, LGB+ individuals remain disproportionately food insecure, suggesting that structural or systemic barriers not addressed through federal food assistance programs contribute to elevated risk.