LGBTQ+ Disparities in Food Insecurity, Food Assistance Use, and Barriers to Food Assistance
6 affiliations
- 1Harvard Medical School, Boston, Massachusetts
- 2Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- 3Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mass General Brigham, Boston, Massachusetts
- 4The Greater Boston Food Bank, Boston, Massachusetts
- 5Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- 6Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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.
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BibTeX
@article{waters2026lgbtq,
title = {{LGBTQ+ Disparities in Food Insecurity, Food Assistance Use, and Barriers to Food Assistance}},
author = {Austin R. Waters and Lauren G. Fiechtner and Meghan E. Perkins and Man Luo and Michele F. Schuckel and Catherine D’Amato and Brittany M. Charlton},
journal = {JAMA Network Open},
year = {2026},
month = oct,
doi = {10.1001/jamanetworkopen.2026.38129},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2854969},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - LGBTQ+ Disparities in Food Insecurity, Food Assistance Use, and Barriers to Food Assistance
AU - Austin R. Waters
AU - Lauren G. Fiechtner
AU - Meghan E. Perkins
AU - Man Luo
AU - Michele F. Schuckel
AU - Catherine D’Amato
AU - Brittany M. Charlton
PY - 2026
DA - 2026/10/08
JO - JAMA Network Open
DO - 10.1001/jamanetworkopen.2026.38129
UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2854969
AB - 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.
SN - 2574-3805
ER -