Food insecurity gap between LGBTQ+ and other Massachusetts adults survives adjustment for income

The gap is 21.6 percentage points ^[15]. LGBTQ+ respondents reported food insecurity at about 1.65 times the rate of other adults ^[16]. Those are the 2024 figures. Across 2022 to 2024 the researchers tracked food insecurity, food pantry use and SNAP participation, along with the reasons people gave for not seeking help ^[7].

The most informative part of the design is the adjustment. The researchers accounted for demographic and socioeconomic differences between the two groups, and the disparity persisted throughout the study period ^[1]. That rules out the plainest explanation: that LGBTQ+ respondents were poorer, or differed demographically, along lines the survey measured. "Differences in income and other economic factors did not fully explain this gap, suggesting that LGBTQ+ people face additional barriers that put them at greater risk of food insecurity," said Austin R. Waters, the study's lead author, who is a research fellow at the Harvard Pilgrim Health Care Institute's LGBTQ Health Center of Excellence ^{[2] [3]}.

"Did not fully explain" suggests that income and other economic factors accounted for part of the gap. The phys.org account of the paper does not give the adjusted estimate, the 2022 baseline or how many of the 9,174 respondents identified as LGBTQ+ ^[4].

The thing this doesn't tell you is what fills the residual. An adjusted gap holds whatever the model's variables could not absorb, including any factor the survey never asked about. The barrier data answer a separate question: why LGBTQ+ adults who did not use food pantries stayed away ^[8]. I think those answers make the authors' account plausible. A survey of reasons is observational, though, and it cannot show that removing those barriers would close the gap.

Timing gives the account more support. Several of the reported barriers grew over the same years ^[9] in which assistance use stayed level while need climbed ^[6]. That is consistent with barriers holding uptake down. It is also consistent with other changes over the same years. "LGBTQ+ adults are facing growing food needs, but they also face barriers to getting help, including embarrassment and fear that others will know they use a food pantry," Waters said ^[11].

Most of the fixes participants proposed would let someone get food without being seen collecting it ^[10]. The study was run with the Greater Boston Food Bank and Mass General Brigham ^[14]. "Food assistance programs can play an important role in reducing food insecurity, but they must also address the stigma and logistical barriers that prevent many LGBTQ+ adults from accessing support," said senior author Brittany Charlton, a Harvard Medical School associate professor of population medicine ^{[12] [13]}.