Food Insecurity among Lesbian, Gay, Bisexual, and Transgender Adults During the COVID-19 Pandemic in the United States, July-October 2021

Abstract

Background: The lesbian, gay, bisexual, and transgender (LGBT) population makes up approximately 6% of the total United States (US) population. Levels and patterns of food insecurity in the LGBT population during the COVID-19 pandemic compared with the general population are unknown. This study examines prevalence and sociodemographic correlates of food insecurity among LGBT and straight/heterosexual adults in the US. Methods: Using the US Census Bureau’s Household Pulse Survey from July to October 2021 (N=372,542), differentials in food insecurity according to LGBT status were analyzed by multivariate logistic regression. Results: The prevalence of food insecurity during the pandemic was 25.6% for transgender adults aged ≥18, significantly higher than that for lesbian/gay adults (11.6%), bisexual adults (13.5%), and straight/heterosexual adults (7.8%). Compared with the straight/heterosexual population, LGBT adults had lower education and income levels and higher unemployment and were more likely to be non-Hispanic White and single. Transgender adults were particularly disadvantaged with respect to socioeconomic status, job loss, and lack of health insurance. After controlling for socioeconomic and demographic covariates, lesbian/gay, bisexual, and transgender adults experienced, respectively, 36%, 35%, and 157% higher odds of food insecurity than straight/heterosexual adults. Black/African American, Hispanic, and mixed-race/ethnicity, lower education and income, lack of homeownership, divorce/separation, lack of health insurance, and recent job loss were significant predictors of food insecurity among LGBT adults. Inequalities in food insecurity by LGBT status were similar in large metropolitan areas. Conclusions and Implication for Translation: Significant disparities in food insecurity exist with LGBT adults, particularly transgender adults, at substantially increased risk of experiencing food insecurity, economic hardship, and social disadvantage during the pandemic and likely in greater need of social and public assistance. Health policies aimed at improving the social and material conditions may lead to improved food security and health outcomes among LGBT adults and the general US population.