{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:51:36Z","timestamp":1791474696434,"version":"4.3.4"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n LGBTQ+ identity, defined using a 2-step measure of sexual orientation and gender.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n 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\u2013co-created interventions to reduce disparities among LGBTQ+ individuals in food insecurity and improve equitable access to food assistance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.38129","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:00:45Z","timestamp":1791471645000},"page":"e2638129","source":"Crossref","is-referenced-by-count":0,"title":["LGBTQ+ Disparities in Food Insecurity, Food Assistance Use, and Barriers to Food Assistance"],"prefix":"10.1001","volume":"9","author":[{"given":"Austin R.","family":"Waters","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren G.","family":"Fiechtner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mass General Brigham, Boston, Massachusetts"},{"name":"The Greater Boston Food Bank, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan E.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mass General Brigham, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mass General Brigham, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele F.","family":"Schuckel","sequence":"additional","affiliation":[{"name":"The Greater Boston Food Bank, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"D\u2019Amato","sequence":"additional","affiliation":[{"name":"The Greater Boston Food Bank, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany M.","family":"Charlton","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T.H. 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