Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec:12:100655.
doi: 10.1016/j.ssmph.2020.100655. Epub 2020 Aug 22.

Disparities in food insecurity at the intersection of race and sexual orientation: A population-based study of adult women in the United States

Joanne G Patterson  1 , Jennifer Russomanno  2 , Andreas A Teferra  3 , Jennifer M Jabson Tree  4
Affiliations

Disparities in food insecurity at the intersection of race and sexual orientation: A population-based study of adult women in the United States

Joanne G Patterson et al. SSM Popul Health. 2020 Dec.

Abstract

Food insecurity affects 1 in 8 American adults annually, and is more prevalent in Black and sexual minority women. We applied an intersectional approach to investigate food insecurity prevalence in women with intersecting minority race and sexual orientation. We used two United States surveillance systems-National Health Interview Survey (NHIS) 2013-2018 and National Health and Nutrition Examination Survey (NHANES) 2005-2014, to estimate how race and sexual orientation jointly influence food insecurity prevalence in women aged 18-59 years (NHIS: N = 47596; NHANES: N = 5106). All analyses were stratified for Supplemental Nutrition Assistance Program (SNAP) use. Relative measures estimated weighted prevalence ratios (PR) comparing Black and White sexual minority women (SMW) to heterosexual White women. Absolute prevalence measures estimated the excess prevalence of food insecurity due to multiple marginalization. Patterns of food insecurity prevalence were similar across NHIS and NHANES, and differed only for non-SNAP users. Relative prevalence of food insecurity was greater in Black SMW than heterosexual White women in NHIS (PR: 2.16; 95% confidence interval [CI], 1.41-3.30) and NHANES (PR: 2.79; 95% CI, 1.73-4.51). The strength of the association between multiple marginalization and food insecurity was stronger for Black SMW than White SMW. Absolute measures were significant only for NHIS and did not support our a priori hypothesis: For non-SNAP users, being Black and sexual minority reduced the joint disparity in food insecurity by approximately 50% (Synergy Index: 0.52; 95% CI, 0.11-0.93). Overall, our study illuminated population-level differences in food insecurity among women of diverse minority races and sexual orientations. Black SMW experienced high rates of food insecurity, which may contribute to chronic disease disparities. Yet, intersecting minority social positions (race and sexual orientation) reduced food insecurity; these findings are unexpected and must be further investigated. Increasing SNAP use among multiply marginalized women may attenuate food insecurity disparities.

Keywords: Emergency food assistance; Food insecurity; Intersectionality; Race/ethnicity; Sexual minority women; United States.

PubMed Disclaimer

Conflict of interest statement

Scientists’ social identities shape their experiences, perspectives, and subsequent research questions, methodological approaches, and interpretation of results. To promote accountability and responsibility in the study of marginalized groups and their health experiences, it is especially important that scientists acknowledge their social identities. Our four-member research team includes three, White, sexual minority, cis-gender female investigators, and one, Black, heterosexual, cis-gender male investigator. While we have been thoughtful about our accountability and careful to consider interpretations of our findings in the context of an intersectional framework, rooted in Black feminist thinking, our interpretations are shaped by our social identities and lenses.

Figures

Fig. 1
Fig. 1
Flowchart of exclusions for deriving the analytic samples_NHIS 2013–2018 and NHANES 2005–2014.
See this image and copyright information in PMC

References

    1. Agénor M., Krieger N., Austin S.B., Haneuse S., Gottlieb B.R. At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: Assessing pap test use disprities by sex of sexual partners among black, latina, and white US women. Social Science & Medicine. 2014;116:110–118. doi: 10.1016/j.socscimed.2014.06.039. - DOI - PubMed
    1. Agénor M., Pérez A.E., Koma J.W., Abrams J.A., McGregor A.J., Ojikutu B.O. Sexual orientation identity, race/ethnicity, and lifetime HIV testing in a national probability sample of US women and men: An intersectional approach. LGBT Health. 2019;6:306–318. doi: 10.1089/lgbt.2019.0001. - DOI - PMC - PubMed
    1. Albelda R., Badgett M.L., Schneebaum A., Gates G. Poverty in the lesbian, gay, and bisexual community. UCLA CCPR Population Working Papers. 2009. https://williamsinstitute.law.ucla.edu/wp-content/uploads/Albelda-Badget... Accessed July 1, 2019.
    1. Anderson S.A. Core indicators of nutritional state for difficult-to-sample populations. Journal of Nutrition. 1990 doi: 10.1093/jn/120.suppl_11.1555. - DOI - PubMed
    1. Badgett M.V.L. Best practices for asking questions about sexual orientation on surveys. 2009. https://williamsinstitute.law.ucla.edu/wp-content/uploads/SMART-FINAL-No... Accessed July 1, 2019.