Federal Food Assistance Programs Research Articles

Food Insecurity Is Common in Patients with Inflammatory Bowel Disease and Is Associated with Increased Ultra-Processed Food Intake.

Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population. This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System. Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least "sometimes" in the last 12 months and 10% reporting decreased food access "often" in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, p = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, p = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support. The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality.

Understanding Food Insecurity and Participation in Food Assistance Programs among Hispanic/Latino Residents of Hialeah, Florida, before and during the COVID-19 Pandemic

The 63.6 million Hispanic individuals living in the United States constitute the largest ethnic or racial minority group in the country. Hispanic/Latino households report a high prevalence of food insecurity, and often, food-insecure individuals cope by turning to emergency and federal food assistance programs for immediate or long-term assistance. This paper focuses on Hialeah, Florida, a predominantly Hispanic/Latino city in Miami-Dade County. It examines which demographic factors influence participation in food assistance programs and the occurrences of periods of disrupted food access. This study examines two questions: (1) What factors are associated with participation in food assistance programs? (2) To what extent did study participants use food assistance programs before and during the COVID-19 pandemic? We conducted a survey and collected 684 responses from April to August 2022. We gathered data on participants’ identities, household attributes, and their usage of federal and emergency food assistance programs. We used Pearson’s chi-square tests to identify significant associations between food assistance usage, food access, and respondents’ demographic characteristics. We also used binary logistic regression models to assess probabilities. The findings of this research are significant, indicating that the COVID-19 pandemic exacerbated food access challenges in Hispanic/Latino households in 2022. The data also revealed that low-income households, respondents below the age of 40, individuals born in the United States, those with low educational attainment, and those living in multifamily households had the highest likelihood of using food assistance programs. Single- and non-single-parent households, employment status, languages spoken at home, and number of children in the household were also statistically significant factors in predicting food assistance usage. This research provides valuable insights into how individuals in a city responded to the pandemic by utilizing food assistance programs.

The Association between Federal Nutrition Assistance Programs and Adolescent Food Security during the COVID-19 Pandemic: Evidence from Baltimore, Maryland.

Given the lack of attention on adolescent food insecurity, the primary objective of this study was to assess the association of household participation in federal food assistance programs with food security status among adolescents in Baltimore during the COVID-19 pandemic. Adolescents, ages 14-19 years, were invited to participate in two online surveys. The baseline was implemented between October 2020 and January 2021, while the follow-up took place one year later from November 2021 to January 2022 after schools had re-opened. We then matched survey participants with household participation in food nutrition assistance programs using data obtained from the Maryland Department of Social Services. We used logistic regression to examine the association between food assistance program participation status and food insecurity. Additionally, to examine whether the impact of program participation on food insecurity changed between the baseline survey and one year later at follow-up when schools re-opened, a difference-in-differences analysis was conducted. The results showed no significant associations between adolescent food security and participation in any of the federal nutrition assistance programs. Increased attention on how best to improve adolescent food security in low-income households that can respond to the unique needs of adolescents is clearly warranted.

Hindrances and Enablers of Healthy Eating Behavior Among College Students in an HBCU: A Qualitative Study.

Research indicates widespread unhealthy eating habits among college students, posing long-term health risks. This study at a Historically Black College and University (HBCU) aimed to explore the perceived obstacles and facilitators to healthy eating among college students, using the social ecological model (SEM). Through focus group discussions and key informant interviews, the study identified several barriers to healthy eating, including challenges in accessing federal food assistance resources, gaps in nutrition knowledge, cost concerns, limited food variety on campus, difficulty accessing grocery stores, and a lack of cooking skills. To address these barriers, participants suggested various solutions, such as implementing cooking demonstrations, providing nutrition education, increasing food variety on campus, offering gardening opportunities, adjusting cafeteria hours for more flexibility, making fresh produce more available on campus, assisting students in accessing federal food assistance programs, and providing transportation to nearby grocery stores. The findings highlight the need for targeted interventions to promote healthier dietary behaviors among college students, particularly those attending HBCUs. By addressing the identified barriers and implementing the suggested solutions, initiatives can be developed to support students in making healthier food choices, ultimately reducing long-term health risks associated with unhealthy eating habits.

Impact of Food Insecurity and Community and Federal Food Assistance Program Usage on Experiencing a Negative Health Condition Among Latinx Individuals in the NC High Country

Impact of Food Insecurity and Community and Federal Food Assistance Program Usage on Experiencing a Negative Health Condition Among Latinx Individuals in the NC High Country

Vendors’ Perceptions and Experiences with WIC Online Shopping Implementation

BackgroundOnline shopping (OS) holds promise for improving the shopping experience for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, little is known about vendors’ perspectives on implementing OS in the context of WIC. ObjectivesThe present study aimed to understand vendors’ experiences, needs, and barriers to WIC OS implementation. MethodsWe recruited vendors at various stages of WIC OS planning and implementation (n = 16). Semistructured interviews were conducted, transcribed, and coded using subconstructs of the i-PARIHS framework domains (e.g., Characteristics of the Innovation, recipient, context, and facilitation) to assess determinants related to adoption and implementation of WIC OS among vendors. ResultsInterviewees represented various organizations, including local (n = 5), regional (n = 4), and national (n = 5) entities, along with enablement platforms (n = 2). The interviews yielded themes related to experiences planning and implementing a WIC OS system (n = 7) and perceived needs and barriers (n = 3). Vendors drew on prior experiences with Supplemental Nutrition Assistance Program (SNAP) OS to inform WIC OS projects, stressing the importance of building relationships and collaborating, particularly in technical partnerships, during WIC OS implementation. They also highlighted the value of leveraging existing OS systems to implement WIC OS projects, discussed WIC OS perceived benefits, emphasized the role of educating staff and participants on its usage, and valued WIC OS implementation guidance provided by WIC agencies. Needs and barriers for vendors contemplating WIC OS implementation included the need for evidence of successful implementation of WIC OS projects, understanding current regulatory implications, and appraising existing priorities and financial considerations for adopting and implementing WIC OS. ConclusionsWIC OS innovations are integral to modernizing the federal food assistance program. The present study highlights the role of vendor engagement, collaboration, guidance from WIC agencies, and knowledge sharing in ensuring WIC OS success. These insights can inform how WIC State agencies engage vendors to implement WIC OS.

Student Opposition to University Pouring Rights Contracts

IntroductionThe majority of large public universities have exclusive pouring rights contracts (PRCs) with beverage companies that produce and market sugar-sweetened beverages (SSBs). PRCs contain provisions that conflict with recommendations from major public health organizations that institutions reduce SSB availability, marketing, and consumption. This study assessed the following among students at 3 public universities: student perception of PRCs–the extent to which they favored or opposed PRCs, the association between student socioeconomic characteristics and perception of PRCs, student estimates of PRC revenue, and the association between student PRC revenue estimates and perception of PRCs. To contextualize results, actual PRC revenue as a percent of total revenues was estimated. MethodsA cross-sectional exploratory study was conducted among a convenience sample of 1,311 undergraduate SSB-consuming students recruited from 3 large and diverse public universities in Northern California. On an online questionnaire, undergraduate students indicated the extent to which they favored or opposed PRCs on a 10-point scale (oppose=1-5, favor=6-10) and provided a numeric estimate of the percentage of total university revenue they thought their university's PRC generated. Regression models were used to analyze differences in perception of PRCs by student socioeconomic status and estimates of university revenues generated by PRCs. Additionally, PRCs and financial reports were obtained from the 3 universities to estimate actual PRC revenue as a percent of total revenues. Survey data were collected between August and November 2018 and analyzed August 2022. ResultsA large majority of students (81%) opposed PRCs, and opposition did not significantly differ by student socioeconomic status, including by levels of food security, need-based financial aid, participation in federal food assistance or healthcare programs, parental education, or parental income (all p-values > 0.14). The median student estimates for PRC revenue as a percentage of total university revenue was 10%. In contrast, the estimated actual annual revenue generated from the PRCs ranged from 0.01-0.04% at these schools. Revenue estimates were not significantly associated with participants’ opposition or favoring of PRCs (p = 0.65). ConclusionsA large majority of students opposed PRCs, and this opposition was similar regardless of student socioeconomic status or student estimates of PRC revenues. Students markedly overestimated (by >100-1000-fold) the percentage of university revenue that came from PRCs. University administration should consider student views on PRCs when deciding whether to exit or continue with PRCs.

Food Insecurity within a Public University and the Role of Food Assistance Programs Amid the Global Pandemic

Food insecurity (FI) is a pressing concern among university students in the United States, and the COVID-19 pandemic has exacerbated this issue. Providing food assistance for university students has become more challenging due to pandemic-related consequences and interventions. This study aims to (1) analyze social inequalities in FI among university students in a large public university during the pandemic, (2) investigate the association of their utilization of campus, community, and federal food assistance programs (FAPs) and FI, and (3) understand the barriers students face in accessing FAPs. Survey questionnaires were distributed to students to gather their socio-demographics, FI, and usage of FAPs. Logistic regression was utilized to assess the relationship between students’ FI and their use of FAPs. Among the surveyed students (n = 282), 33.7% reported experiencing FI. Higher FI rates were observed among socially vulnerable student groups, for example, non-Hispanic Black (62.5%) and Hispanic students (38.7%), compared with non-Hispanic White students (32.1%). FAPs had a limited influence on students’ FI due to low utilization. The primary barriers to FAPs were insufficient information, ineligibility, and social stigma. The findings suggest it is crucial to reduce barriers to using FAPs and develop targeted interventions for marginalized students to address inequalities in FI.

In Pursuit of Equitable Access in Federal Food and Nutrition Assistance Programs.

In Pursuit of Equitable Access in Federal Food and Nutrition Assistance Programs.

A Mixed-Methods Study of Perceived Implementation Challenges for WIC Online Ordering and Transactions.

Federal food assistance programs are working towards online grocery shopping. Online ordering in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is emerging following successful implementation in Supplemental Nutrition Assistance Program (SNAP). To identify anticipated challenges, potential solutions, and expected costs of WIC online ordering. Cross-sectional, mixed-methods, web-based, survey research. Data were collected from December 2020 to January 2021. Purposeful and snowball sampling included WIC stakeholders involved in developing processes and systems required for WIC online ordering. Respondents represented diverse geographic areas, levels of intraorganizational authority, and WIC benefit card types. The research team used a rapid analysis and lean coding approach to identify emergent themes from open-ended survey responses. Descriptive statistics were used to describe the distribution of responses across themes and stakeholder types. Respondents (n= 145) described 812 anticipated challenges within 20 themes grouped into five topic areas: rules and regulations; shopping experience; security, confidentiality, fraud, and WIC State agency processes; training, assistance, and education; and equitable access and buy-in. Addressing anticipated regulatory issues were among the few concrete potential solutions described. The two most frequent costs reported were increased staff time and start-up and ongoing technology costs. This study identified several, critical anticipated challenges and considerations that will help prepare WIC state agencies for opportunities to expand online ordering to WIC participants.

Federal Food Program Participation and Beverage Intake Among Families With Low Household Income

ObjectiveExamine beverage intake among families with low income by household participation in federal food assistance programs. DesignCross-sectional study conducted in fall/winter 2020 via an online survey. ParticipantsMothers of young children insured by Medicaid at the time of the child's birth (N = 493). Variables MeasuredMothers reported household federal food assistance program participation, later categorized as Supplementation Nutrition Program for Women, Infants, and Children (WIC) only, Supplemental Nutrition Assistance Program-Education (SNAP) only, both WIC and SNAP, and neither. Mothers reported beverage intake for themselves and their children aged 1–4 years. AnalysisNegative binomial and ordinal logistic regression. ResultsAfter accounting for sociodemographic differences between groups, mothers from households participating in WIC and SNAP consumed sugar-sweetened beverages (incidence rate ratio, 1.63; 95% confidence interval [CI], 1.14–2.30; P = 0.007) and bottled water (odds ratio, 1.76; 95% CI, 1.05–2.96; P = 0.03) more frequently than mothers from households in neither program. Children from households participating in WIC and SNAP also consumed soda (incidence rate ratio, 6.07; 95% CI, 1.80–20.45; P = 0.004) more frequently than children in either program. Few differences in intake were observed for mothers or children participating in only WIC or SNAP vs both programs or neither program. Conclusion and ImplicationsHouseholds participating in both WIC and SNAP may benefit from additional policy and programmatic interventions to limit sugar-sweetened beverage intake and reduce spending on bottled water.

Food Insecurity in the United States: Measurement, Economic Modeling, and Food Assistance Effectiveness

We first discuss the genesis and development of the Food Security Module in the United States. We then present a conceptual model of food insecurity, drawing on consumer choice theory. The model shows how food insecurity exhibits a quality–quantity trade-off and has linkages to policy levers. Next, we present new stylized facts pertaining to food consumption for those who report food insecurity versus those who do not. Adults residing in food-insecure households consume lower-quality diets across the entire distribution of diet quality and experience more volatility in caloric intake. Males younger than 20 years in food-insecure households exhibit no differences in diet quality but consume fewer calories, while the opposite is true for younger females. We review the literature pertaining to the effects of federal food assistance programs on food insecurity. The Supplemental Nutrition Assistance Program tends to reduce household food insecurity, while having little to no effect on nutritional quality. Federal programs pertaining to children (i.e., the school food programs and the Special Supplemental Nutrition Program for Women, Infants, and Children) tend to reduce food insecurity while also increasing the nutritional quality of children's diet.

Fatty Liver Disease and Food Insecurity: Excess in Scarcity.

Nonalcoholic fatty liver disease (NAFLD) is widely prevalent in the U.S and is the primary cause of chronic liver disease. Existing evidence shows that food insecurity may be an independent risk factor for fatty liver disease and is associated with poor health outcomes. Understanding the role of food insecurity in these patients can help develop mitigation strategies to address the growing prevalence of NAFLD. Food insecurity is associated with increased overall mortality and health care utilization among patients with NAFLD and advanced fibrosis. Individuals from low-income households with diabetes and obesity are particularly susceptible. Trends in prevalence of NAFLD mirror that of obesity and other cardiometabolic risk factors. Several studies in both adult and adolescent population have described an independent association between food insecurity and NAFLD. Concentrated efforts to lessen food insecurity may improve health outcomes in this group of patients. High-risk patients with NAFLD should be linked with local and federal supplemental food assistance programs. Programs directed at addressing NAFLD-related mortality and morbidity should focus on improving food quality, access to these foods, and promote healthy eating habits.

Integrating Human-Centered Design Methods Into a Health Promotion Project: Supplemental Nutrition Assistance Program Education Case Study for Intervention Design.

Human-centered design, or design thinking, offers an extensive toolkit of methods and strategies for user-centered engagement that lends itself well to intervention development and implementation. These methods can be applied to the fields of public health and medicine to design interventions that may be more feasible and viable in real-world contexts than those developed with different methods. The design team aimed to develop approaches to building food skills among caregivers of children aged 0-5 years who are eligible for a federal food assistance program while they were in the grocery store. They applied 3 specific human-centered design methods-Extremes and Mainstreams, Journey Mapping, and Co-Creation Sessions-to collaboratively develop intervention approaches to enhance Supplemental Nutrition Assistance Program Education (SNAP-Ed) reach and impact across food retail settings. Extremes and Mainstreams is a specific kind of purposive sampling that selects individuals based on characteristics beyond demographics. Journey Mapping is a visual tool that asks individuals to identify key moments and decision points during an experience. Co-Creation Sessions are choreographed opportunities for individuals to explicitly contribute to the design of a solution alongside research or design team members. Ten caregivers with diverse lived experiences were selected to participate in remote design thinking workshops and create individual journey maps to depict their grocery store experiences. Common happy points and pain points were identified. Nine stakeholders, including caregivers, SNAP-Ed staff, and grocery store dieticians, cocreated 2 potential intervention approaches informed by caregivers' experiences and needs: a rewards program and a meal box option. These 3 human-centered design methods led to a meaningful co-design process where proposed interventions aligned with caregivers' wants and needs. This case study provides other public health practitioners with specific examples of how to use these methods in program development and stakeholder engagement as well as lessons learned when adapting these methods to remote settings.

Challenges to Food Charity Resilience During the COVID-19 Pandemic

ABSTRACT The coronavirus 2019 (COVID-19) pandemic caused many significant disruptions to the food system, including the charitable food sector. Using qualitative interviewing, this research draws from the experiences of food pantry staff and volunteers during the early months of the pandemic in the greater Buffalo, New York area. Participants describe the impacts of the COVID-19 pandemic on product acquisition, distribution, and other challenges. Buffalo food charity organizations adapted to these challenges and demonstrated how diversified food supply lines, strong interorganizational relationships, and federal food assistance programs could increase food charity organizations’ resilience to emergencies like pandemics in the future.

Grocery Purchase Changes Were Associated With A North Carolina COVID-19 Food Assistance Incentive Program.

Many low-income Americans experience food insecurity, which may have been exacerbated by economic instability during the early stages of the COVID-19 pandemic in 2020. In this study we assessed the impact of Healthy Helping, a short-term fruit and vegetable incentive program aimed at alleviating food insecurity and improving diet quality for Supplemental Nutrition Assistance Program participants, on grocery purchases, using transaction data from a large supermarket chain in North Carolina. We compared Healthy Helping participants' purchases of key food groups before and during the program with purchases by control shoppers participating in federal food assistance programs during the same period. Healthy Helping enrollment was associated with a $26.95 increase in monthly spending on fruit, vegetables, nuts, and legumes-an increase of 2.5 grams of fiber per 1,000 kilocalories purchased-and other shifts in the composition of food purchases, relative to control shoppers. These findings suggest that the program increased healthy food purchases while also increasing dollar sales at participating retailers. On average, participants did not use the full benefit; future research should explore factors associated with non- or underuse of benefits, to inform program design and outreach.

Federal Food Assistance Program Participation during the COVID-19 Pandemic: Participant Perspectives and Reasons for Discontinuing.

This study aims to describe reasons for discontinuing participation and experiences participating in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) during the COVID-19 pandemic. We analyzed data from a cross-sectional online survey distributed to a national sample, restricted to (1) households that discontinued participating in SNAP (n = 146) or WIC (n = 149) during the pandemic and (2) households that participated in SNAP (n = 501) or WIC (n = 141) during spring 2021-approximately one year into the pandemic. We conducted thematic analyses of open-ended survey questions and descriptive statistics for Likert-scale items. Themes raised by respondents who discontinued participating in SNAP or WIC included difficulty recertifying and virus exposure concerns. Former WIC participants reported the program was not worth the effort and former SNAP participants reported failing to requalify. Respondents participating in WIC or SNAP during the pandemic mentioned transportation barriers and insufficient benefit value. WIC participants had trouble redeeming benefits in stores and SNAP participants desired improved online grocery purchasing experiences. These results suggest that enhancements to WIC and SNAP, such as expanded online purchasing options, program flexibilities, and benefit increases, can improve program participation to ensure access to critical nutrition supports, especially during emergencies.

Socioeconomic Inequalities Impact the Ability of Pregnant Women and Women of Childbearing Age to Consume Nutrients Needed for Neurodevelopment: An Analysis of NHANES 2007-2018.

Adequate consumption of nutrients that support infant neurodevelopment is critical among pregnant women and women of childbearing age. Understanding the potential effects of socioeconomic inequalities on nutrient gaps in these life stages is thus important for informing strategies to mitigate negative health consequences. Usual intake (foods and dietary supplements) of neurodevelopment-related nutrients was determined from 24 h recalls among women of childbearing age and pregnant women (20–44 years) using data from 2007–2018 NHANES. Usual intake was compared across household food security, poverty-to-income ratio (PIR), and household participation in federal food and nutrition assistance programs. Intake of EPA + DHA was universally low with >95% of all women (pregnant and non-pregnant) below the DGA recommendation from foods alone. Women in households that participated in the Supplemental Nutrition Assistance Program had a significantly lower intake of multiple nutrients relative to those who did not participate. For example, 50% had intakes below the estimated average requirement (EAR) for vitamin A (versus 32%), 42% were below the EAR for calcium (versus 33%) and 65% were below the EAR for magnesium (versus 42%). Similar gradients were observed by PIR and household food security, and among pregnant women whereby gaps were more evident in those experiencing socioeconomic inequalities. The use of dietary supplements attenuated shortfalls for most nutrients. These findings highlight a critical need to support the nutritional requirements for women of childbearing age and pregnant women.

Barriers to Summer Food Service Program (SFSP) Implementation Before and After COVID-19: A Qualitative, Collective Case Study

ObjectivesSFSP, as a federal food assistance program, could ensure that children have sufficient nutritious food during summer. According to a 2016 USDA report, only 0.4–0.6% of eligible children participated in this program in Nebraska, which makes for one of the lowest SFSP participation rates in the U.S. This study aims to better understand how the COVID-19 pandemic has impacted SFSP implementation in urban and rural settings across the state. MethodsIn this qualitative, collective case study, we conducted eight structured zoom interviews with three SFSP state agencies (two rural and one urban) and five SFSP sponsors (three rural and two urban) in the state of Nebraska who worked in SFSP in summers of 2019 and 2020. Two project team researchers independently coded interview transcripts following an inductive qualitative thematic analysis and used NVivo software to sort and organize the themes. ResultsInterviews revealed that the following themes of barriers in implementing SFSP before the COVID-19 pandemic were: 1) lack of enough transportation to get kids to the meal sites, 2) SFSP staff shortage, 3) federal restrictions on getting schools qualified to run the SFSP, 4) time limitation and issues around starting a new program, 5) not having superintendents on board, and 6) reconstructing and remodeling the meal sites. Specific themes related to issues amplified by COVID were: 1) lack of transportation for food delivery in rural areas, 2) keeping up with COVID adjustments, and 3) meal preparation and food storage problems. Interestingly, most interviewees mentioned that COVID adjustments of SFSP made it easier to run the program by removing the requirements of physical meal sites for children and decreasing the 50% threshold, which allowed more schools to run the summer meals. ConclusionsInsights from this study may inform the development of policies that expand food access to vulnerable families. On the organizational level, this includes providing participating kids and their parents with both meal distribution options - meal sites and delivery options - during summer. On the policy level, this calls for revising the eligibility of SFSP by decreasing the threshold level from 50% to 30% to allow more schools in low-income neighborhoods to participate. Funding SourcesInternal faculty funding.

Food insecurity and SNAP use among sexual minority people: analysis of a population-based sample from National Health Interview Survey, 2017

BackgroundFood insecurity is a pressing public health problem. Lesbian, gay, and bisexual (LGB) people are at increased risk for food insecurity, yet this issue remains grossly understudied among this population. The purpose of this study was to add to the existing literature surrounding food insecurity and the use of federal food assistance programs (SNAP) among LGB people.MethodsThis study used publicly available, de-identified data from the 2017 National Health Interview Survey (NHIS). Primary variables were sexual orientation, food security status, and receipt of SNAP. Food security was assessed using the 10-item USDA Family Food Security measure.ResultsIn our sample, people who identified as bisexual had the highest rates of food insecurity (23.8%, n = 76). Female sexual minorities were 52% more likely to experience food insecurity (aOR = 1.518, 95% CI 1.105–2.087, p = .01) and 44% more likely to report household SNAP assistance than their heterosexual counterparts (aOR = 1.441, 95% CI 1.025–2.028, p = .03). SNAP partially mediated the association between sexual orientation and food insecurity for LGB females.ConclusionsOur findings add to the growing empirical evidence documenting food insecurities among sexual minority adults. Our results reiterate the need for sexual orientation to be included in nationally representative federal food security measures.