School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
School of Public Health, Boston University, Boston, MA, USA.
Am J Health Promot. 2024 Jan;38(1):68-79. doi: 10.1177/08901171231211134. Epub 2023 Oct 29.
We sought to describe the prevalence of food insecurity and its relationship with mental health, health care access, and use among lesbian, gay, and bisexual (LGB) adults in the U.S.
We analyzed data from the National Health Interview Survey (NHIS), a cross-sectional study of noninstitutionalized adults from all 50 states and the District of Columbia.
The study sample was restricted to LGB adults ≥18 years (N = 1178) from the 2021 NHIS survey.
Food security was assessed using the 10-item U.S Adult Food Security Survey Module. Study outcomes were mental health (depression, anxiety, life satisfaction, and serious psychological distress), health care utilization, and medication adherence.
Descriptive statistics and linear and generalized linear regressions.
The study sample consisted of 69% White, 14% Hispanic/Latinx, 9% Black, and 8% people of other races. Approximately half (53%) identified as bisexual and 47% identified as gay or lesbian. Eleven percent were food insecure. Sexual orientation, income-to-poverty ratio, and health insurance were significant correlates of food insecurity. In multivariable analyses, food insecurity was significantly associated with mental illness (including depression, anxiety, and serious psychological distress), limited health care access and use (including inability to pay medical bills, delay in getting medical and mental health care, and going without needed medical and mental health care), and medication nonadherence (including skipping medication, taking less medication, delay filling prescription, and going without needed prescription).
Food insecurity is a constant predictor of adverse mental health and low medical and mental health care use rates among LGB adults in the United States. Achieving food security in LGB people requires improving their financial and nonfinancial resources to obtain food.
我们旨在描述美国女同性恋、男同性恋和双性恋（LGB）成年人的食物不安全状况的流行程度及其与心理健康、获得和使用医疗保健的关系。
我们分析了来自全国健康访谈调查（NHIS）的数据，这是一项对全美 50 个州和哥伦比亚特区的非住院成年人进行的横断面研究。
研究样本仅限于来自 2021 年 NHIS 调查的≥18 岁的 LGB 成年人（N=1178）。
使用美国成人食物安全调查模块的 10 项指标评估食物安全。研究结果为心理健康（抑郁、焦虑、生活满意度和严重心理困扰）、医疗保健利用和药物依从性。
描述性统计和线性和广义线性回归。
研究样本中 69%为白人，14%为西班牙裔/拉丁裔，9%为黑人，8%为其他种族。大约一半（53%）的人认为自己是双性恋，47%的人认为自己是同性恋或女同性恋。11%的人食物不安全。性取向、收入与贫困比率和医疗保险是食物不安全的显著相关因素。在多变量分析中，食物不安全与精神疾病（包括抑郁、焦虑和严重心理困扰）、有限的医疗保健获取和利用（包括无力支付医疗费用、延迟获得医疗和心理健康护理以及不接受所需的医疗和心理健康护理）以及药物不依从（包括漏服药物、少服药物、延迟开处方和不服用所需处方）显著相关。
在美国，LGB 成年人的食物不安全状况是负面心理健康和低医疗和心理健康保健使用率的一个持续预测因素。在 LGB 人群中实现食物安全需要改善他们获得食物的财务和非财务资源。
