Gibb James K, Williams Sarah, Mikelstiens Kaspars, Charles Jada, McKinnon Leela, Beach Laura, McKerracher Luseadra, Fields Jessica
Department of Anthropology, Indiana University, Bloomington, Indiana, USA.
Kinsey Institute, Indiana University, Bloomington, Indiana, USA.
Am J Hum Biol. 2025 Sep;37(9):e70131. doi: 10.1002/ajhb.70131.
The COVID-19 pandemic has disproportionately affected vulnerable populations, including sexual and gender minority (SGM) people. Food insecurity, prevalent among this population, may influence perceived vulnerability to infection and related psychological outcomes. This study investigated the association between food insecurity and perceived vulnerability to infection among SGM adults in Toronto, Canada, during the third wave of the COVID-19 pandemic.
A mixed-methods study was conducted with 338 self-identified SGM adults recruited via respondent-driven sampling to complete an internet-based survey between March and July 2021. Measures included food security status, germ aversion, perceived infectability, and COVID-19 worry. Structural equation modeling (SEM) examined pathways linking food insecurity, discrimination, sleep quality, and perceived vulnerability to disease, adjusting for demographic and socioeconomic covariates.
The SEM showed that discrimination predicted increased food insecurity (β = 0.30, p < 0.001) and poorer sleep quality (β = 0.26, p < 0.001). Sleep quality mediated the relationship between food insecurity and perceived vulnerability to disease (indirect effect = 0.16, p < 0.001). Discrimination had a significant total effect on perceived vulnerability to disease (β = 0.22, p < 0.001).
These findings highlight the roles of food insecurity, discrimination, and sleep quality in shaping perceptions of disease vulnerability and risk among SGM people. Interventions addressing food security, mental health, and structural inequities are crucial for mitigating health disparities both during public health crises and in everyday life.
新冠疫情对包括性少数群体（SGM）在内的弱势群体造成了尤为严重的影响。该群体中普遍存在的粮食不安全状况，可能会影响其对感染易感性的认知以及相关心理结果。本研究调查了在加拿大安大略省多伦多市新冠疫情第三波期间，粮食不安全与SGM成年人对感染易感性认知之间的关联。
采用混合方法研究，通过应答驱动抽样招募了338名自我认定为SGM的成年人，于2021年3月至7月完成一项基于网络的调查。测量指标包括粮食安全状况、对病菌的厌恶、对感染易感性的认知以及对新冠的担忧。结构方程模型（SEM）检验了连接粮食不安全、歧视、睡眠质量和对疾病易感性认知的路径，并对人口统计学和社会经济协变量进行了调整。
结构方程模型显示，歧视预示着粮食不安全状况加剧（β = 0.30，p < 0.001）和睡眠质量变差（β = 0.26，p < 0.001）。睡眠质量在粮食不安全与对疾病易感性认知之间起中介作用（间接效应 = 0.16，p < 0.001）。歧视对疾病易感性认知有显著的总体影响（β = 0.22，p < 0.001）。
这些发现凸显了粮食不安全、歧视和睡眠质量在塑造SGM人群对疾病易感性和风险认知方面的作用。解决粮食安全、心理健康和结构性不平等问题的干预措施，对于在公共卫生危机期间和日常生活中减轻健康差距至关重要。
