Food Insecurity, Discrimination, and Vigilance: Does Sexual Minority Status Matter?

Background and Purpose

Food insecurity remains an important social determinant of health. Beyond physical and mental health, food insecurity has been linked to frequent experiences of stigma and discrimination. Experiences of stigma and discrimination due to food insecurity may be heightened among adults with additional stigmatized or marginalized identities, such as sexual minorities. Consistent with minority stress and intersectionality theories, this compounded stigma and discrimination may contribute to worse experiences of food insecurity and its effects on the physical and mental health of sexual minorities. However, it remains understudied whether sexual minority status moderates the relationship between food insecurity and experiences of stigma and discrimination. In this study, we examine whether the association between food insecurity, everyday discrimination, and heightened vigilance is moderated by sexual minority status.

Methods

We analyzed 2023 National Health Interview Survey (NHIS) sample adult data (N=27,680) using survey-weighted linear regression to examine associations of food insecurity, sexual minority status, and their interaction with two outcomes: everyday discrimination and heightened vigilance. Food insecurity was derived from the NHIS adult 4-category food security recode and dichotomized as food insecure or food secure. Sexual minority was also dichotomized as gay/lesbian/bisexual or non-gay/lesbian/bisexual. Everyday discrimination was measured using a reverse-coded summed score of five items from the Everyday Discrimination Scale assessing unfair treatment in day-to-day life, and heightened vigilance was measured using a reverse-coded summed score of four items assessing anticipation and preparation for discrimination; higher scores indicated more frequent discrimination or vigilance. Models adjusted for demographic and socioeconomic covariates, including age, sex, race, marital status, education, and income/poverty indicators.

Results

In adjusted models, food insecurity and sexual minority status were each significantly associated with higher discrimination and heightened vigilance scores. For everyday discrimination, food insecurity was associated with a 1.90-point higher score, and sexual minority status with a 1.33-point higher score. Similarly, for heightened vigilance, food insecurity was associated with a 2.05-point increase, and sexual minority status with a 1.9-point increase. The interaction with both outcomes was significant and positive, indicating that the association between food insecurity and discrimination and vigilance was stronger among sexual minority adults experiencing food insecurity compared to all the other groups. These results suggest a compounding burden of food insecurity and sexual minority status on both discrimination and anticipatory vigilance.

Conclusions and Implications

Study findings suggest that food insecurity and sexual minority status are not merely independent correlates of discrimination and vigilance but may jointly intensify these experiences. This compounding pattern underscores the importance of examining intersecting social positions when studying psychosocial stress and health equity. In social work research, testing interaction effects is essential to advancing rigor because main effects alone can obscure whether risks are amplified for specific subgroups. In this study, our interaction analyses helped identify who is most affected and clarify heterogeneity. In turn, the results generated more precise evidence to guide equity-focused interventions and strengthen the analytic rigor of social work research, enabling a better understanding and a more effective response to layered forms of disadvantage and exclusion.