How Stigma Impacts Participant Experiences with Food Security Programs

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Written by: Thea Bergen, HER Graduate Student Worker

The United States has an extensive network of food banks and government-assisted nutrition programs that play a vital role in helping individuals and families access healthy foods during challenging times. Yet, many individuals who participate in these programs have reported experiencing stigma when seeking assistance. Nutrition assistance programs rely on dedicated staff and volunteers to provide services, and often, resources for training, including funding and time, can be limited. Unfortunately, many do not receive training on stigma.

Even with their tremendous value, according to new HER-funded research, individuals can experience many types of stigma—both at the individual and structural levels—which can prevent them from comfortably seeking programs and services. This leaves a critical gap in assistance for those who are food insecure. Research spanning individual experiences, structural barriers, and intervention strategies shows how stigma erodes dignity, limits access, and undermines health.

This blog post summarizes findings from a study led by Drs. Allison Karpyn, Shreela Sharma, and McKenna Halverson examining food insecurity-related stigma through two comprehensive reviews and qualitative interviews with food assistance clients in Pennsylvania, Texas, and Delaware. These efforts reveal how shame, discrimination, and structural barriers prevent many from accessing available support.

How did the research team approach this study?

The team first conducted a scoping review to examine the evidence on stigma related to food insecurity and food assistance programs in the U.S. They also assessed structural and individual stigma through phone interviews conducted with 18 emergency food program clients in Pennsylvania and Delaware and 19 clients in Texas. Structural stigma was explored through questions such as, “What is your typical experience like when you visit a food pantry to get food?” Individual stigma was explored through questions such as, “How do you think your friends/family feel about you visiting the food pantry?” Finally, an additional review of articles was conducted to identify intervention strategies on food insecurity-related stigma. This review identified 46 different intervention strategies across 18 articles.

What did the research team find?

The team identified many ways in which stigma manifests both at an individual and structural level in food security programs. At an individual level, people experience four types of stigma:

1) Anticipated stigma—refers to the fear of being judged for using food security programs

2) Enacted stigma—refers to rude or disrespectful treatment from staff, cashiers, and volunteers

3) Internalized stigma—the idea that people adopt the stereotypes or prejudices about their group, in this case, those who are food insecure and use government programs

4) Stereotype threat—refers to the fear of confirming negative stereotypes, which can result in stress-induced behaviors that reinforce stigma.

Anticipated stigma was the most commonly reported (mentioned in 59.6% of the 99 included articles), followed by enacted stigma (35.4% of articles), and then internalized stigma (20.2% of articles), which can lead to lower self-esteem and negative self-perception. Together, these individual forms of stigma reveal how deeply shame and judgment can erode dignity, shaping not only how people experience food assistance but whether they seek it at all.

Structural barriers, meanwhile, emerge through the design and administration of food assistance programs, where policies, eligibility rules, and pantry environments often reinforce inequities and create systemic obstacles to accessing support. This type of stigma can manifest itself through both implicit and explicit actions in food assistance programs. Through interviews conducted among participants in emergency food programs, researchers identified several ways in which structural stigma shows up. Long wait times, lack of agency over food choice, accessibility concerns for those living with a disability, and receiving food that is starting to go bad, were all common themes among participants. Researchers found that this often translated into participants’ time and needs not being valued or considered. These insights align with public health research showing that structural barriers and system-level stigma, which are embedded in priorities, rules, and resource distribution, de-prioritize those who need assistance and limit their autonomy.

When examining intervention strategies intended to address food insecurity-related stigma, 89% of the 46 interventions reviewed intervened at a structural level. The structural interventions included benefit modernization (moving from paper to EBT card), moving food banks to more central locations, shifting to pantry choice/grocery models as opposed to prepackaged food bags, improving ADA accessibility, and policies such as expanding SNAP benefits. Only 6% of interventions available were intrapersonal, such as those focusing on increasing the empathy and cultural competency of future health professionals and providers. Lastly, 4% of the interventions were at the interpersonal level, which focused on interactions between staff and clients. Interventions at this level included cultural humility training and codes of conduct, such as unifying agreements among staff and volunteers that prioritize service with respect and dignity.

How can these research findings be used to inform policy and practice?

Translating these findings into action means rethinking both policy design and everyday practice to ensure food assistance programs operate with dignity, respect, and accessibility at their core.

Policy Recommendations:

  • Integrate stigma reduction into food assistance program designs.
  • Support for new tools and recommendations for infrastructure and policy to reduce wait times in lines, as well as extended services for those with disabilities.
  • Prioritize funding for the development of validated stigma measurement tools to track how programs are addressing stigma.

Practice Recommendations:

  • Train staff on the core components of stigma and how individuals and policies can exacerbate experiences.
  • Provide anonymous feedback opportunities to ensure the lived experience of clients is driving practice. Feedback should be regularly reviewed and operationalized. 
  • Adopt client-choice models at food banks and food pantries.
  • Ensure food quality aligns with the cultural and nutritional needs of program participants.

Prioritizing these policy and practice recommendations would allow pantries and programs to meet clients’ immediate food needs while fostering environments where clients feel valued rather than judged. Researchers also point out that people experience stigma in intersectional ways. For example, an individual’s disability status, race, legal status, can intersect to shape unique experiences of stigma.

To ensure that participants in food assistance programs receive the support they need, it is essential to look at how support is provided and examine commonalities and differences across communities. Addressing both individual and structural stigma in emergency food assistance programs is needed to ensure equitable access, protect dignity, and strengthen the effectiveness of policies and practices that combat food insecurity. 

How can I learn more?

Thank you to Dr. Allison Karpyn, Dr. Shreela Sharma, Dr. McKenna Halverson, and Evyn Appel for discussing their findings with us. To learn more, see their published work below and on the Healthy Eating Research website.

Published Briefs

Published Papers