Food insecurity-related stigma and disclosure among emergency food program clients: a qualitative analysis

Abstract

Background: Stigma is a well-recognized barrier to accessing emergency food assistance, yet relatively few studies have systematically documented the experiences of pantry clients using a stigma framework. Guided by the Stigma and Food Inequity Framework, this study aimed to examine clients’ experiences of individual-level food insecurity-related stigma and their decisions around disclosing participation in emergency food programs. Methods: We conducted 45-minute semi-structured interviews with 18 emergency food program clients in Pennsylvania and Delaware. Discussion guide topics included individual-level stigma (i.e., anticipated, enacted, internalized, stereotype threat), perceived stigma, and disclosure experiences. Demographic and food insecurity (Hunger Vital Sign screener) data were also collected. Data were analyzed using a hybrid inductive and deductive coding approach. Results: Participants experienced multiple forms of stigma while accessing emergency food program assistance, which negatively impacted their well-being and prevented them from returning to certain pantries. Anticipated stigma in the form of embarrassment and nervousness was the mostly commonly reported individual-level stigma manifestation, followed by enacted stigma (e.g., poor treatment by pantry staff). Despite these stigmatizing experiences at food pantries, clients received predominantly positive responses from family and friends upon disclosing their emergency food assistance usage. Conclusions: Interventions such as staff training, anonymous feedback mechanisms for clients and staff, word of mouth recommendations and peer support