What Does Stigma Really Mean?

 

We hear the word stigma a lot. People might say, “There’s a stigma around asking for help,” or “They felt stigmatized.” But what does that really mean, especially when it comes to things like food insecurity?

In everyday conversation, stigma usually means someone being judged or treated unfairly. But in science and public health, stigma is more than just one person being treated badly. It also includes unfair systems, public attitudes, and even how people feel about themselves. Let’s break it down using the Stigma and Food Inequity Framework, a tool researchers use to understand how stigma shows up in people’s lives and makes it harder for them to get the food they need.

 

  1. Structural-Level Stigma

This kind of stigma is built into policies, rules, and systems.
It’s not about one person’s actions—it’s about the way things are set up.

Example:
A food pantry that requires a lot of personal information to get help or a government program with complicated paperwork that makes it hard to apply.

 

  1. Individual-Level Stigma

This form of stigma is personal.

It shows up in relationships with others, and even in the way someone sees themselves. It includes two parts (target and perceiver).

 

  1. Target Stigma – What people experience when they are stigmatized

This is the stigma that directly affects people who are food insecure. It shows up in three ways:

  • Anticipated Stigma

The fear that others will judge you.
Example: Avoiding a food pantry because you’re afraid people will think less of you.

  • Enacted Stigma

When you’re actually treated unfairly or shamed.
Example: A cashier makes a rude comment when you pay with food benefits.


  • Internalized Stigma

When you start to believe the negative thoughts others say about you.
Example: Feeling like a bad parent because you need help feeding your family—even though food insecurity is not your fault.

 

  1. Perceiver Stigma – What people believe about others

This includes the thoughts and behaviors of people who hold stigma toward others. It has three parts too:

  • Stereotypes

The assumptions people make about other groups.
Example: Thinking that people who use food stamps are lazy or irresponsible.

  • Prejudice

The negative feelings people have toward others because of those stereotypes.
Example: Feeling annoyed or resentful toward people who receive food assistance.

  • Discrimination

The actions that come from stereotypes and prejudice.
Example: Refusing to donate to a food pantry because you don’t believe people “deserve” help.

 

Why This Matters

Stigma is more than just feeling bad. It can actually stop people from getting the help they need, which makes food insecurity worse. It also adds to bigger problems, like health and income inequality—especially for people who are already facing other kinds of discrimination. Understanding stigma helps us create better systems and more compassionate support for everyone.

How Stigma Shapes the Experience of Food Pantry Users

For many Americans, food pantries offer a vital lifeline. But for those who rely on them, the need for nourishment can come with something else— stigma.

New research from the Food Stigma Research Lab highlights how anticipated stigma—the fear of being judged—emerges as the most common barrier faced by people accessing food assistance. This internal anxiety often manifests as embarrassment or nervousness, especially during initial visits.

“I think the very first time I went, I felt a little embarrassed at first,” shared a 65-year-old pantry client from Pennsylvania. “But I’m okay with it now. It doesn’t hurt me, it doesn’t make me feel any different. If you need stuff, you need stuff.”

For others, that sense of shame lingers, prompting efforts to stay anonymous. One woman described her approach: “If you don’t want nobody to see you, don’t park right in front of the place. Just park up the street a little bit… pull your hair back, put on a baseball cap, put on a mask, and go get yourself right.”

These stories reveal the quiet burdens many carry in their search for basic needs—burdens shaped not just by hunger, but by how society views those who ask for help. Addressing food insecurity means more than providing groceries. It means creating environments that affirm dignity, reduce shame, and remind people that needing support should never feel like a secret.

Addressing Structural Stigma in Emergency Food Assistance Settings


By McKenna Halverson

When people turn to food pantries for help, they should feel supported—not judged or overlooked. But for many, the experience can be frustrating, uncomfortable, and even demeaning. This is often due to structural stigma—unfair systems and practices that make it harder for people to get the help they need, in ways that respect their dignity.

Our recent study involving interviews with 18 emergency food program clients in Pennsylvania and Delaware highlighted how some common challenges in food pantries send a harmful message: your time and needs don’t matter.

What does structural stigma look like in food assistance?

Participants in the study shared real experiences that show how stigma shows up in these settings:

  • Long wait times—sometimes in bad weather, with no seating or shelter
  • Limited or no choice in what food they receive
  • Inaccessible buildings for people with disabilities
  • Expired or poor-quality food that feels like “leftovers” or “garbage”
  • Burdensome paperwork or unfriendly staff during the intake process

Why does this matter?

Research shows that when people feel judged or excluded by support systems, it can:

  • Increase feelings of shame and isolation
  • Make them less likely to seek help again
  • Worsen physical and mental health over time

What can be done?

There are several ways food programs can reduce stigma and build more respectful, supportive environments:

  • Offer full-choice models 
    • Full-choice models (like grocery store-style setups) give people more control and respect cultural, dietary, or religious needs
    • However, different models (e.g., online ordering) may work better for people with mobility issues—so flexibility is key
  • Improve food quality
    • Avoid expired or spoiled items
    • Set clear quality standards for food donations
    • Work with local farmers for fresher produce
  • Make spaces more accessible
    • Add seating, ramps, or covered areas
    • Reduce wait times and crowds
  • Simplify administrative processes
    • Limit paperwork
    • Train staff to be welcoming, inclusive, and trauma-informed

Bottom line:

Fighting hunger isn’t just about providing food—it’s about doing it with dignity. Everyone deserves access to safe, nutritious food in a way that respects their time, their needs, and their humanity.

 

Food is Medicine in Action: Feeding Families Program Shows Promising Results

Chronic conditions like diabetes, hypertension, and obesity continue to challenge families and healthcare systems across Delaware. But a growing movement—Food is Medicine (FIM)—offers a bold, evidence-based solution: integrate nutritious food and healthcare to improve outcomes and reduce costs. From February 2023 to February 2024, Westside Family Healthcare, in partnership with CRESP at the University of Delaware, implemented the Feeding Families program—a yearlong FIM pilot designed to improve health outcomes for individuals living with chronic conditions. Findings from the study are now published in the Delaware Journal of Public Health. 

 

What the Program Offered
Participants in the program received:

  • Bi-weekly deliveries of nutrient-dense foods
  • Personalized nutrition counseling
  • Behavioral coaching and goal setting

The initiative targeted individuals diagnosed with or at risk of diabetes, hypertension, and obesity, providing both food access and the tools needed for long-term lifestyle changes.

 

Key Findings
Researchers from the University of Delaware evaluated the program’s impact on health and behavior. Results included:

  • Reduced Body Mass Index (BMI): Participants experienced significant weight loss.
  • Improved Dietary Habits: Intake of sodium, added sugars, and unhealthy fats decreased.
  • Enhanced Nutrition Knowledge and Confidence: Participants gained skills to make healthier food choices.
  • Modest Improvement in Food Security: Some participants reported better access to nutritious food.
  • A1C Trends: While changes in blood sugar control (A1C) were not statistically significant, data showed a positive trend.


Why It Matters for Delaware
In 2020, chronic diseases accounted for 61% of all deaths in Delaware. Healthcare costs are also among the highest in the nation—averaging $12,899 per person annually. Programs like Feeding Families provide a new path forward, helping residents manage conditions through prevention and lifestyle support, rather than emergency intervention.

 

Policy Implications
The results of the Feeding Families program demonstrate that Food is Medicine works—particularly when implemented through trusted community health centers like Westside Family Healthcare. To scale and sustain impact, Delaware can:

  • Establish Medicaid waivers to fund Food is Medicine programs
  • Support local healthcare providers in delivering food-based interventions
  • Incorporate FIM into statewide chronic disease prevention strategies