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