Structural-Level Stigma Within Emergency Food Assistance Programs: Perspectives from Delaware and Pennsylvania

: To characterize the ways in which structural stigma manifests within emergency food program settings. Methods : We conducted 30-minute semi-structured interviews with 18 emergency food program clients in Pennsylvania and Delaware between August and December of 2024. The discussion guide included open-ended questions regarding client experiences of structural stigma, with an emphasis on issues of access and quality. Demographic data and household food insecurity (Hunger Vital Sign) were also captured. A hybrid inductive and deductive coding approach was used to analyze the data. Results : Structural stigma is a persistent issue within emergency food program environments, impacting both participant access and quality. Access constraints included long wait times, limited agency over food choice, and accessibility challenges for individuals with physical disabilities, whereas quality constraints included receiving expired/spoiled foods or foods not aligned with participants' nutritional needs. These issues led to the erosion of autonomy and dignity and perpetuated clients' feelings of shame, frustration, and discomfort. Conclusions : Intervention strategies such as routinely assessing structural stigma, implementing and monitoring quality standards, increasing infrastructure funding for pantries, creating direct distribution channels with local growers, and revising tax incentive policies show promise for reducing structural stigma within emergency food program settings. Implications : Findings indicate the importance of addressing structural barriers related to accessibility and quality to reduce stigma and create more equitable and inclusive food assistance systems.