In the United States, the U.S. Department of Agriculture reports that 33.8 million Americans are food insecure. These individuals do not have access to enough food to meet the needs of their household; thus, they must employ various coping strategies to stretch the food they can acquire. Yet, hunger is not the issue. It is merely the symptom of a combination of root causes- social inequities that vary from economic hardship to inadequate access to transportation, poor physical and mental health, as well as other barriers related to the social determinants of health. When examining the relationship between food insecurity and mental well-being, specifically, there is a bidirectional association. An individual who is food insecure is more likely to experience poor emotional health, including depression, anxiety, and stress. The converse is also true. A person who experiences poor mental health is also at a heightened risk of facing food insecurity. This relationship epitomizes the intersectionality of food insecurity and mental health. As low-income families struggle to feed themselves and their loved ones, they also often face the stigma surrounding the utilization of food assistance programs. They report negative emotions, like shame, anger, and isolation when considering waiting in line at food pantries or while being bounced around to various social services. To ensure that those who are eligible are accessing the resources that are available to them, we must employ strategies that combat the stigmatization of people who use assistance programs, whether it be for food or other social services.
The cyclical relationship between mental health and food insecurity is well documented and highlights how stigma can place additional burdens on people who are going through a difficult time in their lives. To better understand how food insecurity affects emotional health, U.S. Hunger polled a focus group, asking the following: “How do you feel when you are experiencing food insecurity?” Responses were received from 1,367 individuals who had previously applied for food assistance via the Full Cart online application. The respondents could select multiple responses with the majority (73.4%) reporting that they felt stressed. Participants additionally reported feeling anxious (54.9%), depressed (52.8%), angry (22.6%), isolated (19.3%), overwhelmed (<1%), and embarrassed (<1%). In line with these findings, Fang and colleagues (2021) found that food-insecure individuals were 257% more likely to report anxiety and 253% more likely to report depression during the COVID-19 pandemic. This risk of heightened mental illness related to food insecurity was significantly higher than that reported by those who became unemployed during the pandemic. Utilization of economic assistance programs (e.g., unemployment benefits, stimulus payments), also did not lower the risk of anxiety and depression. These findings suggest that economic burdens experienced by low-income families are not the sole source of heightened feelings of anxiety and depression. Alternatively, other factors related to shame and stigma surrounding food assistance evoke negative emotions. Thus, when applying for and receiving food assistance, it is essential that individuals in need are treated with dignity and discretion.
To destigmatize the use of food assistance programs we must first recognize food insecurity as a social equity issue and then seek to understand the people who experience it. We can educate ourselves and better understand the human experience of food insecurity by listening to first-hand accounts and testimonials provided by those who seek food assistance. U.S. Hunger has found that this can be accomplished through the employment of an online food assistance application as it allows people to share their personal accounts in a private, judgment-free space. This process eliminates the shame that is frequently reported by those who seek food assistance in-person at local food pantries and other charitable organizations while providing insight into the challenges being faced within our communities. For example, one Full Cart Applicant shared:
“The first time I needed help with food, I was terrified and embarrassed. Now many years later, needing help again that hasn’t gone away, and it stops me in my tracks from accessing a pantry around the corner. It doesn’t help that you have to wait in a line on a busy neighborhood street and they yell your name out when it’s your turn.”
An online application is a viable option to reduce the stigmatization of food assistance. It provides relief to those who need it while transparently revealing that food insecurity is intertwined with many social issues and is a reality for many people of various backgrounds and abilities. When people are treated with dignity and respect, they feel hopeful in spite of their circumstances.
“This last year has been one of the most defeating, and heartbreaking years. We have had a traumatic injury steal my mother’s mental state and put her into early dementia, we’ve gone through foreclosure on our home, for the first time in my life having utilities turned off.. as a single mother to three, two of which have special needs on top of being a caregiver for my mother. This year has broken me in more ways I ever imagined and every day has been a struggle to push forward. Food insecurity has recently become a reality for us, also a first for me in my life to go through. I just want to thank the donors who take the time to think of others who aren’t in the best spots in life and help without judgment. We are grateful beyond words thanks to your generosity and kindness.”
The application of human-centric Artificial Intelligence (AI) and Machine learning serves as another way to leverage technology to combat stigma. AI offers an objective method of evaluating people’s lived experiences. This process removes the influence of negative emotions, like shame and guilt, allowing the system to produce objective recommendations for services based on data-driven input. By collecting personal accounts, we can gain an accurate understanding of the prevalence and scale of the issue. Machine learning algorithms can then be used to impartially process the data to identify applicants most at risk of low or very low food insecurity and tailor support accordingly. Compassionate use of technology, therefore, can help us gain insight into the reality of food insecurity while providing more caring and compassionate support to those who need it.
“I lost everything. Despite the struggle and fight to remain stable, I was one day away from living on the street. It was the first and only time I faced hardship and was thoroughly defeated. The weight of it all crushed me. If not for a few friends and many strangers who got me back to where I needed to be, I wouldn’t be here today. The first time I really needed food I was referred to a pantry. It was one of the hardest things I had ever done. I felt guilty, embarrassed, and that I was a failure. …Words of thanks can be flat and meaningless, [but] a personal story brings those words to life. You’ve done a good deed, and it’s based in action.”
Corissa Raymond, MPH, is Data & Research Writer; and Alexandra Rouzier, is Client Experience Manager at U.S. Hunger. For more information about U.S. Hunger and how we use technology to unite families to a healthier tomorrow, please contact us at data@ushunger.org.
References
- Bruening, M., Dinour, L., & Chavez, J. (2017). Food insecurity and emotional health in the USA: A systematic narrative review of longitudinal research. Public Health Nutrition, 20(17), 3200-3208. doi:10.1017/S1368980017002221
- Fang, D., Thomsen, M.R. & Nayga, R.M. (2021) The association between food insecurity and mental health during the COVID-19 pandemic. BMC Public Health, 21(607). https://doi.org/10.1186/s12889-021-10631-0
- Leung, C.W., Laraia, B.A., Feiner, C., Solis, K., Stewart, A.L., Adler, N.E., & Epel, E.S. (2022). The Psychological Distress of Food Insecurity: A Qualitative Study of the Experiences of Low-Income Parents and Their Coping Strategies. Current Developments in Nutrition, 4(Supplement_2), 224.
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