"It makes you feel worthless." The lived experience of discrimination in the US food assistance system.

This study examined the lived experience of judgment, mistreatment, and fear related to federal food assistance programs and the emergency food system among families experiencing food insecurity with specific attention to the intersections of holding multiple stigmatized identities while engaging with food assistance. Between November 2022 and June 2023, Feeding MI Families enrolled 781 English and Spanish-speaking parents experiencing food insecurity from 3 Michigan cities. Participants completed closed- and open-ended survey questions assessing their experiences of judgment, mistreatment, and fear related to using food assistance. Quantitative methods were used to identify similarities in these experiences across food assistance program use and sociodemographic characteristics, and qualitative methods were used to identify themes in participants' descriptions of their experiences. Approximately one-third of participants reported experiencing judgment due to using food assistance (38.4 %) or having worried about mistreatment by food assistance programs (37.5 %). Over half (54.8 %) of those born outside the US feared that using assistance would affect their immigration status. Participants described structural issues in the administration of food assistance programs as discriminatory. Often, these experiences were entwined with participants' gender, race, ethnicity, and language fluency. Participants also frequently spoke of interpersonal discrimination due to their use of food assistance, including being stereotyped as lazy, unemployed, and abusing the system. These experiences often occurred while grocery shopping, when one's use of food assistance can be on display. Social and structural interventions that combat stereotypes of food insecurity and improve the efficiency and dignity of food assistance systems could increase program utilization and impacts, particularly within communities that hold other stigmatized identities, decreasing the physical, emotional, and cognitive burden of food insecurity.