Background
This survey was initially developed in 2020 in partnership with the National Food Access and COVID Research Team (NFACT), which was made up of researchers from 15 states across the country. The original goal of this study was to understand the impacts of the COVID-19 pandemic on food security and food access across the state. At the time, The Greater Boston Food Bank (GBFB) was one of only two food banks conducting this type of research. As of 2026, there are very few food banks who are currently doing similar work, including Capital Area Food Bank and Second Harvest Heartland. We remain leaders in this work today.
Since its inception, this survey has evolved with input from state, community, and healthcare partners, including the members of the GBFB Health and Research Council. In addition to tracking food insecurity rates, the study also explores barriers and facilitators to food and nutrition assistance program participation (e.g., food pantries, WIC, SNAP, and universal school meals). We seek to capture and amplify the experiences of populations with high rates of food insecurity and highlight solutions to food insecurity proposed by those with lived expertise.
Survey Design and Development
Each summer, the GBFB and Mass General Brigham for Children (MGBfC) data and research teams collaborate with key partners—including representatives from the Department of Transitional Assistance; Special Supplemental Nutrition Program for Women, Infants, & Children (WIC); the Department of Early and Secondary Education (DESE), and community food pantries—to update the survey’s themes and content. Revisions are based on partner feedback and what questions matter most to them, and drafts are reviewed prior to finalization. The survey is also reviewed by GBFB’s unique Health and Research Council, a group of 30 experts in research, policy, and community advocacy representing multiple institutions and organizations, and the Massachusetts Food Bank Coalition members.
In total, the survey includes over 300 questions, with branching logic that makes the survey experience unique to each person based on their individual responses. The average time it takes to complete the survey is 25 minutes.
Survey domains include:
- Demographics (age, race/ethnicity, gender/sexual identity, income, education, region, employment, military service, marital status, and household size)
- 12-month and 30-day food insecurity
- Nutrition security
- Adult and child health insurance, health conditions, health-related quality of life, healthcare utilization, and healthcare food insecurity screening
- Food assistance program use
- Food pantry use, perceptions, cultural appropriateness, discrimination, and barriers
- SNAP perceptions and barriers
- WIC perceptions and barriers
- Financial hardship, including housing and homelessness, food tradeoffs, and coping strategies
- Adult and child diet quality
- Infant feeding
- Mental health status, including anxiety, depression, and general perceived discrimination
- Adverse and positive childhood experiences
Measuring Food Security
A core function of this survey is to measure rates of food security across the state of Massachusetts annually. Prior to 2022, we measured food insecurity prevalence using the USDA’s validated Six-Item Short Form Food Security Survey Module. Since 2022, we began using the full 18-item USDA Household Food Security Module, which allows us to additionally measure both the severity of household food insecurity as well as child-level food insecurity.
Notably, the GBFB statewide survey consistently measures annual rates of food insecurity in Massachusetts that are far higher than national estimates.1 This gap likely reflects methodological differences as well as the use of larger sample sizes in our study. GBFB’s survey is anonymous and online—reducing stigma and encouraging honest responses. In contrast, the USDA had conducted its survey through the Census Bureau’s Current Population Survey, using phone and in-person interviews, which may lead to underreporting. GBFB's estimates are consistent across survey years and align with estimates from other organizations using similar online methodologies.2,3 Importantly, particularly with the USDA’s termination of the federal food insecurity survey in 2025, GBFB's estimates are consistent across survey years and align with estimates from other organizations using similar online methodologies.4
Recruitment and Data Collection
Each year, over 3,000 adults across Massachusetts complete our anonymous, online survey, administered by a survey research firm. Demographic quotas (age, race/ethnicity, gender, income, education, and region) are based on the American Community Survey, with oversampling of low-income households to better represent those most likely to experience food insecurity. Statistical weighting, conducted by research partners at MGBfC, ensures that survey results and food insecurity estimates reflect the overall Massachusetts population using U.S. Census estimates.
Data Cleaning and Analysis
After data collection, a two-stage cleaning process is conducted by both the survey research firm and the GBFB and MGBfC data and research teams. Erroneous responses—such as those from bots, incomplete submissions, and entries that fail internal quality checks—are removed. Once cleaned and analyzed, final results are reviewed by the GBFB’s Health and Research Council to ensure methodological rigor and accurate interpretation before publication.
Analyzing Healthcare Costs
To better quantify the impact of food insecurity on healthcare costs and to build on earlier work from The Greater Boston Food Bank and Children’s HealthWatch completed in 2016,5 beginning in 2024, we estimated the healthcare costs associated with excess emergency room visits and hospitalizations due to food insecurity in Massachusetts among those on Medicaid.
To come up with these estimates, participants in this survey were asked to report on emergency room visits and hospitalizations. Rates of emergency room and hospitalization use were compared between food-insecure and food-secure households adjusted for age, gender, self-reported chronic diseases, household’s race/ethnicity, education, marital status, region, and rurality. The cost was calculated based on the 2021 Medical Expenditure Panel Survey, which provides national averages for emergency and inpatient costs and average emergency room and hospitalization visits per person on Medicaid.6 These cost figures were adjusted to 2024 dollars using the Personal Healthcare Indices.7 These estimates were then multiplied by the number of people on Medicaid based on the American Community Survey.8
Institutional Review Board
This research is reviewed and approved by the Mass General Brigham Institutional Review Board (IRB). The IRB has determined that this project meets the criteria for exemption.
Funding the Study
The 2025 Massachusetts Statewide Survey on Food Insecurity is the 6th annual survey conducted by The Greater Boston Food Bank and Mass General Brigham. Over the years, funding has been provided by Stop & Shop, the Hunger to Health Collaboratory, The Massachusetts Department of Elementary and Secondary Education, The Greater Boston Food Bank, and the Massachusetts General Hospital’s Executive Committee on Research (ECOR) and Department of Pediatrics.
Questions?
For more information, please reach out to our team at data@gbfb.org.
