Stigma is best understood as a negative reputation that creates real costs—emotional, social, physical, time, and financial—or the perception that costs will be incurred.

In 2015-2016, NCOA conducted in-depth interviews with 40 benefits counselors to better understand the phenomenon of stigma, how it manifests among their clients, and the strategies that they utilize to counter stigma during the benefits application process. The findings from this effort are detailed in this report.