More than 2 million adults across Massachusetts, representing over one-third of households, are unable to afford enough food or are uncertain where their next meal will come from, according to a study released Tuesday.

The report paints a dire picture of the persistent problem a significant portion of the state faces — affording basic nutritional essentials. And it comes as state officials warn that Republican lawmakers’ proposed cuts to federal assistance programs could throw further families’ food supply into uncertainty.

The report released by the Greater Boston Food Bank and Mass General Brigham is “a wake-up call for coordinated action across every sector,” Food Bank President and CEO Catherine D’Amato said at a press conference in Revere announcing the report.

“Doing nothing is not an option,” she said. “Hunger is a solvable problem, yet it requires all of us.”

Food insecurity ticks up

The rate of state residents who are food insecure rose sharply during the first year of the COVID-19 pandemic and has ticked up ever since, according to the study, now in its fifth year.

In a survey of 3,000 Massachusetts adults between November and March, 37% reported being food insecure in the past year, meaning they lacked the financial resources to afford sufficient food.

In 2019, the last full year before the pandemic, 19% of Massachusetts households were food insecure. A year later, that number rose to 30%. It had crept higher, to 34% last year, before rising to 37% this year.

More than 650,000 households, nearly a quarter of those in the state, were also determined to have very low food security, meaning a person in their household had skipped meals for lack of money.

Representing the most severe form of food insecurity, the rate of Massachusetts households falling into that category has quadrupled since the pandemic began five years ago, the study showed.

A third of Massachusetts children are food insecure, though the number has fallen slightly over the last two years, the report showed.

Still, the most severe cases of child food insecurity are back on the rise. After dipping in 2023 from 14% to 11%, the rate of childhood food insecurity rose to 15% last year.

Real people behind the statistics

Behind the report are millions of Massachusetts adults and children struggling to put food on the table, or uncertain where their meals each day may come from.

Among them is Jacqueline Martinez, 54, and the 16-year-old granddaughter she raises in Revere. She said the rising cost of food and other expenses make it ever more difficult to afford the nutritious meals, with fresh produce and protein, that her parents cooked when she was growing up.

“It’s heartbreaking,” Martinez told MassLive on Tuesday.

Rep. Ayanna Pressley recalled recognizing growing up that her own mother was holding back on meals so her daughter had enough to eat, she said Tuesday at the press conference in Revere.

Food insecurity lingers everywhere, hiding in plain sight, she said.

“There is no profile” for hunger, Pressley said. “It can be anybody.”

Pandemic’s lasting effects are a major cause

The lasting effects of the pandemic likely play a significant role in the hunger crisis, the study indicated. Rising food and housing costs that further strain food budgets also contribute, as does the rollback of social programs that expanded during the pandemic, including the Supplemental Nutrition Assistance Program, or SNAP, formerly known as food stamps.

Food banks warn they won’t be able to provide enough help to offset the cuts proposed to SNAP, Medicaid and other programs by Congressional Republicans.

In Revere on Tuesday, House Democratic Whip Katherine Clark spoke of women in her district who survive with help from the federal food assistance system. One, a single mother, can afford one meal a day without SNAP. Another single mother runs out of money by the third week of the month, despite working three jobs. SNAP benefits help her make it to the next month, Clark said.

“Hunger is a great injustice of our time,” she said. “It is not abstract or something that we can’t touch or feel. It is physical and it is immediate.”

Hispanic and Black residents hit the worst

More than 60% of Hispanic residents of Massachusetts are food insecure, a rate that has risen from 44% pre-pandemic and remains persistently higher than other demographics.

Food insecurity affected 46% of Black people in Massachusetts last year, the first time since 2020 that the rate had fallen beneath 50%. In 2019, 31% of Black residents were food insecure.

Rates of food insecurity also more than doubled among White and Asian people since 2019, rising from about 15% each to 32% last year.

The counties of Western and Central Massachusetts, as well as Bristol County, showed the highest rates of food insecurity in the state. Hampden County led the state, with 54% of residents food insecure.

Food insecurity has cascading consequences

The report also indicated rising rates of poor nutrition among food-insecure households, contributing to a litany of other health issues with cascading costs, such as diabetes and heart disease.

Households struggling to afford enough food face tradeoffs between nutrition and other necessities, struggling to keep pace with heat and electricity bills, rent and debt.

“The consequences of hunger ripple far beyond the dinner table,” Dr. Lauren Fiechtner, director of nutrition at Mass General Brigham for Children, said Tuesday in Revere. “Food insecure households are significantly more likely to experience poor nutrition, chronic illness and gaps in routine medical care.”

Respondents to the food bank’s survey indicated they would purchase healthier foods and have more freedom to pay other expenses if food costs weren’t as much of a concern.

Food insecurity “is about having the correct food, not just having food,” one man from Hampden County told the study’s authors. He said he frequently diverts to less expensive, processed foods because of the higher cost of fresh produce, dairy and protein.

“The cost of hunger is staggering and measured not just in dollars, but in health opportunity and human potential,” D’Amato said. “These are not just statistics. These are our neighbors, these are humans, these are people, these are families.”