Fear, violence, inequality, and stunting in Guatemala

Am J Hum Biol. 2022 Feb;34(2):e23627. doi: 10.1002/ajhb.23627. Epub 2021 Jun 14.


Background: Stunting is defined by the public health community as a length- or height-for-age <-2 SD of a growth standard or reference and is claimed to be caused by poor nutrition, repeated infection, and inadequate psychosocial stimulation.

Material and methods: Stunting is common at all income levels in middle- and low-income countries. At the higher income levels, stunting is unlikely to be caused by nutrient deficiency or infectious disease.

Results: In Guatemala, 17% of <5-year-olds in the highest family income quintile are stunted. Guatemala has a history of violence from armed conflict, current-day social and economic inequalities, government corruption, and threat of kidnapping for the wealthiest families.

Discussion and conclusion: The high level of persistent violence creates an ecology of fear, an extreme range of inequalities in Social-Economic-Political-Emotional resources, and biosocial stress that inhibits skeletal growth and causes stunting for people of all income levels.

MeSH terms

  • Child, Preschool
  • Fear
  • Growth Disorders* / epidemiology
  • Growth Disorders* / etiology
  • Guatemala / epidemiology
  • Humans
  • Income*
  • Socioeconomic Factors
  • Violence