Hunger in Vulnerable Families in Southeastern Europe: Associations With Mental Health and Violence

Background: Hunger can influence healthy development of children and has been
shown to be associated with other determinants of child health, such as violence within
the family and maternal (mental) health problems. Whilst the majority of research has
been conducted in high-income countries with vulnerable populations, less is known
about the circumstances in low-and-middle-income countries. This study explored the
experience of hunger in vulnerable families in three Southeastern European countries,
and simultaneously examined relationships with four sets of risk factors—lack of financial,
mental, familial, and social resources.
Methods: Families (N = 140) were recruited for a parenting intervention targeting
child behavioral problems. Baseline data was collected on hunger, socioeconomic
characteristics, mental health and wellbeing, family violence (i.e., child maltreatment and
intimate partner violence), and social and emotional support. Univariate and multivariable
risk factors of hunger were examined cross-sectionally with regression models.
Results: Overall, 31% of families experienced at least one form of hunger in the last
month. Worse family functioning, current intimate partner violence, and more instances of
child neglect showed univariate associations with family hunger. In hierarchical analysis,
five risk factors remained significantly associated with the experience of hunger: lower
adult educational, literacy level, emotional support, more children in the household and
higher scores on parental depression, anxiety, and stress.
Conclusions: Hunger in Southeastern European families, among families with children
showing elevated behavioral problems, was associated with more family violence,
but specifically poorer mental health and less emotional support above and beyond
socio-structural strains. Adapting parenting interventions to support the primary caregiver
in getting more access to emotional support may potentially also change hunger and
its association with health and violence. However, this hypothetical pathway of change
needs explicit testing