Guatemala, the most populous country in Central America (more than 14 million people) with the largest city in Central America (Guatemala City), is also home to the most stunted population in the Western Hemisphere (prevalence of nearly 50%) and the sixth most stunted population among children under five years old globally (United States Agency for International Development (USAID), 2018). With a Gini index above 50 (i.e. a measure of statistical dispersion of wealth varying from 0, perfect equality, to 100, perfect inequality), the unequal distribution of wealth, especially the poverty of the Mayan population living in the rural Western Highlands of Guatemala, contributes to extreme stunting that affects nearly 70% of children in the highly inaccessible Departments (i.e. "States") of Huehuetenango, Quitzaltenango, Quiche, San Marcos and Totonicapan. Stunting, defined as height‐for‐age more than two standard deviations below the United Nations World Health Organization (UNWHO) Child Growth Standards median, results in an irreversible loss of cognitive ability and physical well‐being contributing to a poverty trap where short‐of‐stature adults are unable to provide a better life for their children (United Nations World Health Organization, 2014).
Available at: http://works.bepress.com/daniel_oerther/114/