The research team, led by Bernadett Varga and Gábor Pál Stromájer of the University of Pécs, together with Renáta Büki-Vilics and Tímea Stromájer-Rácz, set out to explore how socioeconomic variation within a socially vulnerable population relates to health-related quality of life, parental health behaviors, dietary and feeding-related conditions, and the use of preventive healthcare services. Data collection began in April 2026 and focused on families with children aged zero to three years. Because these families are socially vulnerable and often difficult to reach through conventional survey channels, the researchers used targeted field-based data collection and convenience sampling, ultimately enrolling 88 participants.

Methodologically, the study combined a self-developed questionnaire covering sociodemographic characteristics, health behaviors, dietary conditions and preventive healthcare utilization with the SF-36, a widely validated instrument for measuring health-related quality of life across eight domains, including mental and physical health. The statistical toolkit was deliberately broad: chi-square tests and independent-samples t-tests for bivariate comparisons, analysis of variance for group differences, multiple linear regression to identify independent predictors of quality of life, and Firth’s penalized logistic regression for outcomes with sparse data. That last technique matters. When an outcome is rare or a category is thinly populated, conventional logistic regression can produce unstable, wildly inflated odds ratios; Firth’s method applies a penalized likelihood that corrects for small-sample bias, making it well suited to exploratory work in small, vulnerable cohorts like this one.

The headline result concerns food. Children of mothers with lower educational attainment consumed sugary snacks significantly more frequently, a difference that held up statistically with a p-value of 0.005. More striking still, the penalized regression revealed that families describing their financial situation as average had dramatically lower odds of being unable to provide five daily meals compared with families reporting poor financial status, with an odds ratio of 0.052 and a 95 percent confidence interval running from 0.0004 to 0.469. In plain terms, even a modest step up from poverty-level finances was associated with a roughly twentyfold reduction in the odds of meal insecurity. The direction of the association was reinforced from the dietary side as well: rare fruit and vegetable consumption was linked to significantly higher odds of being unable to provide five daily meals compared with daily consumption, with an odds ratio of 11.506 and a confidence interval of 1.832 to 131.516.

These numbers tell a coherent story about nutritional security in early childhood. Five daily meals is a benchmark of structured, adequate feeding for toddlers and preschoolers, and the inability to reach it signals a household under genuine strain. The finding that fruit and vegetable scarcity clusters with meal insecurity suggests that the problem is not merely one of meal frequency but of dietary quality, the dimension of nutrition most tightly linked to micronutrient adequacy, immune development and long-term metabolic health. The sugary snack pattern among children of less-educated mothers fits the broader international literature, in which lower educational attainment is consistently associated with energy-dense, nutrient-poor feeding practices, often because cheaper calories are more accessible under budget pressure.

Caregiver mental health emerged as the study’s second major theme. In bivariate analyses, respondents’ mental health scores on the SF-36 were lower among participants with poorer financial status and lower maternal educational attainment. Yet when the researchers moved to the multivariable model, these socioeconomic factors were no longer independently associated with mental health. That statistical pattern is common in small exploratory studies and carries an important interpretive lesson: the apparent link between poverty and psychological distress in this cohort may operate through other variables, such as feeding stress, housing conditions or social support, rather than as a direct independent effect. The authors are careful on this point, framing the mental health findings as associated mainly with household socioeconomic indicators at the bivariate level rather than as proven causal drivers.

The preventive healthcare picture was strikingly uneven. Participation in health visitor screenings was remarkably high at 96.6 percent, reflecting the strength of Hungary’s universal health visiting system, in which trained nurses make regular contact with families with young children, often in the home. Attendance at pediatric dental screenings, by contrast, was low at just 34.1 percent. That gap is more than a curiosity. Early childhood caries remains one of the most common chronic conditions of early childhood worldwide, and disadvantaged communities typically bear a disproportionate burden. A system that successfully brings nearly every family into health visitor contact but reaches only one in three children for dental screening represents a clear, actionable target for intervention, particularly since existing health visitor infrastructure could plausibly serve as a bridge to oral health services.

The authors emphasize that the preventive healthcare utilization indicators showed a heterogeneous and primarily descriptive pattern, and they are explicit that the study is exploratory. With 88 participants recruited through convenience sampling in a single national program, the findings cannot be generalized to all families in disadvantaged settlements, and the cross-sectional design precludes any claim about causality. It is equally plausible that financial hardship worsens feeding outcomes as that feeding difficulties strain household finances. Confidence intervals as wide as the one attached to the fruit and vegetable finding, spanning from under 2 to over 130, are a reminder of the statistical uncertainty inherent in small-sample penalized models. What the study loses in precision, however, it gains in access: data from populations this hard to reach are rare, and even exploratory estimates fill a genuine evidence vacuum.

The research was conducted under the ethical principles of the Declaration of Helsinki, with approval from the Regional Research Ethics Committee of the University of Pécs granted in March 2026, and the authors declare no competing interests and no external funding. The team acknowledges the participating families and the professionals of the Felzárkózó Települések, or Closing Gap Settlements, Program, whose cooperation made the fieldwork possible. That program, which targets Hungary’s most deprived communities with integrated services for children and families, provided the practical entry point that academic surveys often lack in settlements where distrust of institutions and logistical barriers routinely depress participation.

The practical implications reach beyond Hungary. Across Europe and beyond, policymakers designing early childhood interventions for marginalized communities frequently treat the target population as homogeneous, applying uniform programs to communities that are internally diverse in income, education and need. This study’s central message is that within-population socioeconomic variation matters, even inside already-disadvantaged settlements. Families reporting average finances differed measurably from families in poverty on meal provision, and maternal education left a detectable fingerprint on children’s snacking patterns. Future preventive and supportive programs, the authors conclude, should account for that internal variation, attend to caregiver well-being as a component of child health, and treat family-level nutritional security as a priority. In the earliest years of life, when the foundations of physical and cognitive development are laid, the difference between five meals a day and fewer may echo for decades.

Subject of Research: Socioeconomic determinants of caregiver well-being and early childhood health indicators in disadvantaged Hungarian settlements

Article Title: Household socioeconomic variation, caregiver well-being, and selected early health-related indicators among families with children aged 0–3 years living in disadvantaged settlements in Hungary

Article References: Varga, B., Büki-Vilics, R., Stromájer-Rácz, T., & Stromájer, G. P. (2026). Household socioeconomic variation, caregiver well-being, and selected early health-related indicators among families with children aged 0–3 years living in disadvantaged settlements in Hungary. BMC Public Health. https://doi.org/10.1186/s12889-026-29618-w

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29618-w

Keywords: early childhood, socioeconomic inequality, caregiver well-being, nutritional security, preventive healthcare, disadvantaged settlements, Hungary, maternal education, SF-36, health visitors, dental screening, public health