This chapter examines the underlying causes for the downward spiral in the quality of life for most Guatemalans. Investigators with a variety of disciplinary viewpoints have tried to relate hunger and disease, especially in children, to inadequate access to agricultural land, falling incomes, and rising unemployment levels. Food insecurity and consequent malnutrition will most certainly be even more extreme for the urban and rural poor, both indigenous and Ladino. The provision of health care for 80 percent of Guatemala's population is primarily the responsibility of the Ministry of Health and Social Welfare. The potentials for equitable economic growth for the ethnically diverse population was taken into consideration and incorporated into the development plans made by the Cerezo government. To further complicate the economic picture, unemployment and underemployment continued to increase significantly. Indian ethnicity is difficult to define because of the tremendous amount of cultural, linguistic, and economic variation that divides the indigenous people in Guatemala.