Family structures and functioning are profoundly shaped by broader social conditions, particularly in contexts marked by economic instability and social transition. This paper examines the impact of social problems such as extreme poverty, addictions, migration, prostitution, and violence on family organization, roles, and relational dynamics, with specific reference to North Macedonia. It draws on the results from a mixed-methodology empirical research carried out in 2025 to analyze social risks faced by biological families in North Macedonia as reasons for child separation and placement into alternative care. The study employed a mixed-methods approach, combining quantitative survey data from the Centers for Social Work with qualitative data from focus groups and semi-structured interviews. Sampling was purposive and stratified by region and stakeholder group to ensure representation across all eight statistical regions in North Macedonia and key target populations. The total sample included 16 Centers for Social Work (53% coverage), 34 professionals, 79 children, and 59 parents and foster carers. The presentation of findings is based on individual and family narratives to provide a more authentic and nuanced understanding of their lived experiences.

The study demonstrates how structural vulnerabilities shape family functioning in a post-socialist, economically stratified society. Unemployment, income inequality, and regional disparities—especially in rural and marginalized communities—produce chronic stress and poverty, leading to parental strain and disrupted caregiving. Addictions, including alcohol, gambling, and drug use, intensify conflict and financial instability. Labor migration reshapes family structures, affecting supervision, emotional bonds, and gender roles. Prostitution, trafficking, and domestic violence further undermine well-being and social inclusion. These risks interact cumulatively, increasing family fragility. The paper calls for integrated policies and services addressing poverty, addiction, and stronger protection mechanisms against violence.