A family-oriented psychosocial intervention reduces inflammation in low-SES African American youth
Open accessAbstract
Significance: Children from families of low socioeconomic status (SES) are vulnerable to a variety of health problems. These risks begin in early childhood and persist across the lifecourse. Studies hint that nurturant parenting may offset these health risks, but it remains unclear whether these findings reflect a causal process and have clinical utility. Here we describe a randomized controlled trial, which sought to improve parenting and build youth competencies in low-SES African American families. The endpoint was low-grade inflammation, a process that underlies many health problems to which low-SES youth are vulnerable. Eight years after the intervention, youth who participated had significantly less inflammation than controls. If substantiated, these findings may provide a strategy for narrowing some of America’s social and racial disparities in health.
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Caregiving-focused interventions may mitigate the physiological effects of ELA.
“Considerable evidence suggests that caregiving-focused interventions, for instance, may mitigate the physiological effects of ELA.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [98]
Caregiving-focused interventions improved ELA-associated chronic inflammation, telomere shortening, and gray matter volumetric changes in longitudinal research.
“Some parameters improved by caregiving-focused interventions in longitudinal research include ELA-associated chronic inflammation [98], telomere shortening (accelerated genetic aging) [99], and gray matter volumetric changes [100].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [98]
A 7-week family-oriented psychosocial intervention implemented among low-SES, 11-year-old youth resulted in lower markers of inflammation when youth were 19-years-old relative to a waitlist control.
“An intervention study also showed that relative to a waitlist control, a 7-week family-oriented psychosocial intervention implemented among low-SES, 11-year-old youth resulted in lower markers of inflammation when youth were 19-years-old (Miller et al., 2014).”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Miller et al., 2014
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How stress can influence brain adaptations to motherhood
Kim, P. (2020) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2020.100875 · Cited by 73 · see citing works
“…to these environmental risk factors are frequently targeted for interventions to reduce stress and improve parenting skills (Beeber et al., 2008; Miller et al., 2014; Morris et al., 2017; Olds et al., 2007), understanding of the mechanisms by which stress influences parenting quality remains…”
Recent developments in the study of social relationships, stress responses, and physical health
Hostinar, C. E. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.05.004 · Cited by 69 · see citing works
Brody, G. H., Yu, T., & Shalev, I. (2017) · Health Psychology · doi:10.1037/hea0000443 · Cited by 65 · see citing works
Self-citationBhushan, D., Kotz, K. J., McCall, J., Wirtz, S., Gilgoff, R., Dube, S. R., Powers, C., Olson-Morgan, J., Galeste, M., Patterson, K., et al. (2020) · doi:10.48019/peam8812 · Cited by 71 · see citing works
Miller, G. E., Borders, A. E., Crockett, A. H., Ross, K. M., Qadir, S., Keenan-Devlin, L., Leigh, A. K., Ham, P., Ma, J., Arevalo, J. M. G., et al. (2017) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2017.04.014 · Cited by 62 · see citing works
Self-citationAnnual Research Review: Neuroimmune network model of depression: a developmental perspective
Nusslock, R., Alloy, L. B., Brody, G. H., & Miller, G. E. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13961 · Cited by 63 · see citing works
“For example, a randomized controlled trial showed that a family-strengthening intervention implemented with low-income 11-year-old youth and their mothers resulted in lower levels of inflammation in the youth at age 19 (Miller, Brody, Yu, & Chen, 2014).”
Self-citationLam, P. H., Chiang, J. J., Chen, E., & Miller, G. E. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104917 · Cited by 57 · see citing works
Self-citationChristophe, N. K., Stein, G. L., Romero, M. Y. M., Chan, M., Jensen, M. R., González, L., & Kiang, L. (2019) · Journal of Youth and Adolescence · doi:10.1007/s10964-019-01037-8 · Cited by 55 · see citing works
Farrell, A. K., Simpson, J. A., Carlson, E. A., Englund, M. M., & Sung, S. (2016) · Health Psychology · doi:10.1037/hea0000424 · Cited by 55 · see citing works
“, 2011), and parenting interventions have been found to be effective in improving child health (Miller et al., 2014).”
BackgroundFarrell, A. K., Waters, T. E. A., Young, E. S., Englund, M. M., Carlson, E. E., Roisman, G. I., & Simpson, J. A. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1541517 · Cited by 54 · see citing works
“Miller et al. (2014) have found that a parenting intervention deployed in middle childhood in a sample of rural, low-income Black families reduced inflammation levels when children reached early adulthood.”
BackgroundIncreased cardiometabolic and mortality risk following childhood maltreatment in the United Kingdom
Chandan, J. S., Okoth, K., Gokhale, K. M., Bandyopadhyay, S., Taylor, J., & Nirantharakumar, K. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.015855 · Cited by 48 · see citing works
Quidé, Y., Bortolasci, C. C., Spolding, B., Kidnapillai, S., Watkeys, O. J., Cohen-Woods, S., Carr, V. J., Berk, M., Walder, K., & Green, M. J. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.110013 · Cited by 44 · see citing works
Childhood/Adolescent stressors and allostatic load in adulthood: Support for a calibration model
Berg, M. T., Simons, R. L., Barr, A. B., Beach, S. R. H., & Philibert, R. A. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.09.028 · Cited by 47 · see citing works
Home sweet home? Home physical environment and inflammation in children
Schmeer, K. K., & Yoon, A. J. (2016) · Social Science Research · doi:10.1016/j.ssresearch.2016.04.001 · Cited by 47 · see citing works
“Further, an intervention study of 11-year old rural African American children found that a program aimed at reducing psychosocial stress in children significantly decreased inflammation, in part due to improved parenting in the treated group (Miller et al., 2014).”
Hanson, J. L., Gillmore, A. D., Yu, T., Holmes, C. J., Hallowell, E. S., Barton, A. W., Beach, S. R. H., Galván, A., MacKillop, J., Windle, M., et al. (2019) · Child Development · doi:10.1111/cdev.13154 · Cited by 41 · see citing works
Self-citationToward a Mechanistic Understanding of Links Between Close Relationships and Physical Health
Farrell, A. K., & Stanton, S. C. E. (2019) · Current Directions in Psychological Science · doi:10.1177/0963721419855657 · Cited by 41 · see citing works
Hastings, P. D., Serbin, L. A., Bukowski, W. M., Helm, J. L., Stack, D. M., Dickson, D. J., Ledingham, J. E., & Schwartzman, A. E. (2019) · Development and Psychopathology · doi:10.1017/s095457941900021x · Cited by 39 · see citing works
“…intervention, including individual-and family-focused psychosocial interventions administered in childhood (Campbell et al., 2014) and adolescence (Miller, Brody, Yu, & Chen, 2014), suggesting that the effects of neighborhood disadvantage on children ’ s quality of family relationships and…”
Community violence and cellular and cytokine indicators of inflammation in adolescents
Finegood, E. D., Chen, E., Kish, J. L., Vause, K. J., Leigh, A. K. K., Hoffer, L. C., & Miller, G. E. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104628 · Cited by 39 · see citing works
Self-citationSchmidt, K. L., Merrill, S. M., Gill, R., Miller, G. E., Gadermann, A., & Kobor, M. S. (2021) · Developmental Review · doi:10.1016/j.dr.2021.100983 · Cited by 42 · see citing works
Self-citationTranslating the Biology of Adversity and Resilience Into New Measures for Pediatric Practice
Shonkoff, J. P., Boyce, W. T., Bush, N. R., Gunnar, M. R., Hensch, T. K., Levitt, P. R., Meaney, M. J., Nelson, C. A., Slopen, N. B., Williams, D. R., et al. (2022) · PEDIATRICS · doi:10.1542/peds.2021-054493 · Cited by 39 · see citing works
Difficult Family Relationships, Residential Greenspace, and Childhood Asthma
Chen, E., Miller, G. E., Shalowitz, M. U., Story, R. E., Levine, C. S., Hayen, R., Sbihi, H., & Brauer, M. D. (2017) · PEDIATRICS · doi:10.1542/peds.2016-3056 · Cited by 40 · see citing works
Self-citationHealth Disparities: A Life Course Health Development Perspective and Future Research Directions
Larson, K., Russ, S. A., Kahn, R. S., Flores, G., Goodman, E., Cheng, T. L., & Halfon, N. (2017) · Springer eBooks · doi:10.1007/978-3-319-47143-3_20 · Cited by 38 · see citing works
“As an example, a recent study showed that a psychosocial intervention focused on building family strengths and youth competencies was successful in improving biomarkers of health in early adulthood for African-American youth in lower SES families (Miller et al. 2014).”
BackgroundNeuro-, Cardio-, and Immunoplasticity: Effects of Early Adversity
Pakulak, E., Stevens, C., & Neville, H. (2018) · Annual Review of Psychology · doi:10.1146/annurev-psych-010416-044115 · Cited by 37 · see citing works
Effects of relationship functioning on the biological experience of stress and physical health
Farrell, A. K., & Simpson, J. A. (2016) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2016.04.014 · Cited by 37 · see citing works
Destin, M. (2018) · American Psychologist · doi:10.1037/amp0000297 · Cited by 36 · see citing works
Emotional and instrumental support during childhood and biological dysregulation in mid-life
Slopen, N., Chen, Y., Priest, N., Albert, M., & Williams, D. R. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.12.003 · Cited by 35 · see citing works
“…interventions with families can lead to improvements in child behavior, hypothalamic–pituitary adrenal axis activity, and parental attachment (Fisher et al., 2006; Leve et al., 2012; Slopen et al., 2014a), and can have a lasting impact on inflammatory outcomes in adolescence (Miller et al., 2014).”
Annual Research Review: Social relationships and the immune system during development
Robles, T. F. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13350 · Cited by 36 · see citing works
Stephens, J. E., Kessler, C. L., Buß, C., Miller, G. E., Grobman, W. A., Keenan‐Devlin, L. S., Borders, A. E. B., & Adam, E. K. (2020) · Developmental Psychobiology · doi:10.1002/dev.22000 · Cited by 34 · see citing works
Self-citationSuglia, S. F., Appleton, A. A., Bleil, M. E., Campo, R. A., Dube, S. R., Fagundes, C. P., Heard-Garris, N. J., Johnson, S. B., Slopen, N., Stoney, C. M., et al. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106736 · Cited by 31 · see citing works
East, P. L., Doom, J. R., Delker, E., Blanco, E., Burrows, R. A., Correa‐Burrows, P., Lozoff, B., & Gahagan, S. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.112962 · Cited by 32 · see citing works
“In fact, a recent intervention that strove to strengthen family relationships showed significant reductions in individuals’ inflammation, affirming such associations (Miller et al., 2014).”
BackgroundEmotions, relationships, health and illness into old age
Uchino, B. N., & Rook, K. S. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.05.014 · Cited by 33 · see citing works
“Consistent with this possibility, one intervention found that training families in parenting skills was related to lower levels of inflammation in the child approximately 8 years later [78].”
BackgroundProactive Parent Engagement in Public Schools
Moore, K. J., Garbacz, S. A., Gau, J. M., Dishion, T. J., Brown, K. L., Stormshak, E. A., & Seeley, J. R. (2016) · Journal of Positive Behavior Interventions · doi:10.1177/1098300716632590 · Cited by 31 · see citing works
Brody, G. H., Yu, T., Chen, E., & Miller, G. E. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.04.017 · Cited by 31 · see citing works
Self-citationRace, Methodology, and Social Construction in the Genomic Era
Zuberi, T., Patterson, E. J., & Stewart, Q. T. (2015) · The Annals of the American Academy of Political and Social Science · doi:10.1177/0002716215589718 · Cited by 31 · see citing works
“…work by Chen and Miller highlight that both social interactions and environments shape gene expression and biological functioning in racial minorities and other populations characterized by social disadvantage (brody et al. 2014, 2013; Chen et al. 2011; Miller et al. 2014; Miller and Chen 2013).”
BackgroundAdverse Childhood Experiences and Blood Pressure in Women in the United States: A Systematic Review
Scott, J., McMillian-Bohler, J. M., Johnson, R., & Simmons, L. A. (2021) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13213 · Cited by 31 · see citing works
Farrell, A. K., Slatcher, R. B., Tobin, E. T., Imami, L., Wildman, D. E., Luca, F., & Zilioli, S. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.02.011 · Cited by 29 · see citing works
Kleih, T. S., Entringer, S., Scholaske, L., Kathmann, N., de Punder, K., Heim, C. C., Wadhwa, P. D., & Buß, C. (2022) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2022.02.004 · Cited by 30 · see citing works
“, 2021) and non-pregnant populations (Miller et al., 2014; Hostinar et al., 2015; Walker, 2019; Bonaccio et al., 2016).”
Gotlieb, R. J. M., Yang, X., & Immordino‐Yang, M. H. (2024) · Scientific Reports · doi:10.1038/s41598-024-56800-0 · Cited by 29 · see citing works
The role of childhood unpredictability in adult health
Maner, J. K., Hasty, C. R., Martínez, J. L. C., Ehrlich, K. B., & Gerend, M. A. (2022) · Journal of Behavioral Medicine · doi:10.1007/s10865-022-00373-8 · Cited by 27 · see citing works
“, by increasing the consistency of a child’s daily routines) may hold potential for improving health (Miller et al., 2014; Schreier & Chen, 2010).”
BackgroundAn Extension to the stress-buffering model: Timing of support across the lifecourse
Lam, P. H. (2024) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2024.100876 · Cited by 33 · see citing works
“…studies that induced stressors (ruling out that protection is due to low stressor frequency confounding with high support; Gunnar, 2017), and experimental studies that manipulated social support (providing causal evidence that support led to protection; Miller et al., 2014; Perry et al., 2021).”
ResultNeighborhood Social Conditions, Family Relationships, and Childhood Asthma
Chen, E., Hayen, R., Lê, V. T., Austin, M. K., Shalowitz, M. U., Story, R. E., & Miller, G. E. (2019) · PEDIATRICS · doi:10.1542/peds.2018-3300 · Cited by 25 · see citing works
Self-citationEhrlich, K. B., Miller, G. E., & Chen, E. (2015) · Development and Psychopathology · doi:10.1017/s0954579415000930 · Cited by 25 · see citing works
Self-citationChiang, J. J., Chen, E., & Miller, G. E. (2018) · Nature Human Behaviour · doi:10.1038/s41562-018-0316-5 · Cited by 25 · see citing works
“Indeed, there is preliminary evidence to suggest that strengthening family relationships can offset some of health consequences of childhood socioeconomic disadvantage 45 .”
Self-citationMiller, T. R., Waehrer, G. M., Oh, D. L., Purewal, S. K., Walker, S. O., Marques, S. S., & Harris, N. B. (2020) · PLoS ONE · doi:10.1371/journal.pone.0228019 · Cited by 25 · see citing works
Familism and Inflammatory Processes in African-American, Latino, and White Youth
Chiang, J. J., Chen, E., Leigh, A. K. K., Hoffer, L., Lam, P. H., & Miller, G. (2019) · Health Psychology · doi:10.1037/hea0000715 · Cited by 21 · see citing works
“Family connectedness and support can lower levels of inflammation as noted above, and can mitigate the negative effects of youths’ stress on inflammation and on the ANS and HPA axis (Barton, Yu, Brody, & Ehrlich, 2018; Luecken, Hagan, Wolchik, Sandler, & Tein, 2016; Miller et al., 2014).”
Self-citationCronan, S. B., Uchino, B. N., de Grey, R. G. K., & Trettevik, R. (2017) · Springer eBooks · doi:10.1007/978-1-4614-6439-6_1425-2 · Cited by 23 · see citing works
Mechanistic Understanding of Socioeconomic Disparities in Cardiovascular Disease
Miller, G. E., Chen, E., & Shimbo, D. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.04.043 · Cited by 22 · see citing works
Self-citationReward Responsiveness and Ruminative Styles Interact to Predict Inflammation and Mood Symptomatology
Moriarity, D. P., Ng, T. H., Titone, M. K., Chat, I. K.-Y., Nusslock, R., Miller, G. E., & Alloy, L. B. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.11.007 · Cited by 22 · see citing works
Self-citationEarly Life Adversity and Pubertal Timing: Implications for Cardiometabolic Health
Bleil, M. E., Spieker, S. J., Gregorich, S. E., Thomas, A. S., Hiatt, R. A., Appelhans, B. M., Roisman, G. I., & Booth‐LaForce, C. (2020) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaa082 · Cited by 23 · see citing works
“specific intervention benefits observed in relation to metabolic syndrome, prediabetes, inflammation, and health behaviors (Brody et al., 2017, 2019; Chen et al., 2018; Miller et al., 2014).”
BackgroundThe missing hallmark of health: psychosocial adaptation
López-Otı́n, C., & Kroemer, G. (2024) · Cell Stress · doi:10.15698/cst2024.03.294 · Cited by 24 · see citing works
Beyond Early Adversity: The Role of Parenting in Infant Physical Health
Stern, J. A., Beijers, R., Ehrlich, K. B., Cassidy, J. A., & de Weerth, C. (2020) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000804 · Cited by 20 · see citing works
“Preliminary evidence for a causal pathway between parenting and healthrelated risk factors comes from a randomized controlled trial of a family intervention for low-income mothers and their 11-year-olds: Intervention youth had lower inflammation than control youth at age 19, and this effect was partially mediated by i…”
BackgroundChat, I. K.-Y., Nusslock, R., Moriarity, D. P., Bart, C. P., Giollabhui, N. M., Damme, K. S. F., Carroll, A., Miller, G. E., & Alloy, L. B. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.03.006 · Cited by 19 · see citing works
Self-citationO’Brien, J. R., Loi, E. C., Byrne, M. L., Zalewski, M., & Casement, M. D. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01224-4 · Cited by 20 · see citing works
“This was an intervention study using a low-income African American sample where 11-year old youth and their parents were randomized to participate in either a 7-week skills-building program designed to increase involved-vigilant parenting, or an active control group of psychoeducation [65].”
MethodOverbeek, G. J., Creasey, N., Wesarg, C., Huijzer-Engbrenghof, M., & Spencer, H. (2020) · New Directions for Child and Adolescent Development · doi:10.1002/cad.20362 · Cited by 21 · see citing works
Miller, G. E., Chen, E., Finegood, E. D., Shimbo, D., & Cole, S. W. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.11.003 · Cited by 19 · see citing works
Self-citationBoylan, J. M., Cundiff, J. M., Jakubowski, K., Pardini, D. A., & Matthews, K. A. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay006 · Cited by 20 · see citing works
Resilience following childhood adversity: The need for a heuristic multilevel dynamic framework
Pasteuning, J., Gathier, A. W., Vinkers, C. H., & Sep, M. S. C. (2024) · Neuroscience Applied · doi:10.1016/j.nsa.2024.104069 · Cited by 20 · see citing works
“Findings by Miller et al. (2014) showed how a psychosocial intervention, focused on improving parenting, strengthening family relationships, and building youth competencies improved inflammation in children of low socioeconomic status (SES) (Miller et al., 2014), as seen by reduced expression of IL-1 β , (cid:0) 6, (c…”
InfluentialChen, E., Miller, G. E., Yu, T., & Brody, G. H. (2017) · International Journal of Obesity · doi:10.1038/ijo.2017.246 · Cited by 17 · see citing works
Self-citationChildhood Neighborhood Disadvantage, Parenting, and Adult Health
Mrug, S., Barker-Kamps, M., Orihuela, C. A., Patki, A., & Tiwari, H. K. (2022) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2022.01.028 · Cited by 17 · see citing works
“Multiple prospective studies show the importance of consistent and supportive parenting for better adult health, including lower BMI and inflammation.(35-37) Some of these relationships appear mediated by differential DNA methylation in inflammation-related genes.”
BackgroundBiological Embedding of Psychosocial Stress Over the Life Course
Eachus, H., & Cunliffe, V. T. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-811060-7.00012-7 · Cited by 17 · see citing works
A preliminary investigation of attachment style and inflammation in African-American young adults
Ehrlich, K. B., Stern, J. A., Eccles, J. S., Dinh, J., Hopper, E. A., Kemeny, M. E., Adam, E. K., & Cassidy, J. A. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1541516 · Cited by 16 · see citing works
Thomas, M., Rakesh, D., Whittle, S., Sheridan, M. A., Upthegrove, R., & Cropley, V. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106371 · Cited by 17 · see citing works
- Authors
- Miller, G. E., Brody, G. H., Yu, T., & Chen, E.
- Affiliations
- Northwestern University (US)
- University of Georgia (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2014-07-21
- Volume
- 111
- Issue
- 31
- Pages
- 11287-11292
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC4128159
- OpenAlex
- W2123137959
- Cited by
- 180
- References
- 61
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 13 · 2023: 15 · 2022: 13 · 2021: 22 · 2020: 27 · 2019: 17 · 2018: 13 · 2017: 25 · 2016: 16 · 2015: 8 · 2014: 2
- FWCI
- 21.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL108723)
- National Institute on Drug Abuse (P30DA027827)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD058502)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Keywords
- inflammation, low socioeconomic status, African American youth, cytokines, family relationships, youth competencies, racial disparities in health, rural Georgia
- MeSH terms
- Adolescent, Black or African American, Child, Family Relations, Female, Humans, Inflammation, Male, Mothers, Social Class, Social Support, Cytokines, Parenting, Young Adult
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