Children being Reared by their Grandparents in Rural Appalachia: A Pilot Study of Relations Between Psychosocial Stress and Changes in Salivary Markers of Inflammation Over Time

  • Peggy S. KellerEmail author
  • Shuang Bi
  • Nancy Schoenberg
Original Article


Grandparents in rural Appalachia with primary caregiving responsibilities for their grandchildren often struggle with high levels of stress, inadequate resources, and poor physical and mental health. However, implications for children of being raised by grandparents rarely have been examined, particularly in terms of stress biomarkers. The present study investigated salivary C-reactive protein, interleukin-6, and tumor necrosis factor alpha in a small sample of children (N = 20) aged 5 to 18 years being reared by grandparents in two rural counties in Kentucky, a region well known for its resource scarcity. Saliva samples were collected from children 30 min after waking at two time points spaced one year apart. Grandparents and children completed a series of questionnaires via interview. Children’s internalizing symptoms were related to greater markers of inflammation over time. Grandparent stress and poor mental health were also related to greater inflammation, while grandparent positive parenting and religiosity were associated with lower inflammation.


Inflammation custodial grandparents mental health 



The study was supported by a grant awarded to Nancy Schoenberg, Principle Investigator from the Retirement Research Foundation, an Igniting Research Collaborations grant awarded to Peggy S. Keller, Principle Investigator, and Nancy Schoenberg, Co-Investigator by the University of Kentucky, and a small grant awarded to Peggy S. Keller, Principle Investigator from the University of Kentucky Center for Clinical and Translational Science (CCTS). The CCTS is funded by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Retirement Research Foundation.

Compliance with Ethical Standards

Disclosure of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Standards and Informed Consent

This study was conducted with the approval of the university Institutional Review Board; informed consent was obtained from grandparents and informed assent was obtained from grandchildren.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of KentuckyLexingtonUSA
  2. 2.Southern Methodist UniversityDallasUSA
  3. 3.Department of Medical Behavioral ScienceUniversity of KentuckyLexingtonUSA

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