Daily family assistance and inflammation among adolescents from Latin American and European backgrounds

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Abstract

To assess the biological impact of time spent helping the family during the teenage years, we examined circulating levels of interleukin-6 (IL-6), soluble interleukin-6 receptor (sIL-6r), and C-reactive protein (CRP) in 64 adolescents (Mage = 17.79 years) from Latin American and European backgrounds. Analyses of nightly diary checklists over 14 days showed that the amount of time spent helping the family in a variety of ways, such as cooking, cleaning, and sibling care, was associated with long-term elevations of sIL-6r and CRP, even after controlling for ethnicity, parental education, BMI, substance use, distress, and frequency of daily family assistance 2 years earlier. However, adolescents who derived a greater sense of role fulfillment from helping the family on a daily basis had lower levels of sIL-6r and CRP as compared to their peers who engaged in the same amount of family assistance. Additional work should explore the family context that drives high levels of assistance among adolescents, as well as the variety of ways adolescents may derive meaning from this activity.

Introduction

Family assistance is an understudied yet significant aspect of family interactions during the adolescent years. Providing support and assistance to other family members are important activities of teenagers in the United States, sometimes taking up as much time as socializing with friends and studying for school (Hardway and Fuligni, 2006). Tasks such as caring for siblings, cooking and cleaning, and running errands for parents are particularly common among adolescents from Latin American backgrounds. Due to a combination of cultural traditions, immigrant status, family size, and economics, American families from Mexican and other Latin American backgrounds place a stronger importance upon the role of children and adolescents to assist in the maintenance of the household (García Coll and Vázquez García, 1995). As a result, adolescents from these groups spend up to twice the amount of time helping other family members as compared to their peers from European backgrounds (Hardway and Fuligni, 2006).

The implications of high levels of family assistance for the health and well being of adolescents are currently unknown. Membership in families with difficult social and economic environments during childhood has been linked to elevated levels of inflammation later during adulthood (Taylor et al., 2006). Among adults, high levels of family caregiving have been shown to be associated with both self-reported poor health and biomarkers of compromised immune function and heightened cardiovascular risk (Vitiliano et al., 2003). For example, Kiecolt-Glaser et al. (2003) observed elevated levels of the pro-inflammatory cytokines IL-6 among adults caring for a spouse with dementia. Yet virtually all of this work has been conducted among adults and much of it has focused on caring for the elderly, particularly those with a challenging debilitating condition such as dementia. It is unknown whether similar patterns would be observed among a sample of adolescents engaging in more normative types of family assistance. Given increased interest in the early detection of risk factors for cardiovascular disease (CVD) and other inflammation-related health issues, it would be important to examine this potential risk factor during the adolescent years (Williams et al., 2002).

Consistent with the research on adults, high levels of family assistance during the teenage years may have negative implications for health. Cooking, cleaning, and caring for siblings can be burdensome and stressful for adolescents who face the competing demands of being a teenager, such as studying for school and socializing with friends (Burton, 2007, Chase, 1999). Such an impact could be evident in elevated levels of inflammation, which have been shown to be upregulated among individuals facing chronic levels of strain and activation of the hypothalamic–pituitary–adrenal axis, such as those who engage in long-term care and family assistance (Kiecolt-Glaser et al., 2003). On the other hand, family assistance may show no link with increased inflammation during adolescence. Activities such as caring for siblings and housework are likely to be less stressful than caring for debilitated family members and the general health of teenagers may be robust enough to avoid being negatively impacted by family assistance. In addition, family assistance can be a meaningful activity for adolescents as it provides a sense of purpose and role fulfillment for teenagers, particularly those from groups such as Latin Americans who strongly value such activities. Deriving a sense of meaning and purpose from life stressors has been shown to be associated with better health outcomes (Bower et al., 2003), and the same may be true for family assistance during adolescence.

The current study examined the associations between the daily family assistance of a sample of adolescents from Latin American and European backgrounds and their circulating levels of interleukin-6 (IL-6), the soluble interleukin-6 receptor (sIL-6r), and C-reactive protein (CRP). IL-6 is a pro-inflammatory cytokine that has been shown to be related to caregiving (Kiecolt-Glaser et al., 2003), sIL-6r enhances IL-6 activity as it allows it access into cells that don’t bear the receptor themselves (Kallen, 2002), and CRP is a relatively downstream indicator of chronic and elevated levels of IL-6 activity and has been shown to be a risk factor for the later development of CVD (Lagrand et al., 1999). The role played in the associations between family assistance and inflammation by factors such as parental education, obesity, and emotional distress were examined, as was the extent to which adolescents derived a sense of role fulfillment from providing assistance to the family.

A unique feature of the current study was the use of the daily diary method in which participants reported the occurrence of family assistance, emotional distress, and role fulfillment on a daily basis for a two-week period. The daily diary method is superior to traditional questionnaire techniques because it “captures life as it is lived” and is less susceptible to recall biases (Bolger et al., 2003). Previous analyses from the same study showed how daily reports of interpersonal conflict and harassment were more predictive of CRP than a traditional questionnaire measure of stressful life events (Fuligni et al., 2009), highlighting the value of employing such a direct measure of actual experience over more typical questionnaire inventories, which usually ask respondents to generalize their reports across time and experiences.

Section snippets

Sample and design

The sample of 64 adolescents in the current study is a sub-sample of a group of 383 adolescents from three high schools in the Los Angeles area who took part in a larger study of the daily experience of adolescents when they were in the 12th grade (Mage = 17.79 years in the 12th grade). The current sample consisted of 39 participants from Latin American backgrounds, most of whom (95%) reported Mexican as their ethnic background, and 25 participants from a mix of European backgrounds (e.g., Irish,

Results

Overall, the means and standard deviations of the study variables portray a generally healthy sample (Table 1). There were no gender differences in any of the indicators of inflammation (ts(57–62) = 1.27–1.81, n.s.) and the only ethnic difference in inflammation was that those with Latin American backgrounds had significantly higher levels of IL-6 (M = 1.43, SD = 0.80) than those with European backgrounds (M = 1.08, SD = 0.47), t(55.88) = 2.11, p < .05. The sub-sample of 64 adolescents who participated in

Discussion

Adolescents who spent more time assisting the family through activities such as cooking, cleaning, and sibling care exhibited elevated levels of inflammation independent of factors such as ethnicity, parental education, BMI, substance use, distress, and even frequency of daily family assistance 2 years earlier. These results are consistent with previous research conducted among adult caregivers of the elderly and the sick (Vitiliano et al., 2003) and were evident among both genders and ethnic

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