Human subadult skeletal remains can provide a unique perspective into biosocial aspects of past populations. However, for a variety of reasons, they are often overlooked in the skeletal record. This is especially true for the Mississippian period (ca. 1000 years before present to ca. 400 years before present) populations that inhabited the Middle Cumberland region (MCR) and Eastern Tennessee Region (ETR). Most of the previous studies of these areas focused on adult skeletal remains, leaving out a large and extremely important population segment. To further expand current knowledge on the prehistory of the MCR and ETR, skeletal indicators of disease, growth, body proportions, and metabolic stress were investigated among the subadult remains from four archaeological sites. Crucial to overcoming limitations associated with the osteological paradox, the biological results were placed into an archaeological context based on prior studies as well as paleoclimatological data.

Results demonstrate a high degree of homogeneity both within and between regions for most skeletal indicators investigated. Within the ETR, there is no evidence for biological differences between the Early Dallas and the later Late Dallas and Mouse Creek cultural phases;​ this finding is consistent with previous studies of adult skeletons. Despite the presumed signs of increased conflict at the Dallas site, rates and types of skeletal pathology and growth disruptions are comparable to other sites in the region. These findings suggest there was no large-scale incursion of an outside population into the ETR during the Late Mississippian Period, or if one occurred, it is biologically invisible.

Cultural differences between the ETR and MCR have been clearly demonstrated in previous studies. Although the skeletal data for the two regions are similar in many respects, there are several noteworthy differences. Namely, the subadults from the ETR display a higher frequency of pathology than those from MCR, while stature is significantly lower in younger subadults from the MCR. These results, combined with climatic and archaeobotanical data, suggests that the MCR subadults were under increased stress, especially during their earlier years. This may have been associated with increased interpersonal violence and dependence on few food sources occurring with greater scarcity.