AUTHOR=Vineis Paolo , Avendano-Pabon Mauricio , Barros Henrique , Bartley Mel , Carmeli Cristian , Carra Luca , Chadeau-Hyam Marc , Costa Giuseppe , Delpierre Cyrille , D'Errico Angelo , Fraga Silvia , Giles Graham , Goldberg Marcel , Kelly-Irving Michelle , Kivimaki Mika , Lepage Benoit , Lang Thierry , Layte Richard , MacGuire Frances , Mackenbach Johan P. , Marmot Michael , McCrory Cathal , Milne Roger L. , Muennig Peter , Nusselder Wilma , Petrovic Dusan , Polidoro Silvia , Ricceri Fulvio , Robinson Oliver , Stringhini Silvia , Zins Marie TITLE=Special Report: The Biology of Inequalities in Health: The Lifepath Consortium JOURNAL=Frontiers in Public Health VOLUME=8 YEAR=2020 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00118 DOI=10.3389/fpubh.2020.00118 ISSN=2296-2565 ABSTRACT=

Funded by the European Commission Horizon 2020 programme, the Lifepath research consortium aimed to investigate the effects of socioeconomic inequalities on the biology of healthy aging. The main research questions included the impact of inequalities on health, the role of behavioral and other risk factors, the underlying biological mechanisms, the efficacy of selected policies, and the general implications of our findings for theories and policies. The project adopted a life-course and comparative approach, considering lifetime effects from childhood and adulthood, and pooled data on up to 1.7 million participants of longitudinal cohort studies from Europe, USA, and Australia. These data showed that socioeconomic circumstances predicted mortality and functional decline as strongly as established risk factors currently targeted by global prevention programmes. Analyses also looked at socioeconomically patterned biological markers, allostatic load, and DNA methylation using richly phenotyped cohorts, unraveling their association with aging processes across the life-course. Lifepath studies suggest that socioeconomic circumstances are embedded in our biology from the outset—i.e., disadvantage influences biological systems from molecules to organs. Our findings have important implications for policy, suggesting that (a) intervening on unfavorable socioeconomic conditions is complementary and as important as targeting well-known risk factors, such as tobacco and alcohol consumption, low fruit and vegetable intake, obesity and a sedentary lifestyle, and that (b) effects of preventive interventions in early life integrate interventions in adulthood. The report has an executive summary that refers to the different sections of the main paper.