Does the southern health disadvantage extend to accelerated biological aging: evidence from the health and retirement study.

OBJECTIVES: Recent studies have shown worse health across various conditions (i.e., morbidity, disability, and mortality) among residents in the U.S. South compared to other regions. Accelerated aging may be a pathway underlying part of this disadvantage; however, few studies have examined this. To address this gap in the literature, this study examines whether accelerated aging measures are associated with residence in the U.S. South in childhood and older adulthood.

METHODS: Using the 2016 Venous Blood Study (VBS) of the Health and Retirement Study, we use linear regression models to examine the association between Southern residential history in childhood and adulthood and biological aging (i.e., PhenoAge, GrimAge, DunedinPACE, Expanded Biological Age, and an Epigenetic Factor Score). We also evaluate the sensitivity of these patterns, adjusting for demographic composition and health behaviors, such as age, gender/sex, parental education, educational attainment, race/ethnicity, having a higher BMI, smoking status, health insurance coverage, and preventative healthcare uptake.

RESULTS: Having been born and currently residing in the U.S. South is positively associated with accelerated aging measured by PhenoAge, GrimAge, DunedinPACE, our Epigenetic Factor, and Expanded Biological Age. These associations were attenuated after adjusting for demographic composition and health behaviors; only DunedinPACE, our Epigenetic Factor, and Expanded Biological Age had significant associations after the adjustment for demographic composition and health behaviors.

DISCUSSION: Accelerated aging among those with residential Southern histories in childhood and adulthood may partially account for the Southern health disadvantage.