Special Report: The Biology of Inequalities in Health: The Lifepath Consortium.

Funded by the European Commission Horizon2020 programme, the Lifepath research consortium aimed to understand the impacts of socioeconomic inequalities on the biology of healthy ageing. The main research questions included the impact of inequalities on health, the role of behavioural 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, unravelling their association with ageing processes across the life-course. Lifepath studies suggest that socioeconomic circumstances are embedded in our bodies from the outset – literally, disadvantage gets into molecules and biological systems. Our findings have important implications for policy, suggesting that (a) intervening on unfavourable 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 are complementary to interventions in adulthood.