Social determinants of health and epigenetic clocks: a systematic review and meta-analysis of 140 studies
- 1Max Planck Research Group Biosocial - Biology, Social Disparities and Development, Max Planck Institute for Human Development, Berlin, Germany
- 2Robert N Butler Columbia Aging Center and Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- 3Max Planck Research Group Biosocial - Biology, Social Disparities and Development, Max Planck Institute for Human Development, Berlin, Germany. [email protected]
Abstract
Social determinants of health are social factors that affect health and survival. Two of the most powerful social determinants are socioeconomic status (SES) and race/ethnicity; people with lower SES or marginalized race/ethnicity tend to experience earlier onset of aging-related diseases and have shorter lifespans. DNA methylation (DNAm) measures of biological aging, often referred to as "epigenetic clocks", are increasingly used to study the social determination of health. However, there are several generations of epigenetic clocks and it remains unclear which are most sensitive to social factors affecting health. Moreover, there is uncertainty about how technical factors, such as the tissue from which DNA is derived or the technology used to measure DNA methylation may affect associations of social determinants with epigenetic clocks. We conducted a pre-registered multi-level meta-analysis of 140 studies, including N = 65,919 participants, encompassing 1,065 effect sizes for associations of SES and racial/ethnic identity with three generations of epigenetic clocks. We found that associations were weakest for the first generation of epigenetic clocks developed to predict age differences between people. Associations were stronger for the second generation of epigenetic clocks developed to predict mortality and health risks. The strongest associations were observed for a third generation of epigenetic clocks, sometimes referred to as "epigenetic speedometers", developed to predict the pace of aging. In studies of children, only the speedometers showed significant associations with SES. Effects of sex and technical factors were minimal and there was no evidence of publication bias.
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BibTeX
@article{willems2026social,
title = {{Social determinants of health and epigenetic clocks: a systematic review and meta-analysis of 140 studies}},
author = {Yayouk Eva Willems and A. D. Rezaki and M. Aikins and A. Bahl and Q. Wu and Daniel W. Belsky and Laurel Raffington},
journal = {Nature Human Behaviour},
year = {2026},
month = jun,
doi = {10.1038/s41562-026-02477-6},
url = {https://doi.org/10.1038/s41562-026-02477-6},
note = {CC BY},
}
RIS
TY - JOUR
TI - Social determinants of health and epigenetic clocks: a systematic review and meta-analysis of 140 studies
AU - Yayouk Eva Willems
AU - A. D. Rezaki
AU - M. Aikins
AU - A. Bahl
AU - Q. Wu
AU - Daniel W. Belsky
AU - Laurel Raffington
PY - 2026
DA - 2026/06/12
JO - Nature Human Behaviour
DO - 10.1038/s41562-026-02477-6
UR - https://doi.org/10.1038/s41562-026-02477-6
AB - Social determinants of health are social factors that affect health and survival. Two of the most powerful social determinants are socioeconomic status (SES) and race/ethnicity; people with lower SES or marginalized race/ethnicity tend to experience earlier onset of aging-related diseases and have shorter lifespans. DNA methylation (DNAm) measures of biological aging, often referred to as "epigenetic clocks", are increasingly used to study the social determination of health. However, there are several generations of epigenetic clocks and it remains unclear which are most sensitive to social factors affecting health. Moreover, there is uncertainty about how technical factors, such as the tissue from which DNA is derived or the technology used to measure DNA methylation may affect associations of social determinants with epigenetic clocks. We conducted a pre-registered multi-level meta-analysis of 140 studies, including N = 65,919 participants, encompassing 1,065 effect sizes for associations of SES and racial/ethnic identity with three generations of epigenetic clocks. We found that associations were weakest for the first generation of epigenetic clocks developed to predict age differences between people. Associations were stronger for the second generation of epigenetic clocks developed to predict mortality and health risks. The strongest associations were observed for a third generation of epigenetic clocks, sometimes referred to as "epigenetic speedometers", developed to predict the pace of aging. In studies of children, only the speedometers showed significant associations with SES. Effects of sex and technical factors were minimal and there was no evidence of publication bias.
SN - 2397-3374
ER -