@article {Graf2021.03.02.21252685,
	title = {Testing Black-White Disparities in Biological Aging Among Older Adults in the United States: Analysis of DNA-Methylation and Blood-Chemistry Methods},
	journal = {American Journal of Epidemiology},
	volume = {191},
	year = {2022},
	pages = {613-625},
	abstract = {Biological aging is a proposed mechanism through which social determinants drive health disparities. We conducted proof-of-concept testing of 8 DNA-methylation (DNAm) and blood-chemistry quantifications of biological aging as mediators of disparities in healthspan between Black and White participants in the 2016 wave of the Health and Retirement Study (n = 9,005). We quantified biological aging from 4 DNAm "clocks" (Horvath, Hannum, PhenoAge, and GrimAge clock), a DNAm pace-of-aging measure (DunedinPoAm), and 3 blood-chemistry measures (PhenoAge, Klemera-Doubal method biological age, and homeostatic dysregulation). We quantified Black-White disparities in healthspan from cross-sectional and longitudinal data on physical performance tests, self-reported limitations in activities of daily living, and physician-diagnosed chronic diseases, self-rated health, and survival. DNAm and blood-chemistry quantifications of biological aging were moderately correlated (Pearson{\textquoteright}s r = 0.1-0.4). The GrimAge clock, DunedinPoAm, and all 3 blood-chemistry measures were associated with healthspan characteristics (e.g., mortality effect-size hazard ratios were 1.71-2.32 per standard deviation of biological aging) and showed evidence of more advanced/faster biological aging in Black participants than in White participants (Cohen{\textquoteright}s d = 0.4-0.5). These measures accounted for 13\%-95\% of Black-White differences in healthspan-related characteristics. Findings suggest that reducing disparities in biological aging can contribute to building health equity.},
	keywords = {aging clocks, biological aging, healthy aging, pace of aging, Racial Disparities},
	doi = {https://doi.org/10.1093/aje/kwab281},
	author = {Graf, GH and Crowe, CL and Kothari, M and Kwon, D and Jennifer J Manly and Turney, IC and Valeri, L and Daniel W. Belsky}
}
