Metabolic dysfunction over a life course key to healthy ageing inequality

Abstract

The UK is experiencing a decline in healthy life expectancy, now at 62.4 years for men and 60.9 years for women. Socioeconomic deprivation plays a significant role in health disparities, affecting individuals across the life arc. Girls born in the most deprived areas may live 19 fewer years in good health compared to those in wealthier areas. Health inequalities are particularly severe for ethnic minorities, with Black and Asian individuals reporting poorer health at a younger age. Health inequalities correlate with socioeconomic status. In old age, 2.1 million older adults live in poverty, with Black and Asian communities again disproportionately affected. While ageing increases the risk of morbidities, poor health is not inevitable; however, disadvantaged populations face early-life risk factors, such as low birth weight, linked to future conditions like diabetes and cardiovascular disease. CELLO, an interdisciplinary network, focuses on cellular metabolism throughout life in disadvantaged populations, examining how both genetic and environmental factors shape metabolic dysfunction and contribute to social health inequalities. This review stems from discussions within the network, aiming to advance understanding of healthy ageing across the life course.

Keywords: Ageing; Disadvantaged populations; Health inequalities; Metabolism.

Fig. 1

Association between metabolic disease and cellular senescence. The influence of biological, environmental and biopsychosocial factors contributed to the increased senescent cell burden in tissues. Obesity contributes to a diabetic-like state together with immune perturbations, which in turn fuels the accumulation of senescent cells. Senescent cells drive inflammation and metabolic dysfunction, ultimately leading to premature ageing and the appearance of co-morbidities

Fig. 2

Significant health disparities across London's boroughs, particularly highlighting the stark differences in average weekly earnings, obesity rates, and life expectancy. The data show that poorer boroughs, characterised by lower average weekly earnings (lightest blue), tend to have higher mortality rates and a greater burden of obesity (darkest blue) [78]