ABSTRACT
Chronic low back pain (cLBP) is an age-related condition that affects over 60% of older adults and costs up to
$315 billion annually. The burden of age-related diseases, including cLBP, disproportionately impacts Black
Americans and residents of high deprivation neighborhoods. High deprivation neighborhoods have a high
concentration of poverty and lack socioeconomic resource-based indicators such as employment and quality
housing. Disturbingly, life expectancy may be up to 20 years shorter for residents of high deprivation
neighborhoods. Yet, the biological mechanisms that link living as a Black American, high deprivation
neighborhoods, worse cLBP outcomes, and shortened life expectancy remain unclear. Epigenetic changes
such as DNA methylation (DNAm) link environmental exposures to gene expression and may affect disease
risk. Such epigenetic modifications may affect an individual’s biological (epigenetic) age, which can be
estimated with DNAm patterns. Though epigenetic age acceleration (EpAA) strongly predicts mortality and has
been observed in many age-related conditions, including chronic pain, it remains unclear whether EpAA can
explain the relationship between neighborhood deprivation and racial disparities in cLBP. Our central
hypothesis is that Blacks and residents of high deprivation neighborhoods experience higher levels of stress
that exert “wear and tear” on the body and epigenetically accelerate age. Our long-term goal is to improve age-
related conditions by uncovering biological mechanisms for place-based (e.g., geographic) disparities in age-
related chronic conditions. The objective of this study is to examine the relationships between EpAA with
neighborhood deprivation, race, and cLBP. Using Hannum’s approach for epigenetic age calculation, we will
examine EpAA from 50 Black and 50 White men and women, including equal numbers of cLBP and pain-free
controls. Aim #1: To investigate the relationship between EpAA with cLBP and status and severity. Aim #2: To
examine the associations between EpAA with neighborhood deprivation, race, and sex. Aim #3: To explore
whether EpAA mediates the relationship between neighborhood deprivation and cLBP severity. Our findings
will significantly impact health disparities research by pointing towards one pathway for the onset and course of
age-related conditions.