Evidence map›Paper›PMID 40369587›Full record

ArticleClinical epigenetics2025

Associations of epigenetic aging with self-rated health, access to care, and healthcare utilization in a representative sample of United States adults.

Jamaji C Nwanaji-Enwerem, Dennis Khodasevich, Nicole Gladish, Hanyang Shen, Anne K Bozack, Saher Daredia, Belinda L Needham, David H Rehkopf, Andres Cardenas

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical epigenetics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Translational Geroscience Strategies for Delaying Multimorbidity.ACS pharmacology & translational science · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jamaji C Nwanaji-EnweremDepartment of Emergency Medicine, Center for Health Justice, and Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, HUP, Ground Ravdin, 3400 Spruce Street, Philadelphia, PA, 19104, USA. nwanajij@pennmedicine.upenn.edu.
Dennis KhodasevichDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.
Nicole GladishDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.
Hanyang ShenDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.
Anne K BozackDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.
Saher DarediaDivision of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.
Belinda L NeedhamDepartment of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
David H RehkopfDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.
Andres CardenasDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.

Funding

Race/Ethnicity, DNA Methylation, and Disparities in Cardiovascular Mortality: NHANES 1999-2002R01MD011721 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI NEEDHAM, BELINDA L., REHKOPF, DAVID H · 2017 to 2021
$3.1M
PRENATAL AND POSTNATAL EXPOSURE TO ENVIRONMENTAL MIXTURES: NEURODEVELOPMENT AND DNA METHYLATION BIOMARKERSR01ES031259 · NIEHS · UNIVERSITY OF CALIFORNIA BERKELEY · PI CARDENAS, ANDRES · 2020 to 2024
$1.9M
NIEHS NIH HHS R01 ES031259NIH HHS R01ES031259NIH HHS R01MD011721NIMHD NIH HHS R01 MD011721
6 · The paper itself

Abstract

backgroundHealth status is closely linked to both healthcare access and utilization. While previous research has identified associations between health status and DNA methylation-based biomarkers of aging (epigenetic aging), studies exploring these relationships in the context of healthcare access and utilization remain limited. To address this gap, we analyzed cross-sectional associations in a representative sample of 2,343 U.S. adults from the 1999-2000 and 2001-2002 cycles of the National Health and Nutrition Examination Survey (NHANES). Our study examined the relationships of self-rated health status, healthcare access, and healthcare utilization with seven epigenetic aging biomarkers: HannumAge, HorvathAge, SkinBloodAge, PhenoAge, GrimAge2, DNAm Telomere Length (DNAmTL), and DunedinPoAm.

resultsAfter adjusting for chronological age, demographics, lifestyle factors, and health insurance, participants with good-excellent self-rated health had a 1.58-year lower PhenoAge (95% CI - 2.54, - 0.62 P = 0.006) and a 1.16-year lower GrimAge2 (95% CI - 1.80, - 0.53, P = 0.004) than participants with poor-fair health. Participants who reported having a routine place where they received healthcare had a lower GrimAge2 (β = - 1.44-years, 95% CI - 2.66, - 0.22, P = 0.03) than participants without a routine healthcare location. Participants with ≥ 10 healthcare visits in the prior year had a shorter DNAmTL (β = - 0.05-kb, 95% CI - 0.09, - 0.01, P = 0.02) than participants with < 10 visits. After including additional adjustments for estimated leukocyte proportions, participants who were hospitalized overnight in the prior year had a shorter DNAmTL (β = - 0.05-kb, 95% CI - 0.08, - 0.01, P = 0.02) than non-hospitalized individuals.

conclusionsOur findings reinforce previous reports linking better health status to lower epigenetic aging and provide new evidence of associations of epigenetic aging with measures of healthcare access and utilization. If validated, these findings suggest that epigenetic aging biomarkers may be useful in studying disease processes and assessing health outcomes related to access and utilization.

Indexed as

AgingEpigenesis, GeneticHealth Services AccessibilityHealth StatusPatient Acceptance of Health CareAdultAgedBiomarkersCross-Sectional StudiesDNA MethylationEpigenomicsFemaleHumansMaleMiddle AgedNutrition SurveysBiomarkersB2MCRPDNA methylation ageLeptinNHANESPackyears

Identifiers

PMID40369587
PMCPMC12079918

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.