How education gets under the skin: Pathways linking educational advantage to slower biological aging

Educational attainment strongly predicts inequalities in accelerated biological aging. These differences are likely due to social and material benefits of education levels, but studies have yet to systematically evaluate how multiple overlapping pathways simultaneously are associated with differences in accelerated biological aging in later life. Using nationally representative data from the 2016 Venous Blood Study from the Health and Retirement Study (n = 9025; mean age = 70) in the United States and structural equation modeling, we investigate multiple adult life pathways between educational attainment and accelerated biological aging through a broad blood chemistry-based indicator of multisystem physiological aging (Expanded Biological Age). We find that economic (wealth), social (social participation), psychological (depression), and behavioral (smoking) pathways combine to explain up to 47% of the educational gradient in biological aging. Economic and social factors emerged as the strongest mediating pathways, explaining 20% and 13%, respectively, whereas psychological and behavioral factors explained a smaller share (7% and 7%, respectively). These findings highlight that multiple domains of adult life may underlie the association between higher educational attainment and slower biological aging. We additionally find that biological aging associations are contingent on level of education, where older adults without a high school diploma had 2.7 times the effect magnitude for social participation compared to those with at least a high school diploma, but no effect of wealth or smoking, demonstrating that pathways may manifest differently at varying levels of social advantage. This study also points to the importance of considering severe social disadvantage that may undermine the potential benefits of otherwise important resources for healthy aging.