Chronological age advances at precisely the same rate irrespective of income, occupation, or circumstance. The more complicated phenomenon is biological aging. Our organs and physiological systems do not deteriorate uniformly. Two individuals of the same chronological age can differ substantially in cardiovascular health, immune function, and susceptibility to disease. One may remain independent into their eighties, while another develops chronic illness decades earlier.

Researchers have attempted to quantify these differences using biological aging markers, including changes in DNA chemical modification, called methylation. Methylation influences gene function and underpins so-called epigenetic clocks, some of which estimate physiological deterioration or predict subsequent disease and mortality.

A 2025 longitudinal study published in The Journals of Gerontology examined disadvantage during childhood and adulthood alongside epigenetic measures around the age of fifty. Both were associated with faster aging on certain measures. An unequal childhood may leave DNA signatures that persist for decades, although circumstances in adulthood continue to matter too.

In May 2026, researchers publishing in JAMA Network Open examined nearly 3,800 adults and conditions across 267 American counties. Those raised in areas characterized by greater poverty, educational disadvantage, and racial segregation subsequently exhibited biological signatures associated with accelerated aging and inflammation. Some associations remained after accounting for individual and family socioeconomic circumstances. The wider environment in which someone grows up may leave measurable traces in their biology twenty years later.

Poverty does not make every disadvantaged person biologically older by a predictable number of years. What the evidence increasingly supports is that biological aging is socially and politically patterned and cannot be understood by examining individual behavior alone.

Lifespan is the number of years you live. Health span is how many of these years you remain healthy. According to the World Health Organization (WHO), global life expectancy reached 73.3 years in 2023, compared with healthy life expectancy of 62.8 years. This means that for most people, living longer is decoupled from living well.

The WHO’s 2025 report on the social determinants of health found that people born in countries with the highest life expectancy could expect to live thirty-three years longer than those born in countries with the lowest. But mortality describes only part of the inequality. The years preceding death determine whether someone can work without debilitating pain, remain physically independent, and enjoy the ordinary freedoms that reasonable health makes possible.

In Britain, the figures are particularly damning. For 2022 to 2024, the Office for National Statistics estimated that men in England’s most deprived areas could expect just 49.8 years of good health, compared with 69.2 in the least deprived areas. For women, the corresponding figures were 48.2 and 68.5 years. These are estimates of healthy years across a lifetime, not the ages at which everyone becomes ill. Nevertheless, the gap approaches twenty years within the same country, under the same health care and retirement arrangements.

Across the Atlantic, a landmark American study published in the Journal of the American Medical Association found that among those reaching forty, men in the richest 1 percent could expect to live 14.6 years longer than those in the poorest 1 percent. Among women, the difference was 10.1 years. From 2001 to 2014, life expectancy increased substantially among the wealthiest Americans, while gains at the bottom were small. Longevity was improving, but its benefits were being distributed along familiar economic lines.

Australia offers another illustration. For 2020 to 2022, official statistics estimated that Aboriginal and Torres Strait Islander men had a life expectancy 8.8 years shorter than nonindigenous men; among women, the gap was 8.1 years. These inequalities cannot be reduced to income alone. Structural discrimination, geographical disadvantage, and unequal access to resources help explain why the benefits of a wealthy society remain so unevenly distributed.

There is a term for the process through which social disadvantage contributes to premature deterioration of health: “politically accelerated aging.” This does not mean governments determine the biological age of every citizen. It describes how political and economic arrangements influence the conditions under which aging takes place, systematically exposing some populations to greater physiological harm than others.

Consider the accumulation of disadvantage across an ordinary working life. A child grows up in overcrowded housing, exposed to damp, pollution, and material insecurity. Employment brings unpredictable hours, physically demanding work, and limited protection against illness. As adulthood progresses, disturbed sleep, financial anxiety, and difficulties accessing timely health care become familiar companions.

None of these exposures guarantees premature deterioration. Cumulatively, however, they may increase the risk of ill health through chronic stress responses, inflammation, metabolic dysfunction, and cardiovascular disease. What appears in a medical record as hypertension, diabetes, or premature functional decline may reflect decades of circumstances over which the individual exercised remarkably little control.

Housing standards, employment protections, wages, environmental regulation, social security, and health care provision are not natural phenomena. They are shaped by legislation, economic priorities, and public spending. Though governments are not responsible for biological processes, they are responsible for political ones: whether low-paid workers can afford to be ill, whether homes are habitable, whether workplaces are safe, and whether preventive care is available before disease becomes disabling.

The language of personal responsibility becomes particularly harmful here. Individuals are encouraged to improve their sleep, reduce stress, exercise regularly, and make healthier dietary choices. Much of this advice is sound. But its practical application depends upon resources that are unequally distributed. Adequate sleep is difficult when employment requires irregular night shifts. The instruction to reduce stress offers little assistance to someone facing eviction. Nutritious food requires not only knowledge but money and time.

To the Bryan Johnsons of the world, aging is a process to be rigorously optimized. For many working people, daily life must be organized around the demands of earning enough to survive.

Johnson’s experiment reveals the extraordinary resources now being directed toward extending healthy life. Much of his program rests upon established principles: physical activity, sufficient sleep, sensible nutrition, and attention to cardiovascular and metabolic health. Other interventions remain experimental, with uncertain long-term benefits. There is no secret elixir of youth. There are, however, immense privileges and resources to operationalize these principles. These advantages cannot be reproduced merely by instructing someone on a low income to follow the same protocol. Yet the increasingly commercialized longevity industry presents aging as a problem of personal investment, selling biological age testing, supplements, and specialist clinics to those able to afford them.

Advances in geroscience, the field of medicine that investigates how biological aging drives chronic disease, may eventually produce substantial public benefits. The contradiction arises when the promise of longevity is detached from the circumstances that determine who becomes ill early and who can obtain effective treatment. A society that struggles to provide adequate preventive health care to disadvantaged communities can apparently sustain a flourishing market in personalized interventions for the affluent.

Consider retirement. Governments increasingly discuss longer working lives in the name of pension sustainability, as though chronological age adequately measures everyone’s capacity to remain economically active. Someone who has spent decades in physically demanding employment, developed chronic illness in middle age, and received limited preventive care is not entering retirement in circumstances comparable to an affluent professional with autonomy over their working life. Both may reach the same statutory pension age. Their capacity to enjoy the years that follow can be profoundly different. Extending working lives, without confronting these inequalities, risks imposing further costs upon those already carrying the greatest burden.

The political response cannot consist solely of widening access to commercialized, fad-driven longevity technologies. Decent housing, secure employment, adequate incomes, safer working conditions, accessible public spaces, and properly funded health care can prevent avoidable deterioration. These things are important beginning in childhood, not at the threshold of retirement. By the time someone reaches old age, much of their lifetime exposure to disadvantage has already occurred, and we have simply missed the boat.

Understanding the processes of aging should make the politics of their unequal distribution more urgent. If researchers can identify biological signatures associated with poverty and chronic stress, policymakers can no longer plausibly treat these conditions as separate from population health. The ability to measure aging must be matched by a determination to prevent its avoidable acceleration.

There is something deeply perverse, Dickensian even, about a society that can investigate whether the wealthy might live beyond the ordinary limits of aging yet tolerates conditions that leave millions debilitated long before old age. Bryan Johnson’s extraordinary efforts may improve his health, though I am willing to bet my medical license that his lifespan will be firmly ordinary. The more immediate concern is for those experiencing material deprivation: lives are being shortened, independence restricted, and, increasingly, biological deterioration appears to be accelerated.

The challenge is not simply to discover how humans might live longer. It is to confront why the opportunity to grow old in good health remains so unequally distributed. A longer life should not depend upon the ability to purchase protection from the conditions that make others age prematurely.