The interface of geroscience with longitudinal health disparities research: a 20-year retrospective of the Healthy Aging in Neighborhoods of Diversity across the Life Span study.

Geroscience may be the juggernaut that coalesces the pathways of biologic knowledge to expand our understanding beyond describing differences in rates of aging to feasible interventions for improving quality of life as we age. To accomplish this, geroscience must interdigitate with long-standing immutable factors about health. As early as the 17th century, physicians and early demographers like John Graunt, Percival Potts, Bernardino Ramazzini, and Rudolf Virchow identified the importance of differences in health trajectories and outcomes for individuals, and underlying aspects of health disparities. These differences in health status relate to numerous social determinants of health as they interact with biological risk factors and the environment. These populations and the psychosocial factors that influence health and longevity must be considered as an integral part of geroscience. Longitudinal studies that examine factors influencing the development of age-related health differences over time should be a key component of geroscience. The HANDLS study provides a useful demonstration project showing the value of studying aging in urban dwelling American adults, some of whom face significant social adversity based on race, socioeconomic status, and other factors.