Economic Intervention as a Prescription for Disparities in Healthy Aging: The Paycheck Plus RCT.

The COVID-19 pandemic has underscored the large disparities in healthy aging by race and social class within the United States. We hypothesize that policies that alleviate poverty can reduce these disparities by intervening on the process of biological aging. However, testing this hypothesis is challenging because anti-poverty intervention experiments run for years, but aging-related diseases develop over decades. We recently developed a laboratory measure of the pace of biological aging that can overcome this challenge. This measure uses epigenetic marks called DNA methylation that record how fast a person’s body is aging. People with a fast pace of aging develop chronic disease at younger ages and live shorter lives than those with a slow pace of aging. By comparing post-intervention pace of aging between treatment and control groups, we can test whether an anti-poverty intervention slows the pace of aging using a gold-standard randomized controlled trial (RCT). We propose to measure the pace of aging in 657 participants in a proven RCT of enhanced Earned Income Tax Credits. Our pilot would be the first-ever experimental test of the hypothesis that reducing poverty can slow the pace of aging, and provide proof-of-concept for future social-policy experiments to build aging health equity.