All ETDs from UAB

Advisory Committee Chair

Edwin N Aroke

Advisory Committee Members

Burel Goodin

Bertha Hidalgo

Mirjam-Colette Kempf

Peng Li

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Residents of high-deprivation neighborhoods shoulder a greater burden of age-related health conditions, including experiencing worse chronic musculoskeletal pain outcomes, compared to residents of more affluent neighborhoods. Advancing age is a risk factor for chronic health conditions, which epigenetic modifications may explain. Epigenetic age acceleration occurs when an individual’s epigenetic age is older than their chronological age, and that discordance has been identified as a strong predictor of age-related conditions. Epigenetic age acceleration has also been correlated with neighborhood deprivation. However, the mechanisms for neighborhood disparities in chronic musculoskeletal pain remain unclear. The purpose of this dissertation study was to examine the relationship between neighborhood deprivation, chronic musculoskeletal pain outcomes, and epigenetic age acceleration in adults. This purpose was accomplished through three manuscripts: 1) a scoping review of neighborhood characteristics and epigenetic age acceleration, 2) a secondary analysis, methodological study comparing a measure of neighborhood deprivation with other measures of socioeconomic status among adults with chronic low back pain, and 3) a secondary analysis which explored whether epigenetic age acceleration mediated the relationship between neighborhood deprivation and pain severity in adults with knee osteoarthritis pain. In the main findings of this dissertation study (manuscript three), we found that increased neighborhood iii deprivation was associated with increased pain severity and that epigenetic age acceleration may explain that relationship. These findings support future work on epigenetics and epigenetic age acceleration as a mechanism for the link between neighborhood and chronic musculoskeletal pain.

Included in

Nursing Commons



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