Neighborhood quality was associated with accelerated DNAm aging for Horvath age acceleration (β = 1.8 95% CI: 0.4, 3.1), Hannum age acceleration (β = 1.7 95% CI: 0.4, 3.0), and PhenoAge acceleration (β = 2.1 95% CI: 0.4, 3.8). Using linear regression models, we evaluated associations in the total sample and stratified by sex and social cohesion. We examined associations between three neighborhood social environment measures (poverty, quality, and social cohesion) and three epigenetic clocks (Horvath, Hannum, and PhenoAge) using data from the Detroit Neighborhood Health Study (n=158). DNA methylation (DNAm), a proposed mechanism and biomarker of biological aging responsive to environmental stressors, offers promising insight into potential molecular pathways. Living in adverse neighborhood environments has been linked to risk of aging-related diseases and mortality however, the biological mechanisms explaining this observation remain poorly understood. Future research could fruitfully consider other potential mechanisms, such as alcohol availability or the role of stress research that considers multiple mechanisms and their combined effects may be most informative. Our results provide further evidence of a relation between education inequality and drinking behavior while illustrating the importance of considering different drinking outcomes and heterogeneity between neighborhood subgroups. There was no evidence that these associations were mediated by social drinking norms, although norms did vary with education inequality. The results tended to differ in magnitude depending on respondents' individual educational levels. In adjusted generalized estimating equation regression models, one-standard-deviation-higher education inequality was associated with 1.18 times higher odds of alcohol use (logistic regression odds ratio=1.18, 95% confidence interval 1.08-1.30) but 0.79 times lower average daily alcohol consumption among alcohol users (Poisson regression relative rate=0.79, 95% confidence interval 0.68-0.92). Neighborhood social norms about drinking were examined as a possible mediator. Analyses were adjusted for neighborhood education level, income level and income inequality, as well as for individual demographic and socioeconomic characteristics and history of drinking prior to residence in the current neighborhood. Using data from the New York Social Environment Study (conducted in 2005 n=4000), we examined the associations of neighborhood education inequality (measured using Gini coefficients of education) with alcohol use prevalence and levels of alcohol consumption among alcohol users. The neighborhood distribution of education (education inequality) may influence substance use among neighborhood residents.
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