Metabolic dysfunction over a life course key to healthy ageing inequality.

The UK is experiencing a decline in healthy life expectancy, now at 62.4 years for men and 60.9 years for women. Socioeconomic deprivation plays a significant role in health disparities, affecting individuals across the life arc. Girls born in the most deprived areas may live 19 fewer years in good health compared to those in wealthier areas. Health inequalities are particularly severe for ethnic minorities, with Black and Asian individuals reporting poorer health at a younger age. Health inequalities correlate with socioeconomic status. In old age, 2.1 million older adults live in poverty, with Black and Asian communities again disproportionately affected. While ageing increases the risk of morbidities, poor health is not inevitable; however, disadvantaged populations face early-life risk factors, such as low birth weight, linked to future conditions like diabetes and cardiovascular disease. CELLO, an interdisciplinary network, focuses on cellular metabolism throughout life in disadvantaged populations, examining how both genetic and environmental factors shape metabolic dysfunction and contribute to social health inequalities. This review stems from discussions within the network, aiming to advance understanding of healthy ageing across the life course.