The National Autism Indicators Report on Income and Race in Autism Health Care
The National Autism Indicators Reporton how race and income affect the health status of people with autism was recently published in the United States.
To better understand income disparities between children with and without autism and how these disparities affect health, data from the 2017-2020 National Child Health Survey was assessed.
More children with autism in the United States lived in poor (25% vs. 19%) or near-poor (28% vs. 22%) households and fewer in middle-income (26% vs. 28%) or high-income households (21% versus 22%). 31%) households compared to non-autistic children, respectively.
Among all autistic children, Black, Indigenous, and Colored (BIPOC) children were more likely to live in low-income households than white children, in which the proportion of BIPOC children with autism decreased as the household income increased and the proportion of white children increased.
Children with autism were more likely to have fair or poor (8% versus 1%), good (26% versus 25%) or very good (36% versus 25%) health and fewer had excellent health (31% vs 65%) compared to non-autistic children. Stratified by household income, fewer poor (23%) or near-poor (23%) children with autism had excellent health compared to children from high-income households (41%).
Regardless of income, black children with autism had the highest rate of excellent health (31%), followed by children of other ethnicities (30%), white (27%) and Hispanic (26%).
Caregivers of black children reported the highest rate of severe autism (22%) and white caregivers the least (9%).
Compared to non-autistic children, autistic children from low- and high-income households reported more chronic health conditions involving headaches or body aches, respiratory/breathing problems, stomach/intestinal problems, eating or swallowing problems, decayed teeth or cavities, toothache, and bleeding gums.
More children with autism had a medical visit in the past year (88% vs. 80%) and used mental health care (44% vs. 9%), but fewer received dental care (81% versus 87%) compared to the non-autistic population, respectively. Despite increased health care use, children with autism were more likely to not receive health care when they needed it in the past year (12% versus 3%).
In autism, fewer black (85%) and Hispanic (82%) children with autism had a medical visit in the previous year than children of white (91%) or other ethnicities (91%) ). Hispanic children (79%) were less likely to receive preventive medical care than black (85%), other ethnicity (90%) or white (91%) children.
Fewer children with autism were covered by private insurance (41% versus 59%) and had insurance that always covered needed services (49% versus 63%) compared to children without autism.
More autistic families reported ≥$1,000 in medical expenses than non-autistic families (22% vs. 13%).
The report authors concluded: “We found that household income appears to be a very important factor in understanding health disparities among people with autism, as it is associated with differences in health status, coverage insurance, medical expenses and access to health care The report also shows that autism, poverty and race/ethnicity appear to be risk factors for poor health and poor health care outcomes. health, individually and in combination.
Anderson KA, Roux AM, Steinberg H, et al. National Autism Indicators Report: The Intersection of Autism, Health, Poverty and Racial Inequality. Philadelphia: Policy and Analytics Center and Life Course Outcomes Research Program, AJ Drexel Autism Institute, Drexel University, April 2022.