The association of autism diagnosis with socioeconomic status

Department of Preventive Medicine and Community Health, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, USA.
Autism (Impact Factor: 3.5). 08/2011; 16(2):201-13. DOI: 10.1177/1362361311413397
Source: PubMed


In 2007 the Centers for Disease Control and Prevention (CDC) reported a higher prevalence of autism spectrum disorder (ASD) in New Jersey, one of the wealthiest states in the United States, than in other surveillance regions.
To examine the association of socioeconomic status (SES) with ASD prevalence.
Information on eight-year-olds with ASD from four counties was abstracted from school and medical records. US Census 2000 provided population and median household income data.
586 children with ASD were identified: autism prevalence was 10.2/1000, higher in boys than girls (16 vs. 4/1000); higher in white and Asian non-Hispanics than in black non-Hispanics and Hispanics (12.5, 14.0, 9.0, and 8.5/1000, respectively); and higher (17.2/1000 (95% CI 14.0-21.1)) in tracts with median income >US$90,000 than in tracts with median income ≤US$30,000 (7.1 (95% CI 5.7-8.9)). Number of professional evaluations was higher, and age at diagnosis younger, in higher income tracts (p < .001), but both measures spanned a wide overlapping range in all SES levels. In multivariable models race/ethnicity did not predict ASD, but the prevalence ratio was 2.2 (95% CI 1.5-3.1) when comparing highest with lowest income tracts.
In the US state of New Jersey, ASD prevalence is higher in wealthier census tracts, perhaps due to differential access to pediatric and developmental services.

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    • "Two studies citing institutional barriers were adjusted for family income and found African American families remained more dissatisfied with the quality of their child's health care than Caucasian families of children with ASD (Liptak et al. 2008; Sansosti et al. 2012). Studies that examined socioeconomic status (SES) and ASD diagnosis reported African American children from low income families were consistently associated with delayed diagnoses , but when controlled for SES African American children with ASD were less likely to have adequate access to health care across incomes (Bhasin and Schendel 2007; Fountain et al. 2011; Jarquin et al. 2011; Liptak et al. 2008; Magana et al. 2012; Mandell et al. 2010a, b; Rosenberg et al. 2011; Thomas et al. 2012; Valicenti-McDermott et al. 2012). "
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Michael Bruce Brimacombe