The social patterning of autism diagnoses reversed in California between 1992 and 2018.
The social patterning of autism diagnoses reversed in California between 1992 and 2018.
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DOI：
10.1073/pnas.2015762117
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发表时间：
2020-12-01
影响因子：
11.1
通讯作者：
Bearman PS
中科院分区：
文献类型：
--
作者：
Winter AS;Fountain C;Cheslack-Postava K;Bearman PS
在美国，自闭症的诊断率历来在更具优势的社会群体——白人和社会经济地位较高的人群中更高。利用1992年至2016年加利福尼亚州所有新生儿的数据，我们发现在我们的研究期间这些趋势发生了逆转。到2018年，3至6岁儿童中，黑人母亲和亚裔母亲所生孩子的自闭症确诊发病率高于非西班牙裔白人母亲所生孩子，社会经济地位较低的父母所生孩子的发病率高于社会经济地位较高的父母所生孩子。这些逆转表明，获取知识和资源在推动过去25年来自闭症患病率上升和自闭症病例模式转变方面起着根本性作用。
随着过去几十年自闭症诊断率急剧上升，患病率通常在白人和社会经济地位较高的人群中最高。利用一个独特的、人口层面的数据集，我们发现近年来自闭症诊断率持续上升，但在研究期间被诊断的人群发生了变化。我们的数据包括1992年至2016年在加利福尼亚州出生的所有13272573名儿童的出生记录，以及加利福尼亚州发展服务部1992年1月至2019年11月的自闭症病例记录。加利福尼亚州的自闭症确诊发病率从1998年每1000名3 - 6岁儿童中有0.49例上升到2018年每1000名3 - 6岁儿童中有3.49例，增长了612%。然而，不同社会人口群体的确诊发病率并非均匀上升。到2018年，黑人母亲和亚裔母亲所生孩子的诊断率高于非西班牙裔白人母亲所生孩子。此外，在非西班牙裔白人母亲和亚裔母亲所生孩子中，社会经济地位较低的孩子的诊断率高于社会经济地位较高的孩子。这些变化与健康差异的社会学理论相符，并为更全面地理解自闭症流行提供了重要线索。
Rates of autism diagnosis in the United States have historically been higher among more advantaged social groups—Whites and those of higher socioeconomic status (SES). Using data from all births in the state of California in 1992 through 2016, we find that these trends reversed during our study period. By 2018, diagnosed autism incidence rates for 3- to 6-y-old children were higher for children of Black and Asian mothers than children of non-Hispanic White mothers and were higher for children of lower SES than of higher SES parents. These reversals point to the fundamental role that access to knowledge and resources plays in driving increased autism prevalence and shifting patterns of autism cases over the past quarter-century. As rates of autism diagnosis increased dramatically over the past number of decades, prevalence rates were generally highest among Whites and among those of higher socioeconomic status (SES). Using a unique, population-level dataset, we find that rates of autism diagnosis continued to be on the rise in recent years, but who is diagnosed changed during the study period. Our data consist of birth records of all 13,272,573 children born in the state of California in 1992 through 2016 linked to autism caseload records for January 1992 through November 2019 from California’s Department of Developmental Services. California’s diagnosed autism incidence rate rose from 0.49 per 1,000 3–6 y olds in 1998 to 3.49 per 1,000 3–6 y olds in 2018, a 612% increase. However, diagnosed incidence rates did not rise uniformly across sociodemographic groups. By 2018, children of Black and Asian mothers were diagnosed at higher rates than children of non-Hispanic White mothers. Furthermore, among children of non-Hispanic White and Asian mothers, children of lower SES were diagnosed at higher rates than children of higher SES. These changes align with sociological theories of health disparities and contain important clues for more fully understanding the autism epidemic.
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DOI：
10.1001/jama.2016.4226
发表时间：
2016-04-26
期刊：
JAMA
影响因子：
--
作者：
Chetty R;Stepner M;Abraham S;Lin S;Scuderi B;Turner N;Bergeron A;Cutler D
通讯作者：
Cutler D
影响因子：
8
作者：
Fountain, Christine;Winter, Alix S.;Bearman, Peter S.
通讯作者：
Bearman, Peter S.
影响因子：
1.8
作者：
Hinkka-Yli-Salomaki, Susanna;Banerjee, P. Nina;Sourander, Andre
通讯作者：
Sourander, Andre
影响因子：
12.7
作者：
Braveman, Paula A.;Cubbin, Catherine;Pamuk, Elsie
通讯作者：
Pamuk, Elsie
影响因子：
8
作者：
Kogan, Michael D.;Vladutiu, Catherine J.;Lu, Michael C.
通讯作者：
Lu, Michael C.