Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum.
Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum.
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DOI：
10.1002/aur.2644
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Shea L
中科院分区：
文献类型：
--
作者：
Schott W;Tao S;Shea L
有证据表明，自闭症成年人有更高的几率患上几种同时发生的疾病，但人们对这一人群中种族和民族的差异知之甚少。使用2008-2012年医疗补助分析提取（MAX）数据，我们(i)确定了与没有自闭症谱系障碍（ASD）诊断的匹配样本相比，自闭症成年医疗补助受益人人群中共同发生疾病的患病率，（ii）进行逻辑回归以估计自闭症诊断预测的这些健康状况的优势比。（三）仅在自闭症人群中，根据种族/民族群体的预测，估计患有这些健康状况的几率。总体而言，自闭症成年人在某些主要健康状况（心血管疾病、中风、癌症、心血管疾病）方面的患病率并不高，但在其他方面（营养状况、癫痫、中枢神经系统紊乱）的患病率确实较高。然而，对种族/民族群体的分析表明，黑人、西班牙裔和亚洲自闭症受益人患糖尿病、住院心血管疾病和高血压等疾病的几率更高。政策制定者应该意识到，在一般人群中发现的种族差异在自闭症人群中仍然存在，应该努力实施系统和计划，以改善对少数自闭症人群的筛查和预防保健。自闭症成年人可能有几种同时发生的身体和精神健康状况，这可能因种族/族裔群体而异。我们发现，与一般的医疗补助人群相比，成年自闭症医疗补助受益人在某些健康状况（如癫痫和营养状况）以及一些精神状况（如焦虑和注意力障碍）方面的几率更高。我们还发现，在普通人群中，种族/民族群体之间的许多相同的健康差异在自闭症成人医疗补助人群中仍然存在。例如，黑人、西班牙裔和亚裔医疗补助受益人患糖尿病的几率更高，黑人和西班牙裔自闭症受益人比白人自闭症受益人患肥胖症和营养状况的几率更高。
Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008–2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries.
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