Mortality in Autism

自闭症死亡率

• 批准号: 10732957
• 负责人: GUOHUA LI
• 金额: $ 43.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10732957
• 关键词: 8 year old; Accidental Injury; Adolescent and Young Adult; Adult; Age; Age Specific Death Rate; Behavior Therapy; Biology; California; Cause of Death; Cessation of life; Characteristics; Child; Child Health; Client; Clinical; Complex; Data; Data Files; Death Rate; Development; Developmental Disabilities; Diagnosis; Drowning; Eligibility Determination; Enrollment; Epidemiology; Epilepsy; Excess Mortality; Funding; Gender; General Population; Health; Health Insurance; Health Policy; Health Services; Hispanic; Housing; Income; Individual; Information Systems; Intellectual functioning disability; Intervention; Life Cycle Stages; Life Expectancy; Literature; Longevity; Low income; Massachusetts; Medicaid; Medicaid eligibility; Monitor; Natural History; Neurodevelopmental Disability; Occupational Therapy; Pneumonia; Population; Population Study; Prevalence; Prognosis; Qualifying; Reporting; Research; Risk; Risk Factors; Sample Size; Services; Social Work; Suicide; Surveillance Program; Sweden; Time; Transportation; United States; Utah; Vocational Education; Wisconsin; adolescent with autism spectrum disorder; aged; autism spectrum disorder; autistic children; beneficiary; cohort; comorbidity; cost; design; disability; effective intervention; epidemiology study; ethnic disparity; health care service; improved; indexing; individuals with autism spectrum disorder; longitudinal analysis; mental health counseling; mortality; mortality disparity; mortality risk; premature; programs; public health insurance; racial disparity; screening; sex; waiver; young adult

The long-term objective of the proposed project is to reduce excess mortality and improve life expectancy for people with autism spectrum disorder (ASD). The specific aims are to: 1) determine age- and sex-specific mortality risk in Medicaid beneficiaries with and without ASD; 2) examine cause-specific mortality risk in Medicaid beneficiaries with and without ASD; 3) identify effect modifiers (e.g., gender and intellectual disability) of mortality risk associated with ASD; and 4) assess racial and ethnic disparities in mortality risk in Medicaid beneficiaries with and without ASD. In the United States, the reported prevalence of ASD among children aged 8 years has more than tripled over the past two decades, increasing from 6.7 per 1,000 in 2000 to 23.0 per 1000 in 2018. There were an estimated 6.9 million persons with ASD in the United States, including over 1.5 million children aged 3-17 years and 5.4 million adults aged 18-84 years. As a complex neurodevelopmental disability, ASD often requires extensive lifetime health care and social services. Research on ASD has been largely concentrated in understanding its biology, identifying risk factors, monitoring prevalence in children, and evaluating treatments and interventions. Although substantially reduced life expectancy for individuals with ASD has been speculated since the early 1990s, research on mortality and lifespan issues in autism remains scant. Medicaid, including the Children’s Health Insurance Program, is the primary public insurance program for individuals with ASD. The proposed project involves constructing a dynamic cohort of about 1 million Medicaid beneficiaries with ASD and about 4 million Medicaid beneficiaries without ASD (two million matched with the exposed cohort on state, year of enrollment, age at enrollment, and sex; and two million matched additionally on type of eligibility) and analyzing longitudinal data over a 24-year study period (1999–2022). Results from the proposed project will provide much-needed epidemiologic evidence for understanding the life- course mortality risk, causes of death, effect modifiers of mortality risk, and racial and ethnic disparities in mortality risk associated with ASD, and for developing effective interventions to reduce excess mortality and informing health policy and service planning for people with ASD.

拟议项目的长期目标是降低过高的死亡率和提高预期寿命