Mortality in Autism

拟议项目的长期目标是减少超额死亡率并提高#年的预期寿命。 自闭症谱系障碍(ASD)患者。具体目标是：1)确定特定的年龄和性别 患有和不患有自闭症的医疗补助受益人的死亡风险；2)检查 患有和不患有自闭症的医疗补助受益人；3)确定影响因素(例如，性别和智力残疾) 与自闭症相关的死亡风险；以及4)在医疗补助中评估死亡风险的种族和民族差异 患有和不患有自闭症的受益人。在美国，自闭症在年龄较大的儿童中的报告患病率 在过去20年中，8年增长了两倍多，从2000年的6.7‰上升到23.0% 2018年为1000人。据估计，美国有690万自闭症患者，其中包括超过150万人 300万名3-17岁儿童和540万名18-84岁成年人。作为一种复杂的神经发育 自闭症患者往往需要广泛的终生保健和社会服务。对ASD的研究已经被 主要集中在了解其生物学，识别危险因素，监测儿童的流行率，以及 评估治疗和干预措施。尽管患有以下疾病的人的预期寿命大大减少 自20世纪90年代初以来，人们一直在猜测自闭症的死亡率和寿命问题的研究仍然存在 斯坎特。医疗补助计划，包括儿童健康保险计划，是主要的公共保险计划 对于患有自闭症的个人。拟议的项目涉及建立一个约100万人的动态队列 患有自闭症的医疗补助受益人和大约400万没有自闭症的医疗补助受益人(200万匹配 暴露的队列包括州、入学年份、入学年龄和性别；200万匹配 此外还包括资格类型)，并分析了24年研究期间(1999-2022年)的纵向数据。 拟议项目的结果将提供急需的流行病学证据，以了解生命- 病程死亡风险、死亡原因、死亡风险的影响因素以及种族和民族差异 与自闭症相关的死亡风险，并开发有效的干预措施，以减少过剩的死亡率和 为自闭症患者提供健康政策和服务规划方面的信息。

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.