Durkin Maureen S, Maenner Matthew J, Baio Jon, Christensen Deborah, Daniels Julie, Fitzgerald Robert, Imm Pamela, Lee Li-Ching, Schieve Laura A, Van Naarden Braun Kim, Wingate Martha S, Yeargin-Allsopp Marshalyn
Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health.
Am J Public Health. 2017 Nov;107(11):1818-1826. doi: 10.2105/AJPH.2017.304032. Epub 2017 Sep 21.
To describe the association between indicators of socioeconomic status (SES) and the prevalence of autism spectrum disorder (ASD) in the United States during the period 2002 to 2010, when overall ASD prevalence among children more than doubled, and to determine whether SES disparities account for ongoing racial and ethnic disparities in ASD prevalence.
We computed ASD prevalence and 95% confidence intervals (CIs) from population-based surveillance, census, and survey data. We defined SES categories by using area-level education, income, and poverty indicators. We ascertained ASD in 13 396 of 1 308 641 8-year-old children under surveillance.
The prevalence of ASD increased with increasing SES during each surveillance year among White, Black, and Hispanic children. The prevalence difference between high- and low-SES groups was relatively constant over time (3.9/1000 [95% CI = 3.3, 4.5] in 2002 and 4.1/1000 [95% CI = 3.6, 4.6] in the period 2006-2010). Significant racial/ethnic differences in ASD prevalence remained after stratification by SES.
A positive SES gradient in ASD prevalence according to US surveillance data prevailed between 2002 and 2010, and racial and ethnic disparities in prevalence persisted during this time among low-SES children.
描述2002年至2010年期间美国社会经济地位（SES）指标与自闭症谱系障碍（ASD）患病率之间的关联，在此期间儿童总体ASD患病率增加了一倍多，并确定SES差异是否解释了ASD患病率中持续存在的种族和民族差异。
我们根据基于人群的监测、人口普查和调查数据计算了ASD患病率及95%置信区间（CI）。我们使用地区层面的教育、收入和贫困指标来定义SES类别。在接受监测的1308641名8岁儿童中，我们确定了13396例ASD病例。
在每个监测年份，白人、黑人及西班牙裔儿童中，ASD患病率均随SES升高而增加。高SES组与低SES组之间的患病率差异随时间相对稳定（2002年为3.9/1000 [95%CI = 3.3, 4.5]，2006 - 2010年期间为4.1/1000 [95%CI = 3.6, 4.6]）。按SES分层后，ASD患病率仍存在显著的种族/民族差异。
根据美国监测数据，2002年至2010年期间ASD患病率存在积极的SES梯度，在此期间低SES儿童中患病率的种族和民族差异依然存在。
