Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York, NY 10027.
Department of Sociology & Anthropology, Fordham University at Lincoln Center, New York, NY 10023.
Proc Natl Acad Sci U S A. 2020 Dec 1;117(48):30295-30302. doi: 10.1073/pnas.2015762117. Epub 2020 Nov 16.
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.
在过去几十年中，自闭症诊断率急剧上升，发病率普遍在白人和社会经济地位较高的人群中最高。利用独特的人群水平数据集，我们发现近年来自闭症诊断率仍在继续上升，但在研究期间被诊断出的人群发生了变化。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育服务部 1992 年 1 月至 2019 年 11 月的自闭症病例记录。加利福尼亚州诊断出的自闭症发病率从 1998 年每千名 3-6 岁儿童 0.49 例上升到 2018 年的每千名 3-6 岁儿童 3.49 例，增长了 612%。然而，诊断发病率并没有在所有社会人口群体中均匀上升。到 2018 年，黑人母亲和亚裔母亲的孩子被诊断出自闭症的比例高于非西班牙裔白人母亲的孩子。此外，在非西班牙裔白人和亚裔母亲的孩子中，社会经济地位较低的孩子被诊断出自闭症的比例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一致，并为更全面地了解自闭症流行提供了重要线索。
