Assessment of racial and ethnic bias in autism spectrum disorder prevalence estimates from a US surveillance system
- PMID: 30892923
- PMCID: PMC6824598
- DOI: 10.1177/1362361319827510
Assessment of racial and ethnic bias in autism spectrum disorder prevalence estimates from a US surveillance system
Abstract
This study assessed potential under-ascertainment of autism spectrum disorder due to missing administrative information for Hispanic and non-Hispanic Black children within the Autism and Developmental Disabilities Monitoring Network. We analyzed data from two Network sites (Colorado and Wisconsin) for surveillance years 2012 and 2014 to determine whether children excluded from autism spectrum disorder prevalence estimates due to missing residency and other information differed from those included by race and ethnicity. We used multiple approaches to impute missing information to evaluate impacts on racial and ethnic disparities in autism spectrum disorder prevalence. Compared with confirmed autism spectrum disorder cases, those excluded due to missing residency were more than twice as likely to be Hispanic (19% vs 44%; p < 0.002), yet the number of cases excluded due to missing residency information was too small to account for prevalence differences. Confirmation of autism spectrum disorder case status was more likely for children with relevant health records than for those with school records only. Moreover, relevant health records were more likely to be missing for Black and Hispanic children than for White children. Observed disparities in autism spectrum disorder prevalence were not accounted for by missing demographic data, but may reflect disparities in healthcare access for developmental evaluations.
Keywords: autism spectrum disorders; epidemiology; health disparities; prevalence.
Figures
Similar articles
-
Racial and Ethnic Disparities in Peripheral Artery Disease.Circ Res. 2021 Jun 11;128(12):1913-1926. doi: 10.1161/CIRCRESAHA.121.318243. Epub 2021 Jun 10. Circ Res. 2021. PMID: 34110901 Review.
-
Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ. 2018 Nov 16;65(13):1-23. doi: 10.15585/mmwr.ss6513a1. MMWR Surveill Summ. 2018. PMID: 30439868 Free PMC article.
-
Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014.MMWR Surveill Summ. 2018 Apr 27;67(6):1-23. doi: 10.15585/mmwr.ss6706a1. MMWR Surveill Summ. 2018. PMID: 29701730 Free PMC article.
-
Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years--Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012.MMWR Surveill Summ. 2016 Apr 1;65(3):1-23. doi: 10.15585/mmwr.ss6503a1. MMWR Surveill Summ. 2016. PMID: 27031587 Free PMC article.
-
Trends in obesity prevalence and disparities among low-income children in Oklahoma, 2005-2010.Child Obes. 2014 Aug;10(4):318-25. doi: 10.1089/chi.2014.0022. Epub 2014 Jul 14. Child Obes. 2014. PMID: 25019336 Review.
Cited by
-
Prenatal Cannabis Use and Offspring Autism-Related Behaviors: Examining Maternal Stress as a Moderator in a Black American Cohort.J Autism Dev Disord. 2024 Jun;54(6):2355-2367. doi: 10.1007/s10803-023-05982-z. Epub 2023 Apr 25. J Autism Dev Disord. 2024. PMID: 37097527 Free PMC article.
-
Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi: 10.15585/mmwr.ss7202a1. MMWR Surveill Summ. 2023. PMID: 36952288 Free PMC article.
-
Differential Performance of Social Communication Questionnaire Items in African American/Black vs. White Children.J Autism Dev Disord. 2024 May;54(5):1820-1833. doi: 10.1007/s10803-023-05931-w. Epub 2023 Mar 10. J Autism Dev Disord. 2024. PMID: 36897518
-
Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care.J Autism Dev Disord. 2024 Mar;54(3):931-942. doi: 10.1007/s10803-022-05861-z. Epub 2023 Jan 10. J Autism Dev Disord. 2024. PMID: 36626007
-
Cross-sectional Comparison of Disparities by Race Using White vs Hispanic as Reference Among Children and Youths With Developmental Disabilities Referred for Speech Therapy.JAMA Netw Open. 2022 Oct 3;5(10):e2234453. doi: 10.1001/jamanetworkopen.2022.34453. JAMA Netw Open. 2022. PMID: 36194413 Free PMC article.
References
-
- American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR). Washington, DE: American Psychiatric Association Publishing.
-
- American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth Edition Washington, DE: American Psychiatric Association Publishing.
-
- Autism and Developmental Disabilities Monitoring Network Surveillance Year 2002 Principal Investigators (2007) Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network,14 Sites, United States, 2002. MMWR, 56 (SS-1):12–28. - PubMed
-
- Avchen RN, Wiggins LD, Devine O, Van Naarden Braun K, Rice C, Hobson NC, et al. (2011) Evaluation of a records-review surveillance system used to determine the prevalence of autism spectrum disorders. J Autism Dev Disord 41(2), 227–236. - PubMed