Socioeconomic Inequality in the Prevalence of Autism Spectrum Disorder: Evidence from a U.S. Cross-Sectional Study
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{"title"=>"Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a U.S. cross-sectional study", "type"=>"journal", "authors"=>[{"first_name"=>"Maureen S.", "last_name"=>"Durkin", "scopus_author_id"=>"7102183497"}, {"first_name"=>"Matthew J.", "last_name"=>"Maenner", "scopus_author_id"=>"25724458300"}, {"first_name"=>"F. John", "last_name"=>"Meaney", "scopus_author_id"=>"7003992702"}, {"first_name"=>"Susan E.", "last_name"=>"Levy", "scopus_author_id"=>"7402774557"}, {"first_name"=>"Carolyn", "last_name"=>"di Guiseppi", "scopus_author_id"=>"36241381700"}, {"first_name"=>"Joyce S.", "last_name"=>"Nicholas", "scopus_author_id"=>"7202440706"}, {"first_name"=>"Russell S.", "last_name"=>"Kirby", "scopus_author_id"=>"7201552967"}, {"first_name"=>"Jennifer A.", "last_name"=>"Pinto-Martin", "scopus_author_id"=>"7003290680"}, {"first_name"=>"Laura A.", "last_name"=>"Schieve", "scopus_author_id"=>"7003346706"}], "year"=>2010, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-77955371018", "pui"=>"359318733", "pmid"=>"20634960", "issn"=>"19326203", "isbn"=>"1932-6203 (Electronic) 1932-6203 (Linking)", "doi"=>"10.1371/journal.pone.0011551", "sgr"=>"77955371018"}, "id"=>"4907e72a-05f4-36bb-9e5e-945efbb36fb4", "abstract"=>"BACKGROUND This study was designed to evaluate the hypothesis that the prevalence of autism spectrum disorder (ASD) among children in the United States is positively associated with socioeconomic status (SES). METHODS A cross-sectional study was implemented with data from the Autism and Developmental Disabilities Monitoring Network, a multiple source surveillance system that incorporates data from educational and health care sources to determine the number of 8-year-old children with ASD among defined populations. For the years 2002 and 2004, there were 3,680 children with ASD among a population of 557,689 8-year-old children. Area-level census SES indicators were used to compute ASD prevalence by SES tertiles of the population. RESULTS Prevalence increased with increasing SES in a dose-response manner, with prevalence ratios relative to medium SES of 0.70 (95% confidence interval [CI] 0.64, 0.76) for low SES, and of 1.25 (95% CI 1.16, 1.35) for high SES, (P<0.001). Significant SES gradients were observed for children with and without a pre-existing ASD diagnosis, and in analyses stratified by gender, race/ethnicity, and surveillance data source. The SES gradient was significantly stronger in children with a pre-existing diagnosis than in those meeting criteria for ASD but with no previous record of an ASD diagnosis (p<0.001), and was not present in children with co-occurring ASD and intellectual disability. CONCLUSIONS The stronger SES gradient in ASD prevalence in children with versus without a pre-existing ASD diagnosis points to potential ascertainment or diagnostic bias and to the possibility of SES disparity in access to services for children with autism. Further research is needed to confirm and understand the sources of this disparity so that policy implications can be drawn. Consideration should also be given to the possibility that there may be causal mechanisms or confounding factors associated with both high SES and vulnerability to ASD.", "link"=>"http://www.mendeley.com/research/socioeconomic-inequality-prevalence-autism-spectrum-disorder-evidence-crosssectional-study-4", "reader_count"=>173, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>8, "Researcher"=>25, "Student > Doctoral Student"=>27, "Student > Ph. D. Student"=>38, "Student > Postgraduate"=>7, "Student > Master"=>33, "Other"=>10, "Student > Bachelor"=>17, "Professor"=>7}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>8, "Researcher"=>25, "Student > Doctoral Student"=>27, "Student > Ph. D. Student"=>38, "Student > Postgraduate"=>7, "Student > Master"=>33, "Other"=>10, "Student > Bachelor"=>17, "Professor"=>7}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Agricultural and Biological Sciences"=>8, "Arts and Humanities"=>3, "Computer Science"=>3, "Earth and Planetary Sciences"=>1, "Economics, Econometrics and Finance"=>2, "Engineering"=>1, "Environmental Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>6, "Materials Science"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>46, "Sports and Recreations"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>52, "Social Sciences"=>36}, "reader_count_by_subdiscipline"=>{"Materials Science"=>{"Materials Science"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>46}, "Social Sciences"=>{"Social Sciences"=>36}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>52}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>8}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>3}, "Engineering"=>{"Engineering"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Computer Science"=>{"Computer Science"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>6}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}}, "reader_count_by_country"=>{"Canada"=>2, "Netherlands"=>1, "United States"=>2, "Brazil"=>1, "Poland"=>1, "France"=>1, "Germany"=>1}, "group_count"=>5}

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  • {"files"=>["https://ndownloader.figshare.com/files/841605"], "description"=>"a<p>SES indicator is % above poverty level based on United States Census 2000 block group data.</p>b<p>CI = Confidence Interval.</p>c<p>Poverty areas include United States Census 2000 block groups in which more than 20% of families with children have incomes below the poverty level <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0011551#pone.0011551-USCensus1\" target=\"_blank\">[38]</a>. Percent of cases living in poverty is 20.4% in sites accessing only data from healthcare sources.</p>d<p>In addition to the χ<sup>2</sup> test of the SES gradient within the stratum of children with no pre-existing ASD diagnosis, a separate χ<sup>2</sup> test of the difference in the SES gradient for children with and without a pre-existing ASD diagnosis also resulted in a p-value <0.0001.</p>e<p>Restricted to sites with access to school records (<i>n</i> = 2713), including those in Arkansas, Arizona, Colorado, Georgia, Maryland, North Carolina, New Jersey, South Carolina.</p>", "links"=>[], "tags"=>["asd", "prevalence", "ratios", "stratified", "pre-existing", "co-occurring"], "article_id"=>512051, "categories"=>["Cancer", "Medicine", "Neuroscience"], "users"=>["Maureen S. Durkin", "Matthew J. Maenner", "F. John Meaney", "Susan E. Levy", "Carolyn DiGuiseppi", "Joyce S. Nicholas", "Russell S. Kirby", "Jennifer A. Pinto-Martin", "Laura A. Schieve"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0011551.t004", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Stratified_Results_ASD_and_SES_a_Prevalence_Ratios_95_CI_b_Stratified_by_Gender_Pre_existing_Diagnosis_Co_occurring_Intellectual_Disability_Developmental_Regression_and_Data_Source_/512051", "title"=>"Stratified Results: ASD and SES<sup>a</sup> Prevalence Ratios (95% CI<sup>b</sup>), Stratified by Gender, Pre-existing Diagnosis, Co-occurring Intellectual Disability, Developmental Regression, and Data Source.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 00:40:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/841693"], "description"=>"a<p>Based on 2000 Census data.</p>b<p>Poverty areas include census block groups in which more than 20% of families with children have incomes below the poverty level <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0011551#pone.0011551-Krieger1\" target=\"_blank\">[36]</a>.</p><p>*p<0.05, comparing ASD cases to population of 8-year-old children residing in the surveillance area.</p>", "links"=>[], "tags"=>["indicators", "asd", "cases", "8-year-old", "children"], "article_id"=>512141, "categories"=>["Cancer", "Medicine", "Neuroscience"], "users"=>["Maureen S. Durkin", "Matthew J. Maenner", "F. John Meaney", "Susan E. Levy", "Carolyn DiGuiseppi", "Joyce S. Nicholas", "Russell S. Kirby", "Jennifer A. Pinto-Martin", "Laura A. Schieve"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0011551.t002", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Socioeconomic_Indicators_for_ASD_Cases_and_the_Population_of_8_Year_Old_Children_in_the_Surveillance_Area_/512141", "title"=>"Socioeconomic Indicators for ASD Cases and the Population of 8-Year-Old Children in the Surveillance Area.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 00:41:17"}
  • {"files"=>["https://ndownloader.figshare.com/files/841733"], "description"=>"a<p>Based on 2000 Census data.</p><p>*p<0.05, comparing ASD cases to population of 8-year-old children residing in the surveillance area.</p><p>**p<0.05, comparing population of 8-year-old children residing in the surveillance area to United States population of 8-year-old children according to 2000 Census data.</p>", "links"=>[], "tags"=>["characteristics", "asd", "8-year-old", "children", "united", "states"], "article_id"=>512182, "categories"=>["Cancer", "Medicine", "Neuroscience"], "users"=>["Maureen S. Durkin", "Matthew J. Maenner", "F. John Meaney", "Susan E. Levy", "Carolyn DiGuiseppi", "Joyce S. Nicholas", "Russell S. Kirby", "Jennifer A. Pinto-Martin", "Laura A. Schieve"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0011551.t001", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_Characteristics_of_ASD_Cases_Population_of_8_Year_Old_Children_in_the_Surveillance_Area_and_Overall_United_States_Population_of_8_Year_Old_Children_/512182", "title"=>"Demographic Characteristics of ASD Cases, Population of 8-Year-Old Children in the Surveillance Area and Overall United States Population of 8-Year-Old Children.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 00:41:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/841488"], "description"=>"<p><sup>1</sup>Thin bars indicate 95% confidence intervals. Within each SES indicator, both the trend test and χ<sup>2</sup> tests were significant at p<0.0001. <sup>2</sup>MHI refers to median household income.</p>", "links"=>[], "tags"=>["asd", "ses", "indicators", "census"], "article_id"=>511923, "categories"=>["Cancer", "Medicine", "Neuroscience"], "users"=>["Maureen S. Durkin", "Matthew J. Maenner", "F. John Meaney", "Susan E. Levy", "Carolyn DiGuiseppi", "Joyce S. Nicholas", "Russell S. Kirby", "Jennifer A. Pinto-Martin", "Laura A. Schieve"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0011551.g001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_per_1000_1_of_ASD_by_three_SES_indicators_based_on_census_block_group_of_residence_/511923", "title"=>"Prevalence per 1000<sup>1</sup> of ASD by three SES indicators based on census block group of residence.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-21 00:40:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/841646"], "description"=>"a<p>CI = confidence interval.</p>b<p>Socioeconomic Status (SES) is indicated by the percentage of families with incomes above the federal poverty level who had children in the census block group of the index child, divided into population SES tertiles.</p>c<p>The following differences in prevalence between ethnic group were statistically significant at p<0.05:</p><p>Overall: Non-Hispanic White versus Non-Hispanic Black; Non-Hispanic White versus Hispanic; Non-Hispanic Black versus Asian; and Hispanic versus Asian. In addition, the overall prevalence of ASD differs at p<0.05 across race/ethnic groups.</p><p>Low SES: Non-Hispanic White versus Non-Hispanic Black; Non-Hispanic White versus Hispanic; and Non_Hispanic White versus Asian. In addition, within the low SES stratum, the prevalence of ASD differs at p<0.05 across race/ethnic groups.</p><p>Medium SES: Non-Hispanic Black versus Hispanic.</p><p>High SES: Non-Hispanic White versus Non-Hispanic Black; Non-Hispanic White versus Asian; and Hispanic versus Asian. In addition, within the high SES stratum, the prevalence of ASD differs at p<0.05 across race/ethnic groups.</p>", "links"=>[], "tags"=>["asd", "8-year-olds", "ratios", "prevalence", "stratified"], "article_id"=>512095, "categories"=>["Cancer", "Medicine", "Neuroscience"], "users"=>["Maureen S. Durkin", "Matthew J. Maenner", "F. John Meaney", "Susan E. Levy", "Carolyn DiGuiseppi", "Joyce S. Nicholas", "Russell S. Kirby", "Jennifer A. Pinto-Martin", "Laura A. Schieve"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0011551.t003", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_95_CI_a_of_ASD_per_1_000_8_Year_Olds_and_Ratios_of_ASD_Prevalence_by_SES_b_Stratified_by_Race_Ethnicity_c_/512095", "title"=>"Prevalence (95% CI<sup>a</sup>) of ASD per 1,000 8-Year-Olds and Ratios of ASD Prevalence by SES<sup>b</sup>, Stratified by Race/Ethnicity<sup>c</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 00:41:02"}

PMC Usage Stats | Further Information

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