Title: Health profiles of adults with autism spectrum disorder: Differences between women and men
Legend: The distributions of ICD-9 codes by group are graphically displayed in Figure 1. The x-axis shows the number of codes and y-axis shows the percentage of participants who had a specific number of code, which vary by domain. For example, 87% of females with autism had less than 50 diagnostic codes in the neurological disease domain and 8% had between 50 and 100 codes. Almost all females in the control group had less than 50 codes related to neurological diseases and only a few had more than 50 codes, meaning that females with autism have a larger number of medical encounters compared with the female controls. Similar patterns were observed in other diagnostic domains.
Citation: DaWalt LS, Taylor JL, Movaghar A, Hong J, Kim B, Brilliant M, Mailick MR. Health profiles of adults with autism spectrum disorder: Differences between women and men. Autism Research. 2021 Sep;14(9):1896-1904. doi: 10.1002/aur.2563. Epub 2021 Jul 2. PMID: 34213066.
Abstract: The purpose of the present study was to investigate the hypothesis that women with autism have poorer health compared with men with autism, and compared with women without autism. Utilizing electronic health records drawn from a single health care system serving over 2 million individuals, 2119 adults with diagnosed autism spectrum disorders were compared with age- and sex-matched controls. When considering health care utilization, we found evidence of multiplicative risk for conditions within some domains (i.e., nutrition conditions, neurologic disease, psychiatric conditions, and sleep disorders) such that women with autism spectrum disorder (ASD) experienced double jeopardy-meaning they had greater rates of health care utilization within a domain than what would separately be expected by virtue of being a woman and having ASD. For other domains (i.e., endocrine disorders, gastrointestinal disorders), the risk was additive such that being a female and having ASD were both associated with higher health care utilization, but there were no significant interaction effects. It was only with respect to one domain (cardiovascular) that rates of health care utilization were reflective of neither ASD diagnosis nor sex. Overall, our findings suggest that women with ASD are a vulnerable subgroup with high levels of health care utilization. LAY SUMMARY: This study asked whether women with autism have poorer health compared with men with autism, and compared with women without autism. To answer this question, we used data from electronic health records. We found that women with autism spectrum disorder (ASD) were at the greatest risk for health problems such as nutrition conditions, neurologic disease, psychiatric conditions, and sleep disorders. More research on health of women with ASD is needed.
About the Lab: The Lifespan Family Research program is dedicated to understanding the impact of having a child with a developmental disability on the family as well as the role of the family in supporting healthy development for individuals with disabilities such as ASDs and fragile X syndrome. Smith DaWalt’s work examines trajectories of development for adolescents and adults with disabilities and the contextual factors associated with positive outcomes. Her research also centers on developing and evaluating intervention programming for youth and young adults with ASD. For example, with funding from NIMH, Smith DaWalt is currently conducting a randomized waitlist control trial of a psychoeducation intervention for young adults with ASD and their families. Also, in partnership with colleagues at the University of North Carolina-Chapel Hill and San Diego State University, the lab is employing an implementation science framework to test a comprehensive treatment model for high school students with ASD. This study includes a sample of over 500 students from 60 high schools across the country (including 20 high schools in Wisconsin). Through these efforts, they seek to understand how to best support individuals with disabilities and their families during life course transitions.