Study Looks at Health Disparities and Autism

Celiac.com 11/08/2023 - Autistic adults often face more significant health challenges than their non-autistic counterparts, as revealed by numerous epidemiological studies. Although this issue has been explored, research has mainly been confined to specific geographical areas and has centered on young autistic individuals aged 35 and under. 

Recent research points to a higher mortality rate in autistic people and less satisfactory self-reported healthcare experiences. A team of researchers recently set out to examine increased rates of chronic physical health conditions in autistic adolescents and adults. 

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The research team included John H. Ward, Elizabeth Weir, Carrie Allison & Simon Baron-Cohen. They are variously affiliated with the Royal Devon University NHS Foundation Trust, Exeter, Devon, UK; the University of Exeter Medical School, Devon, UK; the University of Oxford, Department of Psychiatry, Oxford, UK; the Oxford Health NHS Foundation Trust, Oxford, UK; and the Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, Cambridge, UK.

Do Autistic Individuals Experience Higher Levels of Non-communicable Health Conditions?

The team's study aimed to answer two fundamental questions: Do autistic individuals experience higher levels of non-communicable health conditions, and if so, can these disparities be attributed to differences in demographics, lifestyle factors, and family medical history?

The researchers conducted a cross-sectional, convenience-sampling study through an anonymous online survey, which included over 2300 participants comprising both autistic and non-autistic adults, with roughly half being autistic. The survey collected self-reported data on demographics, autism diagnosis, lifestyle factors (like diet, exercise, sleep, substance use), personal medical history, and family medical history (for all first-degree, biological relatives).

They used binomial logistic regression models of increasing complexity and employed the Benjamini–Hochberg correction to mitigate multiple testing effects. The study analyzed physical health conditions, considering only those with at least 1% endorsement within the sample to reduce the risk of Type I errors. Additionally, they used network analysis methods to explore the presence of multiple health conditions (multi-morbidity) in both autistic and non-autistic individuals.

The study uncovered significantly higher rates of non-communicable health conditions across various organ systems in autistic individuals. These systems included the gastrointestinal, neurological, endocrine, visual, ear/nose/throat, skin, liver and kidney, and hematological systems. This study confirmed previous findings of notable differences in neurological and gastrointestinal symptoms between autistic and non-autistic individuals. The study also found a higher prevalence of celiac disease among autistic individuals compared to non-autistic individuals after controlling for sex, ethnicity, country of residence, alcohol use, smoking, and BMI, however, these results became non-significant after accounting for family history.

Furthermore, this study, the largest to date, identified a higher likelihood of Ehler-Danlos Syndrome (EDS) in autistic females, compared to their non-autistic counterparts. Notably, the research also revealed higher rates  of celiac disease among autistic individuals, even after considering demographic factors such as sex, ethnicity, and country of residence. However, this difference became statistically insignificant when accounting for family history.

In essence, the study underscores that autistic adults face disparities in non-communicable health conditions compared to their non-autistic peers. The findings demonstrate the need for tailored healthcare and interventions to address these disparities and improve the overall health and well-being of autistic individuals.

Read more in Molecular Autism volume 14, Article number: 35 (2023