Neurology
Sex-Specific Life Expectancies for People with Autism Spectrum Disorder Enrolled in Medicaid, United States, 2000-2020 Guohua Li* Guohua Li Zhixin Yang Ashley Blanchard Carolyn DiGuiseppi Caleb Ing
People with autism spectrum disorder (ASD) are known to be at heightened risk of death from injury and some diseases. But epidemiologic research on life expectancy and lifespan issues in ASD is scant. The objective of this study was to estimate sex-specific life expectancies for Medicaid beneficiaries with ASD. Medicaid is the largest public health insurance program in the US. Research-identifiable files from Medicaid [i.e., Medicaid Analytic eXtract (MAX) data files and T-MSIS Analytic Files] and the enhanced MAX mortality data (i.e., mortality data through linkage of Medicaid beneficiaries to the National Death Index) from 2000 to 2020 were analyzed to determine age-specific death rates for beneficiaries with ASD. The standard life table method was used to calculate life expectancies at birth by sex, which were compared with life expectancies for all Medicaid beneficiaries and the US general population as reported by the Centers for Disease Control and Prevention. During the 21-year study period, there were a total of 18,263 deaths among Medicaid beneficiaries with ASD; of them, 13,286 were male and 5,877 were female. Life expectancies at birth for Medicaid beneficiaries with ASD were 64.6 years for males and 65.0 years for females. Compared to the Medicaid population and the general population, male Medicaid beneficiaries with ASD had a 1.9-year deficit and an 11.6-year deficit in life expectancy, respectively, whereas female Medicaid beneficiaries with ASD had an 8.2-year deficit and a 16.0-year deficit in life expectancy, respectively. This study indicates that people with ASD have substantially shorter life expectancies than the general population. The gap in life expectancy between people with ASD and the general population is greater for women than for men.
