Autism Life Expectancy in Medicaid Study 14 Years Shorter
A major study finds Medicaid beneficiaries with autism have a life expectancy of 64.9 years, nearly 14 years shorter than the general U.S.
Medicaid beneficiaries with autism have a life expectancy nearly 14 years shorter than the general U.S. population. A new analysis of over two million people reveals their average life expectancy at birth is just 64.9 years.
The study, led by Columbia University's Guohua Li and published in JAMA Network Open, examined National Death Index data for all U.S. Medicaid beneficiaries from 2000 to 2020. It included 2,048,046 beneficiaries with autism. Their life expectancy was 5.6 years shorter than the broader Medicaid population and 13.8 years shorter than the general public.
Disparities vary by gender and worsened during pandemic
Autistic women on Medicaid face the largest disparity, losing 16 years of life expectancy compared to women in the general U.S. population. Their life expectancy of 65 years is also 8.2 years less than other women on Medicaid. Autistic men on Medicaid lose 11.6 years compared to the general male population, with a life expectancy of 64.6 years.
Progress was erased in 2020. Life expectancy for this group had increased from 63.9 years in the early 2000s to 65.6 years by the late 2010s. The COVID-19 pandemic then caused a 4.1-year drop. This decline was nearly twice as large as the reduction seen in the general U.S. population.
Preventable causes drive excess mortality
The overall mortality risk for autistic Medicaid beneficiaries is 44% higher than for the general Medicaid population. This excess mortality stems from multiple preventable conditions, not a single cause.
| Cause of Death | Relative Risk vs. Medicaid Population |
|---|---|
| Influenza | More than 10 times higher |
| Malnutrition | 7.5 times higher |
| Pneumonitis from solids/liquids | Nearly 7 times higher |
| Accidental drowning | More than 3 times higher |
Other notable contributors include non-transport accidents, pneumonia, falls, accidental exposure to smoke or fire, and sepsis.
Researchers call for targeted interventions
Study author Guohua Li identified actionable steps for primary care providers. Annual flu vaccination for children and adults with autism is a critical start. Nutritional screening and safety precautions around water are also vital. "The excess mortality caused by malnutrition was a sadly surprising finding to me as it was not on my radar," Li said.
Li emphasized that primary care physicians have a pivotal role in closing the life expectancy gap. Preventative care for infectious diseases, coupled with early screening for eating problems and other risks, could save lives. The research team calls for these targeted interventions to become standard practice.
Among the study participants, 76.1% were men, 48.5% were white, 14.6% were Black, and 16.7% were Hispanic. Li noted that while a shorter life span for autistic individuals has been speculated since the 1980s, concrete data was lacking until now. Preventative care for infectious diseases, nutritional screening, and safety precautions could help narrow the life expectancy gap.
