COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions.
Whitney Schott, Sha Tao, Lindsay Shea
PMID 34420427WHAT IT FOUND
Adults with autism, intellectual disability, or mental health conditions on Medicaid had significantly higher odds of living in congregate settings, receiving in-home care, and having severe comorbidities like obesity and chronic lung disease, increasing their COVID-19 exposure and severity risk.
Key findings
01Individuals with autism, intellectual disability, or mental health conditions were more likely to live in residential facilities or receive regular in-home services from outside caregivers compared to the general Medicaid population.
02These groups had higher prevalence of comorbidities that increase COVID-19 severity, including chronic lung disease and obesity, with odds of severe obesity close to or exceeding 2.0 compared to those without mental health conditions.
03The odds of having any high-risk comorbidity were 50% to 55% higher for autistic adults and those with intellectual disability, and almost 2.5 times higher for adults with any mental health condition, compared to the general Medicaid sample.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study uses Medicaid claims data from 2008-2012, which may not reflect current population demographics or healthcare access. Conditions were identified via billing codes, potentially underestimating true prevalence if diagnoses were not coded. The analysis focuses on Medicaid beneficiaries, who may have higher baseline vulnerability due to poverty or disability eligibility, limiting generalizability to insured populations. Risk factors for contracting COVID-19 were assessed indirectly (e.g., residential status) rather than through actual infection data.
Declared interests
The research was supported by the National Institute of Mental Health (NIMH) and the National Institute of Child Health and Human Development (NICHD). The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these findings as evidence that autism or ID directly causes higher COVID-19 infection rates. The study identifies higher prevalence of risk factors like residential living and comorbidities, which are proxies for exposure and severity risk, not direct causal mechanisms of infection.