Racial/Ethnic Differences in Psychiatric and Medical Diagnoses Among Autistic Adults.
Jennifer L Ames, Elizabeth H Morgan, Morénike Giwa Onaiwu and 3 others
PMID 36601333WHAT IT FOUND
Autistic adults had more psychiatric and medical diagnoses than non-autistic adults, but Black, Hispanic, and Asian autistic adults received fewer psychiatric diagnoses than White autistic adults.
These gaps likely reflect under-detection and access barriers rather than lower actual need.
Key findings
01Black, Asian, and other race/ethnicity autistic adults were markedly less likely to be diagnosed with any psychiatric condition, including anxiety, ADHD, and depression, than White autistic adults.
02Among autistic adults, Black and Hispanic adults had higher prevalence of obesity than White adults, while Black adults had higher prevalence of hypertension and diabetes but lower prevalence of autoimmune disease and sleep disorders.
03The lower rates of mental health diagnoses in marginalized groups likely reflect systematic under-detection rather than truly lower psychiatric risk.
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
Race/ethnicity was based on self-report and broad categories, masking heterogeneity within groups. Diagnoses were taken from electronic health records and not validated by standardized clinical exams, so they may reflect access to care and provider bias rather than true prevalence. The study population was insured and part of one integrated health system in Northern California, so findings may not generalize to uninsured adults or other regions. Autism is widely under-ascertained in adults, particularly among marginalized groups, meaning the study may underestimate true disparities. The study did not measure disease severity or duration, which are important facets of health disparities.
Declared interests
The paper does not report specific funding sources or conflicts of interest in the provided text.
The easy way to misread this
Do not interpret the lower rates of psychiatric diagnoses among Black, Hispanic, and Asian autistic adults as evidence that these groups have better mental health or lower need for services. The authors state these findings likely reflect systematic under-detection and access barriers, not truly lower psychiatric risk.