Understanding Racial and Ethnic Disparities in Autism-Related Service Use Among Medicaid-Enrolled Children

Overview

Journal J Autism Dev Disord

Publisher Springer

Date 2020 Nov 21

PMID 33219917

Citations 22

Authors

Lucy A Bilaver

Sarah A Sobotka

David S Mandell

Affiliations

Soon will be listed here.

Abstract

Racial and ethnic disparities in the use of nine common autism-related services among Medicaid-enrolled children with autism spectrum disorder (ASD) were examined, distinguishing between school and other community-based outpatient settings. Using 2012 Medicaid Analytic Extract data, we identified 117,848 continuously enrolled children with ASD. Several racial and ethnic disparities were found, varying by geography. Black, Asian, and Native American/Pacific Islanders received fewer outpatient services compared with white children, but there was no disparity for Latinx children. Black and Asian children received more school-based services than white children. Disparities in case management/care coordination services were largest and present in each minority group. Geographic variation in receipt of services suggests targets for policy intervention to improve access for minorities with ASD.

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References

Mandell D, Listerud J, Levy S, Pinto-Martin J . Race differences in the age at diagnosis among medicaid-eligible children with autism. J Am Acad Child Adolesc Psychiatry. 2002; 41(12):1447-53. DOI: 10.1097/00004583-200212000-00016. View

Zuckerman K, Lindly O, Sinche B . Parent Beliefs About the Causes of Learning and Developmental Problems Among Children With Autism Spectrum Disorder: Results From a National Survey. Am J Intellect Dev Disabil. 2016; 121(5):432-47. PMC: 5575795. DOI: 10.1352/1944-7558-121.5.432. View

Magana S, Parish S, Son E . Functional severity and Latino ethnicity in specialty services for children with autism spectrum disorder. J Intellect Disabil Res. 2016; 60(5):424-34. DOI: 10.1111/jir.12293. View

Le Cook B, McGuire T, Lock K, Zaslavsky A . Comparing methods of racial and ethnic disparities measurement across different settings of mental health care. Health Serv Res. 2010; 45(3):825-47. PMC: 2875762. DOI: 10.1111/j.1475-6773.2010.01100.x. View

Bailey Z, Krieger N, Agenor M, Graves J, Linos N, Bassett M . Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017; 389(10077):1453-1463. DOI: 10.1016/S0140-6736(17)30569-X. View

Zuckerman K, Lindly O, Reyes N, Chavez A, Macias K, Smith K . Disparities in Diagnosis and Treatment of Autism in Latino and Non-Latino White Families. Pediatrics. 2017; 139(5). PMC: 5404727. DOI: 10.1542/peds.2016-3010. View

LaClair M, Mandell D, Dick A, Iskandarani K, Stein B, Leslie D . The effect of Medicaid waivers on ameliorating racial/ethnic disparities among children with autism. Health Serv Res. 2019; 54(4):912-919. PMC: 6606603. DOI: 10.1111/1475-6773.13176. View

Le Cook B, McGuire T, Zaslavsky A . Measuring racial/ethnic disparities in health care: methods and practical issues. Health Serv Res. 2012; 47(3 Pt 2):1232-54. PMC: 3371391. DOI: 10.1111/j.1475-6773.2012.01387.x. View

Smith K, Gehricke J, Iadarola S, Wolfe A, Kuhlthau K . Disparities in Service Use Among Children With Autism: A Systematic Review. Pediatrics. 2020; 145(Suppl 1):S35-S46. DOI: 10.1542/peds.2019-1895G. View

10.

Magana S, Parish S, Rose R, Timberlake M, Swaine J . Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Intellect Dev Disabil. 2012; 50(4):287-99. DOI: 10.1352/1934-9556-50.4.287. View

11.

Zuckerman K, Sinche B, Mejia A, Cobian M, Becker T, Nicolaidis C . Latino parents' perspectives on barriers to autism diagnosis. Acad Pediatr. 2014; 14(3):301-8. PMC: 4006363. DOI: 10.1016/j.acap.2013.12.004. View

12.

Harstad E, Huntington N, Bacic J, Barbaresi W . Disparity of care for children with parent-reported autism spectrum disorders. Acad Pediatr. 2013; 13(4):334-9. DOI: 10.1016/j.acap.2013.03.010. View

13.

Mandell D, Xie M, Morales K, Lawer L, McCarthy M, Marcus S . The interplay of outpatient services and psychiatric hospitalization among Medicaid-enrolled children with autism spectrum disorders. Arch Pediatr Adolesc Med. 2012; 166(1):68-73. PMC: 4764986. DOI: 10.1001/archpediatrics.2011.714. View

14.

Werling D, Geschwind D . Sex differences in autism spectrum disorders. Curr Opin Neurol. 2013; 26(2):146-53. PMC: 4164392. DOI: 10.1097/WCO.0b013e32835ee548. View

15.

Hart L, Larson E, Lishner D . Rural definitions for health policy and research. Am J Public Health. 2005; 95(7):1149-55. PMC: 1449333. DOI: 10.2105/AJPH.2004.042432. View

16.

Liptak G, Benzoni L, Mruzek D, Nolan K, Thingvoll M, Wade C . Disparities in diagnosis and access to health services for children with autism: data from the National Survey of Children's Health. J Dev Behav Pediatr. 2008; 29(3):152-60. DOI: 10.1097/DBP.0b013e318165c7a0. View

17.

Mandell D, Morales K, Xie M, Polsky D, Stahmer A, Marcus S . County-level variation in the prevalence of medicaid-enrolled children with autism spectrum disorders. J Autism Dev Disord. 2010; 40(10):1241-6. PMC: 2912440. DOI: 10.1007/s10803-010-0982-2. View

18.

Frazier T, Georgiades S, Bishop S, Hardan A . Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection. J Am Acad Child Adolesc Psychiatry. 2014; 53(3):329-40.e1-3. PMC: 3935179. DOI: 10.1016/j.jaac.2013.12.004. View

19.

Zuckerman K, Mattox K, Donelan K, Batbayar O, Baghaee A, Bethell C . Pediatrician identification of Latino children at risk for autism spectrum disorder. Pediatrics. 2013; 132(3):445-53. PMC: 3876760. DOI: 10.1542/peds.2013-0383. View

20.

Close H, Lee L, Kaufmann C, Zimmerman A . Co-occurring conditions and change in diagnosis in autism spectrum disorders. Pediatrics. 2012; 129(2):e305-16. DOI: 10.1542/peds.2011-1717. View