Association Between Socioeconomic Status and Prevalence of Hypersensitivity Diseases and Autism: A Nationwide Study of Children.

This study looked at over 100,000 American children to see how family income and education levels relate to autism and allergies. They found that children from families with lower income and education were more likely to have autism and most health conditions studied. About 2.6% of children had autism. Only allergies were more common in families with higher education levels.

This large-scale cross-sectional study analyzed data from 102,341 American children aged 0-17 years using the National Survey of Children's Health (2016-2018) to examine associations between socioeconomic status and various health conditions. The study found a weighted autism prevalence of 2.6%. Results showed that while higher parental education was associated with increased allergy diagnosis, lower socioeconomic status was generally associated with higher odds of autism and most hypersensitivity diseases. The findings challenge the hygiene hypothesis for most conditions studied and suggest socioeconomic disadvantage remains an important risk factor for autism and related health conditions in children.

Results suggest socioeconomic factors influence autism diagnosis patterns, potentially reflecting healthcare access disparities rather than true prevalence differences. Clinicians should consider socioeconomic barriers when developing screening and intervention strategies. The findings emphasize need for equitable healthcare access across socioeconomic groups.

Cross-sectional design prevents causal inference. Relies on parent-reported diagnoses which may be subject to recall bias and differential access to healthcare. Does not account for potential diagnostic bias where higher SES families may have better access to specialist services.

Prior research suggests that children with a low socioeconomic status (SES) background are at an increased risk for special healthcare needs. Conversely, for hypersensitivity-related diseases, many studies reported a lower risk among children with lower SES according to the hygiene hypothesis. We aimed to evaluate the association between SES and several hypersensitivity diseases and autism in a representative American sample. We used data from the 2016, 2017 and 2018 US National Survey of Children's Health.

A total of 102,341 children aged 0-17 years were included. The dependent variables were doctor-diagnosed allergies, arthritis, asthma, diabetes, and autism. The main SES indicators were family poverty levels, highest education of the reported adults and difficulty in family income. Our analysis used logistic regression that accounted for the survey sampling design.

The sample had a mean age of 9.4 ± 5.3 years. The weighted prevalence for allergies was 24.4%, 0.3% for arthritis, 11.9% for asthma, 0.5% for diabetes and 2.6% for autism. Children with adults reporting higher educational levels had greater odds of allergies (adjusted odds ratio and 95% CI: 1.48, 1.23-1.78) than those with lower educational levels. But for all other diseases, most findings suggested that a higher odds of disease was associated with lower SES instead of higher SES.

A low SES background remains an important risk factor for hypersensitivity diseases in children. Most of our results suggested that children with low SES were associated with a higher risk of hypersensitivity diseases and autism.