A new study analysing Medicaid records reveals that autistic individuals enrolled in the programme have a considerably lower life expectancy than other beneficiaries, highlighting preventable causes of mortality and the need for targeted healthcare improvements.
A new analysis of Medicaid records suggests that autistic people enrolled in the programme die younger, on average, than other beneficiaries and face elevated risks from several causes that clinicians often regard as preventable. The study, published in JAMA Network Open and led by researchers at Columbia University Mailman School of Public Health and the University of Colorado Anschutz, estimated life expectancy at birth for Medicaid beneficiaries with autism spectrum disorder at 64.9 years. That is 5.6 years below the overall Medicaid population and 13.8 years below the wider US population.
The findings were based on more than 2 million people with autism enrolled in Medicaid and the Children’s Health Insurance Programme across all 50 states and Washington, DC, from 2000 to 2020. During that period, 18,268 people in the cohort died. The researchers found a 44% higher risk of death among autistic Medicaid beneficiaries than among other enrolees, with particularly elevated mortality linked to influenza, malnutrition, pneumonitis, non-transport accidents, drowning and pneumonia.
The study also showed that life expectancy improved only modestly over time, rising from 63.9 years in the early 2000s to 65.6 years in 2015 to 2019, while the gap with other groups remained. Carolyn DiGuiseppi, an epidemiologist at the Colorado School of Public Health, said the estimate was sobering, and the Columbia team argued that much of the excess mortality could be reduced through stronger primary care, social support and home- and community-based services. The researchers also pointed to flu and pneumonia vaccination, nutrition support and better follow-up care as practical ways to target the most common causes of death.
The analysis has important limits. It is observational and drawn from administrative records, so it can identify patterns but cannot explain why individual deaths occurred. Because Medicaid disproportionately covers people with lower incomes or qualifying disabilities, the results may not apply to autistic people with private insurance. David Mandell, a psychiatrist at the University of Pennsylvania Perelman School of Medicine, told Gizmodo that the study’s estimates were carefully calculated, but said the true life expectancy gap probably lies somewhere between the figures for Medicaid and the general population.
Earlier research points in the same direction. A 2023 study in the UK, published in Lancet Regional Health – Europe, estimated years of life lost among autistic people, while older studies in California, Sweden and elsewhere found higher mortality from injury, suffocation, accidents, seizures and respiratory disease. Taken together, those studies suggest that the risks are not tied to one country or one health system, but they also underline the importance of prevention, routine medical care and practical safety planning for families and caregivers.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
