title: The association of autism diagnosis with socioeconomic status.
abstract: BACKGROUND
  In 2007 the Centers for Disease Control and Prevention (CDC) reported a higher prevalence of autism spectrum disorder (ASD) in New Jersey, one of the wealthiest states in the United States, than in other surveillance regions.
  
  
  OBJECTIVE
  To examine the association of socioeconomic status (SES) with ASD prevalence.
  
  
  METHODS
  Information on eight-year-olds with ASD from four counties was abstracted from school and medical records. US Census 2000 provided population and median household income data.
  
  
  RESULTS
  586 children with ASD were identified: autism prevalence was 10.2/1000, higher in boys than girls (16 vs. 4/1000); higher in white and Asian non-Hispanics than in black non-Hispanics and Hispanics (12.5, 14.0, 9.0, and 8.5/1000, respectively); and higher (17.2/1000 (95% CI 14.0-21.1)) in tracts with median income >US$90,000 than in tracts with median income ≤US$30,000 (7.1 (95% CI 5.7-8.9)). Number of professional evaluations was higher, and age at diagnosis younger, in higher income tracts (p < .001), but both measures spanned a wide overlapping range in all SES levels. In multivariable models race/ethnicity did not predict ASD, but the prevalence ratio was 2.2 (95% CI 1.5-3.1) when comparing highest with lowest income tracts.
  
  
  CONCLUSIONS
  In the US state of New Jersey, ASD prevalence is higher in wealthier census tracts, perhaps due to differential access to pediatric and developmental services.
authors.affiliation: Department of Preventive Medicine and Community Health, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, USA. thomasp1@umdnj.edu
authors.forename: Pauline
authors.initials: P
authors.lastname: Thomas
authors.forename: Walter
authors.initials: W
authors.lastname: Zahorodny
authors.forename: Bo
authors.initials: B
authors.lastname: Peng
authors.forename: Soyeon
authors.initials: S
authors.lastname: Kim
authors.forename: Nisha
authors.initials: N
authors.lastname: Jani
authors.forename: William
authors.initials: W
authors.lastname: Halperin
authors.forename: Michael
authors.initials: M
authors.lastname: Brimacombe
mesh_terms: D000367:Age Factors; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology