Many analyses of autism speak as if it were only a childhood ailment and assume that parents are the main stakeholders. But most children with autism grow up to be adults with autism, and they suffer uniquely high levels of social isolation. Almost 40 percent of youth with an autism spectrum disorder never get together with friends, and 50 percent of never receive phone calls from friends. These figures are higher than for peers with intellectual disability, emotional disturbance, or learning disability. When school ends, many adults with autism have grim prospects. Though evidence is sparse, it seems that most do not find full-time jobs. Compared with other people their age, they have higher rates of depression, anxiety, bipolar disorder, and suicide attempts.
Li G, DiGuiseppi CG, Blanchard A, Russell MT, Ing C. Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries. JAMA Netw Open. 2026;9(9):e2633251. doi:10.1001/jamanetworkopen.2026.33251
In this serial cross-sectional study of Medicaid beneficiaries, life expectancy at birth for those with ASD was approximately 65 years, nearly 6 years less than for the Medicaid beneficiary population and 14 years less than for the US general population. The shortened life expectancy for Medicaid beneficiaries with ASD was due to excess mortality from a variety of diseases and health problems. Compared with the general population, autistic women face a greater deficit in life expectancy than autistic men do, due to more psychiatric comorbidities and resulting excess mortality.4,5,8,9
Our study has several notable limitations. Because Medicaid is a means-tested public insurance program for low-income individuals and individuals with disabilities, beneficiaries with ASD are likely to have lower socioeconomic status and more severe symptoms than autistic individuals who are not enrolled in Medicaid, possibly biasing life expectancies reported in our study toward underestimation.10 Moreover, Medicaid beneficiaries with ASD are disproportionately children, young adults, and males compared with the reference populations, a potential concern for residual bias from unmeasured confounding in the SMRs. Despite these limitations, our findings have important implications for developing targeted interventions to reduce preventable excess mortality among people with ASD.
