A public health approach to reducing health inequalities among adults with autism

People with autism make up around 1% of adults living in the community across the UK. 1 Autism is a neurodevelopmental disorder which manifests from early childhood, with persistent deficits in social communication and social interaction across multiple contexts, along with restricted, repetitive patterns of behaviour, interests, or activities.The current guidance enables diagnosis of autism from level one to three based on the level of support needed to overcome the challenges posed by restrictive behaviours and social communication deficits.2 The health needs of adults with autism is of public health interest because this vulnerable population are socially disadvantaged and often 'hidden' from existing health and social care services.1 Autism is more prevalent in males, those without educational qualifications, and those living in social housing. 1 People with autism with or without an intellectual disability (ID) are at higher risk of multimorbidity in the physical and mental health domains.3 Around 30% of adults with autism have comorbid ID, physical, and mental health conditions.4 Additionally, a recent study using Scotland's 2011 census data, found that adults with autism (n = 6649) can also experience sensory impairments, such as deafness/hearing loss (14.1%, n = 939) and blindness/sight loss (12.1%, n = 807), which can cause additional communication problems.4 While those with comorbid ID are more susceptible to physical health issues, 5 those without ID are at higher risk of mental health problems, including higher than normal suicide rates.6 Adults with autism without ID die 12 years earlier, with suicide being the greatest cause of premature mortality.7 Therefore, this vulnerable population have significantly higher premature mortality rates when compared to the general population.Addressing the complex and disparate health needs of adults with autism requires innovative population based strategies to inform, enable, and empower the target group and its stakeholders.