As rates of autism diagnosis increased dramatically over the past number of decades, prevalence rates were generally highest among Whites and among those of higher socioeconomic status (SES). Using a unique, population-level dataset, we find that rates of autism diagnosis continued to be on the rise in recent years, but who is diagnosed changed during the study period. Our data consist of birth records of all 13,272,573 children born in the state of California in 1992 through 2016 linked to autism caseload records for January 1992 through November 2019 from California’s Department of Developmental Services. California’s diagnosed autism incidence rate rose from 0.49 per 1,000 3–6 y olds in 1998 to 3.49 per 1,000 3–6 y olds in 2018, a 612% increase. However, diagnosed incidence rates did not rise uniformly across sociodemographic groups. By 2018, children of Black and Asian mothers were diagnosed at higher rates than children of non-Hispanic White mothers. Furthermore, among children of non-Hispanic White and Asian mothers, children of lower SES were diagnosed at higher rates than children of higher SES. These changes align with sociological theories of health disparities and contain important clues for more fully understanding the autism epidemic.

在过去的几十年里，随着自闭症诊断率急剧上升，白人和社会经济地位较高的人的患病率普遍最高。使用独特的人口水平数据集，我们发现自闭症诊断率近年来持续上升，但在研究期间被诊断的人发生了变化。我们的数据包括 1992 年至 2016 年在加利福尼亚州出生的所有 13,272,573 名儿童的出生记录，这些记录与加利福尼亚州发展服务部 1992 年 1 月至 2019 年 11 月的自闭症病例记录相关。加州确诊的自闭症发病率从 1998 年的每 1000 名 3-6 岁儿童 0.49 例上升到 2018 年的每 1000 名 3-6 岁儿童 3.49 例，增长了 612%。然而，不同社会人口群体的诊断发病率并未均匀上升。到 2018 年，黑人和亚裔母亲的孩子的诊断率高于非西班牙裔白人母亲的孩子。此外，在非西班牙裔白人和亚裔母亲的孩子中，社会经济地位较低的孩子的诊断率高于社会经济地位较高的孩子。这些变化与健康差异的社会学理论相一致，并为更全面地了解自闭症流行病提供了重要线索。