Autism study finds life expectancy nearly 14 years shorter than US average

Clinical takeaway: Ensure autistic patients receive age-appropriate vaccination and consistent primary care. Assess nutrition and swallowing or aspiration risk when indicated, address psychiatric comorbidities, and tailor injury-prevention counseling—including water safety—to the patient’s abilities and support needs.

Autism research and care have historically emphasized diagnosis and developmental support, leaving less evidence about long-term health. New nationwide data identify a substantial mortality disparity and several potentially preventable targets for care.

Researchers analyzed linked Medicaid and National Death Index data for more than two million beneficiaries with autism spectrum disorder across all US states and Washington, DC, from 2000 through 2020. Among them, 18,268 died.

Estimated life expectancy at birth was 64.9 years—5.6 years shorter than for all Medicaid beneficiaries and 13.8 years shorter than for the US general population. Age- and sex-standardized mortality was 44% higher than in the broader Medicaid population.

Cause-specific mortality was especially high for influenza, at more than ten times the expected rate; malnutrition, nearly eight times; pneumonitis caused by solids or liquids entering the lungs, nearly seven times; nontransport accidents, more than four times; and drowning and pneumonia, about three times each.

Life expectancy rose 1.7 years from 2000–2004 to 2015–2019, but fell 4.1 years in 2020—the largest decline among the three populations compared. Women had a greater deficit than men relative to both comparison groups, which the authors attributed to greater psychiatric comorbidity and associated mortality.

Because Medicaid disproportionately covers lower-income people and those with disabilities, this population may have had greater support needs than autistic people overall. The life expectancy estimate therefore may not apply to the entire autistic population.

“The good news is that much of the excess mortality among people with ASD is avoidable through improved social support, primary care, and home- and community-based services,” said study author Guohua Li, DrPH, MD, professor of epidemiology at Columbia University Mailman School of Public Health.

Source: Li G, et al. (2026 Sep 10) JAMA Netw Open. Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries