There are significant racial inequalities in access to services for adolescents with Autism Spectrum Disorder (ASD). ASD is diagnosed later in children of different races than their white counterparts, they report difficulty accessing treatment services, and ultimately experience poorer health outcomes
We spoke to Doris Lebischak, MD, a child and youth psychiatrist with over 37 years of experience, about this important and vital topic.
Why are there racial differences in diagnosing Autism Spectrum Disorder, or ASD?
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Dr. Lebischak: Structural racism in its various forms affects access to health care. It’s in the health industry too. Structural racism, for example, affects income and education. Income and education are directly related to access to and proper use of health care as it acts as a cascading effect and a widespread disease.
What do providers and families have to consider so that they do not reinforce or perpetuate systemic racism when diagnosing ASD?
Dr. Lebischak: Providers and families must jointly acknowledge that it is present. It has lived in all cultures and has never been eradicated in history. It is a disease in our country that must be treated by all of us.
For example, inequality delays the identification of people diagnosed with autism. Providers need to be aware of the inequality and be more vigilant. Families need to know that they may be at increased risk and take steps to take care of their health. I recommend meeting deadlines, following recommendations, and working with vendors or finding someone to work with to find the right path. It’s important to ask questions or seek information when you feel misunderstood.
As a society we have to learn and practice to recognize racism in ourselves and in our environment. We must take responsibility and do our part to eradicate racism, especially when it comes to diagnosing autism in children or adolescents, regardless of origin or background. Remember, craving for change and following up when it occurs can help reinforce the behavior. We all must be ready to make an effort to fight and eradicate the cultural disease of racism.
How can the system work together to close these gaps and de-stigmatize disparities in ASD?
Dr. Lebischak: Structural racism increases the burden on the individual considerably. It can make up 30% of the total stress.2 In a family with a child diagnosed with ASD, the differences and levels of stress can have a huge impact on the parents and possibly the larger family. There is a high risk of behavioral and chronic illness.
Health care providers need to assess and monitor family members who are at this increased risk. Families need to continue their education and seek care when their functioning is impaired.
The healthcare sector is acclimatizing to AI (artificial intelligence). The work we put into monitoring the differences of all races, religions and classes in our industry will multiply as we near this explosion. I see AI as “the hope” to monitor and eradicate racism in healthcare. While technology improves our ability to fight racism in some sectors, we need to address this inequality in other sectors that affect our health, such as income, education, the environment, emotional, social, physical and spiritual factors.
reference
- Broder-Fingert S, Mateo CM, Zuckerman KE. Structural Racism and Autism. Pediatrics. Published online August 24, 2020. doi: 10.1542 / peds.2020-015420
- Churchwell K., Elkind MSV, Benjamin RM, et al. Call to Action: Structural Racism as a Fundamental Driver of Health Disparities: A Recommendation from the President of the American Heart Association. Traffic. Published online November 10, 2020. doi: 10.1161 / CIR.0000000000000936
This article originally appeared on Psychiatry Advisor
