Analysis of Disparities in Diagnosis of Autism Spectrum Disorder in the Military Health System Pediatrics Population

There have been disparities reported in prevalence of autism by gender, race, and socioeconomic status with older ages of diagnosis in non-White and in female children. Possible disparities in the ages of autism diagnosis are not well-established within the Military Health System (MHS) pediatric population, where we hypothesized less disparities given universal Tricare coverage for active-duty military families and theoretically equal access to the military treatment facility (MTF). We conducted retrospective cross-sectional analysis using deidentified database repository records from the MHS. We collected and analyzed demographic data on children covered by Tricare and newly diagnosed with autism within an MTF (N = 31,355) or outside of the MTF (5,579 respectively). Within the MTF, we identified younger ages of autism diagnosis in non-White children less than 18 years old (p < 2.2e^-16), without significant differences in ages of diagnosis by race in children less than 6 years of age. There were no statistically significant differences in ages of diagnosis between males and females. Outside the MTF, we identified younger ages of autism diagnosis in males versus females with statistically significant difference in average ages of autism diagnosis between males and females less than the age of 18 years (p = 4.4e-08). This difference was not seen in children less than 6 years of age. Racial data was not available for diagnosis outside the MTF. The age of autism diagnosis in the military pediatric population within the MTF did not reflect historical disparities seen in non-White and in female children.