神经发育障碍的社会决定因素:与美国儿童中ADHD和ASD的关联
Chinedu Izuchi1, Chika N Onwuameze2, Godwin Akuta3
1Avera Hospitals, 132 N Dakota Ave, Sioux Falls, SD 57104, USA.
Children (Basel, Switzerland)
|January 28, 2026
概括
社会和环境因素显著影响儿童的注意力缺陷/多动症 (ADHD) 和自闭症谱系障碍 (ASD) 诊断. 处境不利的儿童面临这些神经发育疾病及其并发症的更高风险.
科学领域:
- 儿童神经发育障碍 儿童神经发育障碍
- 社会流行病学社会流行病学
- 儿童健康差异 儿童健康差异
背景情况:
- 注意缺陷/多动障碍 (ADHD) 和自闭症谱系障碍 (ASD) 是儿童神经发育的常见疾病.
- 社会和环境因素,与生物因素一起,塑造发育轨迹和诊断途径.
- 关于影响ADHD,ASD及其并发症的多种社会决定因素,最近的国家数据有限.
研究的目的:
- 检查社会决定因素与ADHD,ASD和美国儿童ADHD/ASD并发症的患病率之间的关联.
- 识别与社会经济地位,社区状况以及种族/种族相关的诊断差异.
主要方法:
- 来自美国国家儿童健康调查 (2018-2023) 的综合横截面数据分析,涉及205,480名儿童 (3-17岁).
- 父母报告,临床医生诊断的ADHD和ASD作为主要结局;并发症被检查为次要结果.
- 社会决定因素包括家庭收入,父母教育,粮食不安全,社区安全和保险类型. 调查加权后勤回归调整为共变量.
主要成果:
- 权衡的患病率:ADHD 9.7%,ASD 2.9%,并发性ADHD/ASD 1.1%. 这两种疾病的患病率均为1.1.
- 低收入,粮食不安全,不安全的社区和父母教育水平较低与ADHD和ASD的几率增加有关.
- 男孩对这两种情况的几率都更高. 非西班牙裔黑人和西班牙裔儿童的自闭症几率低于非西班牙裔白人儿童,这表明识别偏见. 在社会弱势群体中,共患病率更高.
结论:
- 美国儿童的ADHD和ASD患病率模式受到社会因素的影响.
- 调查结果强调了这些神经发育状况的识别和诊断的重大社会差异.
- 将社会风险评估纳入发育查可以促进更公平的识别和干预策略.
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