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Urban–Rural Disparity in the Incidence of Diagnosed Autism Spectrum Disorder in Taiwan: A 10-Year National Birth Cohort Follow-up Study

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Abstract

Autism spectrum disorder (ASD) is reportedly more prevalent in urban areas partly because of better accessibility and affordability to healthcare. With universal health insurance coverage in Taiwan, a previous study has shown no urban–rural disparity in the utilization rate of a child’s preventive healthcare. Under this circumstance, we followed a birth cohort of 176,273 live births from 2006 to 2015 to detect the differences in ASD incidence between urbanicities. After adjusting for socioeconomic factors, children were 1.28 (95% confidence interval (CI): 1.13–1.44) and 1.54 (95% CI: 1.36–1.75) more likely to acquire ASD in satellite and urban areas compared with those in rural areas, respectively. A gradient association between parental educational attainment and ASD incidence was also noted. Greater ASD incidences in more urbanized areas and more advanced educated parents’ children were detected under a circumstance with low barriers to healthcare.

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Authors and Affiliations

  1. Department of Public Health, National Cheng Kung University, No. 138, Shengli Rd., North Dist., Tainan, 704302, Taiwan

    Yuu-Hueih Hsu & Chung-Yi Li

  2. College of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, 112, Taiwan

    Chi-Wen Chen

  3. Department of Pediatrics, National Cheng Kung University Hospital, No. 138, Shengli Rd., North Dist., Tainan, 704302, Taiwan

    Yuh-Jyh Lin

  4. Department of Public Health, College of Public Health, China Medical University, No. 91, Hsueh-Shih Rd., Taichung, 40402, Taiwan

    Chung-Yi Li

  5. Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan

    Chung-Yi Li

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  1. Yuu-Hueih Hsu
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YHH, CWC, YJL, and CYL designed the study, contributed to the interpretation of results, and drafted the initial manuscript. YHH and CYL performed the statistical analyses. CWC, YJL and CYL revised the manuscript.

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Correspondence to Chung-Yi Li.

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Hsu, YH., Chen, CW., Lin, YJ. et al. Urban–Rural Disparity in the Incidence of Diagnosed Autism Spectrum Disorder in Taiwan: A 10-Year National Birth Cohort Follow-up Study. J Autism Dev Disord 53, 2127–2137 (2023). https://doi.org/10.1007/s10803-022-05453-x

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