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interchangeably. The following subsections examine disparities in health and healthcare services experienced by children with autism and present a public health approach to reducing health and health service inequalities among persons with autism and other developmental disabilities. HEALTH DISPARITIES EXPERIENCED BY CHILDREN WITH AUTISM Health status and life expectancy vary between children with autism and typically developing children, as well as among children with autism. Literature reveals that persons with ASD experience increased morbidity and early mortality compared to normally developing individuals.9-11 In addition, literature has clearly documented huge disparities experienced in terms of accessing early diagnosis and support services by persons with autism who are disadvantaged due to their culture, gender, race, and ethnicity among others. This results in even higher disparities in health status and decreased life expectancy experienced by disadvantaged individuals with autism. Furthermore, disadvantaged persons with autism reported poorer access to healthcare services and increased risk for negative health outcomes compared to typically developing children and children with autism who are not disadvantaged. However, persons with autism who are not disadvantaged have a life expectancy that is averagely 28-years lesser than the normally developing individuals.12 Children with autism having comorbid intellectual disabilities (ID) are more prone to physical health problems while those without ID are highly susceptible to mental health disorders as well as unusual suicide rates.13 Among persons with autism without ID suicide is the greatest cause of premature mortality (they die 12-years earlier). Thus, it can be seen that premature mortality rates are considerably higher among this special group compared to the so-called normal individuals. Thus, there is absolute need to put in place strategies to promote health and prevent diseases for children with autism. According to the Fundamental Causes Model of contextual health disparities, health disparities provides an insight of the extent to which individuals can potentially avoid risk.3 In other words, understanding the concept of health disparities directs the putting in place targeted interventions to decrease disparities and improve health outcomes. Pediatr Neonatal Nurs Open J. 2022; 8(1): 1-13. doi: 10.17140/PNNOJ-8-134 Review | Volume 8 | Number 1| Eta VEA 3 In addition to the disparities mentioned it is stated that higher rates of adverse physical health outcomes occur among adults with autism while gastrointestinal disorders, sleep and feeding problems, as well as epilepsy are common in children with ASD.14 Also, evidence for high rates of cardiovascular problems and mental health conditions including early signs of Parkinsonism have been found in adults with autism. Again, it has been reported that adults with autism are usually affected by visual and hearing impairments, which negatively affect their existing impairments in social interaction and communication. Finally, there exist disparities in etiology between ASD and other related developmental disorders. Autism is said to be associated either with chromosomal abnormalities, Fragile X, single gene mutations, genetic syndromes, Tuberous Sclerosis and de novo copy mutations among others.3 Also, biological factors such as increased oxidative stress, shortened telomere length, perturbed proteostasis and the malfunctioning of hypothalamic-pituitary-adrenal axis among others may increase the likelihood of developing autism. It is important to mention that little or nothing is known regarding health disparities in ASD among the middle age and older adults. This needs to be taken in to consideration in order to establish accurate health outcomes especially for persons who are moving towards their end of life. This will ensure that children with DDs grow healthily through adulthood. DISPARITIES IN HEALTHCARE SERVICE UTILIZATION Literature reveals that there exist disparities in healthcare service utilization in relation to cost for persons with disabilities. Up to 15% of individuals with disabilities are unable to access medical care due to cost compared to six percent of
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