Prioritizing Social Determinants of Health in Public Health Surveillance for Autism

In this issue of Pediatrics, Shenouda et al¹  present new prevalence estimates of autistic children with intellectual disability, based on active surveillance in the New York– New Jersey Metropolitan Area between 2000 and 2016. Findings from this study revealed that 1 in 3 autistic children had a cooccurring intellectual disability, with disparate estimates identified for Black and Hispanic children. This study is particularly timely because the Centers for Disease Control and Prevention Autism and Developmental Disabilities Monitoring (ADDM) Network recently determined the updated autism prevalence to be 1 in 44.²  To be sure, population-level surveillance efforts are critical for tracking and improving health equity for distinct demographic groups. The findings presented by Shenouda et al, as well as the vast majority of autism prevalence research, are, however, inherently limited by a lack of capacity to extrapolate findings beyond racial and ethnic group comparisons and link them to...