The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021

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Santomauro, D., Erskine, H. E., Mantilla Herrera, A. M., Miller, P. A., Shadid, J., Hagins, H., Addo, I. Y., Adnani, Q. E. S., Ahinkorah, B. O., Ahmed, A., Alhalaiqa, F. N., Ali, M. U., Al-Marwani, S., Almazan, J. U., Almustanyir, S., Alvi, F. J., Amer, Y. S. A. D., Ameyaw, E. K., Amiri, S.,..., & Ferrari, A. (2024). The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. The Lancet Psychiatry, 12(2), 111-121. https://doi.org/10.1016/s2215-0366(24)00363-8

Publication date: 19 Dec 2024 Added to AutiHub: 29 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
183
Publication authors identified as autistic
1 / 183 (0.5%)
  1. Damian Santomauro *
  2. Holly E. Erskine
  3. Ana M Mantilla Herrera
  4. Paul Anthony Miller
  5. Jamileh Shadid
  6. Hailey Hagins
  7. Isaac Yeboah Addo
  8. Qorinah Estiningtyas Sakilah Adnani
  9. Bright Opoku Ahinkorah
  10. Ayman Ahmed
  11. Fadwa Naji Alhalaiqa
  12. Mohammed Usman Ali
  13. Sabah Al-Marwani
  14. Joseph Uy Almazan
  15. Sami Almustanyir
  16. Farrukh Jawad Alvi
  17. Yasser Sami Abdel Dayem Amer
  18. Edward Kwabena Ameyaw
  19. Sohrab Amiri
  20. Catalina Liliana Andrei
  21. Dhanalakshmi Angappan
  22. Catherine M Antony
  23. Aleksandr Y Aravkin
  24. Tahira Ashraf
  25. Jose L Ayuso-Mateos
  26. Amadou Barrow
  27. Kavita Batra
  28. Maryam Bemanalizadeh
  29. Akshaya Srikanth Bhagavathula
  30. Sonu Bhaskar
  31. Jasvinder Singh Singh Bhatti
  32. Srinivasa Rao Bolla
  33. Gabrielle Britton
  34. Joao Mauricio Castaldelli-Maia
  35. Ferrán Catalá-López
  36. Arthur Caye
  37. Vijay Kumar Chattu
  38. Yuen Yu Chong
  39. Liliana G Ciobanu
  40. Samuele Cortese
  41. Natalia Cruz-Martins
  42. Berihun Assefa Dachew
  43. Xiaochen Dai
  44. Amira Hamed Darwish
  45. Mohsen Dashti
  46. Alejandro de la Torre-Luque
  47. Daniel Diaz
  48. Delaney D Ding
  49. Angel Belle Cheng Dy
  50. Arkadiusz Marian Dziedzic
  51. Sepideh Ebrahimi Meimand
  52. Omar Abdelsadek Abdou El Meligy
  53. Iman El Sayed
  54. Frank J Elgar
  55. Adeniyi Francis Fagbamigbe
  56. Pawan Sirwan Faris
  57. Andre Faro
  58. Nuno Ferreira
  59. Irina Filip
  60. Florian Fischer
  61. Aravind P Gandhi
  1. Balasankar Ganesan
  2. Miglas Welay Gebregergis
  3. Mesfin Gebrehiwot
  4. Bardiya Ghaderi Yazdi
  5. Mohammad-Reza Ghasemi
  6. Afsaneh Ghasemzadeh
  7. Sasidhar Gunturu
  8. Veer Bala Gupta
  9. Vivek Kumar Gupta
  10. Sobia Ahsan Halim
  11. Brian J Hall
  12. Fulei Han
  13. Josep Maria Haro
  14. Ahmed I Hasaballah
  15. Simon I Hay
  16. Darren Hedley
  17. Bartosz Helfer
  18. Md Mahbub Hossain
  19. Bing-Fang Hwang
  20. Umar Idris Ibrahim
  21. Mehran Ilaghi
  22. Md Rabiul Islam
  23. Sheikh Mohammed Shariful Islam
  24. Mahalaxmi Iyer
  25. Khushleen Jaggi
  26. Haitham Jahrami
  27. Elham Jamshidi
  28. Ali Khaleghi
  29. Abdul Aziz Khan
  30. Mohammad Jobair Khan
  31. Feriha Fatima Khidri
  32. Kwanghyun Kim
  33. Hyun Yong Koh
  34. Manasi Kumar
  35. Iván Landires
  36. Long Khanh Dao Le
  37. Seung Won Lee
  38. Zhihui Li
  39. Stephen S Lim
  40. Jose Martinez-Raga
  41. Roy Rillera Marzo
  42. Indu Liz Matthew
  43. Andrea Maugeri
  44. Tomislav Mestrovic
  45. Philip B Mitchell
  46. Salahuddin Mohammed
  47. Ali H Mokdad
  48. Lorenzo Monasta
  49. Fateme Montazeri
  50. Matías Mrejen
  51. Faraz Mughal
  52. Christopher J L Murray
  53. Woojae Myung
  54. Javaid Nauman
  55. Charles Richard James Newton
  56. Huong Lan Thi Nguyen
  57. Chisom Adaobi Nri-Ezedi
  58. Vincent Ebuka Nwatah
  59. Adeolu Olufunso Oladunjoye
  60. Isaac Iyinoluwa Olufadewa
  61. Michal Ordak
  1. Nikita Otstavnov
  2. Raul Felipe Palma-Alvarez
  3. Romil R Parikh
  4. Seoyeon Park
  5. Maja Pasovic
  6. Jay Patel
  7. Marcos Pereira
  8. Maria Odete Pereira
  9. Michael R Phillips
  10. Guilherme V Polanczyk
  11. Mohammad Pourfridoni
  12. Jagadeesh Puvvula
  13. Amir Radfar
  14. Fakher Rahim
  15. Mosiur Rahman
  16. Muhammad Aziz Rahman
  17. Amir Masoud Rahmani
  18. Masoud Rahmati
  19. Zubair Ahmed Ratan
  20. Taeho Gregory Rhee
  21. Luca Ronfani
  22. Priyanka Roy
  23. Basema Ahmad Saddik
  24. Amene Saghazadeh
  25. Joseph W Sakshaug
  26. Sana Salehi
  27. Vijaya Paul Samuel
  28. Senthilkumar Sankararaman
  29. Aswini Saravanan
  30. Maheswar Satpathy
  31. Austin E Schumacher
  32. David C Schwebel
  33. Mario Šekerija
  34. Arman Shafiee
  35. Saeed Shahabi
  36. Muhammad Aaqib Shamim
  37. João Pedro Silva
  38. Yonatan Solomon
  39. Lourdes Bernadette C Sumpaico-Tanchanco
  40. Chandan Kumar Swain
  41. Rafael Tabarés-Seisdedos
  42. Mohamad-Hani Temsah
  43. Samuel Joseph Tromans
  44. Lilian Tzivian
  45. Ravi Prasad Varma
  46. Andres Fernando Vinueza Veloz
  47. Maria Fernanda Vinueza Veloz
  48. Mandaras Tariku Walde
  49. Muhammad Waqas
  50. Nuwan Darshana Wickramasinghe
  51. Renjulal Yesodharan
  52. Dong Keon Yon
  53. Yoosik Youm
  54. Burhan Abdullah Zaman
  55. Youjie Zeng
  56. Magdalena Zielińska
  57. Harvey A. Whiteford
  58. Traolach Brugha
  59. James G Scott
  60. Theo Vos
  61. Alize Ferrari

Abstract

BACKGROUND: High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods. METHODS: For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article. FINDINGS: An estimated 61·8 million (95% uncertainty interval 52·1-72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8-927·2) per 100 000 people, equivalent to 1064·7 (898·5-1245·7) autistic males per 100 000 males and 508·1 (424·6-604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8-16·3) DALYs, equivalent to 147·6 (100·2-208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0-178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7-284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0-237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6-229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9-194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years. INTERPRETATION: The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals. FUNDING: Queensland Health and the Bill & Melinda Gates Foundation.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:40.

Cited references
41
With a DOI
38
Without a DOI, from raw bibliography text
3
5 / 41 (12.2%) cited references include at least one author identified as autistic.
References with data to complete
4 / 41 (9.8%)
References with detected author names
37 / 41 (90.2%)
Without detected author names
4
Without a structured title
0
Without a stable identifier
3
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
3927
From DOI or external metadata
3927
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
360 / 3927 (9.2%) names are linked to an author already present in AutiHub. 3567 / 3927 (90.8%) names are not yet linked.
Names linked to a person identified as autistic
6 / 3927 (0.2%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 6 / 360 (1.7%). Distinct people identified as autistic: 3 / 3063 (0.1%).
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