By Peter A. McCullough, MD, MPH

For some of my adult patients with profound autism, life seemingly can be grim with group home residency, 24 x 7 care and uncertain medical outcomes. One of my fears was confirmed by this recent paper.

Article Review: Li et al., Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries, JAMA Network Open 2026

Journal: JAMA Network Open (published September 10, 2026) Lead author: Guohua Li, DrPH, MD (Columbia Mailman School of Public Health), with Carolyn DiGuiseppi (University of Colorado Anschutz) and colleagues

🧾 What the Paper Actually Did

This is a cross-sectional analysis of administrative claims data—not a clinical study. The authors pulled from:

• Transformed Medicaid Statistical Information System (T-MSIS) and CHIP data

• Linked to the National Death Index for beneficiaries in all 50 states + DC, 2000–2020

Cohort size: 2,048,046 Medicaid beneficiaries coded with ASD; 18,268 deaths recorded. The cohort was 76% male, 49% non-Hispanic White.

Headline findings:

Causes of excess death (sex-standardized mortality ratios):

• Influenza — SMR 10.55 (the standout)

• Malnutrition — SMR 7.56

• Pneumonitis from inhaled solids/liquids — SMR 6.92

• Non-vehicle accidents — SMR 4.48

• Drowning — SMR 3.26

• Pneumonia — SMR 3.06

Sobering point-of-view: life expectancy for this population “is the same as for the general population in Haiti or Angola.”

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IPAK-EDU is grateful to FOCAL POINTS (Courageous Discourse™) as this piece was originally published there and is included in this news feed with mutual agreement. Read More