As Study Links Autism To Higher Flu Deaths, Experts React

A study from the University of Minnesota, recently published in JAMA Network Open, found that autistic beneficiaries of free or low-cost health insurance program Medicaid died at 10.5 times the rate expected in comparison groups.

Compared to Medicaid beneficiaries without the condition, autistic recipients’ life expectancy was 5.8 years lower. Flu was the leading cause of this discrepancy.

These findings, however, involved people in a healthcare system very unlike the UK’s. So, we asked Professor Laura Crane, Chair in Autism Studies at the University of Birmingham and Director of the Autism Centre for Education and Research (ACER), as well as Dr Asiya Maula, a GP at The Health Suite, for their thoughts on whether this has any lessons for the UK.

Dr Maula said that though this study’s results are “deeply concerning,” she stressed that this doesn’t mean having autism automatically makes flu 10 times as likely to kill people.

And disability isn’t the only factor to consider in the US study, which focused on “autistic Medicaid beneficiaries in the United States, a group that may also experience disability, financial disadvantage, coexisting health conditions and barriers to healthcare”.

Still, both she and Prof Crane told HuffPost UK that people with autism really do face additional obstacles “at almost every stage of obtaining medical help”.

That can include issues with phoning a GP, crowded waiting rooms, and unfamiliar doctors, for which acommadations are too rarely made. As a result, healthcare inequalities persist for this group.

And, Prof Crane said, “We also know that autistic people may experience and communicate pain or illness differently from non-autistic people.

“Symptoms can therefore be reported in ways that appear atypical, which can sometimes result in concerns being overlooked or misunderstood by healthcare professionals.

“More broadly, there is evidence that autistic people can experience inequalities across the healthcare pathway, from accessing services through to receiving timely and appropriate treatment.”

The professor pointed to a study of over 500 autistic adults, which showed that 72% of participants found it hard to work out whether their symptoms warranted a GP visit or not.

Per Dr Maula, there’s a risk of something called “diagnostic overshadowing,” in which healthcare providers chalk symptoms up to autism when they’re not related, too; she also said those with autism might appear “calmer” than expected, despite serious health issues, during examination.

“Autism should never be allowed to distract from a proper medical assessment,” the GP said.

Meanwhile, Prof Crane stated: “While I would be cautious about drawing direct conclusions for the UK from a study of US Medicaid beneficiaries (given the difference in our healthcare systems), I do think the findings reinforce broader concerns about the significant health inequalities experienced by autistic people and the importance of making healthcare more accessible, responsive and preventative”.

Dr Maula said that while the basic symptoms of “regular” flu – a relatively sudden onset of “fever or chills, a cough, sore throat, headache, aching muscles and profound tiredness” – remain the same, carers and loved ones should also be on the lookout for altered behaviours.

“Becoming unusually withdrawn or distressed, sleeping far more than usual, communicating less, refusing food or drink, passing less urine or losing the ability to manage familiar tasks may indicate that somebody is seriously unwell,” she explained.

“The crucial question is not simply, ‘Do they look like a typical flu patient?’ It is, ‘Are they significantly different from their usual baseline?’ Families and carers often hold essential information about that baseline and should be listened to.”

The following symptoms require “urgent medical attention” during a flu, she added:

• Difficulty breathing,
• blue or grey lips,
• chest pain,
• confusion,
• being difficult to wake,
• a seizure,
• severe dehydration, or
• symptoms that improve and then suddenly worsen.

“People should call 999 for severe breathing difficulties or another life-threatening emergency.”

Dr Maula said autism itself doesn’t qualify you for a free flu vaccine; eligibility depends on age and risk. (You can see whether you may be entitled to the vaccine through the NHS’ site; some pharmacies offer jabs privately for those aged 18 and over).

“In England’s 2026 to 2027 programme, eligible children are being offered vaccination from September,” she added.

“Adults under 65 in clinical risk groups, including people with a learning disability, are eligible from October. Autism alone is not listed as a clinical risk group, but many autistic people will qualify because of their age, a learning disability or another health condition.”

Professor Crane said “there has been a strong push to introduce annual health checks for autistic people in the UK,” which could help to “identify emerging health concerns proactively, ensure health needs are monitored regularly, and pick up vulnerabilities early before they become more serious problems”.

Research from Newcastle University has found that programs like these are “acceptable and feasible to deliver, and can help identify and address autistic people’s health and care needs,” she ended.

“This work shows the value of proactive, autism-informed healthcare, rather than relying solely on individuals seeking help once problems have become acute.”