The life expectancy for individuals on the Autism Spectrum is significantly reduced compared to the general population, underscoring a complex public health challenge. Research suggests the average lifespan for autistic individuals may be shortened by 16 to 20 years, with some studies placing the average age of death as low as 54 years, and even lower for those with co-occurring intellectual disability. This disparity does not arise from autism itself but stems from an increased burden of medical and psychiatric conditions, compounded by severe systemic obstacles to appropriate care. Addressing this premature mortality requires understanding the biological vulnerabilities, mental health crises, and societal barriers that collectively drive this outcome.
Increased Prevalence of Co-Occurring Physical Health Conditions
A high rate of physical health comorbidities contributes substantially to the reduced lifespan seen in the autistic population. Neurological conditions, particularly epilepsy, represent a major direct cause of premature death. Epilepsy prevalence in autistic individuals is remarkably high, affecting 10% to 12% of the population overall—nearly ten times the general population rate. The co-occurrence of epilepsy elevates the risk of mortality by over 800% compared to those with autism alone, often due to sudden unexpected death in epilepsy (SUDEP).
Cardiovascular and metabolic diseases also present a disproportionate risk, often exacerbated by lifestyle factors and medication side effects. Autistic individuals have a 57% higher risk of developing diabetes, and the risk for Type 2 diabetes is specifically increased by 146%. They also face a 69% higher risk of dyslipidemia and a 46% higher risk of atherosclerotic heart disease compared to the neurotypical population. Atypical eating patterns, sedentary behavior, and weight gain from psychotropic medications contribute to this heightened cardiometabolic risk.
Gastrointestinal issues are common comorbidities that can lead to chronic health complications. These disorders, alongside chronic pain, may result in poor nutritional status or systemic inflammation. These persistent physical health problems represent a constant strain on the individual’s well-being. The number of co-occurring physical health conditions creates a complex medical profile demanding specialized and coordinated care.
Elevated Mental Health Risks and Suicide Mortality
Psychiatric mortality, particularly suicide, is a significant driver of reduced life expectancy in the autistic community. Autistic individuals are up to seven times more likely to die by suicide than the general population, with the risk highest in those without a co-occurring intellectual disability. This increased risk is linked to high rates of co-occurring conditions like depression and anxiety disorders. Social isolation, chronic stress from camouflaging autistic traits, and emotional distress also contribute to heightened burnout and self-harm.
Autistic women face an especially high risk, being up to 13 times more likely to die by suicide compared to non-autistic women. Up to 66% of autistic adults report having considered suicide, underscoring a widespread mental health crisis. This crisis is exacerbated by systemic failures in mental health care where the unique presentation of distress in autistic people is often misunderstood.
A phenomenon known as diagnostic overshadowing occurs in psychiatric settings when autistic traits are mistakenly attributed as the sole cause of emotional distress or are perceived as masking a concurrent illness. This misinterpretation can lead to inadequate or delayed treatment for severe depression, anxiety, or post-traumatic stress disorder. The lack of appropriate, autism-informed mental health support significantly compounds the risk of self-harm and suicide mortality.
Systemic Barriers to Effective Healthcare Access
The biological and psychiatric vulnerabilities of the autistic population are worsened by widespread systemic barriers within the healthcare system. Many providers lack specific training on the unique ways autism presents in adults, leading to incorrect assumptions and poor quality of care. This deficit often results in physical symptoms being incorrectly dismissed as behavioral issues related to autism rather than genuine medical problems. For example, chronic pain may be overlooked because the individual struggles to communicate the nature of their discomfort.
Communication challenges represent a major hurdle, as many autistic patients find it difficult to articulate symptoms in a typical clinical interview setting. Over half of autistic adults report difficulty communicating with a doctor. Furthermore, the sensory environment of clinics—with bright lights, loud noises, and strong smells—can be overwhelming, causing anxiety that limits engagement with care. Simple tasks like booking appointments by telephone can be prohibitive, delaying necessary interventions.
The structure of healthcare itself poses a barrier, as short appointment times do not allow flexibility for autistic patients to process information or communicate complex needs. Socioeconomic factors also play a role, as individuals with autism have a higher rate of healthcare utilization and significantly higher annual healthcare costs. These difficulties create a cycle of delayed diagnosis, undertreatment, and poorer outcomes for existing conditions.
Increased Risk of Accidental and Preventable Death
External safety factors and environmental vulnerabilities contribute to a high rate of accidental and preventable deaths. Individuals with autism are three times more likely to die from injury than the general population. The risk of drowning is particularly concerning, as it is the leading cause of death for children with autism.
Wandering, or elopement, is a common behavior, with nearly half of children with autism attempting to leave a safe environment. This tendency to elope, often driven by a goal or attraction to water, leads to catastrophic outcomes. Accidental drowning accounts for up to 71% of all deaths following elopement incidents.
Children with autism are 160 times more likely to die from drowning than their neurotypical peers. Difficulties with risk assessment, sensory processing differences, and poor motor coordination can also increase vulnerability to other accidents, including traffic injuries. These preventable deaths highlight the need for comprehensive safety planning, community awareness, and specialized support to mitigate environmental hazards.