Friday, February 05, 2010

California's Autism Clusters: Take Two in Hollywood

Hubby handed over the Health and Wellness section of the Wall Street Journal and smack dab on the bottom front page fold, a map of California with wouldn't you know it, another autism cluster in a metropolitan area, this time, Los Angeles (LA Confidential: Seeking Reasons for Autism's Rise).

Maybe right in the backyard of Jenny McCarthy, Playboy Bunny/Public Health Menace, the reigning queen of the vaccines-cause-autism crowd. 

Columbia researchers found children born in the affluent ring around LA,  including Beverly Hills and West Hollywood are 4 times as likely to be diagnosed with autism.  Sounds similar to the study out last month (see my Autism Clustered in Affluent Areas) showing similar clusters in LA and 9 other posh parts around California.  

More autism cases in affluent areas, we got it.   We're not talking cause here.  Affluence doesn't cause autism, so what's up?  Why more moneyed kids turning up with diagnoses?

Let's talk about those wealthier pockets around the state ... 

Sure, those more affluent, better educated parents generally (yes, I know there are exceptions, but we're dealing with regional averages) have better health insurance, know more about autism, live near major treatment centers, near doctors better equipped to recognize autism and at earlier ages, we went over that with the first study.  Those are largely what we'll call "social factors".  Of course there could also be other differences between the affluent and less affluent regions, possibly "environmental" factors but not something that would be common (evenly distributed) in these areas, like a widespread pollutant, for instance, smog. The Marine Layer to some of our friends.  Hey Laura!  Hey Jay! 

Our two teams of researchers disagree when it comes to what it is about the wealthier areas that ups the autism rates. 

The UC Davis researchers attributed the differences to the parent's education.  So when they looked at parents of similar education ("controlled for education"), there were no differences between autism diagnoses for folks in the area and those outside the cluster.   Basically the clusters disappeared.  Imagine we take a map of California and put a pin showing the birthplace of every child diagnosed with autism - but we only do it for kids with parents, let's say, whose highest level of education is a 4-year college degrees.  We do that then notice the varying regions around the state have similar autism rates.  We do it for parents who attained only a high school education, same thing.  Those with graduate degrees.  Ditto.  The more degrees you got, the more likely your kid will be labeled autistic. 

But the second folks at the party, the Columbia researchers, don't think education explains the LA cluster.  Odd that they didn't share those analyses.  According to the WSJ, the lead guy said he couldn't attribute it to parental ages - he ran those analyses. But "he believes the high levels will also remain after the data are adjusted for education levels, socio-economic status and other demographic characteristics in future studies."  This is important stuff, cannot imagine he didn't run those numbers.  We always do.  ALWAYS.  Not a researcher who doesn't snoop around the data just to find trends, check out alternative hypotheses.   Somebody would have checked it out.  And they must have the relevant demographic information in their data set.  So I'm left wondering why they didn't report it.  Didn't think it relevant?  The first study just came out showing the importance of parental education in getting an autism diagnoses.

So what?  What does it all mean to us here? 

Well, the results are striking for a couple reasons.  First, regardless of whether it's parental education, a growing community awareness of autism, the increasing number of doctors skilled in "detecting" early signs of autism, we got something beyond the more traditional environmental factors like chemicals, pollution, vaccines, the typical feared ones, driving rising diagnoses.  Something more social in nature.   But keep in mind we're talking about differences in rates of diagnoses.  We're not saying there's more autism in these areas but more diagnoses.  

Second, maybe even more important, these results tell us something indirectly about the triggers of autism, the causes.  It can't be attributed to pretty widespread factors like vaccines or pollution, things evenly distributed inside and outside the cluster, otherwise the diagnoses would be similar all over the state and not clustered.

Setting: The Coffee Bean & Tea Leaf...two young(ish) moms just catching up...
Jenny: Did you see that news?  Lots of autism in LA.  I  knew it! The traffic...
Me: Yeah, these drivers. In New Jersey at crosswalks pedestrians have the right of...
Jenny: ...the pollution, the bad air...no wonder there's an autism epidemic.   
Me: Those studies pretty much rule out traffic, smog... Damn. Why didn't I shave my legs?
Jenny (sips fair-trade organic stevia-sweetened decaf soy latte):  But not vaccines. 
Me: How're the schools? What's the cirriculum these days? You doing Singapore Math?
Jenny (texting Oprah): You have no proof vaccines don't cause autism.
Me: But the studies suggest vaccines aren't the cause.
Jenny (texting Book editor):  "Suggest?".  Yeah, you have no proof.
Me: Just like we have no proof the Easter Bunny doesn't exist.  Uggs and short shorts... really?
Jenny (checking Amazon ranking): Like I said, no proof of anything.

As usual, you'll have to pay around $30 to read the actual articles:
DOI (Columbia Study): 10.1016/j.healthplace.2010.01.009
DOI (UC Davis Study): 10.1002/aur.110

1 comment:

susan said...

I really hope we can find the real causes of autism. Thanks.