Household income among families with autistic children and youths in Canada: a cross-sectional matched cohort study

OBJECTIVE: Within the Canadian context, we sought to examine the relationship between households with autistic children/youths and household income. DESIGN: We used data from the 2019 Canadian Health Survey on Children and Youth (CHSCY) to analyse households with a child/youth aged 1-17. Propensity-score matching was used to pair records for children/youths with a reported autism diagnosis to those without. We used linear regression for continuous outcomes (eg, total household income) and Poisson regression for binary outcomes (eg, low household income). All analyses were adjusted for the correlation between matched pairs. PRIMARY OUTCOME MEASURE: Total annual income of all household members. SECONDARY OUTCOME MEASURES: Low household income; single-parent or single-income status; and whether at least one parent was not working or absent from work during the past week. RESULTS: Among a total of 39 951 CHSCY records, we identified a cohort of 815 autistic children/youths. The characteristics of the matched cohort were well-balanced. Households with an autistic child/youth had a mean annual household income that was lower (mean difference: $C16 489; 95% CI $C6384 to $C27 149) compared with matched households without an autistic child/youth. Households with an autistic child/youth were also 26% more likely to be classified as having a low household income (Relative risk (RR) 1.26; 95% CI 1.17 to 1.35) and 20% more likely to rely on a single income (RR 1.20; 95% CI 1.10 to 1.33) compared with households without an autistic child/youth. CONCLUSIONS: Compared with households without an autistic child/youth, those with an autistic child/youth often face more economic challenges, including lower household income and greater risk of food insecurity. Households with an autistic child/youth are more likely to rely on a single income.