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Recent Publications
View All PublicationsA Narrative Review of Cardiovascular Health in Autistic Individuals: Epidemiologic Evidence, Mechanistic Pathways, and Future Directions
Hotez E., Song L., Yang Y.
Current Epidemiology Reports
Autistic individuals are more likely than others to experience poor heart and cardiovascular health. This review brings together current research to better understand why these differences exist and what can be done to address them. Studies show that autistic people are more likely to have risk factors for heart disease, such as higher rates of obesity, stress, and certain co-occurring health conditions. These risks do not come from a single cause. Instead, they reflect a combination of factors, including health behaviors (such as diet and physical activity), biological processes (like stress hormones and inflammation), mental health, access to healthcare, and broader social and environmental influences. Family context and individual differences also play an important role. At the same time, existing research has important gaps. Many studies do not take a full, life-span view of health or fail to capture the complex ways that physical and mental health interact over time. This review highlights the need for more comprehensive and inclusive research approaches. Future studies should examine cardiovascular health across development, consider multiple levels of influence (from biology to environment), and focus on meaningful health outcomes rather than autism traits alone.
Aligning Biomedical Research With Neurodiversity to Support the Metabolic Health of Autistic Individuals
Hotez E., Tomiyama A.J.
Obesity Science & Practice
Autistic individuals represent approximately 1 in 31 people in the United States and experience disproportionately high rates of obesity, type 2 diabetes, cardiovascular disease, and feeding and eating challenges, alongside reduced life expectancy. However, evidence‐based metabolic health interventions for autistic populations remain sparse. This Perspective synthesizes evidence on two interconnected barriers that limit metabolic health research in the autism field: (1) lack of accessible biomedical research methodologies and (2) insufficient attention to mechanisms underlying poor metabolic health in this population, including chronic stress and weight stigma. Drawing on principles from neurodiversity, Universal Design for Research, and the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) guidelines, we outline a neuro‐affirming paradigm that can improve metabolic health research in the autism field. Finally, we provide phase‐by‐phase practical recommendations for researchers, spanning study design, measure development, recruitment, consent, screening, data collection, and interpretation. Aligning metabolic health research with neuro‐affirming principles can generate more rigorous, representative, and ethically grounded evidence and ultimately support more meaningful improvements in metabolic health and overall well‐being for autistic individuals across the life course.
Using a life course health development framework to combat stigma-related health disparities for individuals with intellectual and/or developmental disability (I/DD)
Hotez E., Rava J., Russ S., Ware A., Halfon N.
Current Problems in Pediatric and Adolescent Health Care
This study explored how college students understand and feel about autism and neurodiversity, and whether higher education can help reduce stigma as autistic students transition into adulthood. Most students expressed high overall acceptance of autistic people, but views were more mixed when it came to whether autistic behaviors should be changed or treated. Students also showed strong interest in neurodiversity, alongside wide differences in how much they knew about it. These findings suggest colleges have an important opportunity to build on students’ interest and promote more informed, stigma-reducing campus environments.
About Our Work
The UCLA SHARE Study investigates how stress affects the health and everyday life of autistic teens and young adults. We do this in a respectful and neuro-affirming way, working together with autistic people, families, and clinicians.
We seek to understand real experiences so we can help create better supports, reduce stress, and help autistic people feel healthy and thrive as they grow into adulthood.
The UCLA Stress, Health, and Autism Research (SHARE) Study explores how stress influences physical and emotional health for autistic adolescents and emerging adults. Using innovative biomarker tools—including hair cortisol collection—we aim to build a clearer understanding of how stress affects wellbeing across the life course.