Living in more diverse areas makes teens less likely to get Pip for autism
Nuffield Trust study lends weight to claims reported by Hyphen that parents of autistic Muslim children find it harder to access diagnosis
Young people living in ethnically diverse areas are less likely to access personal independence payments (Pips) due to autism or ADHD than their peers living in white majority areas, analysis has found.
The research by the Nuffield Trust compared for the first time the numbers of 16 and 17-year-olds who had qualified for Pips due to an autism or ADHD diagnosis across England between 2019 and 2025. It found that, while the rate of payments had increased across the whole nation in the five-year period, there was a correlation between the proportion of white people living in a neighbourhood and the number of young people in receipt of Pip for autism and ADHD-related disability.
According to the analysis, this effect was “more pronounced in the most deprived areas, where a one-percentage-point higher proportion of white residents was associated with a 1.5% increase in the recipient rate for ADHD and autism”.
It adds strength to claims previously reported by Hyphen that faith discrimination plays a part in the difficulty of Muslim families in accessing autism diagnoses for their children. The findings also align with previous research showing that Indian and Pakistani children were less likely than their white peers to receive an autism diagnosis.
“It’s a surprise that we see the fastest growth [in Pip awards for autism and ADHD] in the areas that seem to be doing the best on their educational and employment outcomes,” Sally Gainsbury, lead author of the Nuffield Trust analysis, told Hyphen.
She pointed to a number of potential explanations, including economic and ethnic inequalities in the process of medical diagnosis and the subsequent Pip assessment process — not least access to private diagnosis — as well as higher sensitivity to disability within more affluent communities. “It might be that in very affluent areas people see themselves as disabled or having difficulties due to things which would not be considered a disability in less affluent areas,” she said.
A recent review of Pip led by the disability minister Stephen Timms found that the system was “not fit for purpose” and that assessments for access were viewed as “dehumanising, degrading and stressful”. Timms’ report also found that all ethnic minority groups, except those from a Pakistani background, had a lower chance of receiving Pip overall.
“There’s a lot of recognition now that the Pip assessment process is quite unfair and inconsistent so we might see some of that playing through,” said Gainsbury. “It might also be related to inequalities in diagnosis, which might be influenced by racism and cultural factors.”
Gainsbury also identified local authorities where the discrepancy between high rates of deprivation and low rates of Pip claims was the largest, with those with high Muslim populations, including the London boroughs of Brent, Redbridge, Ealing and Newham, all appearing in the top five. “The rate of Pip claims in those local authorities is half of what we would expect if the claims were in line with deprivation,” Gainsbury said. “By contrast, Exeter, which is 90% white, has a rate of Pip claims about twice as high as those boroughs.”
Joey Nettleton Burrows, policy and public affairs manager at the National Autistic Society, said access to appropriate support for autistic people was “inconsistent, with autistic people from the global majority facing additional barriers to assessment, education, social care and mental health support”.
He added: “People of the global majority can feel isolated and in desperate need of support yet face discrimination and judgement. Health and care professionals need to ensure that support is fully inclusive and accessible to all autistic people, and society needs a better understanding of autism to help break down stigma and misconceptions.”
