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Autism is a disorder characterized by impairments in communication, social interaction, and repetitive behaviors. Over the past 40 years, the measured prevalence of autism has multiplied roughly 10-fold. While progress has been made in understanding some of the factors associated with increased risk and rising prevalence, no one knows with certainty what causes autism or what caused autism prevalence to rise so precipitously. There is, however, a growing awareness among scholars that focusing solely on individual risk factors such as exposure toxicants, prenatal complications, or parental education is insufficient to explain why autism prevalence rates have increased so stunningly. Social and institutional processes likely play an important role. For example, changes in diagnostic criteria and an influx of resources dedicated to autism diagnosis may be critical to understanding why prevalence rates have risen. Increased awareness and social influence have been implicated in the rise of autism and a variety of comparable disorders, where social processes mimic the effects of contagion. Studies have examined the contribution of changes in diagnostic criteria and diagnostic substitution to rising autism prevalence rates, but the importance of institutional factors, resources for diagnosis, and greater awareness have not been systematically assessed. The sociological literature on health and inequality, however, provides substantial motivation for exploring how individual- and community-level effects operate to shape the likelihood of an autism diagnosis.