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ADHD diagnoses, medication use lower among African-Americans, Latinos than white children
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Racial and ethnic disparities in attention-deficit/hyperactivity disorder medication persisted because of fewer diagnoses and treatments in African-American and Latino children as opposed to overdiagnoses and treatments in white children, according to study findings.
“Parent-reported rates of ever receiving [an ADHD] diagnosis for children aged 4 to 17 years increased from 7.8% in 2003 to 11% in 2011, and rates of ADHD medication use increased from 4.8% in 2007 to 6.1% in 2011,” Tumaini R. Coker, MD, MBA, assistant professor of pediatrics at the David Geffen School of Medicine and Mattel Children’s Hospital, UCLA, and colleagues wrote. “Studies also describe racial/ethnic disparities in diagnosis indicating that African-American and Latino children may have lower rates of receiving a diagnosis and medication compared with white children.”
Coker and colleagues conducted a multicenter, population-based survey that included 4,297 children and parents to determine whether disparities in ADHD medication were more likely caused by infrequent diagnosis and treatment of African-American and Latino children or too frequent diagnosis and treatment in whites. Parents were surveyed when their children were in fifth, seventh and 10th grades, and the researchers examined disparities in their reported ADHD diagnoses and medication use.
Data indicated that African-American children had lower rates of diagnosis (fifth grade, adjusted OR = 0.4; 95% CI, 0.27-0.59; 10th grade, aOR = 0.42; 95% CI, 0.27-0.67) and medication use for ADHD (fifth grade, aOR = 0.43; 95% CI, 0.29-0.65; seventh grade, aOR = 0.41; 95% CI, 0.28-0.62; 10th grade, aOR = 0.44; 95% CI, 0.28-0.71) compared with white children. Similar decreases were observed when comparing Latino children with white children for diagnoses (fifth grade, aOR = 0.37; 95% CI, 0.22-0.6; 10th grade, aOR = 0.46; 95% CI, 0.26-0.79) and medication use (fifth grade, aOR = 0.4; 95% CI, 0.23-0.7; seventh grade, aOR = 0.43; 95% CI, 0.25-0.74; 10th grade, aOR = 0.41; 95% CI, 0.21-0.79). These ethnicities also showed fewer ADHD symptoms and other mental health comorbidities on average vs. white children.
“Our findings do indirectly suggest that these disparities are more likely from the underdiagnosis/undertreatment of African-American and Latino children than the overdiagnosis/overtreatment of white children,” the researchers said. “Because the rates of diagnosis and treatments are rising in the general population of U.S. children, a significant need remains to identify and treat African-American and Latino children who have ADHD and avoid a widening of these disparities.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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