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Socioeconomic variables affect parent-reported ADHD prevalence differently among ethnic groups

Analysis of national study data show an increase in parent-reported prevalence of attention-deficit/hyperactivity disorder from 2003 to 2011, and that socioeconomic variables affect prevalence differentially between racial/ethnic groups.

“Prevalence of ADHD has been found to vary significantly across race and ethnicity. While higher prevalence is generally found in whites and lower prevalence in Hispanics, the reasons for this disparity are unclear,” Kevin P. Collins, BS, of Mathematica Policy Research, Washington, D.C., and Sean D. Cleary, PhD, MPH, of The George Washington University, wrote. “Evidence suggests that sociodemographic factors may play a role, as identified risk groups include those who use English as their primary language, nonimmigrants, those in the lower economic levels, those with health insurance, and those living with a single mother.”

To study trends in parent-reported ADHD prevalence from 2003 to 2011 across racial/ethnic groups and the role of sociodemographic factors, researchers analyzed data from the National Survey of Children’s Health for 2003, 2007 and 2011. The study cohort included 190,408 children aged 5 to 17 years.

Prevalence of parent-reported ADHD increased by 42.9% overall (P < .001). By age group, prevalence increased by 46.5% among children aged 10 to 14 years (P < .001) and by 52.1% among adolescents aged 15 to 17 years (P < .001).

ADHD prevalence was highest among whites, however, researchers observed increasing trends among all racial/ethnic groups, most notably among Hispanics, who had an 83% increase from 2003 to 2011 (P < .001).

There were also large increases in ADHD prevalence among non-English speakers (107.1%) and children with parents in “other” parent marital situations (70.7%).

ADHD prevalence increased more among females than males (55.3% vs. 39.8%).

Analysis of sociodemographic predictors across race/ethnic groups indicated a consistent association with higher ADHD prevalence among males, children aged 10 to 17 years and children with single mothers.

There was a consistent association with lower ADHD prevalence among non-English speakers. Specifically, white, black, Hispanic and “other” non-English speakers were 60%, 76%, 78% and 92%, respectively, less likely to have a parent report ADHD diagnosis compared with English speakers in their respective racial/ethnic group.

Significant covariates for whites included living below 200% of the poverty level, having no health insurance, living with a stepparent or with parents in “other” marital situations, and living in neighborhoods described as usually safe, sometimes safe and never safe.

Among blacks, significant covariates included living below 100% of the poverty level, having no health insurance, living with a stepparent or parents in “other” martial situations, and living in neighborhoods described as sometimes safe and never safe.

The only additional significant covariate among Hispanics was living in a neighborhood described as never safe.

“Our study showed that, among U.S. children aged 5 to 17 years, parent-reported ADHD prevalence across racial/ethnic groups has risen considerably from 2003 to 2011. While the reasons for this increase in prevalence remain unclear, ADHD diagnoses, treatment, and service utilization represent a growing economic cost to the United States and merit continued monitoring,” Collins and Cleary wrote. “We observed in this study significant differences of the impact of sociodemographic factors across racial/ethnic subgroups. These factors, and possible interactions, represent topics for future study, which may help us to explain racial/ethnic disparities in ADHD.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.