ADHD Diagnosis Disparities in the USA

Plain-language summary

Research suggests that certain groups of children in the U.S. are less likely to be diagnosed and treated for ADHD, despite potentially having the condition. These disparities appear to be influenced by a combination of factors including race, ethnicity, socioeconomic status, and geographic location. However, some evidence suggests that disparities in ADHD diagnosis and treatment are complex, making it challenging to determine whether they result from underdiagnosis or undertreatment of certain groups, or overdiagnosis or overtreatment of others.

Key findings

• Children from racial and ethnic minority groups, as well as those from lower socioeconomic backgrounds, are less likely to be diagnosed with and receive treatment for ADHD.
• Geographic region within the U.S. plays a role in the likelihood of ADHD diagnosis and treatment, with some areas having higher rates than others.
• Factors such as family language use, health insurance coverage, and school composition may also contribute to disparities in ADHD diagnosis and treatment.
• There is mixed evidence on whether these disparities stem from undertreatment of certain populations or overtreatment of others, highlighting the complexity of the issue.
• Further research is needed to fully understand the root causes of these disparities and to develop effective strategies to ensure equitable access to ADHD care for all children.

Studies cited (4)

1. Sociodemographic Disparities in ADHD Diagnosis and Treatment Among U.S. Elementary Schoolchildren — Paul L. Morgan, E. Hu (2023, Psychiatry Research, observational)

   We examined whether some groups of U.S. elementary schoolchildren are less likely to be diagnosed and treated for ADHD in analyses of a population-based cohort (N=10,920). We predicted ADHD diagnosis using measures of race and ethnicity, age, socioeconomic status, birthweight, individually assessed academic, behavioral, and executive functioning, family language use, mental health, health insurance coverage, marital status, school composition, and geographic region. We predicted prescription medication use among those diagnosed with ADHD. We stratified additional analyses by biological sex. Bl

2. Racial and Ethnic Disparities in ADHD Diagnosis and Treatment — Tumaini R. Coker, M. Elliott, Sara L. Toomey (2016, Pediatrics, other)

   OBJECTIVES: We examined racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis and medication use and determined whether medication disparities were more likely due to underdiagnosis or undertreatment of African-American and Latino children, or overdiagnosis or overtreatment of white children. METHODS: We used a population-based, multisite sample of 4297 children and parents surveyed over 3 waves (fifth, seventh, and 10th grades). Multivariate logistic regression examined disparities in parent-reported ADHD diagnosis and medication use in the following analyses:

3. Disparities in ADHD Diagnosis and Treatment by Race/Ethnicity in Youth Receiving Kentucky Medicaid in 2017. — D. Winders Davis, Kahir Jawad, Yana B. Feygin (2021, Ethnicity & Disease, other)

   Background Kentucky has among the highest rate of attention deficit/hyperactivity disorder (ADHD) and stimulant use in the United States. Little is known about this use by race/ethnicity and geography. This article describes patterns of diagnosis of ADHD and receipt of stimulants and psychosocial interventions for children aged 6-17 years receiving Kentucky Medicaid in 2017 and identifies factors associated with diagnosis and treatment. Methods Using Medicaid claims, children with and without ADHD (ICD-10 codes F90.0, F90.1, F90.2, F90.8, and F90.9) were compared and predictors of diagnosis

4. Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems? — Garland AF, Taylor R, Brookman-Frazee L (2015, Journal of racial and ethnic health disparities, other)

   DOI: 10.1007/s40615-014-0069-4