Expanding Understanding of Racial-Ethnic Differences in ADHD Prevalence Rates among Children to Include Asians and Alaskan Natives/American Indians

Abstract

Background

Prior studies show that ADHD prevalence rates vary by race-ethnicity, but these studies do not include a full range of racial-ethnic minority groups.

Objective

This study aimed to understand differences in ADHD prevalence among children across a wider range of racial-ethnic groups, overall and stratified by biological sex.

Method

Data on children aged 5 to 17 from the 2004 to 2018 National Health Interview Survey Sample Child Files were used in analyses (N = 120,129).

Results

Compared to Non-Hispanic White children, ADHD prevalence was lower among Hispanic and Non-Hispanic Asian children. This difference was present for both males and females. Across all racial-ethnic groups, males had higher ADHD prevalence than females.

Conclusion

Results from this study provide further evidence that racial-ethnic disparities in ADHD prevalence rates persist across sex and provide initial evidence of substantially lower ADHD prevalence among Non-Hispanic Asians. Implications, limitations, and future research directions derived from the results are discussed.

Keywords

ADHD prevalence race ethnic minorities sex differences

Get full access to this article

View all access options for this article.

References

Aratani

Cooper

J. L.

(2011). Racial and ethnic disparities in the continuation of community-based children’s mental health services. The Journal of Behavioral Health Services & Research, 39(2), 116–129. https://doi.org/10.1007/s11414-011-9261-z

Ault-Brutus

Alegria

(2016). Racial/ethnic differences in perceived need for mental health care and disparities in use of care among those with perceived need in 1990–1992 and 2001–2003. Ethnicity & Health, 23(2), 142–157. https://doi.org/10.1080/13557858.2016.1252834

Boyle

C. A.

Boulet

Schieve

L. A.

Cohen

R. A.

Blumberg

S. J.

Yeargin-Allsopp

Visser

Kogan

M. D.

(2011). Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics, 127(6), 1034–1042. https://doi.org/10.1542/peds.2010-2989

Brannan

A. M.

Heflinger

C. A.

Bickman

(1997). The caregiver strain questionnaire. Journal of Emotional and Behavioral Disorders, 5(4), 212–222. https://doi.org/10.1177/106342669700500404

Coker

T. R.

Elliott

M. N.

Toomey

S. L.

Schwebel

D. C.

Cuccaro

Emery

S. T.

Davies

S. L.

Visser

S. N.

Schuster

M. A.

(2016). Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics, 138(3), e20160407. https://doi.org/10.1542/peds.2016-0407

Crane

D. R.

Ngai

S. W.

Larson

J. H.

Hafen

(2005). The influence of family functioning and parent-adolescent acculturation on North American Chinese adolescent outcomes. Family Relations, 54(3), 400–410. https://doi.org/10.1111/j.1741-3729.2005.0326.x

Cuffe

S. P.

Moore

C. G.

McKeown

R. E.

(2005). Prevalence and correlates of ADHD symptoms in the national health interview survey. Journal of Attention Disorders, 9(2), 392–401. https://doi.org/10.1177/1087054705280413

Cummings

J. R.

Druss

B. G.

(2011). Racial/ethnic differences in mental health service use among adolescents with major depression. Journal of the American Academy of Child & Adolescent Psychiatry, 50(2), 160–170. https://doi.org/10.1016/j.jaac.2010.11.004

Danielson

M. L.

Bitsko

R. H.

Ghandour

R. M.

Holbrook

J. R.

Kogan

M. D.

Blumberg

S. J.

(2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199–212. https://doi.org/10.1080/15374416.2017.1417860

10.

De la Barra

F. E.

Vicente

Saldivia

Melipillan

(2013). Epidemiology of ADHD in Chilean children and adolescents. ADHD Attention Deficit and Hyperactivity Disorders, 5(1), 1–8. https://doi.org/10.1007/s12402-012-0090-6

11.

DuPaul

G. J.

Reid

Anastopoulos

A. D.

Lambert

M. C.

Watkins

M. W.

Power

T. J.

(2016). Parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms: Factor structure and normative data. Psychological Assessment, 28(2), 214–225. https://doi.org/10.1037/pas0000166

12.

Eiraldi

R. B.

Mazzuca

L. B.

Clarke

A. T.

Power

T. J.

(2006). Service utilization among ethnic minority children with ADHD: A model of help-seeking behavior. Administration and Policy in Mental Health and Mental Health Services Research, 33(5), 607–622. https://doi.org/10.1007/s10488-006-0076-9

13.

Fairman

K. A.

Peckham

A. M.

Sclar

D. A.

(2017). Diagnosis and treatment of ADHD in the United States: Update by gender and race. Journal of Attention Disorders, 24(1), 10–19. https://doi.org/10.1177/1087054716688534

14.

Fernández

M. C.

Arcia

(2004). Disruptive behaviors and maternal responsibility: A complex portrait of stigma, self-blame, and other reactions. Hispanic Journal of Behavioral Sciences, 26(3), 356–372. https://doi.org/10.1177/0739986304267208

15.

Fleming

Fitton

C. A.

Steiner

M. F. C.

Mclay

J. S.

Clark

King

Mackay

D. F.

Pell

J. P.

(2017). Educational and health outcomes of children treated for attention-deficit/hyperactivity disorder. JAMA Pediatrics, 171(7), e170691. https://doi.org/10.1001/jamapediatrics.2017.0691

16.

Garland

A. F.

Lau

A. S.

Yeh

Mccabe

K. M.

Hough

R. L.

Landsverk

J. A.

(2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162(7), 1336–1343. https://doi.org/10.1176/appi.ajp.162.7.1336

17.

Getahun

Jacobsen

S. J.

Fassett

M. J.

Chen

Demissie

Rhoads

G. G.

(2013). Recent trends in childhood attention-deficit/hyperactivity disorder. JAMA Pediatrics, 167(3), 282. https://doi.org/10.1001/2013.jamapediatrics.401

18.

Guo

Kataoka

S. H.

Bear

Lau

A. S.

(2013). Differences in school-based referrals for mental health care: Understanding racial/ethnic disparities between Asian American and Latino youth. School Mental Health, 6(1), 27–39. https://doi.org/10.1007/s12310-013-9108-2

19.

Hays

D. G.

Prosek

E. A.

Mcleod

A. L.

(2010). A mixed methodological analysis of the role of culture in the clinical decision-making process. Journal of Counseling & Development, 88(1), 114–121. https://doi.org/10.1002/j.1556-6678.2010.tb00158.x

20.

Kang

Harvey

E. A.

(2019). Racial differences between Black parents’ and White teachers’ perceptions of attention-deficit/hyperactivity disorder behavior. Journal of Abnormal Child Psychology, 48(5), 661–672. https://doi.org/10.1007/s10802-019-00600-y

21.

Kao

Thompson

J. S.

(2003). Racial and ethnic stratification in educational achievement and attainment. Annual Review of Sociology, 29(1), 417–442. https://doi.org/10.1146/annurev.soc.29.010202.100019

22.

Landes

S. D.

London

A. S.

(2019). Self-reported ADHD and adult health in the United States. Journal of Attention Disorders, 25(1), 3–13. https://doi.org/10.1177/1087054718757648

23.

Lau

A. S.

Garland

A. F.

Yeh

Mccabe

K. M.

Wood

P. A.

Hough

R. L.

(2004). Race/ethnicity and inter-informant agreement in assessing adolescent psychopathology. Journal of Emotional and Behavioral Disorders, 12(3), 145–156. https://doi.org/10.1177/10634266040120030201

24.

Liang

Matheson

B. E.

Douglas

J. M.

(2016). Mental health diagnostic considerations in racial/ethnic minority youth. Journal of Child and Family Studies, 25(6), 1926–1940. https://doi.org/10.1007/s10826-015-0351-z

25.

Liu

Yan

Tong

(2018). The prevalence of attention deficit/hyperactivity disorder among Chinese children and adolescents. Scientific Reports, 8(1), 1–15. https://doi.org/10.1038/s41598-018-29488-2

26.

London

A. S.

Landes

S. D

. (2016). Attention deficit hyperactivity disorder and adult mortality. Preventive Medicine, 90, 8–10. https://doi.org/10.1016/j.ypmed.2016.06.021

27.

London

A. S.

Landes

S. D.

(2021). Cohort change in the prevalence of ADHD among U.S. adults: Evidence of a gender-specific historical period effect. Journal of Attention Disorders, 25(6), 771–782. https://doi.org/10.1177/1087054719855689

28.

Mak

Rosenblatt

(2002). Demographic influences on psychiatric diagnoses among youth served in California systems of care. Journal of Child and Family Studies, 11(2), 165–78. https://doi.org/10.1023/a:1015173508474

29.

Marrast

Himmelstein

D. U.

Woolhandler

(2016). Racial and ethnic disparities in mental health care for children and young adults. International Journal of Health Services, 46(4), 810–24. https://doi.org/10.1177/0020731416662736

30.

Montiel

Peña

J. A.

Montiel-Barbero

Polanczyk

(2007). Prevalence rates of attention deficit/hyperactivity disorder in a school sample of Venezuelan children. Child Psychiatry and Human Development, 39(3), 311–322. https://doi.org/10.1007/s10578-007-0090-5

31.

Morgan

P. L.

Staff

Hillemeier

M. M.

Farkas

Maczuga

(2013). Racial and ethnic disparities in ADHD diagnosis from kindergarten to eighth grade. Pediatrics, 132(1), 85–93. https://doi.org/10.1542/peds.2012-2390d

32.

NAEP. (2019). Results from the 2019 mathematics and reading assessments. U.S. Department of Education. Office of Educational Research and Improvement. https://nces.ed.gov/

33.

National Center for Health Statistics. (2019). Survey description. National Health Interview Survey, 2018. National Center for Health Statistics.

34.

Nitardy

C. M.

Duke

N. N.

Pettingell

S. L.

Borowsky

I. W.

(2015). Racial and ethnic disparities in educational achievement and aspirations: Findings from a Statewide Survey from 1998 to 2010. Maternal and Child Health Journal, 19(1), 58–66. https://doi.org/10.1007/s10995-014-1495-y

35.

Owens

(2020). Relationships between an ADHD diagnosis and future school behaviors among children with mild behavioral problems. Sociology of Education, 93(3), 191–214. https://doi.org/10.1177/0038040720909296

36.

Pastor

P. N.

Reuben

C. A.

(2005). Racial and ethnic differences in ADHD and LD in young school-age children: Parental reports in the national health interview survey. Public Health Reports, 120(4), 83–92. https://doi.org/10.1177/003335490512000405

37.

Ros

Graziano

P. A.

(2018). Social functioning in children with or at risk for attention deficit/hyperactivity disorder: A meta-analytic review. Journal of Clinical Child & Adolescent Psychology, 47(2), 213–35. https://doi.org/10.1080/15374416.2016.1266644

38.

Shi

Hunter Guevara

L. R.

Dykhoff

H. J.

Sangaralingham

L. R.

Phelan

Zaccariello

M. J.

Warner

D. O.

(2021). Racial disparities in diagnosis of attention-deficit/hyperactivity disorder in a US National Birth Cohort. JAMA Network Open, 4(3). https://doi.org/10.1001/jamanetworkopen.2021.0321

39.

Smith

Lyer

R. L.

Langer-Gould

Getahun

D. T.

Strickland

Jacobsen

S. J.

Chen

Derose

S. F.

Koebnick

(2010). Health plan administrative records versus birth certificate records: Quality of race and ethnicity information in children. BMC Health Services Research, 10(1), 1–7. https://doi.org/10.1186/1472-6963-10-316

40.

Visser

S. N.

Danielson

M. L.

Bitsko

R. H.

Perou

Blumberg

S. J.

(2013). Convergent validity of parent-reported attention-deficit/hyperactivity disorder diagnosis. JAMA Pediatrics, 167(7), 674–75. https://doi.org/10.1001/jamapediatrics.2013.2364

41.

Wood

P. A.

Yeh

Pan

Lambros

K. M.

McCabe

K. M.

Hough

R. L.

(2005). Exploring the relationship between race/ethnicity, age of first school-based services utilization, and age of first specialty mental health care for at-risk youth. Mental Health Services Research, 7(3), 185–196. https://doi.org/10.1007/s11020-005-5787-0

42.

Strathearn

Liu

Yang

Bao

(2018). Twenty-year trends in diagnosed attention-deficit/hyperactivity disorder among US children and adolescents, 1997-2016. JAMA Network Open, 1(4), e181471. https://doi.org/10.1001/jamanetworkopen.2018.1471

43.

Yeh

McCabe

Hurlburt

Hough

Hazen

Culver

Garland

Landsverk

(2002). Referral sources, diagnoses, and service types of youth in public outpatient mental health care: A focus on ethnic minorities. The Journal of Behavioral Health Services & Research, 29(1), 45–60. https://doi.org/10.1007/bf02287831