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Racial and Ethnic Disparities in Parent-Reported Diagnosis of ADHD: National Survey of Children’s Health (2003, 2007, and 2011)

J Clin Psychiatry 2016;77(1):52–59
10.4088/JCP.14m09364

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed mental disorder among children in the United States. While overall ADHD prevalence continues to rise, few have examined difference by race/ethnicity.

Objective: To examine trends in parent-reported ADHD prevalence between 2003 and 2011 across racial/ethnic groups and the role of sociodemographic factors in observed differences in ADHD.

Method: Data were from 3 waves of the National Survey of Children’s Health (2003, 2007, and 2011), including 190,408 children aged 5–17 years. Independent variables included race/ethnicity (white non-Hispanic, black non-Hispanic, Hispanic, other non-Hispanic), gender, age, poverty level, primary language, insurance status, parental marital status, and neighborhood safety. Sociodemographic factors and year were compared among those diagnosed with ADHD and between racial/ethnic groups using χ2 tests. Adjusted logistic regression models, stratified by race/ethnicity, were fit to examine the association between identified risk factors and ADHD across racial/ethnic groups. Parental report of an ADD or ADHD diagnosis for a child aged 5–17 years was the dependent variable. If the household included more than 1 child aged 5–17 years, 1 was selected at random.

Results: Increasing trends were observed over the past decade in the prevalence of parent-reported ADHD overall (43%, P < .001), among children aged 10–14 years (47%, P < .001), and adolescents aged 15–17 years (52%, P < .001). Although the ADHD prevalence was still highest among whites, increasing trends were observed for all racial/ethnic groups, most notably among Hispanics, increasing 83% from 2003 to 2011 (P < .001). A greater increase in ADHD was also observed among females (55%, P < .001) than among males (40%).

Conclusions: Economics, family status, non-English language in the home, and neighborhood safety factors differentially impacted diagnosed ADHD across racial/ethnic groups. Although new insights into the role of economic, family, and neighborhood factors on parent-reported ADHD diagnoses were noted, more research is needed to understand causes of the observed racial/ethnic disparities.