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Racial Disparities in ADHD

     

Two recent reports highlight racial disparities in the prevalence of attention-deficit/hyperactivity disorder (ADHD) diagnoses. A meta-analysis published online in JAMA Psychiatry in September found that Black individuals are at higher risk of ADHD diagnosis than the general population, a finding that “challenges generally accepted statements that Black individuals have a lower prevalence of ADHD compared with others,” the authors note.

A report earlier this year from the Centers for Disease Control and Prevention (CDC) similarly found that Black children were more likely to have been diagnosed with ADHD or learning disability compared to white and Hispanic children. ADHD and learning disabilities are the most common neurodevelopmental disorders in children and they often occur at the same time.

The meta-analysis, led by Jude Mary Cénat, Ph.D., of the University of Ottawa in Canada, assessed the results of 21 studies in the U.S. and found that the prevalence of ADHD among Black children and youth under 18 was approximately 14%.

ADHD is often first identified when children enter school and face more academic and social expectations. The study found that teachers reported more symptoms among Black youths than others, but that Black parents were less likely than others to report ADHD symptoms in their children, often out of concerns about stigma and exposing their children to racial discrimination.

Black individuals face many of the same risk factors for ADHD diagnoses as others, the authors note. However, they suggest that aspects related to the intersection of race, low socioeconomic status, racial marginalization, and discrimination, including racist microaggressions, may exacerbate the symptoms of ADHD.

The researchers also suggest ways to reduce the disparities in ADHD diagnosis and treatment, including increasing ADHD assessment and monitoring among Black individuals and additional research that can help to “establish accurate diagnoses and culturally appropriate care for Black youth with ADHD symptoms.”

The CDC study, reported in March of this year, found overall, 14% of children 3-17 have ever been diagnosed with either ADHD or learning disability, including 17% of Black children, 15% of white children and 12% of Hispanic children. (See chart.) Children living in families below the federal poverty level were more likely to be diagnosed with ADHD or a learning disability compared to those in families above the poverty level (19% vs. 13%). That pattern was consistent among white, Black and Hispanic children. 

Figure 1 is a bar graph showing the prevalence of children aged 3 through 17 years who were ever diagnosed with either attention-deficit/hyperactivity disorder or a learning disability, by race and ethnicity, for the years 2016 through 2018.

Prevalence of children aged 3-17 years ever diagnosed with
ADHD or learning disability, U.S. 2016-2018. CDC        


References and Resources

Attention Deficit Disorder Association (https://add.org/)

Cénat, MJ, et al. Prevalence and Risk Factors Associated With Attention-Deficit/Hyperactivity Disorder Among US Black Individuals:  A Systematic Review and Meta-analysis.  JAMA Psychiatry. Online September 9, 2020

Pond, E. Meta-Analysis Assesses ADHD Prevalence, Risk Factors Among Black Individuals in the United States. Psychiatry Advisor. Sept 2020

Centers for Disease Control and Prevention. Racial and Ethnic Differences in the Prevalence of Attention/Deficit Hyperactivity Disorder and Learning Disabilities among U.S. Children Aged 3 – 17 years. NCHS Data Brief No. 358, March 2020. Benjamin Zablotsky, Ph.D., and Josephine M. Alford, M.S

     

ADHDPatients and FamiliesSpecific Learning Disorder

 

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