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Racial and Ethnic Disparity Seen in Attention Deficit/Hyperactivity Diagnoses: Presented at AAP

By Brian Reid

WASHINGTON, DC -- October 11, 2005 -- Hispanic and non-Hispanic blacks in the United States have slightly higher rates of attention deficit/hyperactivity disorder (ADHD) symptoms compared to their non-Hispanic white peers, according to an analysis by U.S. Centers for Disease Control and Prevention officials.

These higher rates of symptoms among black and Hispanic children exist even as diagnosis rates for these groups lag those of whites.

The differences in diagnosis between racial and ethnic groups have been well established, and the work of the CDC team, presented here at the American Academy of Pediatrics (AAP) National Conference and Exhibition, shows that the lack of diagnosis in minority communities does not reflect a lower burden from ADHD symptoms.

"Hispanic and blacks reported that their children had more difficulties than whites," said Susanna Visser, MS, Epidemiologist with the CDC's National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia, who presented the data. "Non-Hispanic black and Hispanics should be getting an ADHD diagnosis. But they're not."

The CDC group gathered data from the 2003 National Health Interview Survey on 9399 children 4 to 17 years of age. The data captured information about ADHD diagnosis as well as behavioral data through parental responses to the survey's "Strengths and Difficulties Questionnaire."

The results showed that both black and Hispanic children tended to suffer from peer problems and conduct concerns more than their white peers. Yet the rate of ADHD diagnosis was 8% for white children, 6.3% for blacks and 3.9% for Hispanics.

According to co-presenter Christine Kennedy, Occupational Therapist, CDC, the lower rate of diagnosis among black and Hispanic children was unlikely to be the result of lower impairment levels.

Instead, cultural differences may have driven the gap in diagnosis rates, and she suggested that socioeconomic factors, including insurance status and access to healthcare, could be responsible for the lower diagnosis rate. In addition, it is possible that children in black or Hispanic communities showing ADHD symptoms could instead be more likely to be diagnosed with other disorders, such as depression.

Past research has suggested distinctions in the treatment of ADHD in different communities, including lower levels of stimulant use. Blacks have also been shown to preferring counseling over medications, according to Visser.

The CDC estimates that 4.4 million children between 4 and 17 years of age have ADHD and that 2.5 million are being medically treated for the disorder.


[Presentation title: Strengths and Difficulties of Children With ADHD: Comparing Racial and Ethnic Differences in Prevalence Rates and Impairment Using Data from the 2003 National Health Interview Survey (NHIS).]

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