Racial and Ethnic Differences in ADHD and LD in Young School-Age Children: Parental Reports in the National Health Interview Survey

Abstract

Objectives. Racial and ethnic disparities have been documented for many physical health outcomes in children. Less is known, however, about disparities in behavioral and learning disorders in children. This study uses data from a national health survey to examine racial and ethnic differences in identified attention deficit hyperactivity disorder (ADHD) and learning disability (LD). Methods. The 1997–2001 National Health Interview Surveys obtained information from parents about the health and sociodemographic characteristics of children. Using these data, prevalence rates of identified ADHD and/or LD were estimated for Hispanic, African American, and white children 6–11 years of age. Racial and ethnic differences in health conditions, income, and insurance coverage were examined as possible explanations for disparities in parental reports of ADHD and LD, as well as the use of any prescription medication among children with ADHD. Results. Hispanic and African American children, compared to white children, had parental reports of identified ADHD without LD less often, and adjustments for the confounding variables—birthweight, income, and insurance coverage—did not eliminate these differences. Hispanic and African American children, compared to white children, also had parental reports of ADHD with LD less often after adjustments for the effects of confounding variables. By contrast, after adjustments for confounding variables, Hispanic and African American children were as likely as white children to have LD without ADHD. Among children with ADHD, use of any prescription medication was reported less often for Hispanic and African American children than white children. These disparities in medication use persisted after adjustments for confounding variables. Conclusions. The prevalence of ADHD and the use of any prescription medication among children with ADHD differed among Hispanic, African American, and white children. These disparities could not be explained by racial and ethnic differences in other health conditions and sociodemographic variables.

Parental attitudes and involvement in psychopharmacological treatment for ADHD: A conceptual model

“…Compared to white parents, AfricanAmericans perceive social stigma with psychopharmacological treatment for ADHD (Davison et al, 2001). Even after controlling for learning disorders, other health conditions, income, and insurance coverage, African-American children had a 40% lower use of medication for ADHD compared to white children (Pastor & Reuben, 2005). Unlike prior research showing African-American parents' lower acceptance and pursuit of medication for their child's ADHD relative to white parents, racial differences were not evident for behavioural therapy (Krain, Kendall, & Power, 2005).…”

Latino Versus Caucasian Response to Atomoxetine in Attention-Deficit/Hyperactivity Disorder

“…However, lifetime prevalence has been reported to be higher in Latino children outside the United States, ranging from 8% in Puerto Rico (Canino et al 2004) to 17.1% in Colombia (Pineda et al 2001). The National Health Interview Survey reported that the prevalence of ADHD in Latino children living in the United Stated is about half that of Caucasian children (3.3% vs. 6.5%) (Bloom and Tonthat 2002;Pastor and Reuben 2005), but language barriers, physician bias, and different developmental expectations of Latino mothers may account in part for these differences (Stevens et al 2004). One consistent difference between these ethnic groups is the lower rate of access to pharmacological treatments in the Latino population (Jensen et al 1999;Bauermeister et al 2003;Stevens et al 2004).…”

Recent Trends in Childhood Attention-Deficit/Hyperactivity Disorder

“…35 Because of small and nonrepresentative samples, previous studies have been limited in their applicability to the gen-eral population. Furthermore, studies [36][37][38] have relied on parent-and teacher-reported cases, which overestimate true prevalence. Accurate estimates of disease burden in a large study population will provide information for determining health care resource allocation for ADHD prevention programs.…”