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A cohort of 238,011 American children was screened for ADHD diagnosis, and the link between ADHD diagnosis and race/ethnicity was explored. The study found that Asian, Hispanic, and Black children were significantly less likely to be diagnosed and treated for ADHD, while white children were more likely to receive treatment.

This study retrospectively examined insurance claims data for children born in the United States between January 1, 2006, and December 31, 2012, who had insurance coverage for at least four years. ADHD diagnosis was defined using International Classification of Diseases codes and treatment within one year of diagnosis, including medication and behavior therapy.

When the data were adjusted for sex, region, and household income, Asian children were 52% less likely, Hispanic children 23% less likely, and Black children 17% less likely to be treated for ADHD than white children.

Guidelines for treatment for ADHD recommend that any child aged 4 through 18 years old that presents with behavioral or academic problems should be evaluated by a primary care physician. The first-line treatment recommendation is behavioral therapy starting with pre-school-aged children, and medication can be added on starting in elementary school-aged children. In pre-school-aged children diagnosed with ADHD, 32% had medication only, and 19% had behavioral therapy and medication.

The cumulative evidence so far suggests that there exist significant racial disparities in the diagnosis and treatment of ADHD among insured children. Among uninsured and underinsured children, the same disparities are likely to be higher. Even among the children that are diagnosed and treated, they are often not being treated according to the guidelines. Further research is needed on the social determinants that contribute to racial/ethnic disparities in ADHD diagnosis and treatmentย [1].

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Source:

[1] Shi, Y., Hunter Guevara, L. R., Dykhoff, H. J., Sangaralingham, L. R., Phelan, S., 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), e210321. https://doi.org/10.1001/jamanetworkopen.2021.0321