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ADHD rates are shown to vary substantially across different geographic regions in the United States.

Attention deficit/hyperactivity disorder (ADHD) is common in childhood and tends to be associated with long-term difficulties in family, academic, and social settings. It is important for researchers and clinical practitioners to have a good understanding of ADHD prevalence in their area so that they may have a better idea about how to engage in testing and allocate resources in an optimal manner. This study, published in the Annals of Epidemiology, provides a measure and analysis of ADHD rates across the United States, with the aim of understanding geographic variation in prevalence estimates. 

ADHD Rates Vary Geographically

For this study, a small area estimation approach was used along with data from the 2016 to 2018 National Survey of Children’s Health to estimate childhood ADHD prevalence estimates at the census regional division, state, and county levels. The sample used included approximately 70,000 children aged between 5 and 17 years. The national ADHD rate was estimated at 12.9%, with a 95% confidence interval. Counties in the western south-central, eastern south-central, New England, and South Atlantic divisions were found to exhibit higher estimated rates of childhood ADHD when compared to counties in the Mountain, Mid-Atlantic, western north-central, Pacific, and eastern north-central divisions.

Geographic Variation in Rates of ADHD Is Substantial in Some Counties

The county divisions that showed higher rates of ADHD showed this elevated rate in many of their counties. Across the western south-central, eastern south-central, New England, and South Atlantic divisions, 55.1%, 53.6%, 49.3%, and 46.2% of the counties included had childhood ADHD rates of 16% or higher, respectively. In contrast, counties in the Mountain, Mid-Atlantic, western north-central, Pacific, and eastern north-central divisions had 2.1%, 4%, 5.8%, 6.9%, and 11.7% percent of their counties show childhood ADHD rates of 16% or more, respectively. This considerable difference can be a useful tool to help researchers and public health professionals understand how to best allocate resources to counties where childhood ADHD prevalence is more widespread.

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Zgodic, A., McLain, A. C., Eberth, J. M., Federico, A., Bradshaw, J., & Flory, K. (2023). County-level prevalence estimates of ADHD in children in the United States. Ann Epidemiol. https://doi.org/10.1016/j.annepidem.2023.01.006