Although most studies have reported differences among prevalence of ADHD between racial and ethnic groups, there are discrepancies in the direction of the inequality. Previous studies suggest that racial and ethnic disparities exist in the diagnosis of ADHD. Knowledge about the age at initial diagnosis and the number of children being diagnosed at a certain age could support the formulation of public health policy to improve early interventions such as medical treatments and school services. 5, 6 However, little is known about the incidence of ADHD diagnosis at the national level. 2, 4 Based on data from national surveys, the prevalence of ADHD in the US appears to have increased in the last 2 decades. 1 - 3 For example, ADHD is associated with poorer quality of life and higher medical costs.

Clinicians should provide racially sensitive care in the evaluation and treatment of ADHD.Īttention-deficit/hyperactivity disorder (ADHD) affects a large number of children and has long-term effects on their health and learning. Future study is needed to elucidate the mechanism behind these disparities, with special attention to Asian children. Asian children had the highest odds of receiving no treatment (odds ratio compared with White children, 0.54 95% CI, 0.42-0.70).Ĭonclusions and Relevance Racial and ethnic disparities in the diagnosis and treatment of ADHD are evident. Compared with other groups, White children were more likely to receive some kind of treatment.

A higher percentage of school-aged children (2904 ) were prescribed medications, and fewer had therapy only (639 ) or no treatment at all (884 ). In the first year after diagnosis, 516 preschool children (19.4%) received behavioral therapy only, 860 (32.4%) had medications only, 505 (19.0%) had both, and 774 (29.2%) had no claims associated with either option. In multivariate Cox regression adjusting for sex, region, and household income, the hazard ratio for Asian children was 0.48 (95% CI, 0.43-0.53) Black children, 0.83 (95% CI, 0.77-0.90) and Hispanic children, 0.77 (95% CI, 0.72, 0.82) compared with White children.

Data on ADHD diagnosis and treatment were adjusted for sex, region, and household income in a multivariate Cox regression model. Main Outcomes and Measures ADHD diagnosis as defined by International Classification of Diseases codes (ninth or tenth editions) and treatment within 1 year of diagnosis, including medication and behavior therapy as defined by billing codes. Data were analyzed between October 2019 and December 2020. Race/ethnicity designations were based on self-report and included non-Hispanic White, Black, Hispanic, and Asian. The last date of follow-up included in the cohort was June 30, 2019. Objective To explore differences in rates of diagnosis of ADHD and use of treatment among children by race and ethnicity.ĭesign, Setting, and Participants This retrospective cohort study assessed insurance claims data of children born in the US between January 1, 2006, and December 31, 2012, who had continuous insurance coverage for at least 4 years. Importance There are limited data on the racial disparities in the incidence of attention-deficit/hyperactivity disorder (ADHD) diagnosis in children at the national level. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.

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