Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?

Miller, Torri; Nigg, Joel T.; Miller, Robin Lin

doi:10.1016/j.cpr.2008.10.001

Cited by 133 publications

(129 citation statements)

References 71 publications

(100 reference statements)

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“…9 However, whether and to what extent these disparities also occur among Hispanics and children of other races/ethnicities has not been systematically examined. 37,38 Our study extends previous work by establishing that children who are African-American, Hispanic, or of other races/ethnicities are less likely than whites to be diagnosed with ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…Racial/ethnic minorities in particular have been reported to be diagnosed with ADHD at lower rates than white children, 7 and therefore may have unmet treatment needs. 8 Children who are African American are diagnosed with ADHD at only two-thirds the rate of white children despite displaying greater ADHD symptomatology, 9 and Hispanic children have also been reported to be underdiagnosed. 1 Less is known about diagnosis disparities for children of other races/ ethnicities.…”

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confidence: 99%

“…1 Less is known about diagnosis disparities for children of other races/ ethnicities. 9 In addition, racial/ethnic minorities who are diagnosed with ADHD have been reported to be less likely to use prescription medication. 2, 10 Hypothesized mechanisms for ADHD diagnosis and treatment disparities include less frequent access to health professionals and service utilization [11][12][13][14] and, when seen, less frequent solicitation by professionals of developmental concerns.…”

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confidence: 99%

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Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Morgan¹,

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Minority children are less likely than white children to be diagnosed and treated with attentiondeficit/hyperactivity disorder. However, diagnosis patterns over time in early and middle childhood and whether confounding factors explain these disparities are not currently well understood.WHAT THIS STUDY ADDS: Racial/ethnic disparities in attentiondeficit/hyperactivity disorder diagnosis occur by kindergarten and continue until eighth grade. Racial/ethnic disparities among diagnosed children in medication use occur in both fifth and eighth grades. These disparities are not attributable to confounding factors. abstract OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early ChildhoodLongitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling.RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children' s risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children' s risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder.CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93

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Section: Discussionmentioning

confidence: 99%

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Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Morgan¹,

et al. 2013

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“…17 The prevalence of ADHD between 1997 and 2006 was ϳ6.5%. 17 The CDC study 17 and other nationally representative studies 18,19 have revealed that ADHD prevalence is highest among poor children. Froehlich et al 18 reported an adjusted odds ratio of ADHD prevalence of 2.3 (95% confidence interval [CI]: 1.4 -3.9) for the poorest quintile compared with the wealthiest quintile.…”

Section: Adhdmentioning

confidence: 99%

Health Inequity in Children and Youth With Chronic Health Conditions

et al. 2010

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BACKGROUND: Over the last decades, there have been great advances in health care delivered to children with chronic conditions, but not all children have benefitted equally from them. OBJECTIVES: To describe health inequities experienced by children with chronic health conditions. METHODS: We performed a literature review of English-language studies identified from the Medline, Centers for Disease Control and Prevention, National Cancer Institute, and Cystic Fibrosis Foundation Web sites that were published between January 1985 and May 2009, included children aged 0 to 18 years, and contained the key words “incidence,” “prevalence,” “survival,” “mortality,” or “disparity” in the title or abstract for the following health conditions: acute leukemia, asthma, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders, cerebral palsy, cystic fibrosis, diabetes mellitus, Down syndrome, HIV/AIDS, major congenital heart defects, major depressive disorder, sickle cell anemia, spina bifida, and traumatic brain injury. RESULTS: Black children had higher rates of cerebral palsy and HIV/AIDS, were less likely to be diagnosed with ADHD, had more emergency department visits, hospitalizations, and had higher mortality rates associated with asthma; and survived less often with Down syndrome, type 1 diabetes, and traumatic brain injury when compared with white children. Hispanic children had higher rates of spina bifida from Mexico-born mothers, had higher rates of HIV/AIDS and depression, were less likely to be diagnosed with ADHD, had poorer glycemic control with type 1 diabetes, and survived less often with acute leukemia compared with white children. CONCLUSIONS: Serious racial and ethnic health and health care inequities persist for children with chronic health conditions.

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“…Children in singlemother families are more likely to have ADHD compared to children in two-parent families (12% versus 8%) [2]. A review by Miller et al [3] found that African-American children have higher ADHD behavior ratings, while puzzlingly at the same time the reported incidence of ADHD is lower for African-American children, with African-American youth being diagnosed only about two-thirds as often as white children. Decreased access to and utilization of psychiatric services by the African-American community can potentially explain this pattern.…”

Section: Introductionmentioning

confidence: 99%

An Assessment of Comorbidity and Social Demographics in a Primarily African-American and Hispanic Population of Boys with ADHD Treated in Psychiatric/Non-Psychiatric and Public/Private Clinics in Miami, Florida

Rothe¹,

Lewis²

2016

J Child Adolesc Behav

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Objective: To determine whether social disadvantage and comorbidity in boys with attention-deficit/hyperactivity disorder (ADHD) differ among psychiatric versus non-psychiatric and public versus private clinics. Methods:This cross-sectional study included boys 6-12 years of age, clinically diagnosed, and pharmacologically treated for ADHD at 1 of 5 clinics in Miami, Florida. The child's caregiver completed a demographics form, the Child Behavior Checklist, and the Child Symptom Inventory. Results:The study included 174 boys (28% African-American and 64% Hispanic). The sample included 42% psychiatric practices and 73% public clinics. Compared to the non-psychiatric sample, children in the psychiatric samples presented more often with ADHD hyperactive-impulsive subtype and combined subtype. Children in the psychiatric clinics had the most severe forms of ADHD and the most comorbid diagnoses, particularly behavioral, mood, and anxiety disorders. Compared to the private clinics, children in the public psychiatric clinic presented more markers of socioeconomic disadvantage. Public clinics also had more severe ADHD, social phobia, aggressive behavior, and externalizing behaviors than private clinics. Conclusions:Comorbidity and severity of ADHD in children treated in primary care clinics were lower than, but clinically comparable to, that found in psychiatric clinics. Socioeconomic disadvantages are present in children treated in public clinics.

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Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?

Cited by 133 publications

References 71 publications

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Health Inequity in Children and Youth With Chronic Health Conditions

An Assessment of Comorbidity and Social Demographics in a Primarily African-American and Hispanic Population of Boys with ADHD Treated in Psychiatric/Non-Psychiatric and Public/Private Clinics in Miami, Florida

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