The 1997-2001 National Health Interview Survey (NHIS) was used to examine racial/ethnic differences among children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and/or Learning Disability (LD) and those who used any prescription medication for a chronic condition.  The NHIS is a cross-sectional survey of a nationally representative sample of households (approximately 40,000 each year) including questions about a randomly selected child in the family.  For this period, data were available for over 20,000 children ages 6-11 years. Low birth weight (<2500 grams) was more frequent among African American (12%) than white children (5%). More Hispanic (28%) and African American (32%) children lacked health insurance (Medicaid, private or other coverage) compared to 8% of white children.

Almost seven percent of the total group was reported to have been diagnosed with ADHD or Attention Deficit Disorder (ADD), and half of these children were reported to also have an LD.  Hispanic and African American children were significantly less likely than non-Hispanic white children to have ADHD (with or without LD) even after controlling for low birth weight, family income level and health insurance.  Another five percent of the sample had been diagnosed with a learning disability by a healthcare or school professional but not ADHD. After considering variables such as income and health insurance, there were no significant racial/ethnic differences in the rates of diagnosed LD.

The NHIS survey specified the percentage of children with any current condition for which prescribed medicine had been taken regularly for at least three months. In this study, 58% of the group reported to have ADHD were said to regularly use prescribed medication as compared to 16% with LD but not ADHD and 7% with neither condition. Higher family income or having health insurance (Medicaid or private) were both independently associated with a higher likelihood of using regular medication with or without ADHD.

In this study, health history and sociodemographic factors such as family income did not explain ethnic/racial differences in the percentage of children reported to have ADHD or the percentage of children with ADHD who took any long-term medication.

(Pastor P. and Reuben C. Public Health Reports 2005;120(4):383-392)

Comment: Despite the limitations of parent-reported health information, this suggests that there is no simple socioeconomic explanation for racial/ethnic differences among children with respect to ADHD diagnosis or medication use for chronic conditions.  –J.O.