The Many Faces of ADHD: ADHD in the U.S. Population
Gallery: Dr. Mark L. Prohaska Director, Neuropsychology Clinic, PC Specialties include the assessment of and interventions for AD/HD, Learning Disabilities, and Sensory Processing Disorders in children and adults. [1 Image] Click any image to expand.
What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a condition that affects children, adolescents, and adults. It is characterized by problems with attention, impulsivity, and hyperactivity.
How common is ADHD?
There are many ways to measure how frequently a health condition occurs. “Prevalence” measures how common a condition is in a given population at a certain point in time or over a period of time. The prevalence of ADHD among U.S. school-age children (aged 3-17)ii is about 9% (up to 5 million children). ADHD is more common in boys than in girls, and more common in non-Hispanic White and African-American children than in Hispanic children. Recent data for children ages 5-17 show the following prevalence ratesiii:
Prevalence by Race:
· All - 9.4%
· White - 9.6%
· Black - 10.5%
· American Indian/Alaska Native - 6.4%
· Asian - 1.4%
· Multiple race - 11.6%
Prevalence by Ethnicity:
· Hispanic - 4.9%
· Non-Hispanic - 10.6%
· Non-Hispanic White - 11.2%
· Non-Hispanic Black - 10.8%
Does ADHD affect adults?
Yes. It was once thought that ADHD only affected children and that they would outgrow it. We now know this is not the case. More often than not, ADHD continues in the adult years, and some adults are even diagnosed in adulthood. The prevalence of ADHD in the U.S. adult populationiv is 4.4%. Of those affected, 38% are women and 62% are men.v
Are rates of ADHD increasing?
The best way to answer this question is to examine prevalence rates over time. The Centers for Disease Control and Prevention (CDC) monitors and analyzes data from many national surveys. One survey, the National Survey of Children’s Health (NSCH), gathers data from tens of thousands of U.S. households on a variety of children’s health issues. Comparison of data from 2003 to 2007 shows an increase in the prevalence of ADHD as reported by parents. Here are some findings:
· Parent-reported rates of ADHD increased 22%, and by 2007, 7.2% of all school-aged children had a diagnosis of ADHD.
· Diagnosis rates varied by geographical region.
· Higher rates were generally found in the Southeastern U.S. , with North Carolina and Louisiana having the highest rates.
· Lower rates were generally found in the Western and Southwestern U.S. with Nevada and New Mexico having the lowest rate.
Why are ADHD prevalence rates increasing?
Surveys of ADHD rates do not address this question directly, but some possible explanations include:
· More screening by pediatricians and other primary care givers.
· Improved awareness about ADHD among both health care practitioners and parents.
· Decreased stigma surround ADHD.
· Availability of better treatment options.
· More cases of ADHD, due to suspected environmental causes such as toxins in the environment and familial elements that effect specific development outcomes in children.
Why do ADHD prevalence rates differ across the US?
There are different rates of ADHD diagnosis and treatment, and these are probably best explained by different state-based policies and programs around such things as: health insurance, both public and private, developmental screening efforts, access to health care, and socio-economic factors such as poverty rates.
Are “parent-reported” rates dependable?
This is a good question. It’s true that “parent-reported” data are not the same as data that come from studies in which expert clinicians conduct assessments using strict diagnostic criteria. However, data from the NSCH surveys strongly suggest that parents and caregivers are reliable sources of information for the purposes of this survey. ADHD prevalence rates from NSCH are consistent with smaller community based studies. Also, the prevalence rates of other neurobiological disorders have trended in a similar predictable fashion.
What are the costs of ADHD?
People with ADHD have more difficulties in school, at work, and in social relationships than those without the disorder. They have higher rates of emergency room visits and automobile accidents, are at greater risk for substance abuse, and experience higher rates of job turnover. The economic cost to society is huge: the cost to the American economy for ADHD has been estimated at between $36 billion and $52 billion annually (2005 dollars).vi
i Prepared by the National Resource Center on ADHD: A Program of CHADD (NRC). The NRC is supported through Cooperative Agreement Number CDC-RFA-DD13-1302 from the Centers for Disease Control and Prevention (CDC). The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.
ii US Centers for Disease Control and Prevention, Summary Health Statistics for US Children: National Health Interview Survey, 2009, http://www.cdc.gov/nchs/data/series/sr 10/sr10 247.pdf .
iii US Centers for Disease Control and Prevention, Attention deficit hyperactivity disorder, learning disability, behavior difficulty, ages 5-17: US, 1999-2010 (Source: National Health Interview Survey); http://22.214.171.124/HDI/TableViewer/tableView.aspx?ReportId=58.
iv National Resource Center on ADHD: A Program of CHADD, www.help4adhd.org/statistics.
v National Resource Center on ADHD: A Program of CHADD, www.help4adhd.org/statistics . http://ajp.psychiatryonline.org/article.aspx?Volume=163&page=716&journalID=13.vi US Centers for Disease Control and Prevention, www.cdc.gov/ncbddd/adhd/facts.html.