How Do Socioeconomic Disadvantages Impact ADHD?

Medically Reviewed by Dan Brennan, MD on July 25, 2022
4 min read

Despite growing insight into adult ADHD, there isn’t much data to explain how income, race, and culture affect trends in diagnosis and treatment of adults with the disorder. One reason for this is that when doctors check kids for ADHD, that’s typically their primary condition. Adults are more likely to have other issues that make an ADHD diagnosis less obvious.

Another factor is that an adult ADHD diagnosis mainly depends on self-reporting. That means adults would have to recognize symptoms in themselves and get treatment. Children are more likely to get a diagnosis because adults who care for them see the symptoms.

But some patterns experts see in children with ADHD may give insight to who gets diagnosed with and treated for the condition as an adult. Here’s what we found.

One study found that kids who live in families below the federal poverty level are more likely to get an ADHD diagnosis compared to kids who don’t. Another suggested the same. More specifically, the risk of diagnosis doubles for children of low socioeconomic status.

Researchers aren’t sure exactly why this is the case, but their studies identified certain factors related to the likelihood of getting a diagnosis, such as financial difficulties and parents’ marital status.

One theory about why ADHD is higher in children of lower socioeconomic groups is that there’s a connection between low socioeconomic status and readiness for school. The less ready a child is to start school, the more likely they are to have behavioral issues. They may not be as mature as their classmates and get an ADHD label.

The higher a family’s income, the lower the percentage of ADHD diagnosis across all racial and ethnic groups. Studies also show a relationship between ADHD diagnosis and attending an unsafe school and living in a dangerous neighborhood.

Although there isn’t much data on the impact of lower income and adult ADHD diagnosis, there is evidence that a missed diagnosis in childhood affects the way you’re able to function and achieve as an adult. Early diagnosis and treatment, such as behavioral management and skills training, helps narrow gaps in skills and knowledge that can affect employability.

One study found that non-Hispanic Black children are more likely to have ever been diagnosed with ADHD or a learning disability compared with non-Hispanic white or Hispanic children aged 3-10.

Surveys of non-Hispanic Black and white children show both groups are more likely to be diagnosed with these developmental conditions than Hispanic children. Theories about why this is true include:

  • Socioeconomic and cultural factors
  • Difference in interpretation of behavior
  • Higher likelihood of other mental health conditions depending on race
  • The way health care providers make diagnoses

But some research shows a different result. Depending on the study, Black children may have a higher or lower rate of ADHD diagnoses compared with non-Hispanic White children.

Other research suggests white adults have the highest rates of ADHD while Asian and Native Hawaiian/Pacific Islander adults had the lowest rates. Researchers aren’t sure why this is, but they do know that racial and ethnic background plays a key role in whether adults with ADHD get help. Reasons for this include:

  • Cultural opinions on mental health services
  • Trust in the medical system
  • Specific preferences about doctors

Thousands of kids are being underdiagnosed and undertreated for ADHD, and research shows this is in large part due to race and ethnicity. The impact of this data extends to adulthood, affecting employment and overall mental health later in life.

In fact, taking medication for ADHD early in life can help lower the risk of:

According to research, kids are more likely to get medication to treat ADHD if they are:

  • Non-Hispanic
  • Living in a home with English as the primary language
  • Living in the South
  • Also diagnosed with another condition

White children are most likely to receive treatment for ADHD.

The higher a family’s income level, the higher the odds a kid with ADHD will take medication to treat their disorder. What’s more, research suggests that inequalities in the health care system are behind the higher chances of kids from upper-class families getting this treatment.

The differences in ADHD diagnosis and treatment between ethnic and racial minority groups and white people in the U.S. has multiple causes, not all of which are known. But others include:

Medical mistrust. Within the Black community especially, there is a history of being ignored and mistreated by the U.S. medical system. Because of this, there is a tendency for Black people to be skeptical of the health care system having their best interest at heart.

ADHD stigma. It’s more likely for people from minority cultures to deal with stigma around a mental health diagnosis than people from white communities. This may create more reluctance to seek a diagnosis in the first place or to undergo treatment for ADHD.

Inadequate treatment. Without a diagnosis or proper treatment, people of lower socioeconomic or minority status are already at a huge disadvantage for managing life well and with the right support.