By Black Health Matters
The symptoms of ADHD may be the same for many demographics, but you may be surprised to learn how this behavioral disorder affects the African-American community differently. From difficulties in diagnosis and treatment to underrepresentation in scientific studies, ADHD looks very different for African Americans, and many children are the ones affected.
What is ADHD?
Attention Deficit Hyperactivity Disorder, ADHD, can’t be detected in a medical exam. It’s a behavioral disorder that causes someone to be easily distracted, start tasks and not finish them, and make careless mistakes. In severe cases, it can affect daily functioning, making it harder to get through school or work. Symptoms may be very different depending on the diagnosis. For example, it could be a predominantly inattentive presentation or a combined presentation. While it’s not an anxiety or mood disorder, ADHD is a risk factor for them and can often lead to learning disabilities.
How ADHD affects African Americans
Now that you know what Attention Deficit Hyperactivity Disorder is, keep reading to learn how it affects ethnic groups like Black people through various risk factors.
Less likely to be diagnosed
While the Individuals with Disabilities Education Act helps support special education for those with diagnosed mental health conditions, it’s difficult to help those who struggle without one.
Everyday Health cited a Pediatrics study from the National Library of Medicine that found Black children were over 30 percent less likely to be correctly diagnosed with ADHD symptoms. The study evaluated 17,000 children from Kindergarten through 8th grade.
Many of those diagnosed with ADHD get their diagnosis once they reach school age, when their symptoms are more apparent in the classroom. Behavioral problems and trouble concentrating leading to learning disabilities, are often the first signs, but they can be missed for various reasons. A vast majority of those cases of childhood ADHD that go undiagnosed occur within the Black population.
There are several environmental factors that contribute to these missed diagnoses, including:
- Low socio-economic status
- Racial discrimination, including clinician biaComorbidityto fewer community resources
- Comorbidity (co-existing anxiety disorders, etc.)
- Overcrowded, underfunded school systems
If diagnosed, they are less likely to be treated
The failure to properly diagnose ADHD symptoms in children of color extends to its treatment. Those diagnosed may not have access to the behavioral therapy or medication needed to manage their ADHD symptoms appropriately. Because it will require sustained mental effort even with treatment, living with this conduct disorder can burden children, adolescents and adults alike.
One of the most significant obstacles many must overcome when seeking treatment for Attention Deficit Hyperactivity Disorder is poverty. Healthcare costs are often too high for those without insurance to afford, keeping them from getting the care they need to manage ADHD symptoms. According to a study pcomorbidityThe Clinical Psychology Review, another barrier to treating ADHD is co-morbidity or having more than one mental health condition. Certain anxiety disorders or mood disorders can complicate symptoms and make them harder to detect.
More risks with untreated ADHD
Like all mental health conditions, untreated ADHD has negative consequences, whether it has been diagnosed or not. In children, it’s most often seen in behavioral problems at home and poor performance in school. These can lead to fewer job opportunities as an adult, trouble forming relationships, and susceptibility to additional mental health conditions, especially mood disorders.
Not managing symptoms of ADHD, for various reasons, increases the risk of legal trouble. Yet another study published in The Clinical Psychology Review showed that a higher percentage of children and adolescents with an ADHD diagnosis were associated with arrests, convictions, and incarcerations in their adult life.
One of the most dangerous symptoms is impulsivity, causing a person to take unnecessary risks. This could be a child running into the street after a toy, substance use, or an adult driving erratically when they become impatient. A study published in The Lancet found that those with untreated ADHD symptoms had a much higher risk of death than those taking non-stimulant medication.
Racial disparities within schools
Disparities within schools have improved immensely in the last decade, allowing many students to benefit from newer textbooks, more modern technology in the classrooms, and more and better-distributed funding. However, some disparities still exist that put some students at a disadvantage. Where one student could be seen as impulsive, another may be seen as defiant. Some school districts have invested in training to help teachers notice the signs of ADHD so students can get the proper diagnosis and benefit from the Individuals with Disabilities Education Act.
Schools with many different ethnic groups benefit when teachers and parents work together to understand ADHD symptoms and how they contribute to learning disabilities. Teachers may spend much of their time outside the classroom preparing reports and completing forms for their many students. While they do their best, they may not always notice every symptom. If you are concerned your child may have a conduct disorder like ADHD, you should bring it up with their teacher or a school counselor.
Cultural differences in behavior
Another reason young African Americans are less likely to be diagnosed is that children and adolescents learn to interact with family, friends, and society differently. The ADHD symptoms of a Black person may look completely other than those of a Caucasian or Latino and, therefore, be missed by providers. This has less to do with the actual symptoms of ADHD, a mood disorder, or any other mental health condition and more to do with cultural differences.
Attention Deficit Hyperactivity Disorder, ADHD, can cause extreme restlessness and similar symptoms, which won’t reflect how someone interacts with their peers in the classroom or at work. While cultural differences may become social factors when looking for ADHD symptoms, they should still not be overlooked.
Fewer black mental health providers
Black Americans are not the only cultural community that feels more comfortable seeking care from providers of the same race. A study by Penn Medicine researchers found that most patients responded favorably in after-care surveys if they saw someone within the same ethnic group. This was across the board, with Caucasian, Latino, Asian, and Black African American populations.
For many patients, this may not pose a problem. However, African populations don’t have as many options as other groups when considering their location, insurance plans, income, and other environmental factors. The American Association of Medical Colleges reports a shortage of mental health providers and an ever-growing demand for services. Without relief, those with ADHD symptoms may find it more challenging to locate African American therapists or psychiatrists.
Underrepresented in ADHD studies
ADHD has been studied extensively over the last several decades, but these studies were primarily focused on many children who were white. It wasn’t until the last ten years or so when ADHD scientists began to study the risk factors, including family history, that affect African Americans specifically. The scientific knowledge and other resources about how this behavioral disorder affects Black people are limited compared to what we know about ADHD in general. There should be many more studies completed before we can say that the African American population is fully represented and the research is accurate.
Less understanding of these societal pressures
Contrasting treatment of behavioral, anxiety, and mood disorders for African Americans has become a part of Black history. What is more concerning, though, is that ADHD treatment continues to affect children, adults, and their family members into the present day. Public opinion is that ADHD can lead to substance use within Black communities as well as create political and economic issues. However, those outside of these communities have very little understanding of the profound effects that inequalities still have when it comes to mental health conditions, therapy, and medication.
The lack or misunderstanding of the way ADHD affects more than just the mind and body but a culture as well has led to the increasing disparity seen in health care.
Attention Deficit Hyperactivity Disorder, ADHD, has been a public health concern for decades, but it is only now becoming a more significant and more prominent issue for Black people. It often falls to the person or parent to recognize ADHD symptoms and seek help, despite the stigma. This ensures that everyone receives a proper diagnosis and can get the treatment necessary to live productively and with a positive mindset.
This article originally ran on BlackHealthMatters.com.