Black–White Differences in Formal ADHD Diagnoses: Unmet Need, or Conscious Decision-Making Process?

I discuss the formal attention deficit hyperactivity disorder (ADHD) diagnosis process and whether the Black–White differences found in this process are the results of unmet needs or conscious decisions.

First, I offer a new analytic framework for understanding the “ADHD process.” The proposed framework breaks ADHD diagnoses down into three stages: the informal diagnosis, the formal diagnosis, and treatment. This approach reveals certain racial trends in the ADHD literature. Second, I use the 2007 National Health Interview Survey (total n = 75,764) to address racial differences.

I find that blacks are less likely to hold a formal ADHD diagnosis than whites. Third, nested logistic models reveal that this racial difference is not explained by health insurance status, family income, or family educational level. New explanatory models for the black–white difference in ADHD should stray from a strict reliance on the “unmet need” discourse, and instead focus on other factors that may affect the decision-making process in diverse families.

This chapter makes three contributions to the wider literature on ADHD and race.