Rates of diagnosis and treatment of Attention Deficit/Hyperactivity Disorder in Manitoba children: considering the socioeconomic gradient
Yallop, Lauren P.
This project investigated the diagnosis and psychostimulant treatment rates of Attention Deficit/Hyperactivity Disorder (ADHD) in Manitoba children. These rates were considered according to sex, age, socioeconomic status (SES), geographical region, and comorbidity with learning disabilities (LD) and behavioral disturbances (BD). Data came from the Manitoba Population Health Research Data Repository, a comprehensive collection of administrative, registry, survey and other databases. The research population included all children aged 0 to 19 years in Manitoba (n = 319,506) with a diagnosis of ADHD (n= 9,233), during two Fiscal years (2003/2004 and 2004/2005). The term “gradient” refers to the relationship between SES and health and emphasizes the idea that the change in outcomes is gradual and occurs across the full range of SES. Results from this study indicate that region of residence (urban versus rural) and comorbid BD moderate the SES gradient, as low income, urban dwelling children with a comorbid diagnosis of BD had the highest rates of ADHD diagnoses and prescriptions. Furthermore, whereas age did not moderate the SES gradient, the crude rates indicated that the SES gradient for ADHD diagnoses and prescriptions was most pronounced in urban children 0 to 13 years of age. Otherwise, all main effects tested (sex, age, socioeconomic status, geographical region, and comorbid BD and LD) were significant in both the diagnosis and prescription models for ADHD. Policy considerations that arise out of this study include more stringent diagnostic and prescription treatment practices, additional support resources for children who are most at risk of having ADHD, and increased information about alternate treatment implementation for ADHD.
ADHD, socioeconomic gradient, child, population, SES, comorbid disorders