Specialized Care May 10, 2012

How Geography Drives ADHD Diagnosis

Diagnosis of ADHD varies widely across the U.S. North Carolina has the highest rate of ADHD diagnosis (16.4% of children) while Nevada has the lowest (6.4%).
Tags
  • Attention Disorders
  • Children

This past year, the utilization of medications to treat attention deficit hyperactivity disorder (ADHD) jumped 9.0%. With this increase, the United States now spends more on prescription drugs for Attention Disorders than it does for all but six other conditions.

Currently, an estimated 5.4 million U.S. children are diagnosed with ADHD. And with new guidelines from the American Academy of Pediatrics that now recommend physicians prescribe these medications to children as young as 4 (previous guidelines suggested a lower limit of age 6), the number of total diagnosed children is likely to grow.

Interestingly, the local impact of this national trend depends highly on where you live.

When looking only at Americans with commercial insurance, Express Scripts researchers found that children living in the South are 63% more likely to be diagnosed with ADHD than children living in western states. When broadening to all American children (including those on Medicaid and other government-sponsored plans where ADHD prevalence is higher), those living in a southern state have approximately a 1 in 9 chance of being diagnosed with this condition.  

Percentage of children with ADHD in US by region

At the individual state level, the disparities are even more startling. North Carolina has the highest rate of ADHD diagnosis (16.4% of children) while Nevada has the lowest (6.4%).

So What Does This All Mean?

Are physicians in the South overdiagnosing ADHD? Are Nevadans simply more tolerant of children who are easily distracted? Are the three most important aspects affecting prevalence of ADHD simply… Location, Location, Location?

Not necessarily. It’s important to note that our research only indicates correlation – not causation – between geography and ADHD diagnosis. We can’t look at this data and suggest that any one region of the United States is more accurate with its diagnoses than the others.

That said, as we study regional disparities for these frequently used medications, we will continue to identify prescription drug trends that lead to better health and value.

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