Trends in the Prevalence and Incidence of Attention-Deficit/Hyperactivity Disorder Among Adults and Children of Different Racial and Ethnic Groups
Winston ChungSheng‐Fang JiangDiana PaksarianAki NikolaidisF. Xavier CastellanosKathleen R. MerikangasMichael P. Milham
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Abstract:
Importance
An increasing prevalence of adult attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment has been reported in clinical settings and administrative data in the United States. However, there are limited data on recent trends of adult ADHD diagnosis among racial/ethnic subgroups.Objective
To examine trends, including associated demographic characteristics, psychiatric diagnoses, and negative outcomes, in the prevalence and incidence of adult ADHD diagnosis among 7 racial/ethnic groups during a 10-year period.Design, Setting, and Participants
This cohort study investigated trends in the diagnosis of ADHD in adults who identified as African American or black, Native American, Pacific Islander, Latino or Hispanic, non-Hispanic white, Asian American, or other using the Kaiser Permanente Northern California health plan medical records. A total of 5 282 877 adult patients and 867 453 children aged 5 to 11 years who received care at Kaiser Permanente Northern California from January 1, 2007, to December 31, 2016, were included. Data analysis was performed from January 2017 through September 2019.Exposures
Period of ADHD diagnosis.Main Outcomes and Measures
Prevalence and incidence of licensed mental health clinician–diagnosed ADHD in adults and prevalence of licensed mental health clinician–diagnosed ADHD in children aged 5 to 11 years.Results
Of 5 282 877 adult patients (1 155 790 [21.9%] aged 25-34 years; 2 667 562 [50.5%] women; 2 204 493 [41.7%] white individuals), 59 371 (1.12%) received diagnoses of ADHD. Prevalence increased from 0.43% in 2007 to 0.96% in 2016. Among 867 453 children aged 5 to 11 years (424 449 [48.9%] girls; 260 236 [30.0%] white individuals), prevalence increased from 2.96% in 2007 to 3.74% in 2016. During the study period, annual adult ADHD prevalence increased for every race/ethnicity, but white individuals consistently had the highest prevalence rates (white individuals: 0.67%-1.42%; black individuals: 0.22%-0.69%; Native American individuals: 0.56%-1.14%; Pacific Islander individuals: 0.11%-0.39%; Hispanic or Latino individuals: 0.25%-0.65%; Asian American individuals: 0.11%-0.35%; individuals from other races/ethnicities: 0.29%-0.71%). Incidence of ADHD diagnosis per 10 000 person-years increased from 9.43 in 2007 to 13.49 in 2016. Younger age (eg, >65 years vs 18-24 years: odds ratio [OR], 0.094; 95% CI, 0.088-0.101;P < .001), male sex (women: OR, 0.943; 95% CI, 0.928-0.959;P < .001), white race (eg, Asian patients vs white patients: OR, 0.248; 95% CI, 0.240-0.257;P < .001), being divorced (OR, 1.131; 95% CI, 1.093-1.171;P < .001), being employed (eg, retired vs employed persons: OR, 0.278; 95% CI, 0.267-0.290;P < .001), and having a higher median education level (OR, 2.156; 95% CI, 2.062-2.256;P < .001) were positively associated with odds of ADHD diagnosis. Having an eating disorder (OR, 5.192; 95% CI, 4.926-5.473;P < .001), depressive disorder (OR, 4.118; 95% CI, 4.030-4.207;P < .001), bipolar disorder (OR, 4.722; 95% CI, 4.556-4.894;P < .001), or anxiety disorder (OR, 2.438; 95% CI, 2.385-2.491;P < .001) was associated with higher odds of receiving an ADHD diagnosis. Adults with ADHD had significantly higher odds of frequent health care utilization (OR, 1.303; 95% CI, 1.272-1.334;P < .001) and sexually transmitted infections (OR, 1.289; 95% CI 1.251-1.329;P < .001) compared with adults with no ADHD diagnosis.Conclusions and Relevance
This study confirmed the reported increases in rates of ADHD diagnosis among adults, showing substantially lower rates of detection among minority racial/ethnic subgroups in the United States. Higher odds of negative outcomes reflect the economic and personal consequences that substantiate the need to improve assessment and treatment of ADHD in adults.While ethnic identity, ethnic relations, ethnic conflict, and immigration are increasingly important factors in national, regional, and international affairs, there are no definitions or criteria consistently applied to delineate ethnic groups in nation worldwide. Thus, in this article, I have examined the concept of ethnic groups and theories of ethnicity concisely, in the hope of promoting discussions of the theories of ethnicity, and popularizing those concepts of ethnic groups and ethnicity.
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Given limited reports on diabetes among U.S. Asian and Pacific Islander youth, we describe the clinical characteristics, incidence, and prevalence of diabetes among Asian, Pacific Islander, and mixed Asian-Pacific Islander youth.Data were collected from 245 Asian, Pacific Islander, and Asian-Pacific Islander participants in the SEARCH for Diabetes in Youth Study, a population-based study of diabetes in youth (aged <20 years). Additionally, we estimated the incidence and prevalence of type 1 and type 2 diabetes for Asian, Pacific Islander, and Asian-Pacific Islander youth combined.Most participants with type 2 diabetes were obese (range Asian 71% to Pacific Islander 100%) with mean BMI >33 kg/m(2). In those with type 1 diabetes, Pacific Islanders were more likely to be obese, with a mean BMI of 26 vs. 20 kg/m(2) for Asian and Asian-Pacific Islander youth (P < 0.0001). The incidence of type 1 diabetes for youth aged 0-9 years was 6.4 per 100,000 person-years and 7.4 per 100,000 person-years for youth aged 10-19 years. The incidence of type 2 diabetes was 12.1 per 100,000 person-years for youth aged 10-19 years.While Asian and Asian-Pacific Islanders with type 1 and type 2 diabetes had lower mean BMIs than Pacific Islanders, all Asian, Pacific Islander, and Asian-Pacific Islanders with type 2 diabetes had mean BMIs above adult ethnicity-specific definitions of obesity. While the majority of Asian, Pacific Islander, and Asian-Pacific Islander youth had type 1 diabetes, older Asian, Pacific Islander, and Asian-Pacific Islander youth (aged 10-19 years) have an incidence of type 2 diabetes almost double that of type 1 diabetes. Public health efforts to prevent type 2 diabetes and obesity in Asian, Pacific Islander, and Asian-Pacific Islander adolescents are needed.
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Author(s): Faruk, Farheen | Advisor(s): Anton-Culver, Hoda | Abstract: Pacific Islanders are often analyzed as a subset of the Asian population. There is a lack of research on the Pacific Islander population in California. Although the Pacific Islander population in the United States is rather small, it is still important to study. The objective of this study determined the risk factors for these cardiometabolic disease conditions in Pacific Islanders. The prevalence of diabetes, high blood pressure, and overweight/obesity were examined in Pacific Islanders, and risk factors associated with these conditions were examined in Pacific Islanders. We found that Pacific Islanders had a weighted prevalence of diabetes that was intermediate in comparison to other race groups. Hypertension was lower than the overall sample prevalence and most race groups. Overweight and obesity prevalence was second highest in the Pacific Islander population. It was also found that the risk factors associated with each disease outcome differed between Pacific Islanders and Whites. Smoking status, high blood pressure, and high BMI were associated with odds of diabetes. Insurance status, diabetes, and high BMI were associated with odds of high blood pressure. Diabetes, high blood pressure, and sex were associated with odds of high BMI in Pacific Islanders.
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This study compared fitness components in 317 women of different ethnicity from BYU-Hawaii. Data was analyzed using SPSS, ANOVA, t-tests, and Tukey’s HSD Post-Hoc Test. Results showed American Caucasians were faster and leaner than Pacific Islanders and Hawaiians. American Caucasians, Pacific Islanders and Hawaiians were stronger than Asians. American Caucasians did more sit-ups than Pacific Islanders and Asians and more back extensions than Pacific Islanders. Asians were leaner than Pacific Islanders and Hawaiians, and faster than Pacific Islanders. Whether these differences resulted from genetics or socio-cultural factors is unclear. Differences may be remedied by ethnic norms as developed in this study.
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Though some anthropologists and ethnologists often discuss the two terms ethnic group and ethnicity,they are not sure about the exact meanings of them.The article discusses ethnic group according to the reality in China.We can use it on three levels.The paper reviews ethnicity and argues that we should connect ethnicity research with social reality.
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The book Ethnic Groups and Their Culture,whose chief editor is Professor Xu Jie-shun,was published by the Heilongjiang People's Publishing House in 2006 and collected the relevant achievements of studies of ethnic groups of the contemporary anthropology researchers.The works provides the latest interpretation of ethnic groups study in the academic circle in China and falls into such sections as special articles,concept of ethnic groups,theory of ethnic groups,identity of ethnic groups,relations of ethnic groups and culture of ethnic groups.
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Implementing modern ethnic education will lead t o creation of a culture conforming to the times and with local and ethnic charac teristics.To achieve this goal,ethnic education must combine objective reality a nd general demands of modern education with subjective desires and special deman ds of ethnic students.Ethnic education must serve ethnic development.
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Abstract Lung, Colorectal, and Pancreatic cancers are among the deadliest due to lack of early detection methods and few effective treatments. Among these cancers, patients who come from White or Black backgrounds have been shown to have the highest incidence and mortality when compared to other racial groups including Pacific Islanders. Although, most data aggregate Asian Americans and Pacific Islanders together, previous studies show that the trends in cancer rates and treatment efficacy is drastically different among these two groups. The Surveillance, Epidemiology and End Results (SEERs) Program conducted by the NIH is one such database that shows Asian Americans and Pacific Islanders as having the lowest incidence and mortality for all three of the top deadly cancers. The SEER is a database that collects cancer statistics from 33 different registries including Hawai'i, four California registries, Alaska, Texas and Utah, which are states with the highest populations of Pacific Islanders. The SEER also identifies White and Black Patients to have the highest incidence of Prostate Cancer but former studies have shown that Pacific Islanders surpass White non-Hispanics which the SEER establishes as the second highest in prostate cancer incidence. By disaggregating the data to analyze Pacific Islanders compared to other racial and ethnic groups, we can determine the true trends of cancer rates and mortality in the Pacific Islander Community. Through this work we will also determine if the standard of care treatments available to patients of these most deadly cancers is effective in those with a Pacific Islander background. Our data and data from other studies have shown that standard of care treatments are more effective in patients of European descent and are not as effective with patients from other communities due to the trials and tools used focusing a majority on caucasian patients. This is due to afflictions such as diabetes, obesity, history of smoking or drinking, and other criteria that may disqualify patients for clinical trials and treatments, however the communities most effected and have the highest prevalence of these criteria are people of color including Pacific Islanders. Our work is meant to do two things 1) lay a foundation to start collecting disaggregated data to get true trends of cancer statistics and 2) to understand the efficacy of treatments on the Pacific Islander community that is usually collected with Asian Americans which may mask the true effect on the microminority community of Pacific Islanders. Citation Format: Daniel J. Salas-Escabillas, Nicholas A. Sowizral, Sarah McNally, Sela V. Panapasa. Investigating standard of care treatments for cancers and their efficacy in Pacific Islander populations [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B049.
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Abstract The effect of ethnic threat on adolescents' ethnic self-concept and own-group ratings, and the role of self-esteem and ethnic identity in mediating this effect were examined. Hispanic high school students in the United States received either negative (threat) or neutral information about their ethnic group. Ethnic self-concept and own-group ratings were then assessed. The negative information resulted in lower overall ethnic group ratings, but not in lower ethnic self-concept. Self-esteem was a better predictor of ethnic ratings than ethnic identity was.
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