Explaining racial and ethnic differences in children's use of stimulant medications

• Published in: Medical care Vol. 45; no. 11; p. 1068
• Main Authors: Hudson, Julie L, Miller, G Edward, Kirby, James B
• Format: Journal Article
• Language: English
• Published: United States 01.11.2007
• Subjects: Adolescent; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - ethnology; Central Nervous System Stimulants - administration & dosage; Central Nervous System Stimulants - therapeutic use; Child; Child, Preschool; Drug Utilization; Female; Humans; Insurance Coverage; Insurance, Health; Male; Mental Health; Socioeconomic Factors
• ISSN: 0025-7079
• DOI: 10.1097/MLR.0b013e31806728fa

To document and explain racial/ethnic differences in the use of stimulant drugs among US children. We use a nationally representative sample of children ages 5-17 years old from the Medical Expenditure Panel Survey (MEPS) for the years 2000-2002. We estimate race-specific means and regressions to highlight differences across groups in individual/family characteristics that may affect stimulant use and differences in responses to these characteristics. Then, we use Oaxaca-Blinder decomposition methods to quantify the portion of differential use explained by differences in individual/family characteristics. Finally, we use pooled regressions with race/ethnicity interactions to formally test the hypothesis that responses to perceived mental health and behavioral problems vary across groups. White children are about twice as likely to use stimulants as either Hispanic or Black children. Differences in individual/family characteristics account for about 25% of the difference between whites and Hispanics, but for none of the difference between whites and blacks. Pooled regressions show that racial/ethnic gaps in stimulant use persist among children with otherwise similar reported mental health conditions. Our finding that the majority of racial/ethnic differences in children's stimulant use is explained by differences in responses to individual/family characteristics highlights the importance of further research to examine the reasons for these differences. It is striking that children with otherwise similar reports of mental health problems have such different outcomes in terms of stimulant use. Potential explanations range from discrimination to cultural differences by race/ethnicity or community.