Social Determinants of Health and ADHD Symptoms in Preschool-Age Children

J Atten Disord. 2022 Feb;26(3):447-455. doi: 10.1177/1087054721996458. Epub 2021 Mar 1.

Abstract

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) disproportionately affects socioeconomically disadvantaged children, but for unclear reasons. We examined the association between social determinants of health (SDH) and ADHD symptoms in a national sample of preschool-age children.

Methods: We conducted exploratory factor analysis (EFA) and exploratory structural equation modeling (ESEM) with a sample of 7,565 preschool-age children from the 2016 National Survey of Children's Health, to examine the association between ADHD symptoms and SDH.

Results: EFA indicated a one-factor structure for ADHD symptoms, and three factors for SDH (socioeconomic status, access to basic needs, and caregiver well-being). Independently, all three SDH were significantly associated with higher ADHD symptoms. However, in the ESEM model, only worse caregiver well-being (β = .39, p < .01) was significantly associated with ADHD symptoms, and fully mediated the relationship between SDH and ADHD symptoms.

Conclusion: Addressing caregiver well-being in preschoolers with ADHD symptoms could be an early intervention strategy.

Keywords: ADHD; SES; family; parental functioning; preschoolers.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Child
  • Child, Preschool
  • Factor Analysis, Statistical
  • Humans
  • Social Class
  • Social Determinants of Health
  • Surveys and Questionnaires