Neighborhood Socioeconomic Characteristics and Utilization of ADHD Medication in Schoolchildren: A Population Multilevel Study in Stockholm County.
Objective:To examine the effects of neighborhood socioeconomic disadvantage and ethnic composition on the utilization of ADHD medication in schoolchildren after accounting for individual- and family-level characteristics.Method:A cohort of all schoolchildren living in Stockholm County was prospectively followed for new prescriptions of ADHD medication (N= 276,955). Three-level logistic regression models were used with individual/family characteristics (e.g., immigrant background) at the first level and small area market statistics (SAMS) and municipality characteristics (i.e., socioeconomic disadvantage and ethnic composition) at the second and third level.Results:SAMS socioeconomic disadvantage was associated with increased utilization of ADHD medication. The utilization of ADHD medication was lower among immigrant children as compared with natives, and their odds of not utilizing medication increased as the degree of concentration of foreign-born increased.Conclusion:These results suggest that interventions at the neighborhood level may offer an additional route for the prevention of the disorder and/or alleviation of its consequences.
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Beata
B
Jablonska
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Kyriaki
K
Kosidou
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Antonio
A
Ponce de Leon
Karolinska Institutet, Stockholm, Sweden.
Björn
B
Wettermark
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Cecilia
C
Magnusson
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Henrik
H
Dal
Stockholm County Council, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Christina
C
Dalman
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D005006:Ethnicity; D005191:Family Characteristics; D006801:Humans; D016015:Logistic Models; D012111:Residence Characteristics; D012959:Socioeconomic Factors
ADHD; SES; epidemiology; ethnic minorities; school-age children