ADHD Questions
ADHD Risk
Is ADHD more common in working-class families?
Charles Li, MD
April 20, 2023
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Children in working-class households have a much higher risk of developing ADHD. Both income and the parents' education have been linked with ADHD risk.
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However, in families where one or both parents have ADHD, income plays less of a role.
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Studies on ADHD persistence have shown that income and education are not linked with recovery odds.
The link between ADHD and income
There is considerable evidence that ADHD may be more common in the working class, at least in the western world.
Several studies have established a link between ADHD risk, income, and education.
One study, summarized below, found that children from low-income families had nearly twice the risk of developing ADHD.
Meanwhile, children from families where the mother went to college had around half the risk.
The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence
The results show that the differences were robust. Children of parents with less education or lower income were more likely to exhibit ADHD symptoms, according to both parents and teachers.
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We found no support for the hypothesis of overreporting by clinicians about children of lower SES: while clinical diagnosis of ADHD was elevated in socioeconomically disadvantaged groups, our results suggest that parent-rated and teacher-rated symptoms were equally elevated in disadvantaged groups.
When researchers looked at the data in more depth, they found that households with children with ADHD had less income throughout the study.
ADHD was associated with a lower household income. However, having kids with ADHD did not reduce income growth over time.
A second study confirmed the link between class and ADHD risk in a different population.
Researchers found that low parental education and low income had a similar effect as having parents with ADHD.
Attention-Deficit/Hyperactivity Disorder (ADHD): Interaction between socioeconomic status and parental history of ADHD determines prevalence
This suggests that growing up working class can play just as significant of a role in ADHD risk as genetics.
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The powerful combined effects of SES and parental history are noteworthy because they suggest that both social and biological risk factors are involved in the etiology of ADHD, a paradigm that is gaining increasing acceptance
One unexpected finding was that income only played a significant role if neither of the parents had ADHD.
This suggests that the relationship between income and ADHD risk might be complex.
For kids with a genetic risk of ADHD, based on their parents having ADHD, income didn’t matter much. They were at a higher risk, no matter if they came from a high-income or low-income family.
Meanwhile, for kids, without a strong genetic risk, income played a much more significant role in ADHD risk.
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One interpretation, though speculative, is that environmental and genetic risk factors work differently. Among children without a strong genetic vulnerability, environmental risk factors become important; however, among children with a substantial genetic vulnerability, the impact of environmental risk factors becomes less important.
How social class affects ADHD, persistence and recovery
Given that those from a working-class background have a significantly higher risk of developing ADHD, what about the risk of long-term ADHD?
Some individuals with ADHD continue having significant symptoms into adulthood. This is termed ADHD persistence and has been associated with significantly more challenges in life.
According to the evidence, growing up working class does not affect ADHD recovery odds.
While income is associated with ADHD development, high-income and low-income individuals have similar odds of recovering from ADHD.
One study found that the main factors predicting recovery are the severity of the symptoms and the presence of other disorders, particularly major depressive disorder, and conduct disorder.
Researchers in this study tested for intelligence and income and found no significant links.
Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta‐analysis
Key takeaways
Based on the evidence, children growing up in working-class families have a much higher risk of developing ADHD. Both income and the parents' education have been associated with ADHD risk.
However, this link does not extend to ADHD persistence. It only affects your risk of developing ADHD and not necessarily recovering from ADHD.