The Effects of Attention-Deficit/Hyperactivity Disorder on Employment and Household Income

Joseph Biederman, MD; Stephen V. Faraone, PhD

Abstract

Context: Many children with attention-deficit/hyperactivity disorder (ADHD) continue to exhibit symptoms of the disorder into adolescence and adulthood. Although ADHD may have a profound impact on activities of daily living, including educational achievement and work performance, limited research exists on ADHD's impact on individual income loss and overall economic effect.
Objectives: Evaluate ADHD's impact on individual employment and income, and quantify costs of ADHD on workforce productivity for the US population.
Design: Two telephone surveys were conducted between April 18, 2003, and May 11, 2003, to collect demographic, educational, employment, and income information.
Participants: Two groups of adults aged 18-64 years were interviewed: those diagnosed with ADHD (n = 500) derived from a national list of mail-paneled members who identified themselves or a household member as having been diagnosed with ADHD, and an age- and gender-matched control group (n = 501) derived from a random digital-dialing sample of a national cross-section not diagnosed with ADHD.
Results: Statistically fewer subjects in the ADHD group achieved academic milestones beyond some high school (P < .05). In addition, fewer subjects with ADHD were employed full time (34%) compared with controls (59%; P < .001). Except for the subgroup of subjects aged 18-24 years, average household incomes were significantly lower among individuals with ADHD compared with controls, regardless of academic achievement or personal characteristics. On the basis of these findings, loss of workforce productivity associated with ADHD was estimated between $67 billion and $116 billion.
Conclusions: Decreased individual income among adults with ADHD contributes to substantial loss in US workforce productivity.

Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eyes only or for possible publication via email: glundberg@medscape.net .

1 2 3 4 5 6

Next Section

Cite this: The Effects of Attention-Deficit/Hyperactivity Disorder on Employment and Household Income - Medscape - Jul 19, 2006.

Table 1. Demographic Characteristics of Survey Population
Parameter	ADHD (n = 500)	Control (n = 501)
Mean age, y (SD)	31.9 (12)	33.4 (14)
Gender (%)
Male	49	49
Female	51	51
Race (%)
White	89	74
Black	2	14
Marital status (%)
Married	44.4	59.3
Not married	28.8	58.9
Geographic location (%)
Urban	37	39
Suburban	30	33
Rural	31	26
Educational attainment (%)
High school or less	48	41
Less than high school	7	2
Some high school	10	5
High school graduate	31	34
Some college or more	52	59
Some college/vocational	33	33
College graduate	11	18
Some postgraduate work	2	2
Postgraduate degree	5	6

ADHD = attention-deficit/hyperactivity disorder.

Table 2. Mean Annual Household Income of Survey Population
Parameter	ADHD	Control	P Value
Overall	$41,511	$52,053	< .001
Gender
Male	$45,645	$54,399	< .05
Female	$37,607	$49,738	< .001
Age
18-24 y	$41,742	$39,494	NS
25-34 y	$33,518	$54,148	< .001
35-49 y	$44,981	$67,196	< .001
50-64 y	$50,556	$63,212	< .05
Race
White	$42,593	$54,273	< .001
Other	$32,750	$46,030	< .05
Marital status
Married	$50,806	$64,928	< .01
Not married	$36,708	$44,555	< .05
Geographic location
Urban	$35,621	$45,225	< .05
Suburban	$51,504	$61,427	< .01
Rural	$39,670	$50,587	< .05

NS = not significant.

Table 3. Projected Annual Income Change Due to ADHD in the United States (Billions)*
Age Group (y)	Household Income (Basic)	Household Income (Advanced)	Heckman (Basic)	Heckman (Advanced)
18-24	$1.4	$1.7	$0.8	$0.6
25-34	-$24.7	-$28.0	-$20.4	-$22.2
35-49	-$57.2	-$67.7	-$31.0	-$36.4
50-64	-$19.0	-$22.0	-$16.5	-$19.5
Total	-$99.4	-$115.9	-$67.0	-$77.5

*The basic models assume that observed differences in educational attainment and achievement are not attributable to ADHD. The advanced models assume that observed differences in educational attainment and achievement are fully attributable to ADHD.

Table 2. Mean Annual Household Income of Survey Population
Parameter	ADHD	Control	P Value
Overall	$41,511	$52,053	< .001
Gender
Male	$45,645	$54,399	< .05
Female	$37,607	$49,738	< .001
Age
18-24 y	$41,742	$39,494	NS
25-34 y	$33,518	$54,148	< .001
35-49 y	$44,981	$67,196	< .001
50-64 y	$50,556	$63,212	< .05
Race
White	$42,593	$54,273	< .001
Other	$32,750	$46,030	< .05
Marital status
Married	$50,806	$64,928	< .01
Not married	$36,708	$44,555	< .05
Geographic location
Urban	$35,621	$45,225	< .05
Suburban	$51,504	$61,427	< .01
Rural	$39,670	$50,587	< .05

NS = not significant.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.