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

Joseph Biederman, MD; Stephen V. Faraone, PhD

In This Article


The economic models used demographic, educational attainment, employment, and household income data from the sample described extensively in a prior report.[19] These data are briefly reviewed here to provide a context for the economic analyses.

Two groups of adults aged 18-64 years were interviewed: those diagnosed with ADHD (n = 500) and an age- and gender-matched control group (n = 501). Demographic characteristics of the survey population are summarized in Table 1 . Gender, age, and location did not differ between study groups; however, differences were noted for educational attainment. A greater number of participants in the ADHD group were white and unmarried, and more participants in the control group were black and married.

Educational Attainment

As illustrated in Figure 1A, significantly more control subjects completed college and some postgraduate work compared with those in the ADHD group (P < .05). The percentage of subjects who had completed high school and some college or received a postgraduate degree was higher in the control group, although not significantly so. In addition, compared with the ADHD group, significantly more subjects in the control group reported receiving mostly grades of A and B in high school (P < .05 for both); more individuals in the ADHD group reported receiving grades of C or below in high school (P < .05) (Figure 1B).

Figure 1A.

Educational attainment of survey population.

Figure 1B.

High school grades of survey population.


Overall, 33.9% of subjects with ADHD were employed full time compared with 59.0% of control subjects, and significant differences were noted between subjects with ADHD and controls across most demographic variables. Figures 2A and 2B illustrate the significant gap in full-time employment rates by sex and academic achievement, respectively, between subjects with ADHD and control subjects (P < .001 for all comparisons).

Figure 2A.

Percentage employed full time, by sex and overall.

Figure 2B.

Percentage employed full time, by academic achievement.

Household Income

Table 2 summarizes the mean household income for subjects with ADHD vs the control group, controlling for demographic variables. Except for the subgroup of subjects aged 18-24 years, the mean annual household income among ADHD subjects was significantly lower across demographic groups compared with that of control subjects (P < .05). Further, with the exception of the subjects with less than a high school education, the annual household income was higher in the control group than in the ADHD group regardless of the level of educational attainment, achieving significance among those with high school and some college education (P < .05) and those with a postgraduate degree (P < .001) (Figure 3).

Figure 3.

Average household income by educational attainment.

The projected annual income change per person attributed to ADHD in the United States was calculated using the basic and advanced specifications with the Heckman and Household Income models. The projected individual income change attributed to ADHD in the United States, with both specifications of each of the 2 models, demonstrated a meaningful decrease in income among subjects with ADHD:


Heckman - Basic: -$8900
Heckman - Advanced: -$10,300
Household Income - Basic: -$13,200
Household Income - Advanced: -$15,400

With both models, the basic specification, which assumes that observed differences in educational attainment and achievement are not attributable to ADHD, demonstrated a lower annual income loss compared with the advanced specification, which assumes that observed differences in educational attainment and achievement are fully attributable to ADHD.

Projected Income Change in United States Attributed to ADHD

The projected aggregate income change attributed to ADHD in the United States by age level is summarized in Table 3 . All 4 configurations demonstrated loss of income as a result of ADHD, with annual loss estimates of $67 billion to $116 billion. However, like the projected individual income changes due to ADHD, the models with advanced specifications produced higher estimates of household income losses compared with those using the basic specification.


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