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Socioeconomic and Racial/Ethnic Disparities in Recovery from Childhood Behavioral or Conduct Problems: Evidence from a Nationally Representative Sample of 3–17 Years Old US Children

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Abstract

Our study provides nationally-generalizable evidence on the racial/ethnic and socioeconomic disparities in diagnosis and recovery from childhood behavioral or conduct problems. We pooled data from 4 years (2016–2019) of the National Survey of Children's Health (NSCH) for 3 to 17 years old US children (N = 114,476). We performed several logistic regression models using complex survey data analysis statistical methodologies to estimate nationally representative and generalizable results in the Stata MP 16 program. About 20.1% of 3–17 years old US children previously diagnosed with behavioral or conduct problems no longer had the current diagnosis (were recovered). Hispanic children [Odds ratio (OR) 0.77, 95% Confidence Interval (CI) 0.65–0-95], immigrant children or children of immigrant parents (first or second generation immigrant children), and children from high-income families [200–399% Federal Poverty Level (FPL)] were about 23%, 38%, and 21% less likely than non-Hispanic White children, children of US native parents, and children with a family income of below 100% FPL to be currently diagnosed with behavioral or conduct problems, respectively. Conversely, Non-Hispanic Black and Hispanic children were about 50% and 40% more likely than non-Hispanic White children to recover from a past diagnosis. Moreover, children from higher-income families (at or above 300% of FPL) were between 1.59 to 1.79 times more likely than those from low-income families (below 100% FPL) to recover from a past diagnosis. Racial/ethnic and socioeconomic disparities in diagnosing appear to persist in recovering from behavioral or conduct problems.

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Data Availability

We have merged five years of data. Separate yearly NSCH data can be accessed through multiple resources, including the United States Census Bureau at: https://www.census.gov/programs-surveys/nsch.html

Abbreviations

ACE:

Adverse childhood experiences

AHRF:

Area Health Resources Files

FPL:

Federal Poverty Level

HRSA:

Health Resources and Services Administration

IRB:

Institutional Review Board

MCHB:

Maternal and Child Health Bureau

NHIS:

National Health Interview Survey

NSCH:

National Survey of Children's Health

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Authors and Affiliations

  1. Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, 600 Forbes Avenue Pittsburgh, Pittsburgh, PA, 15282, USA

    Ahmad Khanijahani

  2. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Larisa Tomassoni

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  1. Ahmad Khanijahani
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Contributions

AK conceptualized and designed the study; acquired and analyzed the data; interpreted the results; outlined, drafted, wrote, revised, and approved the manuscript. LT interpreted the results; drafted, wrote, revised, and approved the manuscript.

Corresponding author

Correspondence to Ahmad Khanijahani.

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Competing interests

The authors declare no potential competing interests.

Ethical Approval

We have used the publicly available version of the National Survey of Children's Health (NSCH) data in this study. The protocol was reviewed and deemed exempt by the Institutional Review Board (IRB) at the first author's institution.

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Appendix

Appendix

See Table 3

Table 3 Unadjusted associations of racial/ethnic, socioeconomic, and other characteristics with a current diagnosis of and recovery from previously diagnosed behavioral or conduct problems among 3–17 years old US children
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Khanijahani, A., Tomassoni, L. Socioeconomic and Racial/Ethnic Disparities in Recovery from Childhood Behavioral or Conduct Problems: Evidence from a Nationally Representative Sample of 3–17 Years Old US Children. J Immigrant Minority Health 25, 744–754 (2023). https://doi.org/10.1007/s10903-022-01444-3

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