The Impact of Attention Deficit Hyperactivity Disorder on the Health of America’s Children

Published March 28, 2019

Specific Findings

Attention deficit hyperactivity disorder (ADHD) is the second most impactful condition affecting children’s health in the U.S. It accounts for 16 percent of the impact all health conditions have on Generation Z (0-19 years old) as measured by the Blue Cross Blue Shield (BCBS) Health Index.SM, 1 Children diagnosed with ADHD struggle with paying attention, controlling impulses and being overly active.2

In 2017, about 2.4 million commercially insured American children were diagnosed with ADHD, climbing more than 30 percent over the past eight years.3 ADHD is most prevalent among middle school-aged children (11-13 years old), and boys are diagnosed about twice as much as girls. With ADHD diagnosis on the rise, it is crucial to better understand the impact of this condition on the health of American children.

1. Diagnosis Significantly Increasing

2nd Most Impactful Condition Affecting US Children

2. Diagnosis Rates Vary by Age, Gender and Geography

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ADHD diagnosis rates are higher in the south and lower in the west, with a nearly three-fold difference between the rates of the highest and lowest states.

ADHD Infographic

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3. Children with ADHD Likely to have other Behavioral Health Conditions

  • About 4 in 10 children with ADHD are also diagnosed with at least one other behavioral health disorder.
  • Depression and anxiety diagnoses sharply increase when children reach middle school and high school.

ADHD map

4. Treatment Patterns Changing Gradually

Though declining, nearly half of children with ADHD were treated with only medication in 2017. The American Academy of Pediatrics (AAP) recommends both behavioral therapy and medication, preferably together, as ADHD treatment options for children 6 years old and up.4

adhd chart

5. Treatment Varies by Region

The southern region of the U.S. has a significantly larger portion of children treated with only medication.

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ADHD is one of the most common behavioral health conditions affecting children in the United States. Over the past eight years, ADHD diagnoses continued to increase, especially impacting middle school-aged boys. While 4 in 10 children with ADHD also have at least one other behavioral health disorder, treatment patterns for ADHD vary widely across the U.S. These ADHD trends indicate a need to continue focusing on the diagnosis and treatment for a growing number of American children.


This is the 25th study of the Blue Cross Blue Shield, The Health of America Report® series, a collaboration between Blue Cross Blue Shield Association and Blue Health Intelligence (BHI), which uses a market-leading claims database to uncover key trends and insights in healthcare affordability and access to care. Analysis was performed by and also includes administrative claims data from HealthCore, a wholly owned and independently operated health outcomes subsidiary of Anthem, Inc. This report focuses on the diagnosis and treatment of ADHD among commercially insured American children 2-18 years old from 2010-2017. The study population was identified by utilizing ADHD diagnosis codes in BCBS medical claims.


  1. Based on 2017 data from the BCBS Health Index unless otherwise specified. For more information, visit the BCBS Health Index.
  2. According to the Centers for Disease Control and Prevention (CDC), ADHD is one of the most common neurodevelopmental disorders of childhood. Read more at
  3. Total patient count was extrapolated from the study population to the commercially insured population of American children (2-18 years old) in 2017.
  4. For children under 6 years old, the AAP recommends behavioral therapy as the first line of treatment before medication. ADHD treatment guidelines from the AAP indicate that for school-age children and adolescents, behavioral treatment in combination with approved medication is the preferable clinical approach. Read more at AAP Publications and