Mapping mental health inequalities: The intersecting effects of gender, race, class, and ethnicity on ADHD diagnosis

Meredith Bergey, Giuseppina Chiri, Nikki L.B. Freeman, Thomas I. Mackie

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


While the effects of social stratification by gender, race, class, and ethnicity on health inequalities are well-documented, our understanding of the intersecting consequences of these social dimensions on diagnosis remains limited. This is particularly the case in studies of mental health, where “paradoxical” patterns of stratification have been identified. Using a Bayesian multi-level random-effects Poisson model and a nationally representative random sample of 138,009 households from the National Survey of Children's Health, this study updates and extends the literature on mental health inequalities through an intersectional investigation of one of the most commonly diagnosed psychiatric conditions of childhood/adolescence: attention-deficit hyperactivity disorder (ADHD). Findings indicate that gender, race, class, and ethnicity combine in mutually constitutive ways to explain between-group variation in ADHD diagnosis. Observed effects underscore the importance and feasibility of an intersectional, multi-level modelling approach and data mapping technique to advance our understanding of social subgroups more/less likely to be diagnosed with mental health conditions.

Original languageEnglish (US)
Pages (from-to)604-623
Number of pages20
JournalSociology of Health and Illness
Issue number3
StatePublished - Mar 2022

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health


  • attention-deficit hyperactivity disorder
  • intersectionality
  • mental health
  • multi-level modelling
  • social constructionism


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