Hi everyone, it's Food For Thought Friday again and we are excited to bring to you this study from Europe on ADHD prevalence in children and adolescents.
The reason is that some of the respondents in this study are of Caribbean heritage! With the paucity of Caribbean research in this area, we are always on the hunt for global research that includes respondents from or in the Caribbean.
Ahem, in case you missed it, that was a subtle ask for you to share whatever research you may come across that meets this criteria. 
So the paper titled, "Attention deficit hyperactivity disorder in first- and second-generation immigrant children and adolescents: A nationwide cohort study in Sweden", was done by Mehdi Osooli, Henrik Ohlsson, Jan Sundquist and Kristina Sundquist of the Center for Primary Health Care Research, Lund University, Malmö, Sweden. It is published in the Journal of Psychosomatic Research (Volume 141, February 2021, 110330) [https://doi.org/10.1016/j.jpsychores.2020.110330]
Background
Studies on the incidence of Attention Deficit Hyperactivity Disorder (ADHD) among immigrant children and adolescents is limited and results are mixed. The aim of this study was to compare the ADHD risk between first- and second-generation immigrants aged 4–16 years and their native peers in Sweden.
Methods
This was an open nationwide retrospective cohort study. We included natives and children and adolescents with an immigrant background, born 1987–2010, and aged 4–16 years at baseline.
Overall 2,707,976 children-adolescents including 1,902,526 (70.3%) natives, 228,889 (8.4%) first-generation, 160,839 (5.9%) second-generation with a foreign-born father (and a native mother), 133,217 (4.9) second- generation with a foreign-born mother (and a native father), and finally 282,505 (10.4%) second-generation immigrants with two foreign-born parents were included in the study.
We identified participants using national population data and participants were observed until they received an ADHD diagnosis in the National Patient Register, turned 18 years, migrated, died, or until the end of the study, whichever came first. ADHD risks were adjusted for birth year and age and maternal income at baseline.
Highlights
What's known (1) Data on ADHD risk among first- and second-generation immigrant children and adolescents is limited.
What's new: (1) Most immigrant groups in Sweden had lower ADHD risk than natives. (2) Immigrants with a native mother and those from certain regions of the world had higher ADHD risks compared with natives.
What's relevant: (1) Our results may suggest a better psychiatric health or lower healthcare utilization among some immigrant groups in Sweden. (2) Those subgroups that are most affected may need improved and tailored support in the school system.
So here is the kicker for us here in the Caribbean - While for both males and females, the ADHD risk was lower among most immigrant groups, the combination of a Swedish-born mother and foreign-born father (including Caribbean fathers) was associated with an increased risk of ADHD. Generally, immigrants from other Scandinavian countries, North America, and Latin America and the Caribbean had higher rates of ADHD compared with natives.
Latin American and Caribbean respondents were children or grandchildren of men from the following territories - Antigua and Barbuda, Argentina, Aruba, Bahamas, Barbados, Belize, Bolivia, Brazil, British Virgin Islands, Cayman Islands, Chile, Colombia, Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Sint Maarten (Dutch part), St. Kitts and Nevis, St. Lucia, St. Martin (French part), St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, Turks and Caicos Islands, Uruguay, Venezuela (RB), and the Virgin Islands (U.S.)
The key question of course is WHY? Sadly, the researchers did not uncover the actual reasons in their study. However, they offered several potential explanations:-
1. Immigrant women with a native partner may find substantial opportunities for integration into the new country whereas immigrant men may experience unemployment and downward social mobility in the host country.
2. Approximately 40% of native women in Finland who married a man from a low-income country have considered divorce mainly due to the husband’s employment opportunities.
3. Spouses’ sustained unemployment over time may be more likely to affect a woman’s opinion of her husband than the opposite.
4. Although Sweden provides some unemployment benefits to its citizens, such support does not protect males from problems with perceived low status, loss of purpose, and/or loss of dignity due to their unemployment.
5. Unemployment and economic challenges are also linked with adult drug use and drinking problems, which are known predictors of ADHD in the offspring.
As a result of the economic impact of the Covid response around the world, many men have lost their employment both in their native and adopted countries. One can only wonder what the research may show a decade or two from now as to the impact of the past 2 years on ADHD rates in their descendants.
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