Petra Persson, Stanford University
"Family Spillover Effects of Misdiagnosis: The case of ADHD”
Abstract
When a health condition is imperfectly observed by an individual, screening plays a critical role in detection and allocation of medical treatment. Screening policies commonly rely on links between individuals to tag people as having an elevated risk of disease and target screening toward them. This paper documents an important unintended consequence of this strategy for a large set of medical conditions in which the diagnosing technology is noisy and generates errors—a tag can propagate marginal (mis-)diagnoses across individuals who are linked to one another, and exacerbate the misallocation of health care resources. We focus on the case of Attention Deficit Hyperactivity Disorder (ADHD), a condition in which relative age immaturity has been shown to generate marginal (mis )diagnoses in numerous countries. We use Swedish administrative data to demonstrate that youngest for- grade children born before the school entry cutoff are more likely to be diagnosed with ADHD and consume ADHD drugs than their oldest-for-grade peers born after the cutoff. We then show that this relative-age-induced misdiagnosis of ADHD propagates to multiple members of a child’s family, leading to increases in the likelihoods that the child’s younger sibling (cousin) is diagnosed with and treated for ADHD, respectively. Lastly, we find that younger siblings and cousins of children born before the cutoff have worse economic and human capital outcomes than younger siblings and cousins of children born after the cutoff, pointing to potentially important costs of the ADHD spillovers.
Petra Persson is an applied microeconomist whose research agenda focuses on investigating interactions between family
decisions and the policy environment. The broad goal of this agenda is to shed light on the importance of the economics of the family for the design of government programs – a perspective that is critical to inform optimal policy design, and that may have important consequences for family wellbeing.