How a New Study on Medicaid-Enrolled Adults Sheds Light on the Hidden Struggles of Neurodivergent Black Women
Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) have long been viewed through a childhood lens, often framed around how they present in young, white boys. But for many African American women, these conditions go unrecognized until much later in life—if they’re recognized at all.
A groundbreaking study of over 3.5 million Medicaid-enrolled adults is helping to change that narrative.
Listen to the Rooted Will, Rising Advocate Podcast
What the Study Found
Published in JAMA Network Open, the study found that autistic adults are significantly more likely to also have ADHD compared to the general population. Among autistic adults with intellectual disabilities, nearly 40% had ADHD. Among those without intellectual disabilities, 27% had both conditions.
Compare that to the general adult population—only 2.7% had ADHD.
But the story doesn’t end there. Adults with both autism and ADHD were more likely to suffer from:
- Substance use disorders
- Cardiovascular disease
- Injuries and hospitalizations
For instance, 13.2% of autistic adults with ADHD had a substance use disorder, compared to 5.7% of those with autism alone.
Why This Matters for Black Women
For Black women, these findings are even more critical.
Historically, African American women have been underdiagnosed and misdiagnosed when it comes to mental health and neurodevelopmental disorders. The “strong Black woman” stereotype often forces us to suppress our symptoms, push through burnout, and suffer in silence.
Common ADHD or autism symptoms in Black women are frequently misinterpreted as:
- Being moody or emotional
- Being inattentive or lazy
- Struggling with anxiety or depression (without deeper investigation)
This leads to a dangerous cycle of undiagnosed conditions, untreated symptoms, and worsening health outcomes.
Are You Missing the Signs?
If you’ve always felt different, overwhelmed, or constantly in “survival mode,” you’re not alone. Signs of ADHD or autism in adult women—especially Black women—can include:
- Difficulty focusing or following through on tasks
- Sensory sensitivities (to sound, light, textures)
- Social exhaustion or awkwardness
- Emotional dysregulation
- Chronic fatigue or burnout
- Trouble managing time or routines
These aren’t just quirks—they could be symptoms of a deeper neurological pattern that deserves recognition and support.
Treatment Can Change Lives
The study also showed promising results for those who received ADHD medication. Autistic adults who took ADHD medications had:
- Fewer cardiovascular issues
- Fewer injury-related visits
While more research is needed, this suggests that early intervention and proper treatment can reduce health risks and improve quality of life.
Moving Forward with Awareness
Healthcare providers need to do better, and we need to demand better.
That starts with:
- Culturally competent care
- Training providers to recognize neurodivergence in diverse populations
- Amplifying the voices of Black women living with these conditions
For Black women navigating these diagnoses in adulthood, community support, advocacy, and access to knowledgeable professionals are key to healing.
Final Thoughts
You are not invisible. You are not too late. And you are not alone.
If you or a loved one suspects ADHD or autism, speak to a provider who understands adult diagnosis and cultural barriers. Understanding your brain isn’t a weakness. It’s power.
Let’s continue to unmask the truth together.
More from Mahogany Speaks to You
Understanding Autism in Black Children
Unmasking Autism in the Workplace
