Wealthy Americans often already have access to or utilize services that would help someone with ADHD manage their symptoms regardless of whether they get a diagnosis or not.

There are so few affluent Americans left that it’s a significantly small percentage of the population already, meaning though they are more likely to have a diagnosis available to them, they make up a small percentage of people who actually have ADHD.

Poor people have less overall knowledge about learning disabilities and Neurodivergences on the whole. They assume that because they also have the same symptoms (which they don’t recognize as symptoms), it’s a matter of laziness, a moral failing, or a lack of work ethic/ability to buckle down).

When I was a kid, there was also a lot of assumptions about who could have ADHD (girls “didn’t” get ADHD, it was a boys disease). And ADD was considered a separate thing. If my mother hadn’t worked in the education system it’s likely I and my siblings never would have been tested at all.

Support systems in schools are lacking, underfunded, understaffed, and unsupported. Lots of kids fall through the cracks, even when they aren’t neurodivergent.

Even less people have access to mental healthcare and for those that do it’s still exorbitantly expensive even with insurance.

Without healthcare it’s unlikely that you can get access to medication. ADHD meds are considered narcotics /schedule 2 drugs. Can’t get them without a prescription.