Assistant Professor of Sociology at New York University
Despite the rise of medical interventions to address behavioral issues in childhood, the social determinants of their use remain poorly understood. By analyzing a dataset that includes the majority of prescriptions written for stimulants in the United States, we find a substantial effect of schooling on stimulant use. In middle and high school, adolescents are roughly 35% more likely to fill a stimulant prescription during the school year. Children and adolescents from socioeconomically advantaged families are more likely than their peers to selectively use stimulants only during the academic year, and these differences persist when we compare higher and lower SES children seeing the same doctors. We link these responses to academic pressure by exploiting variation between states in educational accountability system stringency. We find that the largest differences in school year and summer stimulant use exist in states with more accountability pressure, and these differences are also larger for higher SES children. Our study uncovers a new pathway through which medical interventions may act as a resource for families of higher socioeconomic status to transmit educational advantages to their children, either intentionally or unwittingly.