Disparities are closely tied to systemic differences in diagnosis, access, and social context. ADHD is diagnosed at significantly higher rates in boys than girls during childhood, leading to more early exposure to stimulant medications and easier access later in life. Students from higher socioeconomic backgrounds more likely have access to mental health services, receive formal diagnoses, and obtain prescriptions. PCE use is also more common among students in elite academic settings, Greek life, and predominantly white communities, reflecting broader patterns of privilege.