Chao M, Wade C, Kronenberg F.

Social factors and utilization of complementary and alternative medicine.

Richard & Hinda Rosenthal Center for Complementary and Alternative Medicine, 630 West 168th St, Box 75, New York, NY 10032. mtc28@columbia.edu

BACKGROUND/PURPOSE: The purpose of this study is to examine how social factors—race/ethnicity, socioeconomic position, and gender—are associated with differences in complementary and alternative medicine (CAM) utilization and medical pluralism. National studies indicate that CAM use is associated with women, non-Hispanic Whites, and those of higher socioeconomic position (SEP). This study explicitly examines whether socioeconomic effects on CAM use mitigate gender and racial/ethnic differences or if these social factors operate independently from one another.

METHODS: Hypotheses were tested through secondary data analysis of the 2002 National Health Interview Survey (NHIS), which oversampled minority populations and included a supplement on alternative medicine. We examined the effects of social factors on use of any type of CAM, professional forms of CAM, self-care forms of CAM, and medical pluralism (the use of multiple modalities of healthcare). For each dependent measure we compared two models: one that included factors of SEP (education, income, and employment status) and one that did not. To account for the complex survey design of NHIS, multiple variable logistic regression and multinomial analyses were performed with Stata 9.0 for Windows. All analyses adjusted for the possible confounding effects of age, marital status, region, and health status.

RESULTS: Socioeconomic position mitigated but did not fully account for the effects of race/ethnicity on all measures of healthcare utilization—race/ethnicity remained a significant predictor of CAM use. Gender effects on CAM use were more pronounced when accounting for SEP. Socioeconomic variables were significantly associated with CAM use in the past year, independent of the effects of race/ethnicity and other social factors.

CONCLUSION: Prior epidemiological research has documented demographics of CAM users but has been limited in elucidating why there are differences in CAM use among population groups. This study assessed whether SEP accounted for group differences in CAM use. Findings from this study, that race/ethnicity and SEP independently affect CAM use, suggest a need for more nuanced analyses within and between racial/ethnic groups. Understanding differences in access to and utilization of CAM would elucidate the role of CAM in contributing to the elimination of social health disparities.

 

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