Skip to main content
Top
Published in: BMC Health Services Research 1/2010

Open Access 01-12-2010 | Research article

Health need and the use of alternative medicine among adults who do not use conventional medicine

Authors: Richard L Nahin, James M Dahlhamer, Barbara J Stussman

Published in: BMC Health Services Research | Issue 1/2010

Login to get access

Abstract

Background

We hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization.

Methods

The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.

Results

19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not.

Conclusions

We found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.
Literature
1.
go back to reference Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC: Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998, 280 (18): 1569-1575. 10.1001/jama.280.18.1569.CrossRefPubMed Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC: Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998, 280 (18): 1569-1575. 10.1001/jama.280.18.1569.CrossRefPubMed
2.
go back to reference Barnes PM, Powell-Griner E, McFann K, Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004, 1-19. 343 Barnes PM, Powell-Griner E, McFann K, Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004, 1-19. 343
3.
go back to reference Barnes PM, Bloom B, Nahin RL: Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008, 10 (12): 1-23. Barnes PM, Bloom B, Nahin RL: Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008, 10 (12): 1-23.
4.
go back to reference Hayward RA, Shapiro MF, Freeman HE, Corey CR: Inequities in health services among insured Americans. Do working-age adults have less access to medical care than the elderly?. N Engl J Med. 1988, 318 (23): 1507-1512. 10.1056/NEJM198806093182305.CrossRefPubMed Hayward RA, Shapiro MF, Freeman HE, Corey CR: Inequities in health services among insured Americans. Do working-age adults have less access to medical care than the elderly?. N Engl J Med. 1988, 318 (23): 1507-1512. 10.1056/NEJM198806093182305.CrossRefPubMed
5.
go back to reference Wagner TH, Guendelman S: Healthcare utilization among Hispanics: findings from the 1994 Minority Health Survey. Am J Manag Care. 2000, 6 (3): 355-364.PubMed Wagner TH, Guendelman S: Healthcare utilization among Hispanics: findings from the 1994 Minority Health Survey. Am J Manag Care. 2000, 6 (3): 355-364.PubMed
6.
go back to reference Fiscella K, Franks P, Doescher MP, Saver BG: Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002, 40 (1): 52-59. 10.1097/00005650-200201000-00007.CrossRefPubMed Fiscella K, Franks P, Doescher MP, Saver BG: Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002, 40 (1): 52-59. 10.1097/00005650-200201000-00007.CrossRefPubMed
7.
go back to reference Hargraves JL, Hadley J: The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res. 2003, 38 (3): 809-829. 10.1111/1475-6773.00148.CrossRefPubMedPubMedCentral Hargraves JL, Hadley J: The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res. 2003, 38 (3): 809-829. 10.1111/1475-6773.00148.CrossRefPubMedPubMedCentral
8.
go back to reference National Center for Health Statistics: Health. United States, 2004, with Chartbook on Trends in the Health of Americans. 2004, Hyattsville. Maryland National Center for Health Statistics: Health. United States, 2004, with Chartbook on Trends in the Health of Americans. 2004, Hyattsville. Maryland
9.
go back to reference Kirby JB, Taliaferro G, Zuvekas SH: Explaining racial and ethnic disparities in health care. Med Care. 2006, 44 (5 Suppl): I64-I72.PubMed Kirby JB, Taliaferro G, Zuvekas SH: Explaining racial and ethnic disparities in health care. Med Care. 2006, 44 (5 Suppl): I64-I72.PubMed
10.
go back to reference Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL: Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993, 328 (4): 246-252. 10.1056/NEJM199301283280406.CrossRefPubMed Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL: Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993, 328 (4): 246-252. 10.1056/NEJM199301283280406.CrossRefPubMed
11.
go back to reference Astin JA: Why patients use alternative medicine: results of a national study. JAMA. 1998, 279 (19): 1548-53. 10.1001/jama.279.19.1548.CrossRefPubMed Astin JA: Why patients use alternative medicine: results of a national study. JAMA. 1998, 279 (19): 1548-53. 10.1001/jama.279.19.1548.CrossRefPubMed
12.
go back to reference Institute of Medicine: Care without Coverage - Too little, too late. 2002, National Academy of Sciences. National Academy Press, Washington, D.C. Institute of Medicine: Care without Coverage - Too little, too late. 2002, National Academy of Sciences. National Academy Press, Washington, D.C.
13.
go back to reference Andersen R, Newman JF: Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 1973, 51 (1): 95-124. 10.2307/3349613.CrossRefPubMed Andersen R, Newman JF: Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 1973, 51 (1): 95-124. 10.2307/3349613.CrossRefPubMed
14.
15.
go back to reference Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36 (1): 1-10. 10.2307/2137284.CrossRefPubMed Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36 (1): 1-10. 10.2307/2137284.CrossRefPubMed
16.
go back to reference de Boer AG, Wijker W, de Haes HC: Predictors of health care utilization in the chronically ill: a review of the literature. Health Policy. 1997, 42 (2): 101-15. 10.1016/S0168-8510(97)00062-6.CrossRefPubMed de Boer AG, Wijker W, de Haes HC: Predictors of health care utilization in the chronically ill: a review of the literature. Health Policy. 1997, 42 (2): 101-15. 10.1016/S0168-8510(97)00062-6.CrossRefPubMed
17.
go back to reference Trinh LTT, Dibley MJ, Byles J: Determinants of antenatal care utilization in three rural areas of Vietnam. Public Health Nursing. 2007, 24 (4): 300-310. 10.1111/j.1525-1446.2007.00638.x.CrossRefPubMed Trinh LTT, Dibley MJ, Byles J: Determinants of antenatal care utilization in three rural areas of Vietnam. Public Health Nursing. 2007, 24 (4): 300-310. 10.1111/j.1525-1446.2007.00638.x.CrossRefPubMed
18.
go back to reference Swenson IE, Thang NM, Nhan VQ, Tieu PX: Factors related to the utilization of prenatal care in Vietnam. J Trop Med Hyg. 1993, 96 (2): 76-85.PubMed Swenson IE, Thang NM, Nhan VQ, Tieu PX: Factors related to the utilization of prenatal care in Vietnam. J Trop Med Hyg. 1993, 96 (2): 76-85.PubMed
19.
go back to reference Broyles RW, Narine L, Brandt EN, Baird-Holmes D: Health risks, ability to pay, and the use of primary care: is the distribution of service effective and equitable?. Preventive Medicine. 2000, 30: 453-462. 10.1006/pmed.2000.0672.CrossRefPubMed Broyles RW, Narine L, Brandt EN, Baird-Holmes D: Health risks, ability to pay, and the use of primary care: is the distribution of service effective and equitable?. Preventive Medicine. 2000, 30: 453-462. 10.1006/pmed.2000.0672.CrossRefPubMed
20.
go back to reference Garrett CR, Treichel CJ, Ohmans P: Barriers to health care for immigrants and nonimmigrants: a comparative study. Minn Med. 1998, 81: 52-55.PubMed Garrett CR, Treichel CJ, Ohmans P: Barriers to health care for immigrants and nonimmigrants: a comparative study. Minn Med. 1998, 81: 52-55.PubMed
21.
go back to reference Stockdale SE, Tang L, Zhang L, Belin TR, Wells KB: The effects of health sector market factors and vulnerable group membership on access to alcohol, drug, and mental health care. Health Services Research. 2007, 42 (3): 1020-1041. 10.1111/j.1475-6773.2006.00636.x.CrossRefPubMedPubMedCentral Stockdale SE, Tang L, Zhang L, Belin TR, Wells KB: The effects of health sector market factors and vulnerable group membership on access to alcohol, drug, and mental health care. Health Services Research. 2007, 42 (3): 1020-1041. 10.1111/j.1475-6773.2006.00636.x.CrossRefPubMedPubMedCentral
22.
go back to reference Jang Y, Kim G, Chiriboga DA: Health, healthcare utilization, and satisfaction with service: barriers and facilitators for older Korean Americans. JAGS. 2005, 53: 1613-1617. 10.1111/j.1532-5415.2005.53518.x.CrossRef Jang Y, Kim G, Chiriboga DA: Health, healthcare utilization, and satisfaction with service: barriers and facilitators for older Korean Americans. JAGS. 2005, 53: 1613-1617. 10.1111/j.1532-5415.2005.53518.x.CrossRef
23.
go back to reference Lasser KE, Himmelstein DU, Woolhandler S: Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Research and Practice. 2006, 96 (7): 1300-1307. Lasser KE, Himmelstein DU, Woolhandler S: Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Research and Practice. 2006, 96 (7): 1300-1307.
24.
go back to reference White-Means SI, Rubin RM: Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care. Journal of Gerontology. 2004, 59B (4): S220-S229.CrossRef White-Means SI, Rubin RM: Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care. Journal of Gerontology. 2004, 59B (4): S220-S229.CrossRef
25.
go back to reference Walter-Ginzburg A, Chetrit A, Medina C, Blumstein T, Gindin J, Modan B: Physician visits, emergency room utilization, and overnight hospitalization in the old-old in Israel: the cross-sectional and longitudinal aging study (CALAS). JAGS. 2001, 49: 649-556. Walter-Ginzburg A, Chetrit A, Medina C, Blumstein T, Gindin J, Modan B: Physician visits, emergency room utilization, and overnight hospitalization in the old-old in Israel: the cross-sectional and longitudinal aging study (CALAS). JAGS. 2001, 49: 649-556.
26.
go back to reference Arcury TA, Gesler WM, Preisser JS, Sherman J, Spencer J, Perin J: The effects of geography and spatial behavior on health care utilization among the residents of a rural region. Health Services Research. 2005, 40 (1): 135-155. 10.1111/j.1475-6773.2005.00346.x.CrossRefPubMedPubMedCentral Arcury TA, Gesler WM, Preisser JS, Sherman J, Spencer J, Perin J: The effects of geography and spatial behavior on health care utilization among the residents of a rural region. Health Services Research. 2005, 40 (1): 135-155. 10.1111/j.1475-6773.2005.00346.x.CrossRefPubMedPubMedCentral
27.
go back to reference Bowen ME, González HM: Racial/ethnic differences in the relationship between the use of health care services and functional disability: the health and retirement study (1992-2004). Gerontologist. 2008, 48 (5): 659-67.CrossRefPubMedPubMedCentral Bowen ME, González HM: Racial/ethnic differences in the relationship between the use of health care services and functional disability: the health and retirement study (1992-2004). Gerontologist. 2008, 48 (5): 659-67.CrossRefPubMedPubMedCentral
28.
go back to reference Kunz JL: Alcohol use and reported visits to health professionals: an exploratory study. J Stud Alcohol. 1997, 58 (5): 474-479.CrossRefPubMed Kunz JL: Alcohol use and reported visits to health professionals: an exploratory study. J Stud Alcohol. 1997, 58 (5): 474-479.CrossRefPubMed
29.
go back to reference Slack-Smith LM, Mills CR, Bulsara MK, O'Grady MJ: Demographic, health and lifestyle factors associated with dental service attendance by young adults. Aust Dent J. 2007, 52 (3): 205-209. 10.1111/j.1834-7819.2007.tb00490.x.CrossRefPubMed Slack-Smith LM, Mills CR, Bulsara MK, O'Grady MJ: Demographic, health and lifestyle factors associated with dental service attendance by young adults. Aust Dent J. 2007, 52 (3): 205-209. 10.1111/j.1834-7819.2007.tb00490.x.CrossRefPubMed
30.
go back to reference Bloom B, Simpson G, Cohen RA, Parsons PE: Access to health care. Part 2: Working-age adults. National Center for Health Statistics. Vital Health Stat. 1997, 10 (197). Bloom B, Simpson G, Cohen RA, Parsons PE: Access to health care. Part 2: Working-age adults. National Center for Health Statistics. Vital Health Stat. 1997, 10 (197).
31.
go back to reference Nahin RL, Barnes PM, Stussman BJ, Bloom B: Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report. 2009, 1-14. 18PubMed Nahin RL, Barnes PM, Stussman BJ, Bloom B: Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report. 2009, 1-14. 18PubMed
32.
go back to reference Schuster TL, Dobson M, Jauregui M, Blanks RH: Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine. J Altern Complement Med. 2004, 10 (2): 349-56. 10.1089/107555304323062347.CrossRefPubMed Schuster TL, Dobson M, Jauregui M, Blanks RH: Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine. J Altern Complement Med. 2004, 10 (2): 349-56. 10.1089/107555304323062347.CrossRefPubMed
33.
go back to reference Cangelosi JD, Markham FS: A descriptive study of personal, institutional, and media sources of preventive health care information. Health Mark Q. 1994, 12 (1): 23-36. 10.1300/J026v12n01_04.CrossRefPubMed Cangelosi JD, Markham FS: A descriptive study of personal, institutional, and media sources of preventive health care information. Health Mark Q. 1994, 12 (1): 23-36. 10.1300/J026v12n01_04.CrossRefPubMed
34.
go back to reference Atkinson NL, Saperstein SL, Pleis J: Using the internet for health-related activities: findings from a national probability sample. J Med Internet Res. 2009, 11 (1): 10.2196/jmir.1035. Atkinson NL, Saperstein SL, Pleis J: Using the internet for health-related activities: findings from a national probability sample. J Med Internet Res. 2009, 11 (1): 10.2196/jmir.1035.
36.
go back to reference Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB: Patterns of health behavior in U.S. adults. Prev Med. 2003, 36 (5): 615-23. 10.1016/S0091-7435(02)00067-1.CrossRefPubMed Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB: Patterns of health behavior in U.S. adults. Prev Med. 2003, 36 (5): 615-23. 10.1016/S0091-7435(02)00067-1.CrossRefPubMed
37.
go back to reference Nahin RL, Dahlhamer JM, Taylor BL, Barnes PM, Stussman BJ, Simile CM, Blackman MR, Chesney MA, Jackson M, Miller H, McFann KK: Health behaviors and risk factors in those who use complementary and alternative medicine. BMC Public Health. 2007, 7: 217-10.1186/1471-2458-7-217.CrossRefPubMedPubMedCentral Nahin RL, Dahlhamer JM, Taylor BL, Barnes PM, Stussman BJ, Simile CM, Blackman MR, Chesney MA, Jackson M, Miller H, McFann KK: Health behaviors and risk factors in those who use complementary and alternative medicine. BMC Public Health. 2007, 7: 217-10.1186/1471-2458-7-217.CrossRefPubMedPubMedCentral
38.
go back to reference Cheung CK, Wyman JF, Halcon LL: Use of complementary and alternative therapies in community-dwelling older adults. J Altern Complementary Med. 2007, 13: 997-1006. 10.1089/acm.2007.0527.CrossRef Cheung CK, Wyman JF, Halcon LL: Use of complementary and alternative therapies in community-dwelling older adults. J Altern Complementary Med. 2007, 13: 997-1006. 10.1089/acm.2007.0527.CrossRef
39.
go back to reference Bair YA, Gold EB, Greendale GA, Sternfeld B, Adler SR, Azari R, Harkey M: Ethnic differences in use of complementary and alternative medicine at midlife: Longitudinal results from SWAN participants. Am J Public Health. 2002, 92: 1832-1840. 10.2105/AJPH.92.11.1832.CrossRefPubMedPubMedCentral Bair YA, Gold EB, Greendale GA, Sternfeld B, Adler SR, Azari R, Harkey M: Ethnic differences in use of complementary and alternative medicine at midlife: Longitudinal results from SWAN participants. Am J Public Health. 2002, 92: 1832-1840. 10.2105/AJPH.92.11.1832.CrossRefPubMedPubMedCentral
40.
go back to reference Gray CM, Tan AW, Pronk NP, O'Connor PJ: Complementary and alternative medicine use among health plan members: A cross-sectional survey. Eff Clin Pract. 2002, 5: 17-22.PubMed Gray CM, Tan AW, Pronk NP, O'Connor PJ: Complementary and alternative medicine use among health plan members: A cross-sectional survey. Eff Clin Pract. 2002, 5: 17-22.PubMed
41.
go back to reference Downey L, Tyree PT, Lafferty WE: Preventive screening of women who use complementary and alternative medicine providers. J Womens Health (Larchmt). 2009, 18 (8): 1133-43. 10.1089/jwh.2008.1230.CrossRef Downey L, Tyree PT, Lafferty WE: Preventive screening of women who use complementary and alternative medicine providers. J Womens Health (Larchmt). 2009, 18 (8): 1133-43. 10.1089/jwh.2008.1230.CrossRef
42.
go back to reference Druss BG, Rosenheck RA: Association between use of unconventional therapies and conventional medical services. JAMA. 1999, 282 (7): 651-656. 10.1001/jama.282.7.651.CrossRefPubMed Druss BG, Rosenheck RA: Association between use of unconventional therapies and conventional medical services. JAMA. 1999, 282 (7): 651-656. 10.1001/jama.282.7.651.CrossRefPubMed
43.
go back to reference Mackenzie ER, Taylor L, Bloom BS, Hufford DJ, Johnson JC: Ethnic minority use of complementary and alternative medicine (CAM): a national probability survey of CAM utilizers. Altern Ther Health Med. 2003, 9 (4): 50-56.PubMed Mackenzie ER, Taylor L, Bloom BS, Hufford DJ, Johnson JC: Ethnic minority use of complementary and alternative medicine (CAM): a national probability survey of CAM utilizers. Altern Ther Health Med. 2003, 9 (4): 50-56.PubMed
44.
go back to reference Graham RE, Ahn AC, Davis RB, O'Connor BB, Eisenberg DM, Phillips RS: Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey. J Natl Med Assoc. 2005, 97 (4): 535-545.PubMedPubMedCentral Graham RE, Ahn AC, Davis RB, O'Connor BB, Eisenberg DM, Phillips RS: Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey. J Natl Med Assoc. 2005, 97 (4): 535-545.PubMedPubMedCentral
45.
go back to reference Weinick RM, Zuvekas SH, Cohen JW: Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Med Care Res Rev. 2000, 57 (Suppl 1): 36-54.CrossRefPubMed Weinick RM, Zuvekas SH, Cohen JW: Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Med Care Res Rev. 2000, 57 (Suppl 1): 36-54.CrossRefPubMed
46.
go back to reference Verhoef MJ, White MA: Factors in making the decision to forgo conventional cancer treatment. Cancer Pract. 2002, 10 (4): 201-207. 10.1046/j.1523-5394.2002.104002.x.CrossRefPubMed Verhoef MJ, White MA: Factors in making the decision to forgo conventional cancer treatment. Cancer Pract. 2002, 10 (4): 201-207. 10.1046/j.1523-5394.2002.104002.x.CrossRefPubMed
47.
go back to reference Hsiao AF, Wong MD, Kanouse DE, Collins RL, Liu H, Andersen RM, Gifford AL, McCutchan A, Bozzette SA, Shapiro MF, Wenger NS, HCSUS Consortium: Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients. J Acquir Immune Defic Syndr. 2003, 33 (2): 157-165. 10.1097/00126334-200306010-00007.CrossRefPubMed Hsiao AF, Wong MD, Kanouse DE, Collins RL, Liu H, Andersen RM, Gifford AL, McCutchan A, Bozzette SA, Shapiro MF, Wenger NS, HCSUS Consortium: Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients. J Acquir Immune Defic Syndr. 2003, 33 (2): 157-165. 10.1097/00126334-200306010-00007.CrossRefPubMed
48.
go back to reference Fiscella K, Franks P, Clancy CM: Skepticism toward medical care and health care utilization. Med Care. 1998, 36 (2): 180-189. 10.1097/00005650-199802000-00007.CrossRefPubMed Fiscella K, Franks P, Clancy CM: Skepticism toward medical care and health care utilization. Med Care. 1998, 36 (2): 180-189. 10.1097/00005650-199802000-00007.CrossRefPubMed
Metadata
Title
Health need and the use of alternative medicine among adults who do not use conventional medicine
Authors
Richard L Nahin
James M Dahlhamer
Barbara J Stussman
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2010
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-10-220

Other articles of this Issue 1/2010

BMC Health Services Research 1/2010 Go to the issue