 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Karen M. Wilson, MPH, Tracy S Sesselberg, MA, and Jonathan D. Klein, MD, MPH. Department of Pediatrics, University of Rochester, 601 Elmwood Avenue, Box 690, Rochester, NY 14642
Objective: A significant proportion of adolescents use complementary and alternative medicine (CAM). Our objective was to determine the relationship between adolescents' access to health care and their use of CAM. Methods: A stratified random sample was drawn from an online database of adolescents. Questions asked included usual source of care (USC), health insurance, having missed needed care in the past year, last well visit, family financial status (SES) and chronic illness status. Data were analyzed using chi-square and logistic regression in SPSS. Current (past 30 day) CAM use was assessed by asking about use of various CAM modalities; current (past 30 day) herbal medicine use was assessed with a list of commonly used herbal remedies and supplements. Data were weighted using a rim-weighting algorithm to be representative of the US population.The final sample had 1281 14-19 year-olds. Results: Adolescents who used a doctor's office or clinic, and those who did not have a main place for care, were most likely to report CAM use (50.2% and 47.3% respectively), compared to those using community health centers or hospital clinics (34.5% and 33.8%; overall p=.016). Adolescents who reported missing care (16.8%) were more likely to use CAM (62.3% vs. 45.7%; p<.001), and herbs (35.8% vs. 27.8%; p=.018), as were those who had not had a well visit in more than two years (55.0%, compared to 33.1% of those with a visit within 2 years and 50.1% of those with a visit within the last year; p=.001). Last well visit was not associated with current herb use. Adolescents with the lowest SES (8.0%) were the most likely to use CAM (69.2%, compared to 45.5% of the highest SES teens, and 48.5% of the middle SES group; p<.001), and herbs (45.2% compared to 27.1% and 28.6% respectively; p=.001). Logistic regression models were created for current CAM and herb use using significant factors from bivariate analysis, demographics, and chronic illness status, to control for interactions. Those who missed care were 1.8 times more likely to use CAM (95% CI 1.3-2.5), and 1.4 times as likely to use herbs (95% CI 1.03-2.0), while teens with low SES were 2.4 times as likely to use CAM (95% CI 1.5-3.9), and 1.8 times as likely to use herbs (95% CI 1.2-2.9). Conclusions: Adolescents with less access to health care are more likely to use CAM and herbs, regardless of health insurance status. Further research is needed to explore the reasons for this access disparity, and to determine whether CAM use is compensating for lack of adequate medical care.
Learning Objectives:
Keywords: Adolescents, Alternative Medicine/Therapies
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.