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APHA Scientific Session and Event Listing

Maria Chao, DrPH, Christine Wade, MPH, and Fredi Kronenberg, PhD. Rosenthal Center for Complementary & Alternative Medicine, Columbia University, 630 West 168th Street, Box 75, New York, NY 10032, 917-509-7763, mtc28@columbia.edu

Social disparities in access to and quality of conventional care are well documented. Yet, how healthcare disparities affect utilization of complementary and alternative medicine (CAM) is not well understood. Using 2002 National Health Interview Survey data, we tested hypotheses on access to and quality of conventional care and use of professional, self-care, and any type of CAM. Covariates included race/ethnicity, education, income, employment status, health status, and demographics. Analyses were performed with Stata 9.0 accounting for survey design.

CAM use was higher among women, non-Hispanic Whites, and those with higher education and income. Controlling for sociodemographics, CAM utilization was significantly associated with worse usual source of conventional care, inability to afford care, and delayed medical care [adjusted odds ratios (AOR) = 0.93, 1.79, and 1.83 respectively]. Respondents with private health insurance were more likely to use CAM than those with no health insurance (AOR = 1.20). Effects were larger for self-care than for professional forms of CAM.

Lack of access to and poor quality of conventional care increase the likelihood of CAM utilization. However, CAM users are more likely to have greater access to resources, such as insurance coverage and higher household income. There is a potential danger of a two-tiered system where safe, regulated CAM treatments are accessible to those with resources while unregulated CAM treatments are readily available to all. Monitoring of CAM use is warranted to ensure safety and documenting disparities in access to health resources is important.

Learning Objectives:

• Describe demographics of CAM users in the United States.
• Explain how access to and quality of conventional care is associated with use of professionalized and non-professionalized CAM.
• Discuss contradictions in the literature on healthcare utilization and CAM use.

Presenting author's disclosure statement:

Not Answered