Racial and Ethnic Differences In Complementary and Alternative Medicine Utilization: The Importance of Theory

Using philosophical congruence theory, this article examines racial and ethnic differences in use of complementary and alternative medicines (CAM). The philosophical congruence theory states that racial and ethnic minorities will use more CAM because CAM is viewed as more medicinally compatible with their values and beliefs about health and illness. This article seeks to explain how these differences vary across CAM modalities. The CAM modalities included in this study include: alternative treatments, mind-body treatments, manipulative treatments, energy therapies, herbs and vitamins, and prayer. These modalities were obtained through factor analysis using LISREL. Data for this study were obtained from the 2002 National Health Interview Survey. In 2002 the supplemental section was on the use of complementary and alternative medicine (CAM). The total sample size was 22,870 adults, aged 18 years and older. Logistic regression was used to test the racial and ethnic variations in use of CAM. Differences were found among racial and ethnic groups examined in this study. For overall CAM use, Hispanics, African Americans, and Asian Americans used significantly less CAM than Non-Hispanic whites. In examining use of alternative treatments, which includes acupuncture, ayurveda, folk, naturopathy, and homeopathy, African Americans are 54% less likely to use alternative treatments than Non-Hispanic whites; however Asian Americans are 106% more likely to use alternative treatments. Hispanics, African Americans and Asian Americans are less likely to use less herbs and vitamins than Non-Hispanic whites (35%, 38%, 35%, respectively). Hispanics, African Americans and Asian Americans also use less manipulative treatments, i.e. chiropractic and massage. African Americans are 57% less likely to use manipulative treatments that non-Hispanic Whites, while Asians are 59% less likely. Hispanics and African Americans are 1.5 times more likely to use prayer for healing than Non-Hispanic whites, while Asian Americans use significantly less prayer. It was hypothesized, based on the philosophical congruence theory, that racial and ethnic minorities will have more use of CAM, however, this hypothesis was only partially supported in the findings. When examining only total CAM use, as much previous research does, the philosophical congruence theory is not supported. Non-Hispanic whites have greater odds of total CAM use as compared to Hispanics, African Americans, and Asian Americans. However, when examining specific modalities of CAM, such as alternative treatments, prayer, and manipulative treatments, the philosophical congruence theory is supported. Racial and ethnic minorities are more likely to utilize CAM based on their belief system.