Alternative and complementary health practices (ACHP) among older urban African Americans

BACKGROUND: Older Blacks have higher rates of chronic illness, disability, and mortality than Whites. Impaired access to healthcare and an understudied complementary and alternative medicine (CAM) tradition make older African Americans particularly vulnerable to drug interactions, delays to conventional treatment, and other risks of CAM use. This study describes ACHP among older African Americans in western Baltimore neighborhoods.

METHODS: The West Baltimore CAM Study assessed ACHP among self-identified African American/Black western Baltimore, Maryland residents ages 60 years and older.

RESULTS: 88.4% reported CAM use versus national estimates of 30%-40%. 79.3% disclosed CAM use to providers. Modalities included acupuncture (3.2%), chiropractic (4.2%), group spiritual practices (17.0%), individual prayer (84.2%), massage (6.3%), meditation/visualization (10.6%), and relaxation (1.1%), as well as herbs/home remedies (29.5%) for conditions including arthritis, colds, constipation, diabetes, pain, hot flashes, hypertension, insomnia, nausea, swelling, immune function, vision, cholesterol, system cleansing, effects of smoking, and prevention/wellness. Any CAM use was associated with frequent church attendance (Chi-square=6.72, p=0.010), female gender (Chi-square=3.94, p=.047) and Medicare (Chi-square=3.73, p=.053). CAM use excluding individual prayer was associated with Medicare (Chi-square=7.14, p=.0075) and lower physical function (t=2.14, p=.034). In multiple logistic regression, only Medicare remained significantly associated with both outcomes.

CONCLUSIONS: Associations of CAM use with receipt of Medicare suggest new possibilities for interventions to promote its safe use. This study adds to the understanding of health status among vulnerable older African Americans living in disadvantaged neighborhoods and identifies issues for further public health investigation.