Health Disparities Widened: Hispanics, Poor and Uninsured More at Risk for Unsupervised Use of Complementary and Alternative Medicine

The tendency to use complementary and alternative medicines (CAM) without informing a healthcare provider is a growing concern due to potential adverse interactions with conventional medicines, or inappropriate use CAM. Our investigation focuses on which population, either demographically or based on patterns of use, is less likely to disclose CAM use to a healthcare provider. We analyzed data from the Alternative Health Supplement to the 2002 National Health Interview Survey (NHIS), including information on 19 different CAM therapies used in the past 12 months. Non-disclosure was defined as either not seeing a healthcare provider, or seeing a healthcare provider and not discussing use of CAM. Thirty-five percent of the US population uses CAM, among which 60% do not disclose CAM use to a healthcare provider. After adjusting for several socio-demographic characteristics, as well as proxies for health status and access to care, the following groups were identified as being less likely to disclose information to a healthcare provider: Hispanics (Odds-ratio (OR)=1.42, p=0.0058); lower income households (household incomes ranging from $15,000 - $34,999, OR=1.42, p=0.0081), and; uninsured populations (OR=1.57, p=0.038), all of whom experience significant health access disparities. Finally, of the 41% of CAM users that identified themselves as using CAM casually (not for a specific disease), 78% did not disclose information. Greater consumer and healthcare education should be developed collaboratively by the government, professional medical associations, and consumer groups to protect already vulnerable populations from potential adverse events from CAM use.