Comparative Analysis of Factors Affecting the Use of Complementary Medicine

Comparative Analysis of Factors Affecting the Use of Complementary and Alternative Medicine and Prayer and Spiritual Healing by Catherine M. Simile, Patricia M. Barnes, Barbara J. Stussman, Beth Taylor, and Catherine M. Simile National Center for Health Statistics Kim McFann and Richard L. Nahin National Center for Complementary and Alternative Medicine The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention. Background • CAM – a group of diverse medical and health care systems , practices, and products that are not presently considered to be part of conventional medicine. Methods • CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS) – Administered to 31,044 sample adults (74.3% response rate) – Addressed 17 types of CAM therapies (including prayer and spiritual healing) – Sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH) Methods (cont’d) • Topical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measures – respondent health behaviors – access to conventional medical services • Logistic regression used to identify independent associations with CAM use and use of prayer Dependent Variables CAM use -- use of any of the following in the past 12 months: Acupuncture Ayurveda Biofeedback Chelation therapy Chiropractic care EHT-Reiki Folk medicine Hypnosis Massage Naturopathy Natural herbs Homeopathic treatment Special diets High dose/megavitamin therapy Yoga/Tai Chi/Qi Gong Relaxation techniques Prayer/spiritual healing for health reasons -- any of the following in the past 12 months: Prayed for your own health Participated in a prayer chain or group for your own health Others prayed for your health Had a healing ritual or sacrament performed for your own health Model Variables: Health Behaviors and Status • Health behaviors: – Physical activity (no exercise, some, regular) – Body weight status (underweight, normal weight, overweight, obese) – Drinking status (<12 drinks in lifetime, 0 drinks in past year, <1 per week, 1-7 per week, 8-14 per week, 15+ per week) – Smoking status (never smoked, former smoker, current smoker) • Health status: – Number of health conditions (0, 1-2, 3-5, 6+) – Functional limitation (yes, no) – Health compared to 12 months ago (worse, same, better) Model Variables: Health Care • Access to conventional care: – – – – Delayed care due to cost (yes, no) Delayed care for reasons other than cost (yes, no) Insurance status (uninsured, private coverage, public coverage) Poverty status (at or below poverty line, 101-199%, 200-299%, 300-399%, 400-499%, 500%+) • Use of conventional medical services: – Number of doctor visits in past 12 months (0, 1, 2-3, 4-9, 10+) – Used over-the-counter medications in past 12 months (yes, no) – Used prescription medications in past 12 months (yes, no) Model Variables: Sociodemographics – Gender (male, female) – Employment status (not employed, private sector, public sector, self-employed/family business) – Race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, non-Hispanic AIAN, non-Hispanic API) – Region (Northeast, Midwest, South, West) – Education (< than HS, HS grad/GED, some college/Associate’s, Bachelor’s, Master’s/Doctorate/Professional) – Age (18-44, 45-64, 65+) Results • Overall, 36.1% of adults used CAM (excluding prayer) and 45.1% used prayer for health reasons in the past 12 months Results: Health Behaviors CAM (OR) Exercise None Some Regular ref 1.73 2.38 ref 1.21 1.31 PRAYER (OR) Body Weight Status Underweight Normal weight Overweight Obese --ref --0.83 --ref ----- Results: Health Behaviors CAM (OR) PRAYER (OR) Drinking Status < 12 drinks lifetime 0 drinks past yr < 1 drink per week 1-7 drinks per week 8-14 drinks per week 15+ drinks per week Smoking Status Never smoked ref ref ref 1.21 1.43 1.59 1.50 --ref --0.76 0.61 0.48 0.50 Former smoker Current smoker 1.13 --- --0.79 Results: Health Status CAM (OR) No. of Health Problems 0 1-2 3-5 6+ Functional Limitation ref 1.55 2.29 3.34 ref 1.25 1.59 2.13 PRAYER (OR) Yes No Health Compared to 12 Months Ago Worse Same Better 1.30 ref 1.23 ref --ref 1.39 1.48 ref 1.32 Results: Access to Conventional Care CAM (OR) Delayed Care Due to Cost PRAYER (OR) Yes No Delayed—Other Than Cost Yes No Insurance Coverage Uninsured Public 1.34 ref --ref 1.51 ref 1.17 ref ref 0.83 ref --- Private --- --- Results: Access to Conventional Care CAM (OR) Poverty Status At or below 101-199% 200-299% ref ----ref ----PRAYER (OR) 300-399% 400-499% 500% + ----1.30 ----0.70 Results: Use of Conventional Care CAM (OR) No. of Doctor Visits PRAYER (OR) 0 1 2-3 4-9 10+ Used OTC Meds Yes No ref --1.21 1.30 1.78 1.23 ref --ref ref ----1.28 1.68 1.27 ref 1.29 ref Used Prescription Meds Yes No Results: Sociodemographics CAM Gender Female Male Employment Status Not working Private sector ref --ref --1.55 ref 1.53 ref PRAYER Public sector Self-emp/fam business --1.41 ----- Results: Sociodemographics CAM (OR) Race/Ethnicity Hispanic Non-Hispanic white Non-Hispanic black Non-Hispanic AIAN Non-Hispanic API Region South Northeast ref 1.12 ref 0.57 --ref ----1.56 1.89 ref 2.61 ----PRAYER (OR) Midwest West 1.20 1.58 0.78 0.62 Results: Sociodemographics CAM (OR) PRAYER (OR) Age 18-44 45-64 1.73 1.64 0.75 --- 65+ Education < HS ref ref ref ref HS/G.E.D. Some coll./AA Bachelors 1.37 1.85 2.40 ------- Master’s + 2.79 --- Conclusions • Different segments of population using CAM and PRAYER; similar findings within these segments • Cost and non-cost barriers to conventional care increase likelihood of CAM use • Respondent health behaviors associated with both CAM use and use of PRAYER Contact Information Catherine M. Simile, Ph.D. National Center for Health Statistics Division of Health Interview Statistics 3311 Toledo Road, Room 2115 Hyattsville, MD 20782 Phone: (301) 458-4499 Email: cus4@cdc.gov