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FILE: § Alternative Medicine § Complementary and Alternative Medicine § Alternative Medicine Use Patterns HC 090515 - 210 Date: RE: April 8, 2002 Article Reviews Alternative Medicine Use in Canada
Wiles J, Rosenberg MW. ‘Gentle Caring Experience’ /Seeking Alternative Health Care in Canada. Health & Place. 2001; 7:209-224. This paper reviews the empirical evidence describing characteristics of users of alternative medicine, compares this to data on Canadian users of alternative care, and seeks to place this information in the context of geographical patterns of consumption and resistance to conventional biomedical practice. The literature review, using sources published since 1990, notes that researchers use various definitions of alternative medicine, therapies, and practices, but no definition is given by the authors. References are cited documenting the growing use of alternative medicine in developed countries. The key identifying factors of alternative medicine users for which there is some consensus are gender (females), educational level (higher), occupational level (full-time, higher level), social class (higher), age (25-49), and health status (poor health, or prevention). There is less consensus regarding reasons for geographical differences (higher use in western states and provinces) or spiritual/religious practice or affiliation. The authors cite research showing that “philosophical congruence,” in which alternative medicine is seen as being more compatible with a person’s beliefs and values, is a strong factor in the use of alternative therapies. Other research cites enabling factors such as availability of services, referrals, and income to be influential in the use of alternative medicine. Most users of alternative medicine also use conventional medicine, but neglect to tell their physicians about their use of alternative medicine. In an analysis of the general file of the 1996-1997 National Population Health Survey of Canada (NPHS), 210,377 observations were evaluated for alternative health services use. Statistically significant crosstabulations revealed that Canadians are much more likely to use a conventional physician than an alternative care provider, probably because of universal public health insurance that frequently does not cover alternative therapies. However, Canadians who use alternative medical care share many characteristics similar to those described in the literature: female gender, higher income, and higher educational level all influence use. There is an east to west gradient in use of alternative health care, partially because western provinces include some alternative care therapies in their health insurance plans. The article then turns to a sociological examination of conventional medical practice (biomedicine) and alternative medicine. Critics of biomedicine say that it treats patients as mechanisms to be repaired rather than whole persons in a social and health context. The authors state that the holistic philosophy of many forms of alternative medicine attracts patients who feel it is more compatible with their worldviews and
beliefs. Individuals are free to choose from many options in the healthcare marketplace, giving rise in the 1990s to “smart consumers” who rely on personal rather than institutional legitimacy in making health care decisions. The article proposes that use of alternative health therapies is motivated by many interrelated factors; its use can be seen as both a refuge for “victimized refugees” from the biomedical systems as well as a means of asserting identity and maintaining sovereignty over the self and the body. In conclusion, the authors state that a complex geography of consumption, including analysis of social, structural, and political conditions, would help in understanding the motivations behind the use of alternative medicine. The goal of this ambitious article is elusive. The authors attempted to combine an annotated literature review and comparison with NPHS data with an in-depth academic sociological and geographical analysis which may have been more appropriately addressed in a separate paper. — Diane Graves, MPH, RD
Enclosure:
The American Botanical Council chose not to enclose the original article with this HC review due to the prohibitive reprint costs required by the original publisher.
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