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FILE: Hispanics: CAM Use HC 120641-277 Date: March 31, 2005 RE: Alternative Medicine Use Among Hispanics in the Los Angeles Area Mikhail N, Wali S, Ziment I. Use of alternative medicine among Hispanics. J Altern Complement Med. 2004;10(5):851-859. The Hispanic population is the fastest growing minority in the United States. However, there is little data profiling the use of alternative medicine by this population. The authors describe a survey on the use of alternative medicine by Hispanics living in the northern part of Los Angeles County. Hispanics were defined as people who moved to the U.S. from Mexico or from Central or South America and Spanish is their native language. First generation U.S. born Hispanics were also included. Subjects (N = 179) were surveyed from January 2000 to June 2001 at churches and hospitals in Northern Los Angeles County. The interview was in Spanish or English. To prevent bias, the subjects were told that the survey was about general health. The survey contained 14 sections with questions on (1) medical condition, (2) demographics, (3) socioeconomics, (4) nonherbal alternative medicine use, (5) herbal use, (6) vitamin and dietary supplement use, (7) reason for use of alternative therapies, (8) perceived efficacy of herbs compared to prescription medications, (9) use of prayer, (10) side effects associated with alternative medicines, (11) perception of safety of prescription medications, (12) source of information about alternative therapies, (13) cost, and (14) satisfaction. Sixty-eight percent of the participants were women. Users of alternative medicine had significantly lower income (P = 0.045), less proficiency in English, and lower education level. Sixty-four percent of the subjects had used alternative medicine, with 57% using herbs. Mint (Mentha spp.) alone or with tea was the most frequently used herb. Cactus (Opuntia spp.) and mint were the most commonly used herbs among diabetics. Nopal {cactus} is often used for diabetes and it appears to be of some value, maybe as a substitute for candy and other products that may exacerbate blood sugar control problems. Multivitamins were the most commonly used vitamin preparation. The main reasons for using alternative therapy were pain (including headache), lack of energy, overweight, and lack of sleep. One third of the subjects reported that prescription
medication was more effective than herbs, while only 5% thought that herbs were more effective. For 23% of the subjects, prayer was the only alternative medicine reported. Most subjects (45%) thought that prescription medications were safer than alternative medicine or that both were safe (45% of subjects). Family and friends were the main source of information about alternative medicine. On average, subjects spent $27.50 per month on alternative medicine. Most (40%) bought alternative medicine products at the supermarket. Fourteen percent of the subjects using herbs reported no cost because they grew the herbs that they used (mint, cactus, aloe vera, and cat's claw [Uncaria tomentosa]). According to one of the authors, Irwin Ziment, the wide variety of herbs sold in supermarkets and in botanicos in North Los Angeles County suggests that some respondents "forgot" to mention purchase and uses of herbal agents, or they just purchased them for older more traditional relatives. In studies of Caucasian Americans, higher income was associated with greater use of alternative medicine. In contrast, this study of Hispanic Americans showed that lower income was associated with greater use of alternative medicine. The cost of herbs is significant, yet non-affluent people in the Hispanic community are willing to purchase herbs and herbal products for their health. The types of herbs used by the Hispanics was entirely different from those used by the general U.S. population, who most often use ginseng (Panax quinquefolius), echinacea (Echinacea spp.), garlic (Allium sativum), and ginkgo (Ginkgo biloba). Most subjects in this study were using "integrative" medicine based on the accepted value of allopathy, but they synergized their treatment with herbs and prayers. The authors believe that this survey demonstrates that not only should medical schools include alternative medicine in their curricula, but they should also point out the cultural variations. An ongoing effort is required to make physicians familiar with their patients' needs for alternative measures in health care maintenance and in illness management. —Heather S. Oliff, PhD
Enclosure: Referenced article reprinted with permission from Mary Ann Liebert, Inc., 2 Madison Ave., Larchmont, NY 10438; Telephone (914)834-3100; Fax (914)834-3582;email:info@liebertpub.com.
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