CAM Use in America: Up Close
"The fact that users of CAM tend to pursue generally healthy lifestyles suggests that they may be open to additional recommendations toward optimizing their health."
— From the study paper
In 2004, NCCAM co-released results from the largest, most representative survey to date on Americans' use of CAM, from an NCCAM-funded supplement to the Centers for Disease Control and Prevention's 2002 National Health Interview Survey (NHIS). The survey found that many Americans are using CAM—36 percent of adults aged 18 years and over, a figure that rose to 62 percent when prayer specifically for health reasons was included in the definition of CAM.
Since the release of the original report, NCCAM has been supporting studies to find out more from this data—for example, on the use of CAM by specific population groups or for certain diseases. This column highlights some of those studies.
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Do exercise and CAM use appear to be related?
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Health Behaviors of CAM Users
If you smoke cigarettes or drink alcohol—or if you used to—what are the odds that you also use CAM? What are those odds if you like to walk in the park, work in the garden, or pursue other exercise?
Richard L. Nahin, Ph.D., M.P.H., of NCCAM (see also 10th Anniversary of NIH Acupuncture Conference) and his colleagues have added to the NHIS portrait of CAM use by focusing their research on certain behaviors that have an impact on health. Specifically, his team looked at the relationship between CAM use and leisure-time physical activity, smoking, alcohol use, body weight, and having had a flu shot or not in the past year. Their study also looked at survey participants' health status, their access to and use of conventional health care, and a number of population factors such as race/ethnicity, education, employment, and area of residence.
Exercise, they found, had by far the strongest association with CAM use. People who exercised regularly were much more likely to use CAM than those who did not exercise. The following factors also had an association with using CAM, although not as strongly: being a light-to-moderate drinker, being a former smoker, and not being obese. They also found that CAM use appeared to be more likely among respondents with poorer health status (for example, having one or more chronic health problems). However, there also appeared to be a subset of CAM users who had better health status than non-CAM-users, and, the authors suggest, may also have been more health-conscious and more actively involved in their health care. There was no association between CAM use and flu vaccination.
Many of their other findings fit with previous studies—for example, that users of CAM, compared with nonusers, are more likely to be female, under age 65, and living in the Western United States; to have a health complaint; to be employed and at a higher income level; and to be educated to at least the bachelor's-degree level.
The authors note that the data indicate that CAM users appear to pursue "generally healthy lifestyles." Questions that remain to be answered include cause-and-effect patterns (for example, whether many CAM users decided at some point to adopt a healthier lifestyle) and whether CAM users maintain patterns of positive health behaviors over time better than do nonusers.
CAM Use in African Americans
Carolyn Brown, Ph.D., and colleagues at the University of Texas at Austin analyzed the use of CAM among African American respondents to the survey. Among their findings:
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- About 68 percent used some form of CAM in the past 12 months. When prayer for health reasons was not included in the definition of CAM, that figure was 27 percent.
- Prayer was the most commonly used CAM therapy (60.7 percent of respondents), followed by herbs (14.2 percent) and relaxation techniques (13.6 percent).
- The demographic profile of African American CAM users (such as age, gender, and education level) was similar to that of the survey population as a whole.
- Compared with the general survey population, African Americans used CAM more to treat specific conditions than to prevent an illness or promote health. Those with medical conditions common in the African American community were most likely to use CAM. Overall, the leading conditions for which CAM was used related to pain, such as recurring pain, aching joints, and arthritis.
The authors noted that one limitation of this study was the fact that African Americans commonly use "home remedies," and this term was not included in the survey.
Sources
Brown CM, Barner JC, Richards KM, et al. Patterns of complementary and alternative medicine use in African Americans. Journal of Complementary and Alternative Medicine. 2007;13(7):751–758.
Nahin RL, Dahlhamer JM, Taylor BL, et al. Health behaviors and risk factors in those who use complementary and alternative medicine. BMC Public Health. 2007;7:217. Editor's note: This article is available free on the Web at www.biomedcentral.com/1471-2458/7/217.
For the original 2004 report, see nccam.nih.gov/news/camstats.htm. For more papers based on the 2002 NHIS, consult the PubMed database at www.ncbi.nlm.nih.gov/sites/entrez or contact the NCCAM Clearinghouse. A CAM supplement was also included in the 2007 NHIS, and the first group of results is expected later this year.
