NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE
Survey Sheds New Light on Adults'—and Children's—Use of CAM
Tai Chi
© Bob Stockfield
Complementary and alternative medicine (CAM) is used frequently in the United States. An updated portrait of this use—including, for the first time, CAM use in children, and trends and changes in overall CAM use since 2002—is now available from a large, national, Federal survey published in December 2008. Among its major findings are that about 38 percent of adult Americans and about 12 percent of American children aged 17 and under are using CAM.
A Collaborative Survey
NCCAM and the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC), developed a detailed set of questions on CAM as part of the 2007 National Health Interview Survey (NHIS). The NHIS is an annual study in which tens of thousands of Americans are interviewed about their health- and illness-related experiences. For the 2007 survey on CAM, researchers interviewed more than 23,300 adults aged 18 years or older. Many respondents also answered questions on CAM use by children in their households (about 9,400 children aged 17 years and under).
"These new findings provide the most current, comprehensive, and reliable information on Americans' use of CAM," said Josephine P. Briggs, M.D., Director of NCCAM. "As in 2002, they confirm that CAM practices are a frequently used component of Americans' health care regimens. They also reinforce the need for rigorous research on the safety and effectiveness of these therapies and for open discussion between patients and providers about CAM use."
The 2007 survey, compared with the 2002 NHIS supplement on CAM:
- Asked about more types of CAM—36 therapies, up from 27 in 2002. These include 10 provider-based therapies such as acupuncture and chiropractic, and 26 therapies that do not require a provider, such as herbal supplements and special diets. The 2007 survey also included new questions focusing on traditional healers and movement therapies.
- Assessed more diseases and conditions.
- Surveyed CAM use in children for the first time.
CAM Use Among Adults
Richard L. Nahin, Ph.D., M.P.H., is a coauthor of the study. He serves as NCCAM's Acting Director of the Division of Extramural Research and Senior Advisor for Scientific Coordination and Outreach. Dr. Nahin noted some other points of comparison with the 2002 data as follows:
- The 2007 figure of 38 percent of adults using CAM is essentially unchanged from the 2002 figure of 36 percent. Dr. Nahin commented that "it appears that the rate of CAM use in the United States has probably stabilized."
- There were changes in 2007, however, in the rate of use of some CAM therapies—including increases in several mind-body therapies (deep breathing exercises, meditation, and yoga) and in acupuncture, massage therapy, and naturopathy (see Figure 1). Rate of use decreased significantly for some therapies, including several special diets (the Atkins, Zone, and Macrobiotic diets) and tai chi.
- The most commonly used CAM modality was various nonvitamin, nonmineral, natural products (17.7 percent) such as herbal medicines and other dietary supplements. In this category, the most commonly used products were fish oil/omega 3/DHA, glucosamine, echinacea, flaxseed oil or pills, and ginseng (Figure 2).
- After natural products, the next most popular CAM therapies were deep breathing exercises (12.7 percent); meditation (9.4 percent); chiropractic or osteopathic manipulation (8.6 percent); and massage (8.3 percent) (Figure 1).
- Adult use of CAM in 2007 was greater in groups that had one or more of the following characteristics (most of which were also found in 2002):
- Female
- A higher level of education
- A race/ethnicity of American Indian/Alaska native, followed by the categories of White, Asian, Black, and Hispanic
- Residence in the Western United States
- A higher income level
- A higher number of health problems (diseases and/or conditions)
- A higher number of doctor visits in the prior 12 months
- History of hospitalization in the year prior to the survey
- Having delayed or not received conventional care in the previous year because of cost issues
- Former smokers.
The highest rates of CAM use were in adults aged 40 to 60. The highest increase in the rate of CAM use was seen in adults aged 60 to 85-plus.
- Americans used CAM most often for conditions involving chronic pain, a trend that was also seen in 2002. The top four diseases/conditions for which people used CAM in 2007 were back pain or other back problems, neck pain or other neck problems, joint pain or stiffness or other joint condition, and arthritis (Figure 3). Next in line were anxiety, cholesterol control, and head or chest cold.
CAM Use in Children
- Almost one in nine children (about 12 percent) in the survey had used CAM. The authors note that the estimates of CAM use by children may actually be on the low side, because some adolescents may not reveal CAM use to parents or other adults in their household.
- The most commonly used CAM therapies in children were nonvitamin, nonmineral, natural products; chiropractic or osteopathic manipulation; deep breathing exercises; yoga; and homeopathic treatment (for figures on children, see nccam.nih.gov/news/camstats/2007).
- Most often, CAM therapies were used in children for back or neck pain, colds, anxiety or stress, other musculoskeletal problems, and attention deficit/hyperactivity disorder (ADD/ADHD).
- Children whose parents used CAM were almost five times more likely to use CAM than children whose parents did not use CAM.
- Child CAM users were similar to adult CAM users when it came to population factors like socioeconomic status and region of residence.
In addition to NCCAM, six other components of NIH supported the 2007 NHIS CAM supplement: the National Heart, Lung, and Blood Institute; the National Institute of Allergy and Infectious Diseases; the National Institute of Mental Health; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the NIH Office of Dietary Supplements; and the NIH Office of Behavioral and Social Sciences Research.
The full report on the 2007 CAM supplement is available through the NCCAM Web site at nccam.nih.gov/news/camstats/2007/. The survey data are also publicly available for additional analysis from the CDC Web site at www.cdc.gov/nchs/nhis.htm.
References
- Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 2007*. CDC National Health Statistics Report #12. 2008.
- Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002*. CDC Advance Data Report #343. 2004.
