Alternative Medicine in the U.S. James G. Anderson, Ph.D. Purdue University

Objective To document trends in alternative medicine use in the U.S. between 1990 and 1997.

Design Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively. A total of 1539 adults in 1991 and 2055 in 1997. Prevalence, estimated costs and disclosure of alternative therapies to physicians were measured.

Other countries % of population who used alternative medicine during the past 12 months 10% Denmark 15% Canada 33% Finland 49% Australia

Types of Alternative Therapies Relaxation techniques Herbal medicine Massage Chiropractic Spiritual healing Megavitamins Self-help group Imagery

Types of Alternative Therapies Commercial diet Folk remedies Lifestyle diet Energy healing Homeopathy Hypnosis Biofeedback Acupuncture

Results Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997. The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3%.

Results Therapies increasing the most included: herbal medicine massage megavitamins self-help groups folk remedies energy healing homeopathy

Results Alternative therapies used most frequently for: Back problems Anxiety Depression Headaches

Disclosure of Alternative Therapies to Physicians 1990: 38.5% 1997: 38.5%

Percentage of Users paying Entirely Out-of-Pocket for Alternative Therapies 1990: 64% 1997: 68.3%

Total Visits to Alternative Medicine Practitioners in the U.S. Alternative Practitioners 1990: 427 million 1997: 629 million Primary Care Physicians 1990: 387 million 1997: 385 million

Estimated Total Expenditures for Alternative Medicine Services 1990: $14.6 billion 1997: $21.2 billion

Why Patients use Alternative Medicine National study of why people in the U.S. use alternative medicine. Objective – to investigate predictors of alternative health care use.

Hypotheses People seek alternative medicine because: (1). they are dissatisfied with conventional treatment. (2). they see alternative medicine as offering more personal autonomy and control over health care decisions. (3). the alternatives are seen as more compatible with their beliefs, values, and world view.

Design Written survey examining use of alternative health care and attitudes toward conventional medicine. 1035 individuals were randomly selected who lived throughout the United States.

Results Predictors of use of alternative medicine: More education Poorer health status Chronic health problems Holistic orientation to health Experience that changed their world view Membership in cultural groups such as environmentalism, feminism, spiritualism Believing in the importance of body, mind, and spirit in treating health problems Perceived efficacy (relief of symptoms)

Results Predictors of use by those who primarily use alternative medicine: Distrust of conventional physicians and hospitals Desire for control over health decisions Dissatisfaction with conventional practitioners Belief in importance ofn one’s inner life