From Cathy Wong,
Your Guide to Alternative Medicine.
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According to a new nationwide government survey (1), 36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine (CAM). CAM is defined as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. When prayer specifically for health reasons is included in the definition of CAM, the number of U.S. adults using some form of CAM in the past year rises to 62 percent.

"These new findings confirm the extent to which Americans have turned to CAM approaches with the hope that they would help treat and prevent disease and enhance quality of life," said Stephen E. Straus, M.D., Director, National Center for Complementary and Alternative Medicine (NCCAM). "The data not only assists us in understanding who is using CAM, what is being used, and why, but also in studying relationships between CAM use and other health characteristics, such chronic health conditions, insurance coverage, and health behaviors."

The survey, administered to over 31,000 representative U.S. adults, was conducted as part of the Centers for Disease Control and Prevention's (CDC) 2002 National Health Interview Survey (NHIS). Developed by NCCAM and the CDC's National Center for Health Statistics (NCHS), the survey included questions on 27 types of CAM therapies commonly used in the United States. These included 10 types of provider-based therapies, such as acupuncture and chiropractic, and 17 other therapies that do not require a provider, such as natural products (herbs or botanical products), special diets, and megavitamin therapy.

Although there have been many surveys of CAM use to date, the various surveys included fewer choices of CAM therapies. In addition, they often surveyed smaller population samples primarily relying on telephone or mail surveys versus in-person interviews used for this survey. Thus, the results from the CAM portion of the NHIS provide the most comprehensive and reliable data to date describing CAM use by the U.S. adult population.

Overall, the survey revealed that CAM use was greater among a variety of population groups, including women; people with higher education; those who had been hospitalized within the past year; and former smokers, compared to current smokers or those who had never smoked. In addition, this was the first survey to yield substantial information on CAM use by minorities. For example, it found that African American adults were more likely than white or Asian adults to use CAM when megavitamin therapy and prayer were included in the definition of CAM.

"We're continuously expanding the health information we collect in this country, including information on the actions people take in dealing with their own health situations," said NCHS Director Edward J. Sondik, Ph.D. "Over the years we've concentrated on traditional medical treatment, but this new collection of CAM data taps into another dimension entirely. What we see is that a sizable percentage of the public puts their personal health into their own hands."

CAM approaches were most often used to treat back pain or problems, colds, neck pain or problems, joint pain or stiffness, and anxiety or depression. However, only about 12 percent of adults sought care from a licensed CAM practitioner, suggesting that most people who use CAM do so without consulting a practitioner. According to the survey, the 10 most commonly used CAM therapies and the approximate percent of U.S. adults using each therapy were:

• Prayer for own health, 43 percent
  
• Prayer by others for the respondent's health, 24 percent
  
• Natural products (such as herbs, other botanicals, and enzymes), 19 percent
  
• Deep breathing exercises, 12 percent
  
• Participation in prayer group for own health, 10 percent
  
• Meditation, 8 percent
  
• Chiropractic care, 8 percent
  
• Yoga, 5 percent
  
• Massage, 5 percent
  
• Diet-based therapies (such as Atkins, Pritikin, Ornish, and Zone diets), 4 percent
  

In addition to gathering data on the use of CAM practices, the survey also sought information about why people use CAM. Key findings indicate that:

• 55 percent of adults said they were most likely to use CAM because they believed that it would help them when combined with conventional medical treatments
  
• 50 percent thought CAM would be interesting to try
  
• 26 percent used CAM because a conventional medical professional suggested they try it
  
• 13 percent used CAM because they felt that conventional medicine was too expensive
  

Interestingly, the survey also found that about 28 percent of adults used CAM because they believed conventional medical treatments would not help them with their health problem; this is in contrast to previous findings that CAM users are not, in general, dissatisfied with conventional medicine.