Discrimination in health care and CAM use in a representative sample of U.S. adults

Discrimination in medical settings may influence patient attitudes about health care and health-seeking behaviors. Patients who experience discrimination may seek alternative means of health care, including use of complementary and alternative medicine (CAM). The objective of this study was to examine the relationship between discrimination in health care and CAM use.

Data come from the 2001 Health Care Quality Survey (HCQS), which used a multistage sampling design with random-digit dialing, oversampling telephone exchanges with higher densities of African-American, Hispanic, and Asian households. The 2001 HCQS sample consisted of 6722 adults living in the continental United States. To correct for the disproportionate sample design, data were adjusted using sample weights to make the results representative of the U.S. population 18 years and older. Present analyses were limited to 6008 respondents who had visited a doctor or clinic or had been admitted to the hospital in the last 2 years.

Outcome measures were CAM use, practitioner-provided CAM use, and herbal medicine use.

In adjusted logistic regression analyses, discrimination in health care was significantly associated with use of herbal medicines alone (adjusted odds ratio=1.47, confidence interval: 1.05, 2.04), but not with use of practitioner-provided CAM (i.e., use of acupuncture, chiropractor, traditional healer or herbalist, alone or in combination with herbal medicines).

Further research is needed to examine the direction of the relationship between discrimination and CAM use and differences by CAM modality.