Race and Ethnicity Differences in Use of CAM and in Communications with Medical Providers about CAM Use M. Maka Tsulukidze, MD, MPA, MPH, PhD Student The University of North Carolina at Charlotte RESEARCH TEAM Sarah B. Laditka, PhD, Associate Professor James N. Laditka, PhD, Associate Professor M. Maka Tsulukidze, MD, MPH, PhD Student Elizabeth M. Tait, MHS, PhD Student What is CAM? “Diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine.” NIH National Center for Complementary and Alternative Medicine (NCCAM) Major Types of CAM Whole Medical Systems e.g., homeopathy, naturopathy Mind-Body Medicine e.g., meditation, prayer Biologically Based Practices e.g., dietary supplements, herbal products Manipulative and Body-Based Practices e.g., chiropractic or osteopathic manipulation Energy Medicine e.g., therapeutic touch, magnetic fields RESEARCH OBJECTIVES To examine race/ethnicity differences in CAM use To investigate race/ethnicity differences in communication about CAM use with health care providers STUDY DESIGN DATA ANALYSES stratified by sex 2007 NHIS CAM supplement RACE/ETHNICITY Hispanics chi-square & logistic regression African Americans accounting for survey design Asian Americans nationally representative Non-Hispanic Whites CONTROLS age; education; marital status; region. self-reported health; health status; health behaviors. 7 chronic health conditions; health insurance. DEPENDENT VARIABLES CAM use with vitamins CAM use without vitamins Ever told medical provider about CAM use STUDY POPULATION Ages 19-64 — Women, 10,151 — Men, 8,388 PRINCIPAL FINDINGS CAM Use by Women, by Race/Ethnicity, NHIS 2007 WHITE HISPANIC Vitamins No Vitamins BLACK ALL RACES 0 20 40 60 80 100 % CAM Use by Men, by Race/Ethnicity, NHIS 2007 WHITE HISPANIC Vitamins No Vitamins BLACK ALL RACES 0 20 40 60 80 % Adult CAM Use by Education, Adjusted ORs, Women 19-64 , NHIS 2007 3.0 2.5 2.0 1.5 1.0 0.5 0.0 ≤8 8-11 12 (Reference) ASSOC BS GRAD Adult CAM Use by Education, Adjusted ORs, Men 19-64 , NHIS 2007 2.5 2.0 1.5 1.0 0.5 0.0 ≤8 8-11 12 (Reference) ASSOC BS GRAD Ever Told Medical Provider about CAM Use, Adjusted ORs, Women 19-64, NHIS 2007 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0.0 HISPANIC ASIAN BLACK OTHER WHITE (Reference) Ever Told Medical Provider about CAM Use, Adjusted ORs, Men 19-64, NHIS 2007 3.0 2.5 2.0 1.5 1.0 0.5 0.0 HISPANIC ASIAN BLACK OTHER WHITE (Reference) STUDY CONSIDERATIONS Does not address CAM efficacy No information about physician practice POLICY & PRACTICE IMPLICATIONS Opportunities to promote CAM use with established health benefits among people in minority groups Medical providers should inquire about CAM use, particularly by minority patients — Evidence of adverse interactions — Opportunity for improved treatment, by combining an effective CAM with conventional therapy or by changing conventional therapy Questions & Comments Thank You!