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!