Income and Education Linked to Non Use of CAM Therapies

Education and income are tied to reduced awareness and use of alternative medical options, say researchers from San Francisco State University. According to the research led by Adam Burke, professor of Health Education, practices like yoga, acupuncture, natural products and chiropractic medicine are less likely to be pursued among people with lower educational levels and incomes.

Studies on the use of complementary and alternative medicine (CAM) have typically focused on learning more about who uses these types of practices and why. Less is known about trends among those who do not partake, which inspired new research by Professor of Health Education Adam Burke, published in PLOS ONE on June 17, 2015. Burke is also the director for San Francisco State’s Institute for Health Studies.

The research, based on the 2007 National Health Interview Survey, looked at data from more than 13,000 respondents who said they had never used acupuncture, chiropractic, natural products or yoga, four common CAM practices.

Lack of knowledge as a reason for non-use was strongly associated with lower education levels and income. Those who attended college were 58 percent less likely to indicate lack of knowledge as a reason for non-use, and individuals with higher incomes were 37 percent less likely.

“The implication of this study is that the lack of access to health knowledge is a root of health inequity,” Burke said. “If you are poor, you have less access to health information for a variety of reasons.”

Physical activity levels were also found to correlate with knowledge. People who described themselves as less physically active were significantly more likely to claim a lack of knowledge of all four complementary practices.

One finding of the study that surprised Burke was that the results held true for survey respondents who experienced lower back pain. Since back pain is the medical condition most commonly linked to use of complementary health treatments, Burke and his coauthors hypothesized that back-pain sufferers would have greater knowledge about these treatments even if they opted not to use them, as their pain would compel them to learn about a variety of remedies. But Burke found that the relationship between lower education levels and lack of knowledge remained — in other words, back pain did not seem to be a significant enough motivator to seek out these common alternative treatments.

But it’s especially important for people with back pain to know about CAM methods, Burke said. “Often, the solution for chronic pain is addictive prescription medications, which are problematic in all communities, especially in lower-income communities,” Burke said. “Complementary methods have the potential to mitigate such addiction problems and may help address the root problem rather than just managing the symptoms, which is a real benefit.”

This study indicates a greater need among doctors to follow best-practice guidelines for sharing information about integrative practices, combining conventional western and CAM approaches, Burke said.

“It’s highly likely that a lack of knowledge prevents some individuals from using these integrative approaches — if they knew more, they would use them more,” Burke said. “These are cost-effective treatments that have limited side effects and may actually help remediate people’s problems. Especially in lower-income communities, it is important for health care providers to recommend them.”