title: Alternative healthcare use in the under-served population.
abstract: OBJECTIVE
  To apply the Behavioral Model for Vulnerable Populations to the examination of the correlates of alternative healthcare utilization among Hispanic and African-American adults residing in public housing.
  
  
  METHODS
  Cross-sectional survey of a community-based sample.
  
  
  METHODS
  Urban public housing communities in the county of Los Angeles.
  
  
  METHODS
  A geographically defined random sample of 287 African-American and Latino heads of households from three urban public housing communities.
  
  
  RESULTS
  The use of alternative health care was assessed with three indices reflecting how frequently respondents used alternative sources of health care: 1) to prevent sickness; 2) to treat sickness; and 3) to substitute for conventional health care. Multivariate analysis of data indicates that lower education, greater perceived racial discrimination, and poorer health status were associated with the use of alternative health care to prevent sickness. Furthermore, greater perceived racial discrimination, greater financial strain, and poorer health status were associated with the use of alternative health care to treat sickness. In addition, four variables were associated with increased frequency of alternative healthcare utilization as a substitute for conventional care, namely: 1) diminished belief that powerful individuals (such as healthcare professionals) control one's health; 2) greater perception of racial discrimination; 3) greater financial strain; and 4) reduced access to health care.
  
  
  CONCLUSIONS
  Enabling characteristics helped explain the use of alternative health care to treat sickness as a substitute for conventional health care, but not to prevent sickness, in this population. Perceived racial discrimination was the strongest correlate for each type of alternative healthcare use, while health status was also a strong predictor. The use of alternative health care for prevention and for substitution should be examined separately in disadvantaged minority populations.
authors.affiliation: Department of Family Medicine, Research Centers in Minority Institutions (RCMI), Charles R. Drew University of Medicine and Science, Los Angeles, California 90059, USA. mobazarg@cdrewu.edu
authors.forename: Mohsen
authors.initials: M
authors.lastname: Bazargan
authors.forename: Keith
authors.initials: K
authors.lastname: Norris
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
authors.forename: Lutful
authors.initials: L
authors.lastname: Akhanjee
authors.forename: José L
authors.initials: JL
authors.lastname: Calderon
authors.forename: Shahriar D
authors.initials: SD
authors.lastname: Safvati
authors.forename: Richard S
authors.initials: RS
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D014504:Urban Health