title: Disparities in complementary and alternative medical therapy recommendations for children in two different socioeconomic communities.
abstract: OBJECTIVE
  To compare the content, quality, and cost of recommendations for children made by complementary and alternative medicine (CAM) retailers within 2 New York City neighborhoods of divergent socioeconomic status (SES).
  
  
  METHODS
  Posing as consumers, researchers sought recommendations from CAM retailers for 2 clinical scenarios: 1) a febrile 6-week-old and 2) a 4-year-old with an upper respiratory infection (URI). All retailers selling CAM therapies outside the direction of a licensed provider within East Harlem (EH) and the Upper East Side (UES) were eligible and mapped. The febrile infant scenario was posed at sites in business in March (n = 23) and the URI scenario at sites that remained in business in April (n = 20) of 2004.
  
  
  RESULTS
  In response to the febrile infant scenario, 33% of UES retailers referred to a MD, 0% to the emergency department, and 47% made other recommendations-of which 43% were not indicated. In EH, 50% referred to a MD, 5% to the emergency department, and 37% made other recommendations. The mean price of UES recommendations was Dollars 9.66, whereas EH was Dollars 2.33 (P = .04). In response to the URI scenario, 93% of UES and 83% of EH retailers made recommendations. The mean price of UES recommendations was Dollars 10.55 while EH was Dollars 4.26 (P = .002).
  
  
  CONCLUSIONS
  Complementary and alternative medicine retailers made numerous recommendations for children, including some that were contraindicated for age. East Harlem retailers tended to refer an infant with a potentially serious condition to the emergency department or to an MD and made less expensive recommendations than their UES counterparts.
authors.affiliation: Division of General Pediatrics, Mount Sinai School of Medicine, New York, NY 10029, USA. amy.damattia@msnyuhealth.org
authors.forename: Amy
authors.initials: A
authors.lastname: Demattia
authors.forename: Harry
authors.initials: H
authors.lastname: Moskowitz
authors.forename: Kathi J
authors.initials: KJ
authors.lastname: Kemper
authors.forename: Danielle
authors.initials: D
authors.lastname: Laraque
mesh_terms: D001741:Black or African American; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000592:standards*; D000529:Complementary Therapies / Q000191:economics / Q000592:standards*; D006630:Hispanic or Latino; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data*; D009519:New York City; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000145:classification*; D012923:Social Class; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000145:classification* / Q000191:economics / Q000592:standards; D044465:White People