Disparities in complementary and alternative medical therapy recommendations for children in two different socioeconomic communities.
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.
Demattia
Amy
A
Division of General Pediatrics, Mount Sinai School of Medicine, New York, NY 10029, USA. amy.damattia@msnyuhealth.org
Moskowitz
Harry
H
Kemper
Kathi J
KJ
Laraque
Danielle
D
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