Medical pluralism among American women: results of a national survey.
BACKGROUND
Medical pluralism can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness. American women use a variety of health services and practices for women's health conditions, yet no national study has specifically characterized women's medical pluralism. Our objective was to describe medical pluralism among American women.


METHODS
A nationally representative telephone survey of 808 women >or=18 years of age was conducted in 2001. Cross-sectional observations of the use of 11 CAM domains and the use of an additional domain--spirituality, religion, or prayer for health--during the past year are reported. Women's health conditions, treatments used, reasons for use, and disclosure to conventional physicians are described, along with predictors of CAM use.


RESULTS
Over half (53%) of respondents used CAM for health conditions, especially for those involving chronic pain. The majority of women disclosed such practices at clinical encounters with conventional providers. Biologically based CAM therapies, such as nutritional supplements and herbs, were commonly used with prescription and over-the-counter (OTC) pharmaceuticals for health conditions.


CONCLUSIONS
Medical pluralism is common among women and should be accepted as a cultural norm. Although disclosure rates of CAM use to conventional providers were higher than in previous population-based studies, disclosure should be increased, especially for women who are pregnant and those with heart disease and cancer. The health risks and benefits of polypharmacy should be addressed at multiple levels of the public health system.
Richard & Hinda Rosenthal Center for Complementary and Alternative Medicine, Columbia University, New York, New York, USA. wade@columbia.edu
Christine
C
Wade
Maria
M
Chao
Fredi
F
Kronenberg
Linda
L
Cushman
Debra
D
Kalmuss
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D015995:Prevalence; D012648:Self Care / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016387:Women's Health