Cross-cultural comparison of visitors to CAM practitioners in the United States and Norway.
OBJECTIVE
The United States and Norway are among the countries that have the highest total expenditure on health per capita and also high utilization of complementary and alternative medicine (CAM). However, these countries have fundamentally different health care systems. The aim was therefore to compare characteristics of adults who have seen a CAM practitioner during the last year in the United States and Norway.


METHODS
Data from the National Health Interview Survey in the United States from 2002 and the Level of Living survey in Norway from 2002 were used. Both surveys were nationally representative household surveys of the noninstitutionalized civilian population. The data consist of 6612 individuals from Norway and 31,044 individuals from the United States.


RESULTS
In the United States, 7.4% of the population had seen a CAM practitioner during the last 12 months compared to 8.7% in Norway (p < 0.001 for difference). In both the United States and Norway, seeing a CAM practitioner was most strongly associated with seeing other health care practitioners and having experienced better or worse self-reported health in the last year. Being male and a daily smoker reduced the odds of seeing a CAM practitioner in both countries. In the United States, but not Norway, having higher education was strongly associated with seeing a CAM practitioner. Higher education was the variable with the biggest difference between the two countries.


CONCLUSIONS
This study indicates that in a country that provides health care services for all based on need regardless of personal income (Norway), the utilization of CAM practitioners is higher and less associated with use of other health care providers than a country with low government expenditure on health (the United States).
Steinsbekk
Aslak
A
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. aslak.steinsbekk@ntnu.no
Rise
Marit By
MB
Aickin
Mikel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000191:economics / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D012737:Sex Factors; D012907:Smoking; D013222:State Medicine; D014481:United States; D055815:Young Adult