title: Health need and the use of alternative medicine among adults who do not use conventional medicine.
abstract: BACKGROUND
  We hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization.
  
  
  METHODS
  The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.
  
  
  RESULTS
  19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not.
  
  
  CONCLUSIONS
  We found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.
authors.affiliation: National Center for Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Bethesda, Maryland 20892-5475, USA. nahinr@mail.nih.gov
authors.forename: Richard L
authors.initials: RL
authors.lastname: Nahin
authors.forename: James M
authors.initials: JM
authors.lastname: Dahlhamer
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stussman
mesh_terms: D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014481:United States; D055815:Young Adult