title: The urban-rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women.
abstract: BACKGROUND
  Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia.
  
  
  METHODS
  Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61 years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables.
  
  
  RESULTS
  Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005).
  
  
  CONCLUSIONS
  In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas.
authors.affiliation: School of Population Health, University of Queensland, Brisbane, Queensland, Australia. j.adams@sph.uq.edu.au
authors.forename: Jon
authors.initials: J
authors.lastname: Adams
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.forename: Chi-Wai
authors.initials: CW
authors.lastname: Lui
mesh_terms: D001315:Australia; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D012423:Rural Health; D012424:Rural Population; D011795:Surveys and Questionnaires; D014504:Urban Health; D014505:Urban Population