title: Alternative health care consultations in Ontario, Canada: A geographic and socio-demographic analysis.
abstract: BACKGROUND
  An important but understudied component of Canada's health system is alternative care. The objective of this paper is to examine the geographic and socio-demographic characteristics of alternative care consultation in Ontario, Canada's largest province.
  
  
  METHODS
  Data is drawn from the Canadian Community Health Survey (CCHS Cycle 3.1, 2005) for people aged 18 or over (n = 32,598) who had a consultation with an alternative health care provider. Four groups of consultations are examined: (1) all consultations (2) massage therapy (3) acupuncture, and (4) homeopath/naturopath. Descriptive statistics, mapping and logistic regression modeling are employed to analyze the data and to compare modalities of alternative health care use.
  
  
  RESULTS
  In 2005, more than 1.2 million adults aged 18 or over consulted an alternative health care provider, representing about 13% of the total population of Ontario. The analysis revealed a varied geographic pattern of consultations across the province. Consultations were fairly even across the urban to rural continuum and rural residents were just as likely to consult a provider as their urban counterparts. From a health perspective, people with a chronic condition, lower health status and self-perceived unmet health care needs were more likely to see an alternative health provider. Women with chronic conditions such as fibromyalgia, high blood pressure, chronic fatigue syndrome and chemical sensitivities were more likely to see an alternative provider if they felt their health care needs were not being met.
  
  
  CONCLUSIONS
  The analysis revealed that geography is not a factor in determining alternative health care consultations in Ontario. By contrast, there is a strong association between these consultations and socio-demographic characteristics particularly age, sex, education, health and self-perceived unmet health care needs. The results underscore the importance of women's health needs as related to alternative care use. The paper concludes that there is a need for more place-specific research that explores the reasons why people use specific types of alternative health care as tied to socio-economic status, health, place of residence, and knowledge of these treatments.
authors.affiliation: Department of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Williams
authors.forename: Peter
authors.initials: P
authors.lastname: Kitchen
authors.forename: Jeanette
authors.initials: J
authors.lastname: Eby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009864:Ontario; D017060:Patient Satisfaction; D012017:Referral and Consultation; D012423:Rural Health; D012959:Socioeconomic Factors; D014504:Urban Health; D055815:Young Adult