title: A comparison of complementary and alternative medicine users and use across geographical areas: a national survey of 1,427 women.
abstract: BACKGROUND
  Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors.
  
  
  METHODS
  A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009.
  
  
  RESULTS
  The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas.
  
  
  CONCLUSIONS
  It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.
authors: Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, New South Wales, Australia. jon.adams@uts.edu.au
authors: Jon
authors: J
authors: Adams
authors: David
authors: D
authors: Sibbritt
authors: Alex
authors: A
authors: Broom
authors: Deborah
authors: D
authors: Loxton
authors: Marie
authors: M
authors: Pirotta
authors: John
authors: J
authors: Humphreys
authors: Chi-Wai
authors: CW
authors: Lui
mesh_terms: D000328:Adult; D001315:Australia; D000529:Complementary Therapies / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D012423:Rural Health / Q000191:economics; D014504:Urban Health / Q000191:economics; D016387:Women's Health / Q000191:economics