title: Beyond the barriers: racial discrimination and use of complementary and alternative medicine among Black Americans.
abstract: This article examines whether self-reported racial discrimination is associated with greater use of complementary and alternative medicine (CAM) and assesses whether the effects of reported racial discrimination are specific to the setting in which the unfair treatment occurred (i.e., medical or nonmedical settings). Data were drawn from the National Survey of Midlife Development in the United States (MIDUS) of Black adults aged 25 and older at baseline (N=201). Analyses account for multiple forms of discrimination: major lifetime discriminatory events and everyday discrimination (more commonplace negative occurrences). Using logistic and negative binomial regression, results reveal that racial discrimination was associated with a higher likelihood of using any type of CAM as well as using more modalities of CAM. Also, both discrimination in health care and discrimination in nonmedical contexts predicted greater use of CAM. The findings underscore the tenet that health care choices, while influenced by health status and availability of health care resources, are also shaped by perceived barriers. The experience of racial discrimination among Black people is associated with greater use of alternative means of health care, as a way to cope with the barriers they experience in institutional settings in the United States.
authors.affiliation: University of Minnesota, Division of Health Policy and Management, 712 Delaware St. SE, Mayo Building, D371, Minneapolis, MN 55407, USA. tshippee@umn.edu
authors.forename: Tetyana Pylypiv
authors.initials: TP
authors.lastname: Shippee
authors.forename: Markus H
authors.initials: MH
authors.lastname: Schafer
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Ferraro
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011287:Prejudice; D014481:United States