title: Discrimination in health care and CAM use in a representative sample of U.S. adults.
abstract: OBJECTIVE
  Discrimination in medical settings may influence patient attitudes about health care and health-seeking behaviors. Patients who experience discrimination may seek alternative means of health care, including use of complementary and alternative medicine (CAM). The objective of this study was to examine the relationship between discrimination in health care and CAM use.
  
  
  METHODS
  Data come from the 2001 Health Care Quality Survey (HCQS), which used a multistage sampling design with random-digit dialing, oversampling telephone exchanges with higher densities of African-American, Hispanic, and Asian households. The 2001 HCQS sample consisted of 6722 adults living in the continental United States. To correct for the disproportionate sample design, data were adjusted using sample weights to make the results representative of the U.S. population 18 years and older. Present analyses were limited to 6008 respondents who had visited a doctor or clinic or had been admitted to the hospital in the last 2 years.
  
  
  METHODS
  Outcome measures were CAM use, practitioner-provided CAM use, and herbal medicine use.
  
  
  RESULTS
  In adjusted logistic regression analyses, discrimination in health care was significantly associated with use of herbal medicines alone (adjusted odds ratio=1.47, confidence interval: 1.05, 2.04), but not with use of practitioner-provided CAM (i.e., use of acupuncture, chiropractor, traditional healer or herbalist, alone or in combination with herbal medicines).
  
  
  CONCLUSIONS
  Further research is needed to examine the direction of the relationship between discrimination and CAM use and differences by CAM modality.
authors: School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA. Sheryl.Thorburn@oregonstate.edu
authors: Sheryl
authors: S
authors: Thorburn
authors: Jennifer
authors: J
authors: Faith
authors: Karen Levy
authors: KL
authors: Keon
authors: Kimberly M
authors: KM
authors: Tippens
mesh_terms: D015670:Acupuncture Therapy / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D026882:Manipulation, Chiropractic / Q000706:statistics & numerical data; D008519:Medicine, Traditional / Q000706:statistics & numerical data; D008875:Middle Aged; D008913:Minority Groups; D015999:Multivariate Analysis; D008517:Phytotherapy / Q000706:statistics & numerical data; D011287:Prejudice; D014481:United States