The Use of Complementary and Alternative Medicine
National Center for Complementary and Alternative Medicine
The Use of Complementary and Alternative Medicine
in the United States
In December 2008, the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) released new findings on Americans' use of complementary and alternative medicine (CAM). The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under. A similar CAM section was included in the 2002 NHIS, providing the opportunity to examine trends in CAM use, too.1
Figure 1 CAM Use by U.S. Adults and Children
36.0%
38.3%
11.8%
About CAM
CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Integrative medicine combines conventional and CAM treatments for which there is evidence of safety and effectiveness.
While scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered
through well-designed scientific studies-- questions such as whether these therapies are safe and whether they work for the purposes for which they are used. NCCAM's mission is to explore CAM practices using rigorous scientific methods and build an evidence base for the safety and effectiveness of these practices.
How Many People Use CAM
In the United States, approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some form of CAM, shown in figure 1.
Adults (2002)
Adults (2007)
Children (2007)
1 Unless noted otherwise, the statistics are for CAM use during the 12 months prior to the 2007 survey. Comparisons from the 2002 NHIS are indicated.
National Institutes of Health
2 The Use of Complementary and Alternative Medicine in the United States
Figure 2 C AM Use by Age - 2007
50
40
36.3%
39.6%
30
20
10
7.6%
10.7%
16.4%
40.1%
44.1%
41.0%
32.1%
24.2%
0-4
5-11
12-17
18-29
30-39
40-49
50-59
60-69
70-84
85+
Age
Figure 3 C AM Use by Race/Ethnicity Among Adults - 2007
60
50.3%
50
43.1% 39.9%
40
30
25.5%
20
10
23.7%
AmerAiclaIansndkiaanN/ative
White
Asian
Black
Hispanic
CAM Therapies Included in the 2007 NHIS: An asterisk (*) indicates a practitioner-based therapy. For definitions of these therapies, see the full report or contact the NCCAM Clearinghouse (see page 4).
Acupuncture* Ayurveda* Biofeedback* Chelation therapy* Chiropractic or osteopathic
manipulation* Deep breathing exercises Diet-based therapies Energy healing therapy/Reiki* Guided imagery Homeopathic treatment Hypnosis* Massage*
Meditation Movement therapies Natural products (nonvitamin and non-
mineral, such as herbs and other products from plants, enzymes, etc.) Naturopathy* Progressive relaxation Qi gong Tai chi Traditional healers* Yoga
Who Uses CAM Most
People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of education and higher incomes. Figure 2 shows the percentage of people using CAM by age. Figure 3 shows CAM use by race/ethnicity.
CAM Therapies Used the Most
Nonvitamin, nonmineral natural products are the most commonly used CAM therapy among adults. Use has increased for several therapies, including deep breathing exercises, meditation, massage therapy, and yoga. Figure 4 shows the percentage of people using the most common CAM therapies and therapies with significant increases between 2002 and 2007.
Use of Natural Products
The most popular natural products are fish oil/omega 3, glucosamine, echinacea, and flaxseed. Figure 5 ranks the top 10 natural products used among adults in 2007 and 2002 (note that the 2007 survey asked about use in the last 30 days, whereas the 2002 survey asked about use in the last year).
Health Conditions Prompting CAM Use
People use CAM for an array of diseases and conditions. American adults are most likely to use CAM for musculoskeletal problems such as back, neck, or joint pain. The use of CAM therapies for head or chest colds showed a substantial decrease from 2002 to 2007. Figure 6 ranks the top 10 conditions prompting CAM use among adults for 2007 and 2002.
The National Center for Complementary and Alternative Medicine 3
Figure 4 1 0 Most Common CAM Therapies Among Adults - 2007
20
17.7%
15
12.7%
9.4%
10
8.6% 8.3%
6.1%
5
3.6%
2.9%
2.2%
1.8%
Natural
Products Deep
Breathing
MeditationChiroprOasctteicop&athic
Massage
Yoga Diet-BTahseerdapiesProgrReseslaivxeatGiounided ImageryHomeopTarethaitcment
Therapies with significant increases between 2002 and 2007 are
Deep breathing Meditation Massage Yoga
2002 11.6% 7.6% 5.0% 5.1%
2007 12.7% 9.4% 8.3% 6.1%
Figure 5 10 Most Common Natural Products Among Adults 40.3%
40 37.4%
40
30
2007* 30
24.1%
2002*
19.9% 19.8%
20
20
15.9% 14.1%
13.0%
11.3% 11.2% 11.0%
10
8.7%
10
21.1% 19.9%
14.9% 12.0% 11.8% 11.7% 10.5% 9.4%
FishOOmile/gaG3lucosamine EchiFnlaacxesaeed Oil/Pills
GinseCngombinaHteiorbnGPinilklsgo BilobaChondroitinSupGpalrelmicCeonetnszyme Q-10
*Percentages among adults who used natural products in the last 30 days.
Echinacea
GinseGnignkgo BilobaSupGpalrelmicenGtslucosamSitn.eJohn's WorPteppermintFishOOmile/ ga 3SuGpipnlgeemSroeyntSsupplements
*Percentages among adults who used natural products in the last 12 months.
Figure 6 D iseases/Conditions for Which CAM Is Most Frequently Used Among Adults
20
17.1%
20
16.8%
15
2007 15
2002
10
5.9% 5.2%
5
3.5% 2.8% 2.1% 2.0% 1.8% 1.6%
1.4%
Back Pain Neck Pain
Joint Pain
Arthritis
AnxietyCholesterol HeCahdesotrMCoulsdcuOlotSshekevereleretaHl eoardaMcihgeraineInsomnia
9.5%
10
6.6%
4.9% 4.9%
5
4.5% 3.7% 3.1% 2.4%
2.2%
Back Pain
HeCahdeostr ColdNeck Pain Joint Pain
AArnthxireittiys/DepressSiotnomSaechveUrepsHeetoardaMcihgeRreacinuerring Pain
Insommia
4 The Use of Complementary and Alternative Medicine in the United States
CAM Use Among Children
The 2007 NHIS asked selected adult respondents about CAM use by children in their households. Overall, approximately 12 percent of children use some form of CAM. Use is greater among:
? Children whose parents used CAM (23.9%) ? A dolescents aged 12-17 (16.4%), compared to
younger children ? White children (12.8%), compared to Hispanic
children (7.9%) and black children (5.9%) ? Children whose parents had higher education
levels (more than high school: 14.7%) ? Children with six or more health conditions (23.8%) ? Children whose families delayed conventional care
because of cost (16.9%)
Figures 7-9 show survey findings on CAM use by children, including top therapies, natural products, and diseases/conditions.
About NCCAM NCCAM's mission is to explore complementary and alternative healing practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals.
To Obtain the Report The report's citation is Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 2008. It is available, along with a press release and graphics, at nccam.news/camstats.htm. People who do not have access to the Internet can contact the NCCAM Clearinghouse (see below) for a copy.
For More Information NCCAM Clearinghouse The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
Toll-free in the U.S.: 1-888-644-6226 TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 Web site: nccam. E-mail: info@nccam.
Additional Reports NCCAM plans to collaborate with NCHS on further analyses of the survey findings. Among the areas of interest to the researchers are CAM costs and spending, dietary supplements, and reasons for CAM use. Future reports will be published by NCHS and posted on the NCCAM web site.
U.S. Department of Health and Human Services National Institutes of Health National Center for Complementary and Alternative Medicine
Created December 2008 D424
*D424*
Figure 7 10 Most Common Therapies Among Children
3.9%
4
3
2.8%
2.2% 2.1%
2
1.3%
1.1% 1.0% 1.0%
1
0.8% 0.5%
NatPuCrroahdliruocptsrOasctteicoDp&aetehpicBreathing
YHoogma eopTarTetrhaaitdcmiteionntal Healers
Massage MeditaDtioient-BTahseerdapPireosgrReseslaivxeation
Figure 8 Most Common Natural Products Among Children*
40
37.2%
30.5%
30
20
17.9%
16.7%
10
Echinacea
FishOOmil/ega 3
CombinaHtieornb Pills
FlaxseOedil/Pills
*Percentages among children who used natural products in the last 30 days.
Figure 9 Diseases/Conditions for Which CAM Is Most Frequently Used Among Children
8
7
6.7%
6.6%
6
5
4.8%
4.2%
4
3
2.5%
1.8%
2
1
Back/Neck Pain
HCheeasdtoCrold Anxiety/Stress
MuscuOlothskeer letal
ADHD
Insomnia
................
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