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 AM Use by U.S. C Adults and Children 38.3% 36.0% About CAM through well-designed scientific studies— CAM is a group of diverse medical and questions such as whether these therapies health care systems, practices, and prod- are safe and whether they work for the ucts that are not generally considered part purposes for which they are used. NCCAM’s of conventional medicine. Complementary mission is to explore CAM practices using medicine is used together with conven- rigorous scientific methods and build an tional medicine, and alternative medicine evidence base for the safety and effective- is used in place of conventional medicine. ness of these practices. Integrative medicine combines conven- How Many People Use CAM tional and CAM treatments for which there is evidence of safety and effectiveness. 11.8% Adults (2007) Children (2007) 38 percent of adults (about 4 in 10) and While scientific evidence exists regarding approximately 12 percent of children some CAM therapies, for most there are (about 1 in 9) are using some form of key questions that are yet to be answered CAM, shown in figure 1. 1 Adults (2002) In the United States, approximately nless noted otherwise, the statistics are for CAM use during the 12 months prior to the 2007 survey. U Comparisons from the 2002 NHIS are indicated. National Institutes of Health The Use of Complementary and Alternative Medicine in the United States Figure 2 C AM Use by Age - 2007 50 44.1% 40 41.0% 40.1% 39.6% 36.3% 32.1% 30 24.2% 20 16.4% 10.7% 7.6% 10 0-4 5-11 12-17 18-29 30-39 40-49 50-59 60-69 70-84 85+ Age Figure 3 60 Who Uses CAM Most C AM Use by Race/Ethnicity Among Adults - 2007 People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of 50.3% 50 education and higher incomes. Figure 2 shows the percentage of people using CAM by age. Figure 3 shows CAM use by 43.1% race/ethnicity. 39.9% 40 30 25.5% 23.7% 20 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 10 therapy, and yoga. Figure 4 shows the percentage of people using increases between 2002 and 2007. Hi sp an ic k ac Bl n ia As W hi te the most common CAM therapies and therapies with significant Am er Al as In ican ka dia Na n/ tiv e 2 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* Meditation Ayurveda* Movement therapies Biofeedback* Natural products Chelation therapy* (nonvitamin and nonChiropractic or osteopathic mineral, such as herbs manipulation* and other products from Deep breathing exercises plants, enzymes, etc.) Diet-based therapies Naturopathy* Energy healing therapy/Reiki* Progressive relaxation Guided imagery Qi gong Homeopathic treatment Tai chi Hypnosis* Traditional healers* Massage* Yoga 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 1 0 Most Common CAM Therapies Among Adults - 2007 Figure 4 20 17.7% Therapies with significant increases between 2002 and 2007 are 15 12.7% 2007 11.6% 12.7% Meditation 7.6% 9.4% Massage 5.0% 8.3% Yoga 5.1% 6.1% Deep breathing 9.4% 10 2002 8.6% 8.3% 6.1% 5 3.6% 2.9% 2.2% Ch Di Yo g e M a et Th -Ba er sed ap ie s Pr og r Re es la siv xa e tio Gu n id ed Im ag er y Ho m eo Tr pa ea th tm ic en t 30 2007* 30 2002* 24.1% 21.1% 19.9% 19.8% 12.0% 11.8% 11.7% 10.5% Gi Su a ce na hi Ec *Percentages among adults who used natural products in the last 30 days. 9.4% lo ba pp G a le rl m ic en Gl ts uc os am St in .J e oh n’ sW or Pe t pp er m i Fi nt sh Om O eg il/ a 3 Su pp Gin le ge m r So en yS ts up pl em en ts 10 g 8.7% Fi s Om h O eg il/ a Gl 3 uc os am in e Ec hi Fl n ac ax ea se ed Oi l/P ill s Gi ns en Co g m bi He nat io Gi rb P n nk ill s go Bi lo ba Ch on dr oi tin Su pp G le arl m ic Co en en ts zy m e Q10 10 14.9% Bi 11.3% 11.2% 11.0% en 13.0% go 14.1% nk 15.9% 19.9% 20 ns 20 40.3% 40 37.4% Gi Na De 10 Most Common Natural Products Among Adults Figure 5 40 as sa g tio n iro Os pra te cti op c & at hi c ita M ed Br ea ep tu ra l Pr od th i uc ts ng 1.8% *Percentages among adults who used natural products in the last 12 months. D iseases/Conditions for Which CAM Is Most Frequently Used Among Adults Figure 6 20 20 17.1% 16.8% 15 2007 15 2002 9.5% 10 10 6.6% 5.2% 1.4% 4.9% 4.5% 3.7% 3.1% 2.4% 2.2% H Ch ea es d o tC r ol Ne d ck Pa in Jo in tP ai n Ar An th xi rit et is y/ De pr es sio St n om Se ac h ve Up re se H or ead t M ac Re igra he cu i rri ne ng Pa in In so m m ia 1.6% Pa in 1.8% Ba ck 2.0% Ch Hea es d o tC r M ol us d cu O Se losk th ve el er et re al H or ead M ac ig he ra in In e so m ni a er ol y 2.1% es t is 4.9% 5 2.8% An x rit Ar th tP ai n Jo in Pa in Ne ck Ba c k Pa in 3.5% ie t 5 Ch ol 5.9% 3 The Use of Complementary and Alternative Medicine in the United States 10 Most Common Therapies Among Children Figure 7 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: 3.9% 4 2.8% 3 • Children whose parents used CAM (23.9%) • Adolescents 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%) 2.2% 2 1.3% 1.1% 1.0% 0.8% Na Ch Pro tura iro du l c Os pra ts te cti c o De p & ep ath ic Br ea th in g Yo ga m eo p T a re t Tr a t hi ad m c iti en on t al He al er s M as sa ge M ed it Di atio et n Th -Ba er sed Pr a p i og es Re res la siv xa e tio n 0.5% Most Common Natural Products Among Children* Figure 8 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. 40 To Obtain the Report 30 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.nih.gov/news/camstats.htm. People who do not have access to the Internet can contact the NCCAM Clearinghouse (see below) for a copy. 20 37.2% 30.5% 17.9% 16.7% Fl ax s Oi eed l/P ill s m bi n He ati rb on Pi lls Co Ec hi na ce a 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. Fi s Om h O eg il/ a 3 10 For More Information NCCAM Clearinghouse 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.nih.gov 1.0% 1 Figures 7-9 show survey findings on CAM use by children, including top therapies, natural products, and diseases/conditions. About NCCAM 2.1% Ho CAM Use Among Children *Percentages among children who used natural products in the last 30 days. E-mail: [email protected] Additional Reports Figure 9 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. 8 iseases/Conditions for Which CAM Is D Most Frequently Used Among Children 6.7% 7 6.6% 6 4.8% 5 4.2% 4 2.5% 3 U.S. Department of Health and Human Services In so m ni a D AD H lo Ot sk he el r et al cu us M Pa in Ch He es ad tC o ol r d An xi et y/ St re ss Created December 2008 D424 *D424* Ne ck National Center for Complementary and Alternative Medicine 1 ck / National Institutes of Health 1.8% 2 Ba 4