Lack of Medicare Coverage May Account for Decline in
Alternative Medicine Use by Seniors
New survey finds 38 percent of adults use
complimentary and alternative medicine: pain primary reason
Dec. 12, 2008 – A new survey finds complementary
and alternative medicine in the US is primarily used to fight pain, yet,
usage tends to decline as adults become senior citizens, who are the
most likely to suffer with pain. The decline is probably because
Medicare does not cover “alternative therapies,” other than chiropractic
care.
Approximately 4 out of 10 adults over age 18
(38.3%) had used some form of complementary and alternative medicine
(CAM) in 2007, according to the nationwide government survey.
For adults younger than 65 years of age, in 2002
and 2007 surveys, those with private health insurance were more likely
than those with public health insurance or uninsured adults to use CAM.
CAM is a group of diverse medical and health care
systems, practices, and products such as herbal supplements, meditation,
chiropractic, and acupuncture that are not generally considered to be
part of conventional medicine.
Adults used CAM most often to treat pain including
back pain or problems, neck pain or problems, joint pain or
stiffness/other joint condition, arthritis, and other musculoskeletal
conditions.
Adult use of CAM therapies for head or chest colds
showed a marked decrease from 2002 to 2007 (9.5 percent in 2002 to 2.0
percent in 2007).
The survey, conducted as part of the 2007 National
Health Interview Survey (NHIS), an annual study in which tens of
thousands of Americans are interviewed about their health- and
illness-related experiences, was developed by the National Center for
Complementary and Alternative Medicine (NCCAM), a part of the National
Institutes of Health (NIH) and the National Center for Health Statistics
(NCHS), a part of the Centers for Disease Control and Prevention (CDC).
The survey included questions on 36 types of CAM
therapies commonly used in the United States - 10 types of
provider-based therapies, such as acupuncture and chiropractic, and 26
other therapies that do not require a provider, such as herbal
supplements and meditation.
"The 2007 NHIS provides the most current,
comprehensive, and reliable source of information on Americans' use of
CAM," said Josephine P. Briggs, M.D., director of NCCAM. "These
statistics confirm that CAM practices are a frequently used component of
Americans' health care regimens, and reinforce the need for rigorous
research to study the safety and effectiveness of these therapies. The
data also point out the need for patients and health care providers to
openly discuss CAM use to ensure safe and coordinated care."
The 2007 survey results, released in a National
Health Statistics Report by NCHS, are based on data from more than
23,300 interviews with American adults and more than 9,400 interviews
with adults on behalf a child in their household. The 2007 survey is the
second conducted by NCCAM and NCHS—the first was done as part of the
2002 NHIS2.
CAM Use Among Adults
Comparison of the data from the 2002 and 2007
surveys suggests that overall use of CAM among adults has remained
relatively steady—36 percent in 2002 and 38 percent in 2007. However,
there has been substantial variation in the use of some specific CAM
therapies, such as deep breathing, meditation, massage therapy, and
yoga, which all showed significant increases.
The most commonly used CAM therapies among U.S.
adults were
● Natural products - nonvitamin, nonmineral (17.7
percent) Most common: fish oil/omega 3/DHA, glucosamine, echinacea,
flaxseed oil or pills, and ginseng3
● Deep breathing exercises (12.7 percent)
● Meditation (9.4 percent)
● Chiropractic or osteopathic manipulation (8.6
percent)
● Massage (8.3 percent)
● Yoga (6.1 percent)
Consistent with results from the 2002 data, in 2007
CAM use among adults was greater among:
● Women (42.8 percent, compared to men 33.5
percent)
● Those with higher levels of education (Masters,
doctorate or professional: 55.4 percent)
● Those who were not poor (poor: 28.9 percent,
near poor: 30.9 percent, not poor: 43.3 percent)
● Those living in the West (44.6 percent)
● Those who have quit smoking (48.1 percent)
CAM Use Among Children
This survey marks the first time questions were
included on children's use of CAM and found nearly 12 percent of U.S.
children aged 17 years and under were users in 2007.
Fish Oil (Omega
3) Top Natural Product Used
Natural
Products – Nonvitamin, Nonmineral
Use of selected
nonvitamin, nonmineral, natural products—adults In 2007, the most
commonly used nonvitamin, nonmineral, natural products used by adults
for health reasons in the past 30 days were fish oil or omega 3 or DHA
(37.4%), glucosamine (19.9%), echinacea (19.8%), flaxseed oil or pills
(15.9%), and ginseng (14.1%).
Frequencies
and age-adjusted percentages of adults 18 years and over who
used selected types of nonvitamin, nonmineral, natural products
for health reasons in the past 30 days, by type of product used:
United States, 2007
Used natural
products
Nonvitamin,
nonmineral, natural products
Thousands
Percent
Fish oil or
omega 3 or DHA
10,923
37.4 (1.13)
Glucosamine
6,132
19.9 (0.91)
Echinacea
4,848
19.8 (1.01)
Flaxseed oil
or pills
4,416
15.9 (0.87)
Ginseng
3,345
14.1 (0.87)
Combination
herb pill
3,446
13.0 (0.83)
Ginkgo
biloba
2,977
11.3 (0.88)
Chondroitin
3,390
11.2 (0.82)
Garlic
supplements
3,278
11.0 (0.66)
Coenzyme
Q-10
2,691
8.7 (0.60)
Fiber or
psyllium
1,791
6.6 (0.61)
Green tea
pills
1,528
6.3 (0.65)
Cranberry
(pills, gelcaps)
1,560
6.0 (0.63)
Saw palmetto
1,682
5.1 (0.46)
Soy
supplements or isofavones
1,363
5.0 (0.53)
Melatonin
1,296
4.6 (0.48)
Grape seed
extract
1,214
4.3 (0.43)
MSM (methysulfonylmethane)
1,312
4.1 (0.37)
Milk thistle
1,001
3.7 (0.49)
Lutein
1,047
3.4 (0.38)
1Respondents
may have used more than one nonvitamin, nonmineral, natural
product.
2The
denominator used in the calculation of percentages was the
number of adults who used nonvitamin, nonmineral, natural
products within the past 30 days, excluding persons with unknown
information for usage of the specified nonvitamin, nonmineral,
natural product.
NOTE: Estimates were age adjusted using the projected 2000 U.S.
population as the standard population and using four age groups:
18–24 years, 25–44 years, 45–64 years, and 65 years and over.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007.
Estimates are based on household interviews of a sample of the
civilian, noninstitutionalized population.
Overall, CAM use among children is about 1 in 9
children. Children are five times more likely to use CAM if a parent or
other relative uses CAM. Other characteristics of adult and child CAM
users are similar—factors such as socioeconomic status, geographic
region, the number of health conditions, the number of doctor visits in
the last 12 months, and delaying or not receiving conventional care
because of cost are all associated with CAM use.
Among children who used CAM in the past 12 months,
CAM therapies were used most often for back or neck pain, head or chest
colds, anxiety or stress, other musculoskeletal problems, and Attention
Deficit/Hyperactivity Disorder (ADD/ADHD).
The most commonly used CAM therapies among children
were
● Nonvitamin, nonmineral, natural products (3.9
percent)
Most common: echinacea, fish oil/omega 3/DHA, combination herb pill,
flaxseed oil or pills, and prebiotics or probiotics
● Chiropractic or osteopathic manipulation (2.8
percent)
● Deep breathing exercises (2.2 percent)
● Yoga (2.1 percent)
"The survey results provide information on trends
and a rich set of data for investigating who in America is using CAM,
the practices they use, and why," said Richard L. Nahin, Ph.D., MPH,
acting director of NCCAM's Division of Extramural Research and co-author
of the National Health Statistics Report.
"Future analyses of these data may help explain
some of the observed variation in the use of individual CAM therapies
and provide greater insights into CAM use patterns among Americans."
Medicare, Medicaid Limited
Federal programs
that may provide some CAM coverage under some circumstances (as of July
2008):
● The
Department of Veterans Affairs (for chiropractic care and acupuncture).
GovBenefits and
USA.gov are two Internet resources that explain Federal health
benefit programs. GovBenefits has a test you can take about qualifying
for programs. State and local departments of health or social services
also have financial assistance programs for eligible residents, and you
can contact them directly to inquire.
Background Information
Inclusion and development of the 2007 supplement
was supported, in part, by seven National Institutes of Health
components: NCCAM; National Heart, Lung, and Blood Institute; National
Institute of Allergy and Infectious Diseases; National Institute of
Mental Health; the Eunice Kennedy Shriver National Institute of Child
Health and Human Development; Office of Dietary Supplements; and Office
of Behavioral and Social Sciences Research.
● 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 10, 2008.
● Barnes P, Powell-Griner E, McFann K, Nahin R.
CDC Advance Data Report #343. Complementary and Alternative Medicine Use
Among Adults: United States, 2002. May 27, 2004.
● While the reference period for overall use of
nonvitamin, nonmineral, natural products was for the past 12 months, the
reference period for the use of specific nonvitamin, nonmineral, natural
products was reduced from 12 months in 2002, to 30 days in 2007 in order
to be more congruent with other national surveys of dietary supplement
use, such as the National Health and Nutrition Examination Survey.
The National Center for Complementary and
Alternative Medicine's mission is to explore complementary and
alternative medical practices in the context of rigorous science, train
CAM researchers, and disseminate authoritative information to the public
and professionals. For additional information, call NCCAM's
Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site
at
nccam.nih.gov.
The NCHS is a component of the Centers for Disease
Control and Prevention (CDC). NCHS's mission is to provide statistical
information that will guide actions and policies to improve the health
of the American people. The CDC protects people's health and safety by
preventing and controlling diseases and injuries; enhances health
decisions by providing credible information on critical health issues;
and promotes healthy living through strong partnerships with local,
national, and international organizations. The complete data set can be
found under "What's New" at
www.cdc.gov/nchs.
The National Institutes of Health (NIH)—The
Nation's Medical Research Agency—includes 27 Institutes and Centers and
is a component of the U.S. Department of Health and Human Services. It
is the primary federal agency for conducting and supporting basic,
clinical and translational medical research, and it investigates the
causes, treatments, and cures for both common and rare diseases. For
more information about NIH and its programs, visit
www.nih.gov.
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