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National Center for Health Statistics; and Richard L. Nahin, Ph.D., M.P.H.,
National Center for Complementary and Alternative Medicine, National Institutes of Health
Abstract Introduction
ObjectiveThis report presents selected estimates of complementary and Complementary and alternative
alternative medicine (CAM) use among U.S. adults and children, using data from medicine (CAM) covers a heterogeneous
the 2007 National Health Interview Survey (NHIS), conducted by the Centers for spectrum of ancient to new-age
Disease Control and Preventions (CDC) National Center for Health Statistics approaches that purport to prevent or
(NCHS). Trends in adult use were assessed by comparing data from the 2007 treat disease. By definition, CAM
and 2002 NHIS. practices are not part of conventional
MethodsEstimates were derived from the Complementary and Alternative medicine because there is insufficient
Medicine supplements and Core components of the 2007 and 2002 NHIS. proof that they are safe and effective
Estimates were generated and comparisons conducted using the SUDAAN (1). Complementary interventions are
statistical package to account for the complex sample design. used together with conventional
ResultsIn 2007, almost 4 out of 10 adults had used CAM therapy in the treatments, whereas alternative
past 12 months, with the most commonly used therapies being nonvitamin, interventions are used instead of
nonmineral, natural products (17.7%) and deep breathing exercises (12.7%). conventional medicine.
American Indian or Alaska Native adults (50.3%) and white adults (43.1%) were Generally, persons who choose
more likely to use CAM than Asian adults (39.9%) or black adults (25.5%). CAM approaches are seeking ways to
Results from the 2007 NHIS found that approximately one in nine children improve their health and well-being
(11.8%) used CAM therapy in the past 12 months, with the most commonly used (2,3) or to relieve symptoms associated
therapies being nonvitamin, nonmineral, natural products (3.9%) and chiropractic with chronic, even terminal, illnesses or
or osteopathic manipulation (2.8%). Children whose parent used CAM were the side effects of conventional
almost five times as likely (23.9%) to use CAM as children whose parent did not treatments for them (4,5). Other reasons
use CAM (5.1%). For both adults and children in 2007, when worry about cost for choosing to use CAM include
delayed receipt of conventional care, individuals were more likely to use CAM having a holistic health philosophy or a
than when the cost of conventional care was not a worry. Between 2002 and transformational experience that changes
2007 increased use was seen among adults for acupuncture, deep breathing ones world view and wanting greater
exercises, massage therapy, meditation, naturopathy, and yoga. CAM use for control over ones own health (6,7).
head or chest colds showed a marked decrease from 2002 to 2007 (9.5% to Many types of CAM practitioners try to
2.0%). treat not only the physical and
Keywords: complementary and alternative medicine c National Health Interview biochemical manifestations of illness,
Survey but also the nutritional, emotional,
social, and spiritual context in which the
illness arises. The overwhelming
majority of patients using CAM
ways: First, the list of products was All estimates and associated CAM and a wide range of other
expanded from 35 in 2002 to 45 in standard errors shown in this report self-reported health characteristics
2007. Second, the reference period for were generated using SUDAAN, a included in the NHIS, such as health
use of these products was reduced from software package designed to account behaviors, chronic health conditions,
12 months in 2002 to 30 days in 2007. for a complex sample design such as injury and poisoning episodes, access to
Finally, the 2007 survey included that of the NHIS (17). All estimates for medical care, and health insurance
questions on the prevalence of CAM use adults were weighted, using the sample coverage. The sample sizes for both the
by children and the diseases or adult record weight, to represent the 2007 and the 2002 NHIS allow for
conditions being treated. U.S. civilian noninstitutionalized detailed analysis of CAM use among
There were several reasons for the population aged 18 years and over. All Hispanic subpopulations, but not among
above changes. First, after publication of estimates for children were weighted, subpopulations of Asians and other
the 2002 NHIS data (9), NCCAM using the sample child record weight, to minority groups with smaller
received suggestions from the represent the U.S. civilian populations.
community for additional therapies to be noninstitutionalized population aged The NHIS questions have several
added. Second, a number of nonvitamin, 017 years. limitations. First, they are dependent on
nonmineral, natural products became In tables shown in this report, respondents memory or their
commonly available after the 2002 estimates with a relative standard error willingness to report use accurately.
CAM supplement was designed. Third, of more than 30% but less than or equal Second, the collection of survey data at
the reference period for nonvitamin, to 50% are identified with an asterisk a single point in time results in an
nonmineral, natural products was (*), indicating they are statistically
inability to produce consecutive annual
shortened from 12 months to 30 days to unstable due to small sample size.
prevalence estimates; and it reduces the
be more congruent with other national Estimates with a relative standard error
ability to produce reliable prevalence
surveys of dietary supplement use, such of greater than 50% are indicated with a
estimates for small population
as the National Health and Nutrition dagger () and are not shown.
Most estimates presented in this subgroups, as this would require a larger
Examination Survey. Finally, pilot
report were age adjusted using the sample or more than 1 year of data.
testing of the 2007 CAM supplement
led to some questions in the 2002 projected 2000 U.S. population as the Third, CAM use among children might
survey being dropped or subsumed into standard population (18,19). Age be higher than our results indicate,
other questions. adjustment was used to allow especially among adolescents who may
comparison of various sociodemographic not reveal their CAM use to parents or
subgroups that have different age other household adults. Finally, there is
Statistical analysis
distributions (see Technical Notes). a difference in the reference periods for
In 2007, NHIS interviews were Estimates were compared using use of nonvitamin, nonmineral, natural
completed in 29,266 households, which two-tailed significance tests at the 0.05 products in 2002 (12 months) and 2007
yielded 75,764 persons in 29,915 level. No adjustments were made for (30 days). Generally, shorter reference
families and a household response rate multiple comparisons. Terms such as periods result in better recall and better
of 87.1% This report is based on data greater than and less than indicate a data.
from 23,393 completed interviews with statistically significant difference. Terms
sample adults aged 18 years and over such as similar or no difference indicate Results
and 9,417 completed interviews for that the statistics being compared were
sample children aged 017 years. The not significantly different. Lack of Use of complementary and
final 2007 sample adult and sample comment regarding the difference alternative medicine in past
child response rates were 67.8% and between any two statistics does not
76.5%, respectively. In 2002, NHIS
12 monthsadults (Table 1)
mean that the difference was tested and
interviews were completed in 36,161 found to be not significant. + In 2007, the CAM therapies most
households, which yielded 93,386 commonly used by U.S. adults in the
persons in 36,831 families and a past 12 months were nonvitamin,
Strengths and limitations of
household response rate of 89.6%. This nonmineral, natural products (17.7%),
report is also based on 2002 data from
the data deep breathing exercises (12.7%),
31,044 completed interviews with A major strength of the CAM data meditation (9.4%), chiropractic or
sample adults aged 18 years and over. in the NHIS is that they were collected osteopathic manipulation (8.6%),
The final 2002 sample adult response for a nationally representative sample of massage (8.3%), and yoga (6.1%).
rate was 74.3%. Procedures used in U.S. adults and children, allowing + Among U.S. adults, the use of some
calculating response rates are described estimation of CAM use for a wide mind body therapies increased
in detail in Appendix I of the Survey variety of population subgroups. The between 2002 and 2007. Specific
Description Document of the NHIS data large sample size also facilitates mind body therapies showing
files (16). investigation of the association between increased use included: deep
Page 4 National Health Statistics Reports n Number 12 n December 10, 2008
breathing exercises, meditation, and pill (17.9%), and flaxseed oil or pills Medical conditions treated
yoga. (16.7%). with CAMchildren (Table 6)
+ Between 2002 and 2007, increased
+ In 2007, among children who used
use was also seen for acupuncture, Medical conditions treated
CAM in the past 12 months, CAM
massage therapy, and naturopathy. with CAMadults (Table 5 therapies were used most often for
+ Between 2002 and 2007, there was a and Figures 1 and 2) back or neck pain (6.7%), head or
significant decrease in the use of the chest colds (6.6%), anxiety or stress
+ In 2007, adults used CAM most often
Atkins diet. (4.8%), other musculoskeletal
to treat a variety of musculoskeletal
problemsincluding back pain or problems (4.2%), and ADHD/ADD
Use of complementary and problems (17.1%), neck pain or (2.5%).
alternative medicine problems (5.9%), joint pain or
children (Table 2) stiffness or other joint condition Use of CAM by selected
+ In 2007, the CAM therapies most
(5.2%), arthritis (3.5%), and other characteristicsadults
musculoskeletal conditions (1.8%) (Table 7)
commonly used by U.S. children in
(Table 5).
the past 12 months were nonvitamin, + In 2007, almost 4 out of 10 adults
+ The prevalence of CAM use for back
nonmineral, natural products (3.9%), (38.3%) had used some type of CAM
pain or problems, neck pain or
chiropractic or osteopathic problems, joint pain or stiffness, and in the past 12 months.
manipulation (2.8%), deep breathing arthritis and fibromyalgia is relatively + Consistent with results from the 2002
exercises (2.2%), yoga (2.1%), and unchanged since 2002 (Figure 1). NHIS, in 2007 CAM use was more
homeopathic treatment (1.3%). + The use of CAM therapies for head prevalent among women, adults aged
+ Children whose parent used CAM or chest colds showed a marked 3069, adults with higher levels of
therapy were about twice as likely as decrease from 2002 to 2007 (9.5% to education, adults who were not poor,
all U.S. children to have used 2.0%) (Figure 2). A smaller decrease adults living in the West, former
nonvitamin, nonmineral, natural in use was seen for stomach or smokers, and adults who were
products (9.2% and 3.9%), intestinal illness (Figure 2). hospitalized in the last year.
chiropractic or osteopathic + A small increase in CAM use was + For adults younger than 65 years of
manipulation (5.7% and 2.8%), deep seen for treating cholesterol problems age, in 2002 and 2007, those with
(Figure 3). private health insurance were more
breathing exercises (5.4% and 2.2%),
likely than those with public health
yoga (4.7% and 2.1%), and
insurance or uninsured adults
homeopathic treatment (2.8% and
1.3%) in the past 12 months.
10
reasons in the past 30 days were fish
oil or omega 3 or DHA (37.4%), 8
glucosamine (19.9%), echinacea 6
(19.8%), flaxseed oil or pills (15.9%), 4
and ginseng (14.1%).
2
0
Use of selected nonvitamin, Back pain Neck pain Joint pain Arthritis, gout,
nonmineral, natural lupus,
fibromyalgia
productschildren (Table 4) Disease or condition
+ In 2007, the most commonly used NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2002 and 2007. Estimates are based on household
nonvitamin, nonmineral, natural interviews of a sample of the civilian noninstitutionalized population.
products used by children for health
reasons in the past 30 days were Figure 1. Percentage of adults 18 years of age and over who used complementary and
echinacea (37.2%), fish oil or omega alternative medicine during the past 12 months to treat selected musculoskeletal diseases
and conditions, by year: United States, 2002 and 2007
3 or DHA (30.5%), combination herb
National Health Statistics Reports n Number 12 n December 10, 2008 Page 5
higher income (poverty status), not modalities by the scientific community In other regards, the characteristics of
living in the South, and having a usual does not correlate with the prevalence of adult and child CAM users are
place of care as associated with a childs use by the public as measured by the similarfor example, education, poverty
use of CAM. 2007 NHIS. For example, the Institute status, geographic region, the number of
In addition to NHIS and MEPS, of Medicine identified 79 systematic health conditions, the number of doctor
there have been several limited visits in the last 12 months, and
reviews of acupuncture and 38 studies
population surveys of CAM use by delaying or not receiving conventional
of homeopathy (placing them 3rd and
children in the United States (3739). care because of cost are all associated
4th among all CAM therapies), yet with CAM use.
These surveys have varied considerably NHIS found that less than 1.5% of the
from NHIS and MEPS in their data adult U.S. public used each of these
collection methods, geographic therapies in a given year. In fact, there
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National Health Statistics Reports n Number 12 n December 10, 2008 Page 9
Table 1. Frequencies and age-adjusted percentages of adults 18 years of age and over who used complementary and alternative
medicine in the past 12 months, by type of therapy: United States, 2002 and 2007
2002 2007
Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,136 1.1 (0.07) 3,141 1.4 (0.10) 0.3
Naturopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498 0.2 (0.03) 729 0.3 (0.04) 0.1
Native American healer or Medicine man. . . . . . . . . . . . ... ... 224 *0.1 (0.05) ...
Nonvitamin, nonmineral, natural products2 . . . . . . . . . . . . 38,183 18.9 (0.28) ... ... ...
Nonvitamin, nonmineral, natural products2 . . . . . . . . . . . . ... ... 38,797 17.7 (0.37) ...
Atkins diet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,417 1.7 (0.09) 2,673 1.2 (0.09) 0.5
Massage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,052 5.0 (0.16) 18,068 8.3 (0.23) 3.3
Mind-body therapies
Meditation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,336 7.6 (0.20) 20,541 9.4 (0.27) 1.8
Deep breathing exercises . . . . . . . . . . . . . . . . . . . . . . 23,457 11.6 (0.24) 27,794 12.7 (0.30) 1.1
Yoga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,386 5.1 (0.16) 13,172 6.1 (0.21) 1.0
Tai chi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,565 1.3 (0.08) 2,267 1.0 (0.08) 0.3
Energy healing therapy/Reiki . . . . . . . . . . . . . . . . . . . . 1,080 0.5 (0.05) 1,216 0.5 (0.06) 0.0
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
0.0 Figure does not meet standards of reliability or precision and quantity more than zero but less than 0.05.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
p <.05. p < .01. p <.001. p <.0001.
1
The totals of the numbers and percentages of the categories listed under Traditional healers, Diet-based therapies, and Movement therapies, are greater than the number and percentage of their
respective category heading because respondents could choose more than one of the categories.
2
While questions were asked about nonvitamin, nonmineral, natural products in both 2002 and 2007, the data are not comparable due primarily to question order and the specific nonvitamin,
3
While questions were asked about Diet-based therapies in both 2002 and 2007, the data are not comparable because respondents were asked about the South Beach Diet in 2007, but not in
2002.
4
While questions were asked about chiropractic therapy in both 2002 and 2007, the data are not comparable because respondents were asked about chiropractic care in 2002 and chiropractic or
NOTES: The denominators for statistics shown exclude persons with unknown complementary and alternative medicine information. Estimates are age adjusted using the projected 2000 U.S.
population as the standard population using four age groups: 1824 years, 2544 years, 4564 years, and 65 years and over.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2002 and 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
National Health Statistics Reports n Number 12 n December 10, 2008 Page 11
Table 2. Frequencies and age-adjusted percentages of children under 18 years of age who used complementary and alternative medicine
in the past 12 months, by type of therapy: United States, 2007
Percent Percent
Number in (standard Number in (standard
Therapy thousands error) thousands error)
Mind-body therapies
Biofeedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 0.2 (0.05) 36 *0.3 (0.12)
Meditation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 725 1.0 (0.12) 400 3.0 (0.51)
Guided imagery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293 0.4 (0.09) 197 1.5 (0.40)
Progressive relaxation. . . . . . . . . . . . . . . . . . . . . . . . . 329 0.5 (0.09) 164 1.3 (0.37)
Deep breathing exercises . . . . . . . . . . . . . . . . . . . . . . 1,558 2.2 (0.22) 704 5.4 (0.76)
Hypnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 *0.1 (0.04) 18
Yoga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,505 2.1 (0.18) 618 4.7 (0.63)
Tai chi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 *0.2 (0.05) 56 *0.4 (0.19)
Qi gong. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 4
Energy healing therapy . . . . . . . . . . . . . . . . . . . . . . . . 161 0.2 (0.05) 52 *0.4 (0.17)
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
Quantity zero.
1
The childs parent was also the sample child respondent, the sample adult, and used CAM. Other sample child respondents are not included.
2
The totals of the numbers and percentages of the categories listed under Traditional healers, Diet-based therapies, and Movement therapies, are greater than the number and percentage of their
respective category heading because respondents could choose more than one of the categories.
NOTES: CAM is complementary and alternative medicine. The denominators for statistics shown exclude persons with unknown complementary and alternative medicine information. Estimates are
age adjusted using the projected 2000 U.S. population as the standard population using three age groups: 04 years, 511 years, and 1217 years.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
Table 3. 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
Number in Percent2
Nonvitamin, nonmineral, natural products thousands (standard error)
1
Respondents may have used more than one nonvitamin, nonmineral, natural product.
2
The 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
NOTE: Estimates were age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 1824 years, 2544 years, 4564 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.
Table 4. Frequencies and age-adjusted percentages of children under 18 years of age 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
Number in Percent2
Nonvitamin, nonmineral, natural products thousands (standard error)
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
1
Respondents may have used more than one nonvitamin, nonmineral, natural product.
2
The denominator used in the calculation of percentages was the number of children who used nonvitamin, nonmineral, natural products within the past 30 days, excluding persons with unknown
3
DHEA is dehydroepiandrosterine.
NOTE: Estimates were age adjusted using the projected 2000 U.S. population as the standard population using three age groups: 04 years, 511 years, and 1217 years.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
Table 5. Frequencies and age-adjusted percentages of adults 18 years of age and over who used complementary and alternative
medicine in the past 12 months, by selected diseases and conditions for which it was used: United States, 2007
Percent2
Number in (standard
Disease or condition1 thousands error)
1
Respondents may have used more than one CAM therapy to treat a disease or condition, but were counted only once under each disease or condition treated. The questions about using a CAM
therapy to treat a disease or condition were only asked of respondents who had used the therapy within the past 12 months. The exception to this is the questions about using nonvitamin,
nonmineral, natural products to treat a disease or condition which were only asked of respondents who had used nonvitamin, nonmineral, natural products within the past 30 days.
2
The denominator used in the calculation of percentages was the number of adults who used CAM within the past 12 months, excluding persons with unknown information about whether CAM
was used to treat the specified condition.
NOTES: CAM is complementary and alternative medicine. Estimates are age adjusted using the projected 2000 U.S. population as the standard population using four age groups: 1824 years,
2544 years, 4564 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.
Table 6. Frequencies and age-adjusted percentages of children under 18 years of age who used complementary and alternative medicine
in the past 12 months by selected diseases and conditions for which it was used: United States, 2007
Number in Percent2
Disease or condition1 thousands (standard error)
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
1
Respondents may have used more than one CAM therapy to treat a disease or condition, but were counted only once under each disease or condition treated. The questions about using a CAM
therapy to treat a disease or condition were only asked of respondents who had used the therapy within the past 12 months. The exception to this is the questions about using nonvitamin,
nonmineral, natural products to treat a disease or condition that were only asked of respondents who had used nonvitamin, nonmineral, natural products within the past 30 days.
2
The denominator used in the calculation of percentages was the estimated number of children who used CAM within the past 12 months, excluding persons with unknown information about
whether CAM was used to treat the specified condition.
3
ADHD is Attention Deficit Hyperactivity Disorder and ADD is Attention Deficit Disorder.
NOTES: CAM is complementary and alternative medicine. Estimates are age adjusted using the projected 2000 U.S. population as the standard population using three age groups: 04 years,
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
Table 7. Age-adjusted percentages of adults 18 years of age and over who used selected complementary and alternative medicine
categories in the past 12 months, by selected characteristics: United States, 2007
Manipulative
Biologically Alternative Energy and body
based Mind-body medical healing based
Characteristic All CAM1 therapies2 therapies3 systems4 therapy therapies5
Age
1829 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.3 ( 1.14) 15.9 ( 0.86) 21.3 ( 0.92) 3.2 (0.41) *0.3 (0.10) 15.1 (0.85)
3039 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.6 ( 0.96) 19.8 ( 0.77) 19.9 ( 0.81) 3.6 (0.34) 0.5 (0.11) 17.2 (0.70)
4049 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.1 ( 0.97) 20.4 ( 0.79) 19.7 ( 0.81) 4.6 (0.38) 0.8 (0.21) 17.4 (0.69)
5059 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.1 ( 1.14) 24.2 ( 0.92) 22.9 ( 1.00) 4.9 (0.40) 1.0 (0.16) 17.3 (0.78)
6069 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.0 ( 1.21) 25.4 ( 1.07) 17.3 ( 0.88) 2.8 (0.34) 0.5 (0.14) 13.8 (0.80)
7084 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.1 ( 1.11) 19.3 ( 0.92) 11.9 ( 0.69) 1.8 (0.31) 9.9 (0.70)
85 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.2 ( 2.32) 13.7 ( 1.89) 9.8 ( 1.58) *1.9 (0.86) 7.0 (1.38)
Education8
Less than high school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.8 ( 0.90) 9.8 ( 0.64) 7.6 ( 0.56) 2.1 (0.36) 6.4 (0.58)
High School Graduate or GED9 recipient . . . . . . . . . . . . . . . . . . . 31.0 ( 0.85) 16.3 ( 0.60) 12.1 ( 0.53) 2.0 (0.22) 0.4 (0.10) 11.5 (0.58)
Some College-no degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.0 ( 1.08) 24.4 ( 0.94) 22.0 ( 0.84) 4.3 (0.43) 0.7 (0.14) 18.0 (0.85)
Associate of Arts Degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.2 ( 1.39) 24.9 ( 1.17) 24.3 ( 1.26) 3.6 (0.46) *0.5 (0.17) 18.2 (1.00)
Bachelor or Arts or Science Degree . . . . . . . . . . . . . . . . . . . . . . 49.6 ( 1.05) 27.5 ( 0.96) 25.5 ( 0.85) 5.4 (0.42) 0.8 (0.13) 20.7 (0.84)
Masters, Doctorate, Professional Degree . . . . . . . . . . . . . . . . . . . 55.4 ( 1.34) 30.1 ( 1.24) 34.2 ( 1.34) 6.1 (0.66) 1.2 (0.28) 23.6 (1.15)
Poverty status7,10
Poor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.9 ( 1.02) 13.7 ( 0.78) 16.5 ( 0.84) 3.2 (0.47) *0.5 (0.16) 8.4 (0.60)
Near poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.9 ( 1.01) 15.6 ( 0.76) 16.0 ( 0.81) 2.6 (0.35) 0.5 (0.13) 10.1 (0.63)
Not poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43.3 ( 0.64) 23.0 ( 0.52) 21.6 ( 0.50) 3.9 (0.21) 0.6 (0.08) 18.1 (0.45)
Health insurance11
Under 65 years:
Private . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42.7 ( 0.65) 21.3 ( 0.49) 22.0 ( 0.53) 3.9 (0.22) 0.6 (0.09) 19.0 (0.51)
Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.6 ( 1.19) 14.9 ( 0.85) 18.7 ( 0.99) 2.6 (0.33) *0.3 (0.11) 9.6 (0.70)
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.5 ( 0.97) 17.0 ( 0.76) 16.2 ( 0.78) 4.0 (0.41) 0.7 (0.14) 9.8 (0.68)
65 years and over:
Private . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1 ( 1.21) 23.4 ( 1.06) 14.2 ( 0.82) 2.0 (0.34) 11.7 (0.80)
Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.1 ( 1.30) 17.2 ( 1.11) 11.5 ( 0.84) 1.7 (0.36) 8.2 (0.78)
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *11.1 ( 4.91)
Marital status7
Never married. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.0 ( 1.05) 18.6 ( 0.87) 20.8 ( 0.89) 3.8 (0.39) 0.8 (0.16) 13.5 (0.67)
Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.6 ( 0.71) 19.0 ( 0.50) 17.5 ( 0.55) 3.2 (0.20) 0.4 (0.07) 15.0 (0.49)
Cohabiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.1 ( 1.83) 21.0 ( 1.62) 20.7 ( 1.60) 4.1 (0.87) 1.1 (0.33) 15.8 (1.49)
Divorced or separated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.5 ( 1.48) 20.4 ( 1.01) 20.3 ( 1.10) 2.9 (0.30) 0.7 (0.13) 16.4 (1.24)
Widowed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.1 ( 2.98) 12.5 ( 1.81) 14.7 ( 2.10) 1.6 (0.39) 8.2 (2.13)
Table 7. Age-adjusted percentages of adults 18 years of age and over who used selected complementary and alternative medicine
categories in the past 12 months, by selected characteristics: United States, 2007Con.
Manipulative
Biologically Alternative Energy and body-
based Mind-body medical healing based
Characteristic All CAM1 therapies2 therapies3 systems4 therapy therapies5
Did not receive conventional care because could not afford it7
Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46.1 (1.50) 24.8 (1.31) 26.3 (1.36) 4.9 (0.54) 1.1 (0.20) 16.7 (1.19)
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.5 (0.51) 19.4 (0.40) 18.5 (0.39) 3.3 (0.17) 0.5 (0.06) 15.0 (0.36)
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
Quantity zero.
1
All CAM includes acupuncture; ayurveda; homeopathic treatment; naturopathy; traditional healers, chelation therapy; nonvitamin, nonmineral, natural products; diet-based therapies; chiropractic or
osteopathic manipulation; massage; movement therapies; biofeedback; meditation; guided imagery; progressive relaxation; deep breathing exercises; hypnosis; yoga; tai chi; qi gong; and energy
healing therapy.
2
Biologically based therapies include chelation therapy; nonvitamin, nonmineral, natural products; and diet-based therapies.
3
Mind-body therapies include biofeedback; meditation; guided imagery; progressive relaxation; deep breathing exercises; hypnosis; yoga; tai chi; and qi gong.
4
Alternative medical systems include acupuncture; ayurveda; homeopathic treatment; naturopathy; and traditional healers.
5
Manipulative and body based therapies include chiropractic or osteopathic manipulation; massage; and movement therapies.
6
Total includes other races and ethnicities not shown separately and persons with unknown education, poverty status, health insurance status, marital status, leisure-time physical activity status,
body weight status, lifetime smoking status, alcohol consumption status, hospitalization status, number of health conditions, number of doctor visits, delay of care due to cost, did not receive care
7
Estimates are age adjusted using the projected 2000 U.S. population as the standard population using four age groups: 1824 years, 2544 years, 4564 years, and 65 years and over.
8
Education is shown only for persons 25 years and over. Estimates are age adjusted to the projected 2000 U.S. population as the standard population using three age groups: 2544 years, 4564
9
GED is General Education Development high school equivalency diploma.
10
Poverty status is based on family income and family size using the Census Bureaus poverty thresholds for 2006. Poor persons are defined as below the poverty threshold. Near poor
persons have incomes of 100% to less than 200% of the poverty threshold. Not poor persons have incomes that are 200% of the poverty threshold or greater.
11
Classification of health insurance coverage is based on a hierarchy of mutually exclusive categories. Persons with more than one type of health insurance were assigned to the first appropriate
category in the hierarchy. Persons under age 65 years and those age 65 years and over were classified separately because of the prominence of Medicare coverage in the older population. The
category Private includes persons who had any type of private coverage either alone or in combination with other coverage. For example, for persons age 65 years and over, Private includes
persons with only private or private in combination with Medicare. The category Uninsured includes persons who had no coverage as well as those who had only Indian Health Service coverage
or had only a private plan that paid for one type of service such as accidents or dental care (see Definition of terms for more details). Estimates are age-adjusted to the projected 2000 U.S.
population as the standard population using three age groups for persons under age 65 (1824 years, 2544 years, and 4564 years), and two age groups for persons aged 65 years and over
12
Leisure-time physical activity: Never or unable to engage in activity includes adults who did not engage in any sessions of light or moderate (causes light sweating or a slight to moderate
increase in breathing or heart rate) or vigorous (causes heavy sweating or a large increase in breathing or heart rate) leisure-time physical activity of at least 10 minutes duration or were unable to
perform leisure-time physical activity; Some activity but less than regular includes adults who engaged in at least one session of light or moderate or vigorous leisure-time physical activity of at
least 10 minutes duration but did not meet the requirement for regular leisure-time physical activity; Regular activity includes adults who engaged in at least three sessions per week of vigorous
leisure-time physical activity lasting at least 20 minutes in duration or at least five sessions per week of light or moderate leisure-time physical activity lasting at least 30 minutes in duration.
13
Body weight status was based on Body Mass Index (BMI) calculated using self-reported height and weight. The formula for BMI is kilograms/meters2. Underweight is defined as a BMI of less
than 18.5; Healthy weight is defined as a BMI of greater than or equal to 18.5 and less than 25; Overweight, is defined as a BMI of greater than or equal to 25 and less than 30; and Obese
14
Lifetime cigarette smoking status: Current smokers have smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days; Former smokers have smoked at least
100 cigarettes in their lifetime, but currently do not smoke at all; Never smokers have never smoked at all or smoked less than 100 cigarettes in their lifetime.
15
Lifetime alcohol drinking status: Lifetime abstainers had less than 12 drinks in their lifetime; Former drinkers had at least 12 drinks in their lifetime, but none in past year; Current light or
infrequent drinkers had at least 12 drinks in their lifetime and 1 or more drinks in the past year, and drank 3 drinks or fewer per week, on average; Current moderate or heavier drinkers had 12
or more drinks in their lifetime, drank alcohol in the past year, and drank more than 3 drinks per week, on average.
16
Number of health conditions is a count variable of approximately 55 chronic and nonchronic conditions found in the 2007 NHIS. These include conditions of the cardio-pulmonary, respiratory,
NOTES: CAM is complementary and alternative medicine. The denominators for statistics shown exclude persons with unknown CAM information.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
Table 8. Age-adjusted percentages of children under 18 years of age who used selected complementary and alternative medicine
categories in the past 12 months, by selected characteristics: United States, 2007Con.
Age
04 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.6 (0.62) 3.2 (0.42) 1.9 (0.32) 2.9 (0.40) *0.3 (0.13) 2.1 (0.41)
511 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 (0.74) 4.3 (0.49) 3.9 (0.40) 2.5 (0.45) *0.2 (0.09) 2.8 (0.39)
1217 years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.4 (0.90) 6.3 (0.63) 6.8 (0.64) 2.5 (0.44) *0.2 (0.07) 5.9 (0.56)
Race7
White, single race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.8 (0.56) 5.2 (0.41) 4.4 (0.33) 2.8 (0.35) *0.2 (0.06) 4.4 (0.34)
Black or African American, single race . . . . . . . . . . . . . . . . . . . 5.9 (0.75) 1.7 (0.37) 3.0 (0.58) 1.4 (0.38) *0.8 (0.26)
Family structure7
Mother and father . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.7 (0.59) 5.2 (0.45) 4.3 (0.33) 2.7 (0.34) *0.2 (0.06) 4.2 (0.35)
Mother, no father. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 (0.80) 3.3 (0.47) 4.8 (0.61) 2.2 (0.43) *0.5 (0.17) 2.5 (0.38)
Parents education7
Less than high school diploma . . . . . . . . . . . . . . . . . . . . . . . . 4.8 (0.69) 1.7 (0.45) 1.9 (0.42) *1.5 (0.46) *1.3 (0.38)
High school diploma or GED8 . . . . . . . . . . . . . . . . . . . . . . . . . 8.0 (0.73) 2.8 (0.46) 2.3 (0.39) 1.7 (0.43) 2.5 (0.41)
More than high school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.7 (0.66) 6.1 (0.49) 5.6 (0.41) 3.2 (0.40) 0.2 (0.06) 4.6 (0.39)
Poverty status7,9
Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 (0.81) 2.2 (0.44) 3.2 (0.51) 2.2 (0.54) 1.4 (0.39)
Near poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3 (0.91) 4.1 (0.64) 2.4 (0.54) 2.2 (0.48) 2.7 (0.47)
Not poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.6 (0.69) 6.0 (0.52) 5.7 (0.42) 2.9 (0.41) *0.3 (0.09) 4.9 (0.40)
Table 8. Age-adjusted percentages of children under 18 years of age who used selected complementary and alternative medicine
categories in the past 12 months, by selected characteristics: United States, 2007Con.
Health insurance7,10
Private . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7 (0.63) 5.4 (0.44) 5.1 (0.38) 2.6 (0.35) *0.2 (0.07) 4.7 (0.40)
Public. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 (0.72) 3.1 (0.42) 3.4 (0.48) 2.5 (0.40) *0.2 (0.09) 2.0 (0.31)
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 (1.33) 5.3 (1.16) 2.6 (0.51) 3.9 (1.09) 2.4 (0.73)
Region7
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 (1.13) 4.2 (0.66) 5.4 (0.72) 2.0 (0.50) 4.0 (0.71)
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.6 (1.05) 4.9 (0.62) 4.5 (0.65) 2.3 (0.62) 4.5 (0.65)
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 (0.65) 3.8 (0.48) 2.9 (0.34) 2.0 (0.36) *0.3 (0.11) 2.4 (0.32)
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.4 (1.00) 6.4 (0.93) 5.5 (0.64) 4.4 (0.82) *0.3 (0.11) 4.5 (0.59)
Did not receive conventional care because could not afford it7
Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4 (3.59) *8.9 (2.70) 10.4 (2.94) *5.4 (2.45) *8.0 (2.85)
No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.6 (0.47) 4.6 (0.34) 4.2 (0.28) 2.6 (0.28) 0.2 (0.05) 3.6 (0.27)
* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and do not meet the standard of reliability or precision.
Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown.
Quantity zero.
1
All CAM includes acupuncture; ayurveda; homeopathic treatment; naturopathy; traditional healers, chelation therapy; nonvitamin, nonmineral, natural products; diet-based therapies; chiropractic or
osteopathic manipulation; massage; movement therapies; biofeedback; meditation; guided imagery; progressive relaxation; deep breathing exercises; hypnosis; yoga; tai chi; qi gong; and energy
healing therapy.
2
Biologically based therapies include chelation therapy; nonvitamin, nonmineral, natural products; and diet-based therapies.
3
Mind-body therapies include biofeedback; meditation; guided imagery; progressive relaxation; deep breathing exercises; hypnosis; yoga; tai chi; and qi gong.
4
Alternative medical systems include acupuncture; ayurveda; homeopathic treatment; naturopathy; and traditional healers.
5
Manipulative and body based therapies include chiropractic or osteopathic manipulation; massage; and movement therapies.
6
Total includes other races and ethnicities not shown separately and persons with unknown poverty status, health insurance status, and number of doctor visits.
7
Estimates are age adjusted using the projected 2000 U.S. population as the standard population using three age groups: 04 years, 511 years, 1217 years.
8
GED is General Education Development high school equivalency diploma.
9
Poverty status is based on family income and family size using the Census Bureaus poverty thresholds for 2006. Poor persons are defined as below the poverty threshold. Near poor persons
have incomes of 100% to less than 200% of the poverty threshold. Not poor persons have incomes that are 200% of the poverty threshold or greater.
10
Classification of health insurance coverage is based on a hierarchy of mutually exclusive categories. Persons with more than one type of health insurance were assigned to the first appropriate
category in the hierarchy. The category Uninsured includes persons who had no coverage as well as those who had only Indian Health Service coverage or had only a private plan that paid for
one type of service such as accidents or dental care (see Definition of terms for more details).
11
Number of health conditions is a count variable of approximately 55 chronic and nonchronic conditions found in the 2007 NHIS. These include conditions of the cardio-pulmonary, respiratory,
musculoskeletal, gastrointestinal, neurological, and endocrine systems.
NOTES: CAM is complementary and alternative medicine. The denominators for statistics shown exclude persons with unknown CAM information.
DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2007. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
Page 18 National Health Statistics Reports n Number 12 n December 10, 2008
Technical Notes calculating response rates are described characteristics such as race and
in detail in Appendix I of the Survey ethnicity, education, and marital status.
Sample design Description Document of the NHIS data It is also helpful for other
files (16). characteristics. The following age
The National Health Interview groups were used for age adjustment:
Survey (NHIS) is a cross-sectional 04 years, 511 years, 1217 years,
Item nonresponse 1824 years, 2544 years, 4564 years,
household interview survey of the U.S.
civilian noninstitutionalized population. In 2007, item nonresponse for each and 65 years and over (Table II).
Data are collected continuously of the sociodemographic indicators Estimates for education and health
shown in this report was about 3% or insurance coverage are restricted to
throughout the year in all 50 states and
less, with the exception of poverty certain age groups and are, therefore,
the District of Columbia. The NHIS
adjusted accordingly.
uses a multistage, clustered sample status, which is based on detailed family
Estimates were calculated using
design to produce national estimates for income as ascertained in the family
software for statistical analysis of
a variety of health indicators. component of the questionnaire. Item correlated data (SUDAAN) (17). The
Information on basic health topics is nonresponse for the poverty indicator SUDAAN procedure PROC DESCRIPT
collected for all household members, if was 18%. Item nonresponse for the was used to produce age-adjusted
necessary by proxy from one adult health behavior, health care, conditions, percents and their standard errors.
family member. Additional information and other health related items was about
is collected for one randomly selected 5.5% or less. For the 2007 Tests of significance
adult and one randomly selected child in complementary and alternative medicine
Statistical tests performed to assess
each family. Self-response is required items, nonresponse ranged from 0.0% to significance of differences in the
for the Sample Adult questionnaire 8.1%, with nonresponse for most items estimates were two-tailed with no
except in rare cases where sample adults being 3.0% or less. For the 2002 adjustments for multiple comparisons.
are physically or mentally incapable of complementary and alternative medicine The test statistic used to determine
responding for themselves. Interviews items, nonresponse ranged from 1.7% to statistical significance of differences
are conducted in the home using a 3.2%. The denominators for statistics between two percentages was
computer-assisted personal interview shown in the tables exclude persons
|XaXb|
(CAPI), with telephone interviewing with unknown complementary and Z=
permitted for follow-up, if necessary. alternative medicine information for a Sa2 + Sb2
Starting in 2006, the sample design given table. The denominators for
where Xa and Xb are the two
included Asian persons in the statistics shown in Tables 7 and 8
percentages being compared, and Sa and
oversampling of minority populations in exclude persons with unknown
Sb are the standard errors of those
the NHIS; previously, only households sociodemographic characteristics, health
percentages. The critical value used for
with black and Hispanic persons were behavior items, and hospitalization two-sided tests at the 0.05 level of
oversampled. The sample adult selection during the past year and are not shown significance was 1.96.
process was also revised in 2006 so that separately, but counts for these persons
when elderly black, Hispanic, or Asian are included in the total. Among the Relative standard error
persons aged 65 years or older were 23,393 interviewed sample adult
present, they had an increased chance of respondents in the 2007 NHIS, 610 Estimates with a relative standard
being selected as the sample adult. adults were missing data for all the error of more than 30% but less than or
complementary and alternative medicine equal to 50% are identified with an
Response rates items. Among the 9,417 sample children asterisk. Estimates with a relative
in the 2007 NHIS, 108 children were standard error of greater than 50% are
In 2007, NHIS interviews were indicated with a dagger () and are not
missing data for all the complementary
completed in 29,266 households, which shown. The relative standard errors are
and alternative medicine items.
yielded 75,764 persons in 29,915 calculated as follows:
families; the household response rate Relative standard error (as a
was 87.1%. The Sample Adult
Age adjustment percentage) = (SE/Est) 100,
questionnaire was completed by 23,393 Data shown in this report were age where SE is the standard error of the
persons aged 18 years and over, and the adjusted using the projected 2000 U.S. estimate, and Est is the estimate.
Sample Child questionnaire was population provided by the U.S. Census
completed for 9,417 children. The final Bureau as the standard population Definitions of terms
response rates (which takes into account (18,19). Age adjustment was used to
household and family nonresponse) for allow comparison among various Demographic terms
the 2007 sample adult and sample child population subgroups that have different
files were 67.8% and 76.5%, age distributions. This is particularly AgeThe age recorded for each
person is the age at his or her last
respectively. Procedures used in important for demographic
birthday.
National Health Statistics Reports n Number 12 n December 10, 2008 Page 19
Body weight statusBody weight and currently smoke cigarettes every Terms related to
status is based on body mass index day or some days. complementary and
(BMI), which is calculated from FormerAdults who have smoked alternative medicine
self-reported height and weight. BMI is at least 100 cigarettes in their lifetime
calculated as weight divided by height2 but currently do not smoke at all. AcupunctureAcupuncture
using metric units (i.e., kilograms/ NeverAdults who never smoked a describes a family of procedures
meters2). cigarette or who smoked fewer than 100 involving stimulation of anatomical
UnderweightAdults with a BMI cigarettes in their entire lifetime. points on the body by a variety of
of less than 18.5. techniques. American practices of
Health care utilization terms acupuncture incorporate medical
Healthy weightAdults with a BMI traditions from China, Japan, Korea, and
of at least 18.5, but less than 25. Usual place for health careUsual
other countries. The acupuncture
place of health care was based on a
Overweight but not obeseAdults technique that has been most studied
question that asked whether respondents
with a BMI of at least 25, but less scientifically involves penetrating the
than 30. had a place that they usually went to
skin with thin, solid, metallic needles
when they were sick or needed advice
ObeseAdults with a BMI of 30 or that are manipulated by the hands or by
about their health. These places include
more. electrical stimulation.
a walk-in clinic, doctors office, clinic,
Alexander techniqueAlexander
health center, health maintenance
Leisure-time physical activity technique is a movement therapy that
organization, hospital emergency room
uses guidance and education on ways to
InactiveDid not engage in any or outpatient clinic, or a military or VA
improve posture and movement. The
sessions of light or moderate (causes health care facility.
intent is to teach a person how to use
light sweating or a slight to moderate ConditionsCondition is a general
muscles more efficiently in order to
increase in breathing or heart rate) or term that includes any specific illness
improve the overall functioning of the
vigorous (causes heavy sweating or a (physical or mental) or injury. All data
large increase in breathing or heart rate) body. Examples of the Alexander
in the 2007 Sample Adult component
leisure-time physical activity of at least technique as CAM are using it to treat
are self-reported, and most questions ask
10 minutes duration or were unable to low-back pain and the symptoms of
whether a condition was diagnosed by a
perform leisure-time physical activity. Parkinsons disease.
doctor or a health professional. The
Some activity but less than Alternative provider or
reference periods for the conditions
regularEngaging in light or moderate practitionerSomeone who is
vary. There are four basic reference
leisure-time physical activities that cause knowledgeable about a specific
periods: ever, past 12 months, past 30
light sweating or a slight to moderate alternative health practice. This person
days, and currently.
increase in breathing or heart rate and provides care or gives advice about its
Number of visits to a doctor in the
last 1029 minutes each time or are use, and usually receives payment for
past 12 monthsThis is the number of
done less than five times per week, or his or her services.
engaging in vigorous leisure-time visits to a doctors office, clinic, or
For some practices, the provider
physical activities that cause heavy other place that the respondent has made
may have received formalized training
sweating or large increases in breathing in the past 12 months regarding his or
and has been certified by a licensing
or heart rate and are done 1019 her own personal health. Overnight
board or related professional association.
minutes each time and/or less than three hospital stays, hospital emergency room
For example, a practitioner of
times per week. visits, home visits and telephone calls
biofeedback (biofeedback therapist)
Regular activityEngaging in light are excluded.
usually has received training in
or moderate leisure-time physical Overnight hospital stayAn
psychology and physiology and may be
activities that cause light sweating or a overnight hospital stay is a measure of
certified by the Biofeedback
slight to moderate increase in breathing the number of times a person was
Certification Institute of America.
or heart rate and occur five or more hospitalized in the previous 12 months.
Atkins dietThis diet emphasizes a
times per week for at least 30 minutes Visits to a hospital emergency room that
drastic reduction in the daily intake of
each time, and/or engaging in vigorous did not result in admission to the
carbohydrates (40 grams or less),
leisure-time physical activities that cause hospital are not included. Overnight
countered by an increase in protein and
heavy sweating or large increases in hospital stays for the birth of a child are
fat.
breathing or heart rate and occur three counted for both the mother and the
AyurvedaAyurveda is a system of
or more times per week for at least 20 child.
medicine that originated in India several
minutes each time. thousand years ago. In the United
States, Ayurveda is considered a type of
Lifetime cigarette smoking status
CAM and a whole medical system. As
CurrentAdults who have smoked with other such systems, it is based on
at least 100 cigarettes in their lifetime theories of health and illness and on
National Health Statistics Reports n Number 12 n December 10, 2008 Page 21
ways to prevent, manage, or treat health hands-on therapy called manipulation body moves through space and to
problems. Ayurveda aims to integrate (or adjustment) as their core clinical improve physical functioning.
and balance the body, mind, and spirit procedure. Guided imageryGuided imagery
(thus, some view it as holistic). This Complementary and alternative involves a series of relaxation
balance is believed to lead to medicine (CAM)Refers to therapies techniques followed by the visualization
contentment and health and to help not usually taught in U.S. medical of detailed images, usually calm and
prevent illness. However, Ayurveda also schools or generally available in U.S. peaceful in nature. If used for treatment,
proposes treatments for specific health hospitals. They include a broad range of the individual will visualize their body
problems, whether they are physical or practices and beliefs such as free of the specific problem or
mental. A chief aim of Ayurvedic acupuncture, chiropractic care, condition. Sessions are typically 2030
practices is to cleanse the body of relaxation techniques, massage therapy, minutes in length, and may be practiced
substances that can cause disease, and and herbal remedies. They are defined several times a week.
this is believed to help reestablish by the National Center for HierberoA Hierbero or Yerbera is
harmony and balance. Complementary and Alternative a traditional healer or practitioner with
BiofeedbackBiofeedback uses Medicine as a group of diverse medical knowledge of the medicinal qualities of
simple electronic devices to teach clients and health care systems, practices, and plants.
how to consciously regulate bodily products that are not presently HomeopathyHomeopathy is a
functions, such as breathing, heart rate, considered to be part of conventional system of medical practices based on
and blood pressure, in order to improve medicine. the theory that any substance that can
overall health. Biofeedback is used to CuranderoA Curandero is a type produce symptoms of disease or illness
reduce stress, eliminate headaches, of traditional folk healer. Originally in a healthy person can cure those
recondition injured muscles, control found in Latin America, Curanderos symptoms in a sick person. For
asthmatic attacks, and relieve pain. specialize in treating illness through the example, someone suffering from
BotanicaA Botanica is a use of supernatural forces, herbal insomnia may be given a homeopathic
traditional healer who supplies healing remedies, and other natural medicines. dose of coffee. Administered in diluted
products, sometimes associated with Deep breathingDeep breathing form, homeopathic remedies are derived
spiritual interventions. involves slow and deep inhalation from many natural sourcesincluding
Chelation therapyChelation through the nose, usually to a count of plants, metals, and minerals.
therapy is a chemical process in which a 10, followed by slow and complete HypnosisHypnosis is an altered
substance is used to bind molecules, exhalation for a similar count. The state of consciousness characterized by
such as metals or minerals, and hold process may be repeated 5 to 10 times, increased responsiveness to suggestion.
them tightly so that they can be several times a day. The hypnotic state is attained by first
removed from a system, such as the Energy healing therapyEnergy relaxing the body, then shifting attention
body. In medicine, chelation has been healing therapy involves the channeling toward a narrow range of objects or
scientifically proven to rid the body of of healing energy through the hands of a ideas as suggested by the hypnotist or
excess or toxic metals. For example, a practitioner into the clients body to hypnotherapist. The procedure is used to
person who has lead poisoning may be restore a normal energy balance and, effect positive changes and to treat
given chelation therapy in order to bind therefore, health. Energy healing therapy numerous health conditions including
and remove excess lead from the body has been used to treat a wide variety of ulcers, chronic pain, respiratory
before it can cause damage. ailments and health problems, and is ailments, stress, and headaches.
Chiropractic careThis care often used in conjunction with other Macrobiotic dietA macrobiotic
involves the adjustment of the spine and alternative and conventional medical diet is low in fat, emphasizes whole
joints to influence the bodys nervous treatments. grains and vegetables, and restricts the
system and natural defense mechanisms EspiritistaAn Espiritista is a intake of fluids. Of particular
to alleviate pain and improve general traditional healer who assesses a importance is the consumption of fresh,
health. It is primarily used to treat back patients condition and recommends nonprocessed foods.
problems, headaches, nerve herbs or religious amulets in order to MassageMassage therapists
inflammation, muscle spasms, and other improve physical or mental health or to manipulate muscle and connective tissue
injuries and traumas. help overcome a personal problem. to enhance function of those tissues and
Chiropractic manipulation FeldenkreisFeldenkreis is a promote relaxation and well-being.
Chiropractic manipulation is a form of movement therapy that uses a method of MeditationMeditation refers to a
health care that focuses on the education in physical coordination and group of techniques, most of which
relationship between the bodys movement. Practitioners use verbal started in Eastern religious or spiritual
structure, primarily of the spine, and guidance and light touch to teach the traditions. In meditation, a person learns
function. Doctors of chiropractic, who method through one-on-one lessons and to focus his attention and suspend the
are also called chiropractors or group classes. The intent is to help the stream of thoughts that normally occupy
chiropractic physicians, use a type of person become more aware of how the the mind. This practice is believed to
Page 22 National Health Statistics Reports n Number 12 n December 10, 2008
result in a state of greater physical Osteopathic manipulation calories or limit portions, dieters are
relaxation, mental calmness, and Osteopathic manipulation is a full-body encouraged to eat whole grain foods and
psychological balance. Practicing system of hands-on techniques to an abundant amount of vegetables.
meditation can change how a person alleviate pain, restore function, and Tai chiTai chi is a mind-body
relates to the flow of emotions and promote health and well-being. practice that originated in China as a
thoughts in the mind. PilatesPilates is a movement martial art. A person doing tai chi
Native American Healer or therapy that uses a method of physical moves his body slowly and gently, while
Medicine ManA Native American exercise to strengthen and build control breathing deeply and meditating (tai chi
Healer or Medicine Man is a traditional of muscles, especially those used for is sometimes called moving
healer who uses information from the posture. Awareness of breathing and meditation). Many practitioners believe
spirit world in order to benefit the precise control of movements are
that tai chi helps the flow throughout
community. People see Native American integral components of Pilates. Special
the body of a proposed vital energy
healers for a variety of reasons, equipment, if available, is often used.
called qi. A person practicing tai chi
especially to find relief or a cure from Pritikin dietWhile meat is
moves her body in a slow, relaxed, and
illness or to find spiritual guidance. allowed, the Pritikin diet (or Pritikin
NaturopathyNaturopathy is an Principle) is low-fat and emphasizes the graceful series of movements. One can
alternative medical system. Naturopathic consumption of foods with a large practice on ones own or in a group.
medicine proposes that there is a healing volume of fiber and water, including The movements make up what are
power in the body that establishes, many vegetables, fruits, beans, and called forms (or routines).
maintains, and restores health. natural, unprocessed grains. Traditional healerA Traditional
Practitioners work with the patient with Progressive relaxationProgressive healer is someone who employs any one
a goal of supporting this power through relaxation is used to relieve tension and of a number of ancient medical practices
treatments such as nutrition and lifestyle stress by systematically tensing and that are based on indigenous theories,
counseling, dietary supplements, relaxing successive muscle groups. beliefs, and experiences handed down
medicinal plants, exercise, homeopathy, Qi gongQi gong is an ancient from generation to generation. The
and treatments from traditional Chinese Chinese discipline combining the use of methods employed by each type of
medicine. gentle physical movements, mental Traditional healer have evolved to
Nonvitamin, nonmineral, natural focus, and deep breathing directed reflect the different philosophical
productsNonvitamin, nonmineral, toward specific parts of the body. backgrounds and cultural origins of the
natural products are taken by mouth and Performed in repetitions, the exercises healer.
contain a dietary ingredient intended to are normally performed two or more Trager Psychophysical Integration
supplement the diet other than vitamins times a week for 30 minutes at a time. Trager Psychophysical Integration is a
and minerals. Examples include herbs or ReikiReiki is an energy medicine movement therapy in which practitioners
herbal medicine (as single herbs or practice that originated in Japan. In apply a series of gentle, rhythmic
mixtures), other botanical products such Reiki, the practitioner places his hands rocking movements to the joints. They
as soy or flax products, and dietary on or near the person receiving
also teach physical and mental self-care
substances such as enzymes and treatment, with the intent to transmit ki,
exercises to reinforce the proper
glandulars. Among the most popular are believed to be life-force energy.
movement of the body. The intent is to
echinacea, ginkgo biloba, ginseng, ShamanA Shaman is a traditional
release physical tension and increase the
feverfew, garlic, kava kava, and saw healer who is said to act as a medium
palmetto. Garlic, for example, has been between the invisible spiritual world and bodys range of motion. An example of
used to treat fevers, sore throats, the physical world. Most gain Trager Psychophysical Integration as
digestive ailments, hardening of the knowledge through contact with the CAM is using it to treat chronic
arteries, and other health problems and spiritual world and use the information headaches.
conditions. to perform tasks such as divination, Vegetarian dietsVegetarian diets
Ornish dietThe Ornish diet is a influencing natural events, and healing are those totally devoid of meat, red or
high fiber, low-fat, vegetarian diet that the sick or injured. white. There are, however, numerous
promotes weight loss and health by SobadorA Sobador is a traditional variations on the nonmeat theme. For
controlling what one eats, not by healer who uses massage and rub example, some vegetarian diets are
restricting the intake of calories. Fruits, techniques in order to treat patients. restricted to plant products only, while
beans, grains, and vegetables can be South Beach dietSouth Beach diet others may include eggs and dairy
eaten at all meals, while nonfat dairy distinguishes between good and products. Another variation limits
products such as skim milk, nonfat bad carbohydrates and fats. Good consumption to raw fruit, sometimes
cheeses, and egg whites are to be carbohydrates are those that are digested supplemented with nuts and vegetables.
consumed in moderation. Products such relatively slowly, and bad fats include Finally, a number of vegetarian diets
as oils, avocados, nuts and seeds, and saturated and trans fats. Although the prohibit alcohol, sugar, caffeine, or
meats of all kinds are avoided. program does not require one to count processed foods.
National Health Statistics Reports n Number 12 n December 10, 2008 Page 23
Complementary and
alternative medicine
questions
The 2007 National Health Interview
Survey Sample Adult and Sample Child
questionnaires contained supplementary
questions on complementary and
alternative medicine (CAM). In
documentation, each question in the
Sample Adult questionnaire is preceded
by its question number, beginning with
ALT. ALT is the acronym for the CAM
section of the Sample Adult
questionnaire. Each question in the
Sample Child questionnaire is preceded
by its question number, beginning with
CAL. CAL is the acronym for the CAM
section of the Sample Child
questionnaire. Due to the unusually
large number of questions that were
used to produce the data used in this
report and the complexity of the
question skip patterns, the CAM
questions have not been included with
this report. The CAM questions in the
Sample Adult and Sample Child
questionnaires and information about
other components of the NHIS are
available from: http://www.cdc.gov/nchs/
nhis.htm.
The 2002 National Health Interview
Survey Sample Adult questionnaire
contained questions on CAM. In
documentation, the CAM question
numbers begin with ALT, as described
above for the 2007 NHIS.
Page 24 National Health Statistics Reports n Number 12 n December 10, 2008
Barnes PM, Bloom B, Nahin RL. All material appearing in this report is in the Director
Complementary and alternative medicine use public domain and may be reproduced or Edward J. Sondik, Ph.D.
among adults and children: United States, copied without permission; citation as to
2007. National health statistics reports; no 12. source, however, is appreciated. Acting Co-Deputy Directors
Hyattsville, MD: National Center for Health Jennifer H. Madans, Ph.D.
U.S. DEPARTMENT OF
HEALTH & HUMAN SERVICES
FIRST CLASS
Centers for Disease Control and Prevention POSTAGE & FEES PAID
Hyattsville, MD 20782
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