Lack of Knowledge Is One Reason People Don’t Use Complementary Health Approaches

A new analysis from the 2007 National Health Interview Survey (NHIS) finds that people with lower educational levels and incomes are less likely to know about and use complementary health approaches even if they have low-back pain (the most common condition for which people often seek out these practices). Although previous surveys have looked at who uses complementary health approaches, not many studies have examined who does not use them and why. The new study appears in the online journal PLoS One.

The NHIS is an annual survey in which tens of thousands of Americans are interviewed about their health- and illness-related experiences. The 2007 survey included a supplement with questions on 36 complementary approaches used in the United States. The supplement also collected information on reasons for non-use of four common complementary health approaches (acupuncture, chiropractic, natural products, and yoga).

Researchers analyzed two different samples of data. The first was a sample of 13,128 adults who had never used acupuncture, chiropractic, natural products, or yoga. The second sample was a subset of these same non-users, 2,580 adults, who also reported low-back pain in the previous 3 months.

Among the findings from the study:

• Individuals with lower levels of educational attainment and lower incomes were more likely to choose the response option “lack of knowledge” as a reason for non-use of common complementary health approaches.
• Individuals with lower educational attainment or other socioeconomic indicators were less likely to select the response option “lack of need” as a reason for non-use. People who could not afford additional care, who did not have a usual place of care, or who had used emergency room services, were also less likely to select “lack of need” as a reason for non-use.
• Contrary to expectations, the absence of back pain was not associated with lack of knowledge. This suggests there was not greater information seeking/health knowledge in those with back pain.
• People with functional limitations were less likely to report "lack of knowledge" as a reason for not using chiropractic, while those who could not afford additional care were more likely to report lack of knowledge related to yoga and acupuncture.
• People who were physically inactive were more likely to cite “lack of knowledge” as a reason for non-use of all four complementary approaches. By contrast, respondents who were physically active were more likely to cite “lack of need” as a reason they do not use these complementary approaches.

The researchers concluded that if individuals with health concerns, such as low-back pain, are aware of clinically appropriate complementary therapies they might use them. They also noted that disparities in the use of complementary health approaches, related to education and other socioeconomic factors, may negatively affect quality of care. Strategies are needed to help reduce the disparities in understanding and to improve access to health care.