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What Complementary and Integrative Approaches Do Americans Use?

Key Findings from the 2012 National Health Interview Survey

What complementary health approaches are most popular in the United States? What’s changed over the years? How does children’s use compare to that of adults?

Answers to these questions—and many more—can be found in the results of the National Health Interview Survey (NHIS), an annual study in which tens of thousands of Americans answer questions about their health. Every 5 years, this survey includes a special section on complementary health approaches. The most recent data on complementary approaches were collected in 2012.

More Information

2012 NHIS Highlights

  • In 2012, 33.2% of U.S. adults used complementary health approaches. This is similar to the percentages in 2007 (35.5%) and 2002 (32.3%).
  • 11.6% of U.S. children age 4 to 17 used complementary health approaches in 2012. There was no meaningful change from 2007, when 12.0% used them.
  • In 2012, as in 2007 and 2002, the most commonly used complementary approach was natural products (dietary supplements other than vitamins and minerals). 17.7% of adults and 4.9% of children age 4 to 17 used natural products.
  • Pain—a condition for which people often use complementary health approaches—is common in U.S. adults. More than half had some pain during the 3 months before the survey.
  • U.S. adults who take natural products (dietary supplements other than vitamins and minerals) or who practice yoga were more likely to do so for wellness reasons than for treating a specific health condition. In contrast, people who use spinal manipulation more often do so for treatment reasons rather than wellness.
  • About 59 million Americans spend money out-of-pocket on complementary health approaches, and their total spending adds up to $30.2 billion a year.
  • In 2012, 60% of NHIS respondents who used chiropractic care had at least some insurance coverage for it, but rates were much lower for acupuncture (25%) and massage (15%).

More Key Facts About Adults

Natural Products

  • Fish oil was the #1 natural product among adults, with 7.8% using it in 2012.
  • Adults’ use of fish oil, probiotics or prebiotics, and melatonin increased between 2007 and 2012.
  • Adults’ use of glucosamine/chondroitin, echinacea, and garlic decreased between 2007 and 2012.
  • Although dietary supplement users were twice as likely to report wellness rather than treatment as a reason for taking supplements, fewer than 1 in 4 reported reduced stress, better sleep, or feeling better emotionally as a result of using dietary supplements.

Mind and Body Approaches

  • The mind and body approaches most commonly used by adults include yoga, chiropractic or osteopathic manipulation, meditation, and massage therapy.
  • The percentage of adults who practice yoga has increased substantially, from 5.1% in 2002 to 6.1% in 2007 and 9.5% in 2012.
  • More than 85 percent of U.S. adults who used yoga perceived reduced stress as a result of practicing yoga.
  • Nearly two-thirds of adult yoga users reported that as a result of practicing yoga they were motivated to exercise more regularly, and 4 in 10 reported they were motivated to eat healthier.
  • Adult yoga users were more likely to affirm feeling better emotionally than users of dietary supplements or spinal manipulation as a result of using that approach.
  • More than 60 percent of U.S. adults using spinal manipulation reported doing so to treat a specific health condition, and more than 50 percent did so for general wellness-related reasons.


  • About 25 million adults (11.2%) have daily pain—that is, they reported that they had pain every day in the 3 months before the survey.
  • Adults with more severe pain had worse health, used more health care, and had more disability than those with less severe pain.

More Key Facts About Children

Natural Products

  • Fish oil was the natural product most commonly used by children, with 1.1% using it in 2012. This is a change from 2007, when echinacea was #1.
  • Melatonin was the #2 natural product used by children in 2012. Its use increased substantially from 2007 to 2012.

Mind and Body Approaches

  • The mind and body approaches most commonly used by children include chiropractic or osteopathic manipulation, yoga, meditation, and massage therapy.
  • Yoga has become more popular among children, just as it has among adults. 3.1% of U.S. children practiced yoga in 2012, compared to 2.3% in 2007.

More Key Facts About Spending and Insurance

  • Out-of-pocket spending for complementary health approaches represents 9.2% of all out-of-pocket spending on health care and 1.1% of total health care spending.
  • In 2012, Americans spent $14.7 billion out-of-pocket on visits to complementary practitioners and $12.8 billion on natural products.
  • Between 2002 and 2012, use rates for chiropractic, acupuncture, and massage among people who had no insurance coverage for these types of care increased, suggesting an increased willingness to pay out-of-pocket.
  • In 2012, partial insurance coverage was more common than complete coverage for chiropractic care, acupuncture, and massage.

This page last modified September 24, 2017