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Complementary and alternative medicine use in Canada and the United States.

Use of complementary and alternative medicine (CAM) has stimulated discussion in both Canada1–4 and the United States5–12 on topics such as who might benefit from CAM insurance coverage and the role of CAM as a substitute for use of conventional medical treatment vs a supplement to such treatment. In the United States, members of racial or ethnic minority groups are less likely to use CAM than are White people, and elevated income is a strong predictor of CAM use.5,6,8 In the United States (unlike in Canada), race and ethnicity are related closely to health insurance status.13 In both Canada4 and the United States,5,6,8 CAM use appears higher in western regions than in other areas. In Canada, western provinces are much more likely than those in the east to cover CAM in their health programs.1 In the United States, some 42 states mandate coverage of chiropractic care in private insurance,9 whereas federal legislation mandates coverage for all people older than 65 years (in the Medicare program) as well as for individuals whose health insurance is provided by large employers regulated under the Employee Retirement Income Security Act.14 
 
This study examined relationships between race, geography, and conventional medical care and the use of acupuncture, chiropractic, homeopathy/naturopathy, and massage therapy.