Study: alternative med use higher in
youth
by Mary
Helen YarboroughPublic Relations
Despite their greater likelihood for socio-economic disparity, blacks reported better health status than their white counterparts, according to a study conducted through the Center for Health Disparities Research (CHDR).
The study, which involved a survey of patients in MUSC’s internal medicine clinic, also concluded that younger people are more likely than older people to use alternative therapies.
As part of an ongoing study of health disparities being conducted by CHDR, three students spent the summer conducting research and surveying 368 patients in the clinic waiting rooms. Those surveyed represented diverse socio-economic, racial and ethnic groups of both sexes between 18 – 90 years of age. While most patients were from South Carolina, some were from out of state. (At least two people surveyed travel to Charleston from Virginia and Florida to see specialists at MUSC.).
The survey included three questionnaires that focused on health literacy, racial/ethnic differences in health-related quality of life, and racial/ethnic differences in complementary alternative medicine (CAM). It was the first such study that included these three components.
Interns Cerrone
Cohen, left, Jerome Higgs and Brittany Smalls studied health
disparities, literacy and alternative therapies sponsored by the Center
for Health Disparities Research.All of the survey respondents answered all three sets of questions posed by students Jerome Higgs of Freeport, Bahamas, a senior at Voorhees College; Brittany Smalls of Charleston, a senior at the College of Charleston; and Cerrone Cohen of Aiken, a second-year MUSC medical student.
Cohen focused on the health literacy question, which would indicate how familiar people are with health terms and information, including names of diseases and conditions, and how they viewed the quality of their lives.
Cohen concluded that, compared to whites, blacks were more likely to be single, have less than a high school education, be uninsured, have household income of less than $10,000, have poor health literacy, and have lower levels of medication adherence. His study showed that, “There were no significant differences by gender, employment, smoking, physical activity, and functional limitation.” When the association between health literacy, medication adherence, and health-related quality of life was assessed, the results showed that “no significant correlations existed between health literacy and medication adherence or health-related quality of life, suggesting that low health literacy did not translate to poorer medication adherence or decreased health-related quality of life.”
“A lot of factors contribute to health disparities,” Higgs said. “Chronic illness, socio-economic factors, access to care and geographic location all play a role in health disparities.”
Higgs said that people who live in urban centers, for example, have greater access to health care than do people who live in rural areas.
Meanwhile, health disparities cross racial and generational lines and are compounded by a lack of practitioner compassion and communication, Smalls said.
“The greatest disparity that exists is between the patient and his or her doctor,” said Smalls. She said that patients are reluctant to question their doctors, and doctors fail to clearly discuss conditions with their patients. “These patients are afraid they’re complaining. But we want them to complain, or the doctors won’t listen to them. We’re trying to correct this problem so we can help the patients,” through outreach and education programs, she said.
The students concluded that a person’s skin color does not automatically determine the level of disparity. And, at least in the MUSC sample, socio-economic factors did not indicate the level of disparities either.
Alternatives becoming mainstream
The Lowcountry is rich in folk remedies. Some remedies date to early Native American cultures, and others were brought over by slaves from Africa and the Caribbean. Still, many have been passed through generations originating from Europe, and more recently, Asia. These folk remedies generally are used by older or rural people. More recent complementary alternative medicines (CAM), such as herbal teas, yoga, meditation, and a host of other remedies, have grown popular among young people.
CAM has been described as a group of diverse medical and health care systems, practices and products that are not considered to be part of conventional medicine by the National Center for Complementary and Alternative Medicine. The use of unconventional medicine, such as CAM, has increased in the United States in the past 14 years from 33.8 percent to 62 percent.
Smalls’ study included all categories of CAM, and found that younger people were more inclined to use CAM than older people.
“We wanted to know what people take or do without a prescription,” Smalls said. “Some people said they pray every day, they use relaxation techniques, and some take vitamins every day.”
Of those surveyed, 69 percent reported having used CAM in the previous 12 months. “CAM use did not differ significantly by race/ethnicity, health literacy, or medication adherence,” the study concluded. “The only significant factor associated with CAM use was age. Individuals aged 34-49 years were significantly less likely to use CAM compared to those aged 18-34 years.”
The results would be surprising without factoring in sophistication and education. “The more educated and affluent a person is, the more likely they are to use alternative therapies,” said Leonard Egede, M.D., CHDR director. CAM in clinical settings may be related to increased patient awareness, better education, and peoples' desire to take more control of their medical care. Younger people seem to be growing more aware and more sophisticated than their parents and grandparents regardless of color or socio-economic status.
Smalls attributed some of the influence to the Asian culture in America, which prefers to use Asian-based alternative therapies, because they don’t trust western medicine. Asian influence on the American culture has made some of these therapies mainstream, such as acupuncture, meditation, and herbs like ginkgo biloba and ginseng.
In his native Bahamas, Higgs said so-called “bush medicine” is thought to strengthen the immune system.
“No one ever thought twice about going to Grandmama’s for herbal tea, because we thought that’s what you do,” Smalls added. “But that’s alternative medicine, too.”
Because the study was conducted at only one MUSC clinic, the study’s findings may not reflect what may be happening across the state.
Egede said that had the study been conducted at other sites, the results may have revealed a greater chasm between blacks, white, poor and rich.
Therefore the summer research study will be expanded to the entire Lowcountry, from Georgetown to Beaufort, and Allendale to Dorchester counties, and focus on community health centers that generally serve low income people. The study will be conducted as part of an existing grant by the U.S. Department of Health and Human Services.
Egede attributed the results in the MUSC study to the quality and access to care in the Division of Internal Medicine and Geriatrics that runs the clinic.
“Regardless of race and financial status, the care is good,” he said.
Egede said the study by the students also demonstrates the significance of maintaining the Center for Health Disparities Research.
“Support for these programs gives bright, young minority students an opportunity to become committed to research,” Egede said.
Friday, Aug. 24, 2007
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