Chao Maria T, Wade Christine M
The Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine, Department of Rehabilitation Medicine, Columbia University, New York, New York, USA.
Ethn Dis. 2008 Winter;18(1):65-71.
Higher socioeconomic status (SES) is associated with using complementary and alternative medicine (CAM) in national surveys. Less is known about how socioeconomic factors affect CAM use in US subpopulations. We examined whether the relationship between SES and CAM use differs by racial/ethnic groups.
Using national survey data, we assessed education and income effects on women's CAM use in four racial/ethnic groups (Whites, Blacks, Mexican Americans, and Chinese Americans), controlling for age, health status, and geographic region. CAM use was defined as using any of 11 domains in the prior year.
Adjusted effects of SES on CAM use were similar among Mexican American and non-Hispanic White women--education had a distinct gradient effect, with each increasing level of education significantly more likely to use CAM; household income > or = $60,000 was associated with CAM use compared to income < $20,000. For Chinese American women, socioeconomic factors were not associated with CAM use when controlling for confounders. Although income was not associated with CAM use among African American women, college graduates were three times more likely to use CAM than those with less than a high school education, adjusting for confounders.
SES effects on CAM use are not uniform across racial/ethnic populations. Other factors, such as culture and social networks, may interact with SES to influence CAM use in minority populations.
在全国性调查中,较高的社会经济地位(SES)与使用补充和替代医学(CAM)相关。关于社会经济因素如何影响美国亚人群体使用CAM的情况,人们了解较少。我们研究了SES与CAM使用之间的关系是否因种族/族裔群体而异。
利用全国性调查数据,我们评估了教育和收入对四个种族/族裔群体(白人、黑人、墨西哥裔美国人、华裔美国人)中女性使用CAM的影响,并对年龄、健康状况和地理区域进行了控制。CAM的使用被定义为在前一年使用11个领域中的任何一个。
SES对CAM使用的调整效应在墨西哥裔美国女性和非西班牙裔白人女性中相似——教育有明显的梯度效应,教育程度每提高一级,使用CAM的可能性显著增加;与收入低于20,000美元相比,家庭收入≥60,000美元与使用CAM相关。对于华裔美国女性,在控制混杂因素后,社会经济因素与CAM使用无关。虽然收入与非裔美国女性使用CAM无关,但在调整混杂因素后,大学毕业生使用CAM的可能性是高中以下学历者的三倍。
SES对CAM使用的影响在不同种族/族裔人群中并不一致。其他因素,如文化和社会网络,可能与SES相互作用,影响少数族裔人群使用CAM。