University of Minnesota, Division of Health Policy and Management, 712 Delaware St. SE, Mayo Building, D371, Minneapolis, MN 55407, USA.
Soc Sci Med. 2012 Apr;74(8):1155-62. doi: 10.1016/j.socscimed.2012.01.003. Epub 2012 Feb 18.
This article examines whether self-reported racial discrimination is associated with greater use of complementary and alternative medicine (CAM) and assesses whether the effects of reported racial discrimination are specific to the setting in which the unfair treatment occurred (i.e., medical or nonmedical settings). Data were drawn from the National Survey of Midlife Development in the United States (MIDUS) of Black adults aged 25 and older at baseline (N=201). Analyses account for multiple forms of discrimination: major lifetime discriminatory events and everyday discrimination (more commonplace negative occurrences). Using logistic and negative binomial regression, results reveal that racial discrimination was associated with a higher likelihood of using any type of CAM as well as using more modalities of CAM. Also, both discrimination in health care and discrimination in nonmedical contexts predicted greater use of CAM. The findings underscore the tenet that health care choices, while influenced by health status and availability of health care resources, are also shaped by perceived barriers. The experience of racial discrimination among Black people is associated with greater use of alternative means of health care, as a way to cope with the barriers they experience in institutional settings in the United States.
本文探讨了自我报告的种族歧视是否与更多地使用补充和替代医学(CAM)有关,并评估了报告的种族歧视的影响是否仅限于不公平待遇发生的环境(即医疗或非医疗环境)。数据来自美国全国中年发展调查(MIDUS),其中包括基线时年龄在 25 岁及以上的黑人成年人(N=201)。分析考虑了多种形式的歧视:主要的终身歧视事件和日常歧视(更常见的负面事件)。使用逻辑回归和负二项回归,结果表明种族歧视与更有可能使用任何类型的 CAM 以及使用更多 CAM 模式有关。此外,医疗保健中的歧视和非医疗环境中的歧视都预示着 CAM 的使用会增加。这些发现强调了一个原则,即医疗保健选择虽然受到健康状况和医疗保健资源的可用性的影响,但也受到感知障碍的影响。在美国的制度环境中,黑人经历种族歧视与更多地使用替代医疗方式有关,这是一种应对他们所经历的障碍的方式。