Attributes of Non-Hispanic Blacks That Use Chiropractic Health Care: A Survey of Patients in Texas and Louisiana
Introduction
Existing research suggests that non-Hispanic blacks use Complementary and Alternative Medicine (CAM) treatments less often than whites,1 with the exception of using religion as a form of CAM.2, 3, 4, 5, 6, 7, 8, 9 In one study, for example, Barnes et al10 demonstrated that 43.1% of white adults sought out CAM treatments in comparison to 25.5% of blacks. Furthermore, there is minimal research that provides an explanation as to why blacks use CAM less often.10, 11, 12, 13 Some reasons for the differences observed have been that whites possess higher education and increased annual income, and that blacks lack access to conventional medicine and demonstrate dissatisfaction with it in general.10, 11, 12, 13, 14
Limited existing research appears to demonstrate that there are also some similarities between white and black CAM users. White CAM demographic studies show that most users are between the ages of 35 and 49 years, are married, possess some level of college education, and have a household income more than $50,000.13, 15, 16, 17, 18, 19 Studies specifically focusing on blacks have found that CAM users have an average age of 43.3 years; they are more likely to be female, have a college education, and possess insurance.14, 20, 21, 22, 23 Blacks who regularly use CAM report that it gives them a sense of power over their own health.14 A common reason for trying CAM among blacks is that they report having another family member use it.22
Most CAM use research does not break down the amount of use of each CAM subtype (eg, chiropractic, herbal medicine, acupuncture) by minorities.24 Because of the unique intrinsic cultural differences that minority groups possess,24 their reasons for using or not using different forms of CAM remain a gap in existing research.
Chiropractic is one form of CAM as defined by the National Center for Complementary and Alternative Medicine.25 All existing survey research studies demonstrate that blacks use chiropractic health care services less often than whites.2, 3, 4, 5, 6, 7, 9, 15, 16, 26, 27, 28, 29 In many instances, whites used chiropractic at least twice as often as blacks.2, 4, 6, 7, 9, 15, 16, 26, 29 Some have attributed this difference to the perception of discrepancies of health care treatment by blacks, lower average educational levels of blacks compared to whites, and the lack of accessibility to doctors of chiropractic (DCs) in black communities.2, 4, 20, 21, 30
Very little information currently exists in the literature that describes use of chiropractic by non-Hispanic black patients. Therefore, the purpose of this study was to develop a profile of and to gain insight to non-Hispanic black patients’ utilization of chiropractic services.
Section snippets
Methods
This study was approved by the Texas Chiropractic College (TCC) Institutional Review Board for human subjects. All subjects were provided a written explanation of the study purpose prior to participation in the survey. This trial was registered with the University hospital Medical Information Network Clinical Trials Registry: trial number UMIN000014669.
Results
Forty-four surveys out of 200 were returned, yielding a response rate of 22%. Table 2, Table 3 and Figure 1 list the demographic data, survey questions, and responses. Data in the “Results” section are listed as percentage followed by raw total response rate for that given question. Demographically, non-Hispanic black patients were most likely to be female (54.5%, 44), be older than 50 years (56.8%, 44), be a college graduate (59.1%, 44), be employed (61.9%, 42), report not receiving public
Discussion
Existing survey research studies show that blacks use chiropractic health care services less often than whites.2, 3, 4, 5, 6, 7, 9, 15, 16, 26, 27, 28, 29 Some researchers have attributed this difference to the perception of discrepancies of health care treatment by blacks, lower average educational levels of blacks compared to whites, and the lack of accessibility to DC s in black communities.2, 4, 20, 21, 30 In this study, researchers found that non-Hispanic black patients that do use
Limitations
The primary limitation of this study was the small sample size. As a result, a broader and larger study would be more informative of data trends within this population. Because of the limited distribution of this survey in cities in Texas and one in Louisiana, the results of this research are most representative of regional attributes of patients and not national attributes.
This is the first time that this survey has been distributed, and it is plausible to suggest that some of the questions
Conclusions
The findings of this small survey study preliminarily suggest that non-Hispanic black patients in the United States appear to be older, be college educated, and have a positive viewpoint on their interactions with their DC.
Funding Sources and Conflicts of Interest
No funding sources or conflicts of interest were reported for this study.
References (67)
- et al.
Characterization of health status and modifiable risk behavior among United States adults using chiropractic care as compared with general medical care
J Manipulative Physiol Ther
(2009) Use of alternative therapies: estimates from the 1994 Robert Wood Johnson Foundation national access to care survey
J Pain Symptom Manage
(1997)- et al.
Use of complementary and alternative medicine for treatment among African-Americans: a multivariate analysis
Res Social Adm Pharm
(2010) - et al.
Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines
Spine J
(2010) - et al.
Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations
Spine J
(2006) - et al.
Chiropractic management of low back disorders: report from a consensus process
J Manipulative Physiol Ther
(2008) - et al.
Chiropractic management of low back pain and low back-related leg complaints: a literature synthesis
J Manipulative Physiol Ther
(2008) - et al.
Review of the use of complementary and alternative medicine by non-Hispanic blacks
Top Integr Health Care
(2013) - et al.
Complementary and alternative medicine (CAM) use by African American (AA) and Caucasian American (CA) older adults in a rural setting: a descriptive, comparative study
BMC Complement Altern Med
(2003) - et al.
The use of complementary and alternative medicine among California adults with and without cancer
Evid Based Complement Alternat Med
(2005)
Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey
J Natl Med Assoc
Variation in complementary and alternative medicine (CAM) use across racial/ethnic groups and the development of ethnic-specific measures of CAM use
J Altern Complement Med
Race/ethnicity and women’s use of complementary and alternative medicine in the United States: results of a national survey
Am J Public Health
The complementarity and substitution between unconventional and mainstream medicine among racial and ethnic groups in the United States
Health Serv Res
Prayer for health and primary care: results from the 2002 National Health Interview Survey
Fam Med
Demographic, behavioral, and health correlates of complementary and alternative medicine and prayer use among midlife women: 2002
J Women's Health
Complementary and alternative medicine use among adults and children: United States, 2007
Natl Health Stat Report
Long-term trends in the use of complementary and alternative medical therapies in the United States
Ann Intern Med
Unconventional medicine in the United States. Prevalence, costs, and patterns of use
N Engl J Med
Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey
J Am Med Assoc
Use of CAM in local African-American communities: community-partnered research
J Natl Med Assoc
Sociodemographic determinants of the utilization of specific types of complementary and alternative medicine: an analysis based on a nationally representative survey sample
J Altern Complement Med
Why patients use alternative medicine: results of a national study
J Am Med Assoc
Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age
Am J Epidemiol
Patterns of complementary and alternative medicine use in African Americans
J Altern Complement Med
A multivariate test of an expanded Andersen Health Care Utilization Model for Complementary and Alternative Medicine (CAM) use in African Americans
J Altern Complement Med
Women’s reasons for complementary and alternative medicine use: racial/ethnic differences
J Altern Complement Med
Utilization of complementary and alternative medicine by United States adults: results from the 1999 national health interview survey
Med Care
Ethnic differences in the use of complementary and alternative medicine at midlife: longitudinal results from SWAN participants
Am J Public Health
Chiropractic: an introduction [Internet]
A longitudinal study of chiropractic use among older adults in the United States
Chiropr Osteopat
The use of chiropractors by older adults in the United States
Chiropr Osteopat
Use of complementary medicine in older Americans: results from the Health and Retirement Study
Gerontologist
Cited by (4)
Characterisation of the Multimodal Care Provided by Uk Chiropractors: a Survey
2022, Research SquareDoctor–patient relationships are a perceived barrier to chiropractic use by non-Hispanic Black Americans
2021, Humanities and Social Sciences CommunicationsPilot study survey attributes of chiropractic patients over 55 years of age
2018, Chiropractic Journal of AustraliaThe chiropractic profession: A scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided
2017, Chiropractic and Manual Therapies