Complementary and Alternative Medicine Use among Older Urban African Americans: Individual and Neighborhood Associations

Purpose: Older African Americans may be vulnerable to risks due to impaired healthcare access and understudied complementary and alternative medicine (CAM) use and other traditions. We describe CAM use among older African Americans in Baltimore, MD, examining associations among CAM and sociodemographic, health status, healthcare utilization and neighborhood factors. Methods: Cross-sectional telephone survey of 95 African Americans ages ≥ 60 on use of CAM modalities (herb/home remedies, prayer, group spiritual practices, meditation/visualization, massage, chiropractic, acupuncture, relaxation/ biofeedback) in prior year. Results: A large majority (88.4%) reported CAM use in the previous year; 50.5% reported CAM use excluding individual prayer. The most commonly reported modalities were individual prayer (96.8%), herbs/home remedies (29.5%) and group spiritual practices (17.0%). Most (77.3%) herbal/home remedy users disclosed use to providers. In multivariable logistic regression at the individual level, CAM was associated with higher number of comorbidities (OR=1.24, 95% CI: 1.06-1.45), older age (OR=1.09, 95% CI: 1.01-1.17) and more years of education (OR=1.24, 95% CI: 1.03-1.49). Adding neighborhood variables attenuated effects of comorbidity (OR=1.17, 95% CI: 0.99-1.39); residence in more racially integrated neighborhoods (OR=1.03, 95% CI: 1.00-1.06; p=0.047) was also important. Conclusions: CAM use was greater than expected. Although disclosure of herb use was high, providers should probe for CAM use.