Factors Associated With Pediatric Use of Complementary and Alternative Medicine

Gurjeet S. Birdee; Russell S. Phillips; Roger B. Davis; Paula Gardiner

doi:10.1542/peds.2009-1406

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TABLE 1

Characteristics of CAM Users Younger Than 18 Years in the United States Excluding Use of Vitamins and Minerals (n = 9414)

Characteristic	CAM Users (N = 1055), %	Non-CAM Users (N = 8254), %
Demographic
Age, y^{^a}
Infant and toddler, 0–4	17.8	29.4
Child, 5–11	34.5	38.3
Adolescent, 12–17	47.7	32.3
Gender
Boys	48.3	51.5
Girls	51.7	48.5
Race^{^a}
Non-Hispanic white	71.6	55.8
Non-Hispanic black	9.1	16.6
Non-Hispanic Asian	3.8	4.2
Non-Hispanic all other races	1.9	1.5
Hispanic	13.6	21.8
Income^{^a}
$19 999 or less	9.4	16.6
$20 000–$34 999	12.0	17.1
$35 000–$64 999	26.6	26.8
$65 000 or more	51.9	39.4
Region^{^a}
West	27.6	22.1
Midwest	27.3	23.3
South	27.1	38.1
Northeast	18.0	16.6
Highest education of either parent^{^a}
Less than high school	5.4	13.7
High school	15.3	23.6
Some college	28.2	30.1
4-y college or more	51.2	32.6
Insurance
Medicaid/Medicare	16.1	25.2
Private	62.6	53.4
Uninsured	7.9	13.3
Unknown	13.3	7.9
Prescription medication use in the previous 3 mo^{^a}	23.1	10.9
Difficulty affording prescription in the previous 12 mo^{^a}	3.8	1.8
Delayed medical care because of difficulties with access^{^a}	15.7	8.9
Missed school days because of illness^{^a}
0–2	47.2	60.1
3–5	29.0	24.7
5–10	13.1	10.2
>10	10.7	5.0
Medical conditions and/or symptoms
ADHD^{^a}	12.4	6.0
Allergies
Hayfever^{^a}	17.9	9.1
Respiratory allergy^{^a}	17.1	8.6
Food/diet allergy^{^a}	7.6	3.5
Other^{^a}	7.9	4.6
Asthma	12.8	8.7
Dermatologic, acne and/or warts^{^a}	16.5	7.6
Developmental disorders^{^a}	7.5	3.1
Fever^{^a}	41.1	27.8
Gastrointestinal
Nausea/vomiting^{^a}	33.8	18.9
Abdominal pain^{^a}	10.9	4.2
Reflux^{^a}	9.6	3.6
Constipation^{^a}	8.3	4.3
Headaches^{^a}	13.2	6.6
Insomnia^{^a}	12.2	4.1
Learning disability^{^a}	13.7	6.6
Musculoskeletal^{^a}	9.7	2.6
Overweight^{^a,^b}	8.7	4.8
Psychological
Depression^{^a}	7.2	2.3
Anxiety and/or stress^{^a}	21.6	6.1
Respiratory infections in the previous 12 mo
Ear infections (≥3)	6.5	4.9
Sinusitus^{^a}	14.2	6.3
Chest/head colds^{^a}	66.0	53.0
Influenza/pneumonia^{^a}	11.1	5.8
Pharyngitis^{^a}	53.9	35.1
Parental use of CAM^{^c}	64.6	27.6

↵a P ≤ .005 for differences between CAM users and non-CAM users.
↵b Child reported by adult respondent as being overweight.
↵c Parental use of CAM represents a subset of all children sampled (n = 7455) where a parental figure (parent, grandparent, foster parent, or legal guardian) completed the adult survey on CAM use.
Data source: NHIS 2007. Weighted percentages were extrapolated from the US census (2000) for the child civilian, noninstitutionalized household population.

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TABLE 2

Sociodemographic Factors and Medical Conditions Independently Associated With All CAM Use and the 3 Most Common CAM Modalities Among Individuals Younger Than 18 Years

Factor	All CAM Use, aOR (95% CI)^{^a}	Mind Body Use, aOR (95% CI)^{^b}	Biologically Based Therapies, aOR (95% CI)^{^c}	Manipulation/Body Work, aOR (95% CI)^{^d}
Sociodemographic
Age, y
Infant and toddler, 0–4	Reference	Reference	Reference	Reference
Child, 5–11	1.08 (0.74–1.58)	1.42 (0.76–2.67)	1.60 (1.03–2.51)	1.18 (0.81–1.72)
Adolescent, 12–17	1.61 (1.11–2.34)	2.45 (1.36–4.40)	2.15 (1.35–3.44)	1.98 (1.39–2.81)
Race
Non-Hispanic white	—	—	Reference	Reference
Non-Hispanic black	—	—	0.60 (0.37–0.96)	0.58 (0.37–0.92)
Non-Hispanic Asian	—	—	0.70 (0.38–1.27)	0.56 (0.25–1.26)
Non-Hispanic all other races	—	—	1.35 (0.49–3.72)	0.72 (0.21–2.54)
Hispanic	—	—	0.62 (0.40–0.95)	0.56 (0.41–0.78)
Region
South	Reference	Reference	Reference	—
Midwest	1.35 (1.04–1.74)	1.25 (0.85–1.82)	0.98 (0.67–1.43)	—
Northeast	1.36 (1.02–1.80)	1.54 (1.06–2.26)	1.02 (0.64–1.64)	—
West	2.05 (1.62–2.59)	1.97 (1.43–2.70)	1.89 (1.24–2.90)	—
Income
$19 999 or less	—	—	—	Reference
$20 000–$34 999	—	—	—	0.75 (0.44–1.27)
$35 000–$64 999	—	—	—	1.32 (0.90–1.96)
$65 000 or more	—	—	—	1.48 (1.03–2.11)
Highest education of either parent
Less than high school	Reference	Reference	Reference	—
High school	1.89 (1.22–2.92)	1.43 (0.79–2.60)	1.55 (0.81–2.99)	—
Some college	2.31 (1.56–3.43)	2.01 (1.17–3.45)	1.71 (0.89–3.26)	—
4-y college or more	4.33 (2.92–6.42)	4.39 (2.50–7.69)	3.55 (1.88–6.69)	—
Prescription medication use in the previous 3 mo	1.51 (1.19–1.92)	—	—	—
Delayed health care because of access and/or economic barriers	—	—	1.50 (1.07–2.10)	—
Medical conditions or symptoms
Abdominal pain	—	—	—	1.73 (1.12–2.68)
Anxiety and stress	2.54 (1.89–3.42)	4.02 (2.92–5.53)	—	—
Dermatologic	1.35 (1.03–1.78)	—	—	—
Fever	—	—	1.47 (1.08–2.00)	—
Insomnia	—	1.63 (1.11–2.41)	2.60 (1.76–3.85)	—
Musculoskeletal	1.94 (1.31–2.87)	—	—	3.69 (2.50–5.44)
Nausea and/or vomiting	1.62 (1.27–2.05)	1.79 (1.32–2.43)	—	1.49 (1.08–2.05)
Reflux	1.56 (1.07–2.28)	—	1.72 (1.10–2.69)	—
Sinusitis	1.54 (1.11–2.14)	—	1.45 (1.02–2.05)	—

↵a ORs have been adjusted for age, region, parental education, prescription medication use, and medical conditions with a P value of ≤.05.
↵b ORs have been adjusted for age, region, parental education, insurance status, and medical conditions with a P value of ≤.05.
↵c ORs have been adjusted for age, race, region, parental education, delays in access to medical care, and medical conditions with a P value of ≤.05.
↵d ORs have been adjusted for age, race, income, and medical conditions with a P value of ≤.05.