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 C AM 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. T he 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, C AM was associated with higher number of comorbidities (OR=1.24, 95% C I: 1.06–1.45), older age (OR=1.09, 95% C I: 1.01–1.17) and more years of education (OR=1.24, 95% C I: 1.03–1.49). Adding neighborhood variables attenuated effects of comorbidity (OR=1.17, 95% C I: 0.99–1.39); residence in more racially integrated neighborhoods (OR=1.03, 95% C I: 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