NEWS

Ethnicity May Affect Alternative, Complementary Therapy Choices

Jemarion Jones

With the increasing acceptance of complementary and alternative medicine among society in general, researchers are narrowing their focus and taking a look at CAM use among minorities to determine if ethnicity influences therapy choices.

Gertraud Maskarinec, M.D., Ph.D., of the University of Hawaii at Manoa recently looked at CAM use among cancer patients from different racial/ethnic populations in Hawaii. (It should be noted that in Hawaii, no one ethnic group is in the majority.) CAM types used among the patients include religious healing or prayer, vitamins and nutritional supplements, and special diets.

Maskarinec found CAM use highest among Filipino and white patients, intermediate for Native Hawaiians and Chinese, and significantly lower among Japanese. He also found ethnic preferences. For example, herbal medicines were preferred by Chinese, Hawaiian healing by Native Hawaiians, and religious healing and prayer by Filipinos.

Differences

Maskarinec offered his own speculations on these differences, particularly on the low use of CAM among the Japanese participants. "We think that . . . the Japanese-Americans in Hawaii are more likely to accept advice from the oncologists and less likely to search for alternatives elsewhere . . . as a part of the Japanese tradition, it is not customary to question physicians’ recommendations."

Marion M. Lee, Ph.D., from the University of California at San Francisco, also examined the use of alternative therapies by women of different ethnic groups with breast cancer. Latino, white, African-American, and Chinese women participated in the study.

About one-half of the women used at least one type of alternative therapy, and about one-third used two types. Lee noted that the therapies used and the factors influencing the choice of therapy varied by ethnicity.

African-American women most often used spiritual healing (36%), Chinese most often used herbal remedies (22%), and Latino women most often used dietary therapies (30%) and spiritual healing (26%). Among whites, 35% used dietary methods and 21% used methods such as massage and acupuncture.

No Clear Explanation

According to Lee, her data did not provide a clear explanation for the differences. However, she speculated that the use of herbal therapies among Chinese women may be because of the prevalence of herbal use by the Chinese in general. In African-Americans, the high use of spiritual healing may indicate a greater focus on spirituality and religious faith. Lee suggested that future studies examine the cultural origins of different therapy choices for both conventional and alternative therapies.

However, a pilot study in New York revealed that ethnic differences sometimes cannot account for differences in CAM use. Linda Cusham, Ph.D., from Columbia University, New York, conducted focus groups with two groups of African-American women and two groups of Latino women ages 18–40 years and 41–80 years. The most commonly used complementary therapies for both groups were teas and herbs, vitamins and nutritional supplements, prayer and spiritual healing, and meditation and relaxation techniques.

CAM use was most common among the older women in both groups. According to Cushman, few racial and ethnic differences emerged in patterns of CAM use. Older women in both groups generally expressed more positive views of CAM and some reservations about conventional medicine. The younger women, however, expressed more reservations about CAM and stressed the need for knowledge of conventional remedies.

‘Many Factors’

"Intracultural variability is based on many factors," said Lee Pachter, D.O., of the University of Connecticut School of Medicine. He said these factors can include social class, socioeconomic status, the availability of medical and complementary medicine resources, how well people have integrated with a new or different culture, how many generations have lived outside the culture of origin, and what type of community they now live in.

While the reasons for differences may vary, most researchers agree that understanding the motivation for certain choices is critical to optimal care.

"If we understood the reasons for their choices better, we may be able to offer them something else that addresses their needs," said Maskarinec. "For example, some data suggest that CAM users have more unmet emotional needs and could benefit from support services that are not available in most oncologists’ offices."



             
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