Academic journal article Rural Society

Rural Diversity in Cam Usage: The Relationship between Rural Diversity and the Use of Complementary and Alternative Medicine Modalities

Academic journal article Rural Society

Rural Diversity in Cam Usage: The Relationship between Rural Diversity and the Use of Complementary and Alternative Medicine Modalities

Article excerpt


Gmplementary and alternative medicine (CAM) a term used to define a group of health care modalities that are not 'part of the dominant medical system' (Panel on Definition and Description 1997: 50). The modalities included under the term are a range of modalities with very different modes of practice (Cohen 2000). While other terms such as 'complementary', 'unconventional', 'alternative' and 'holistic' have been used to describe this group of modalities, 'complementary and alternative medicine' has been one of the most commonly used terms, and is used in this paper.

In the kte 1990s and early 200Os 'rural' places in Australia and the USA have been linked with high general CAM use. For example, in Kermode's study (2001) on the north coast of New South Wales, Australia, current overall rural CAM use was 67% (Kermode et al. 1998). In rural Illinois, USA, Herron and Classer (2003) found that overall CAM use was 63% (Herron & Classer 2003). This CAM use was higher than the 28% to 52% found in national and regional studies with a predominantly metropolitan cohort carried out in the UK, USA and Australia (Astin 1998; Eisenberg et al. 1998; MacLennan et al. 2002; Thomas et al. 2001). Although the time at which these studies was conducted and the instruments used differ, the trend to higher rural CAM use is consistent and the study by MacLennan, Wilson & Taylor (2002) compared rural and metropolitan area expenditure on CAM and found rural expenditure was higher. Rural CAM theorists, however, have not addressed the question of differences in individual CAM use in rural places.

High CAM use in rural places is contrary to many lay and scholarly perceptions about rural health care. Rural people are more likely to have conservative health care values and avoid or delay attending to health care needs unless the problems are debilitating and impeding their capacity to work (Dade-Smith 2004; Humphreys, Mathews-Cowey & Rofley 1996). Traditional health care values might lead to reduced CAM uptake because CAM modalities are not central to traditional modes of health care (Smith et al. 2004; Blue 2002). As many of the CAM modalities are linked to health prevention and wellness, a tendency to avoid or delay seeking health care might also results in less CAM usage (Johnson 1999). Rural CAM use is also assumed to be lower because of access issues (del Mundo, Shepherd & Marose 2002; Wilkinson & Simpson 2001).

The PUC-CAM study looked at individual CAM use in rural and metropolitan places in Victoria, Australia (n=459) (Robinson, Chesters & Cooper 2007; Robinson, Chesters, Cooper & McGrail 2007). This study moved beyond consideration of the generic use of CAM and the concerns of conventional medicine with CAM to the exploration of the diversity within CAM use. It investigated beliefs about the Tiolistic health care' environment encompassing natural healing and scientific medicine in health care and patient and health care provider responsibilities. It also investigated possible links between CAM usage and characteristics popularly believed to be more or less prevalent in rural people, and the health information sources used by CAM users.

This paper describes and discusses the diversity between the rural places surveyed and the impact of rural diversity on the use of twenty-two CAM modalities. It is one of a series of papers on the PUCCAM study that have reported on the survey method and findings. This paper reports that the overall CAM use of the rural respondents in this study was similar to the overall CAM use by the metropolitan respondents. It details the differences in the use of modalities in each of the rural places and considers access to modalities. This paper also briefly describes the characteristics of each of the places. It concludes that the places labelled peri-metropolitan, sea change and agricultural were different and this difference perhaps impacts on CAM use. This may help us towards a better more complex understanding of the health care needs of rural people. …

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