Alternative health care is becoming more acceptable to Americans because of their concern for wellness. The issue of accessibility is not quite as clear, however.
Pressed by the aging baby boom generation, an increasing number of insurance companies are responding to market pressures for coverage of selective alternative therapies, says Arizona State University adjunct professor of geography Rena Gordon and colleagues in the recently-released book, "Alternative Therapies: Expanding Options in Health Care."
Biomedicine has traditionally dominated the medical field, but an increasing number of Americans are going beyond biomedicine for health care treatment and prevention, Gordon said.
Gordon and her co-authors cited a Harvard University study that reported one-third of the adult American population used some type of unconventional therapy and a third of that segment sought the treatment of an alternative practitioner.
Alternative health care includes body healing, mind/spirit and cross-cultural efforts.
"The first major reason that people are using alternatives today, however, is dissatisfaction with aspects of Western biomedicine," Gordon said. "People have found that often it is ineffective in curing chronic diseases and it emphasizes cure rather than prevention. Many medicines can have serious side effects, biomedicine can be very austere and uncaring,
costs have soared and the benefits of biomedicine are often poorly distributed."
Aging baby boomers are interested in health and wellness, and they are open to using health care outside the boundaries of biomedicine. Boomers shop the medical marketplace for something that works for them, using both biomedicine and complementary health practices.
As the U.S. health care system focuses on cost containment, there has been a transition from fee-for-service and indemnity insurance payments to managed care plans. Some insurers have found that covering alternative therapies is cost effective.
"Insurance companies are increasingly covering alternative practices and this may provide more equitable care," Gordon said.
Alternative practitioners use several marketing strategies to reach patient-consumers. They advertise in the media, build referral networks with other providers, use central referral services, participate in health and natural products expositions and form associations with natural and
health food stores.
While metropolitan areas contain the highest number of alternative practitioners, nonmetropolitan, urbanized areas have the highest number of alternative practitioners per capita. That finding from Alan Osborne's research in California, Oregon and Washington appears in chapter 7 of "Alternative Therapies: Expanding Options in Health Care."
Gordon said, "It may be that both alternative practitioners and their patients are attracted to secondary urban centers either as equity refugees or as lifestyle refugees who leave the city crowds and pollution for places with more amenities."
Alternative healers are here to stay, Gordon says, and will probably increase in importance.
"How alternatives will fare in competition with biomedicine in this era of health reform is an open question and one that should be studied by geographers and other social scientists," Gordon said. "The question of equity has an ambiguous answer. We can see gains in overall availability and accessibility, but there may be losses in equity by certain segments of
the population, such as rural and inner city minority populations."
Equity is a hard question to assess, Gordon >
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le on the geography of the availability, accessibility and utilization of alternative therapies. Even less is known about underground alternative practitioners who are difficult to study becausethey operate outside typical legal and medical channels.
Gordon and Wilbert Gesler, professor of geography at the University of North Carolina, presented the paper "Alternative and Complementary Health Practices: Implications on Inequities" at the Association of American Geographers annual meeting in Boston in March.