Social determinants affecting the use of complementary and alternative medicine in Japan: An analysis using the conceptual framework of social determinants of health

Abstract

This study aims to use the conceptual framework of social determinants of health (SDH) to elucidate the social determinants that affect the use of complementary and alternative medicine (CAM) from the perspectives of both intermediary and structural determinants. Data were derived from a survey mailed to 1,500 randomly selected residents (20–69 years old; May–July 2009) of Sendai city in Japan. A generalized linear model was used in the analysis, with CAM use over the past one month as the dependent variable, SDH structural and intermediary determinants as independent variables, and demographic characteristics, indicators of health status, and the evaluation of health or healthcare systems as control variables. The prevalence of CAM usage was 62.1%. The generalized linear model showed that middle subjective social status (OR = 1.47; 95% CI: 1.04–2.07) as structural determinants was significantly associated with CAM usage. Adding the intermediary determinants, the same effect was observed. When demographic characteristics, indicators of health status, and the evaluation of health or healthcare systems were introduced as control variables, the associations of the structural determinants disappeared, revealing that hope (OR = 1.25; 95%CI: 1.04–1.50) as intermediary determinants was associated with the use of CAM. Female sex (OR = 1.47; 95% CI: 1.02–2.12) and health anxiety (OR = 1.68; 95% CI: 1.20–2.34) were associated with CAM usage. We found that intermediary rather than structural determinants were associated with CAM usage. Hope as an intermediary determinant was particularly associated with CAM usage.

Exploring socioeconomic inequalities in the use of medicinal herbs among Iranian households: evidence from a national cross-sectional survey

“…This finding can be explained by the fact that higher SES individuals can afford to buy medicinal herbs due to their higher ability to pay. This observation is consistent with previous studies, in which affordability is one of the most important factors for MH usage [ 17 – 19 , 31 , 32 ]. A study on the use of herbal medicine in Taiwan indicated that CHM use among pregnant women with a higher level of education and larger income had greater rates of CHM usage [ 33 ].…”

“…over the past month. Based on the availability of data in the HIES and previous studies [ 17 – 19 ], we used the gender of household head, age of household head, education status of household head, a constructed wealth index of households (as a proxy for households’ socioeconomic status), residential area (urban/rural), and development stats of province based on their HDI score (low, middle, and high) as the determinants of MH use in households. Province-level data on HDI was accessed from the Institute for Management Research at Radboud University [ 26 ].…”

“…Existing literature highlights that many factors (e.g., education, income, ethnicity, accessibility, and affordability) affected MH use in different countries [ 17 – 19 ]. In the case of Iran, most of the studies on MH use and its main determinants have been focused on specific groups such as pregnant women and those with special health conditions like hypertension, diabetes, HIV, and mental health disorders [ 6 , 11 , 18 , 20 – 22 ].…”

Prevalence, expenditures, and associated factors of purchasing non-prescribed Chinese herbal medicine in Taiwan

“…With the growing knowledge of and positive attitudes towards the self-management of health and medical care around the world, complementary alternative medicine (CAM) is increasing been widely used by people in Western and Asian countries [ 1 – 3 ]. It has been reported that the one-year prevalence of CAM use among the general population in Europe, the United States, and Japan was 25.9% in 2014, 33.2% in 2012, and 62.1% in 2009, respectively [ 1 – 3 ]. According to an estimation made based on a national survey, the total out-of-pocket expenditures for various types of complementary health approaches in the United States were as high as $30.2 billion [ 4 ].…”

The impact of uncertainty in society on the use of traditional, complementary and alternative medicine: a comparative study on visits to alternative/traditional/folk health care practitioners

“…Various types of TCAM among various countries are used by women [13–16], middle-aged people [16–19], and people with health issues [16, 20–22]. Furthermore, TCAM usage was found to be related to individual psychological determinants including hope [23], health anxiety [24], and belief in the efficacy of TCAM [25, 26]. In addition to these biological and psychological determinants, TCAM usage is also associated with sociological determinants such as culture and customs that surround the healthcare domain.…”