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National Center for Complementary and Alternative Medicine

The Use of Complementary

and Alternative Medicine
in the United States
In December 2008, the National Center for Complementary and Alternative Medicine
(NCCAM) and the National Center for Health Statistics (part of the Centers for Disease
Control and Prevention) released new findings on Americans’ use of complementary
and alternative medicine (CAM). The findings are from the 2007 National Health
Interview Survey (NHIS), an annual in-person survey of Americans regarding their
health- and illness-related experiences. The CAM section gathered information on
23,393 adults aged 18 years or older and 9,417 children aged 17 years and under. A
similar CAM section was included in the 2002 NHIS, providing the opportunity to
examine trends in CAM use, too.1

questions such as whether these therapies
are safe and whether they work for the
purposes for which they are used. NCCAM’s
mission is to explore CAM practices using

medicine is used together with conven-

rigorous scientific methods and build an

tional medicine, and alternative medicine

evidence base for the safety and effective-

is used in place of conventional medicine.

ness of these practices.

Integrative medicine combines conven-

36.0%

CAM is a group of diverse medical and

of conventional medicine. Complementary

38.3%

through well-designed scientific studies—

ucts that are not generally considered part

C
 AM Use by U.S.
Adults and Children

About CAM
health care systems, practices, and prod-

Figure 1

How Many People Use CAM

tional and CAM treatments for which there
is evidence of safety and effectiveness.

In the United States, approximately
38 percent of adults (about 4 in 10) and

While scientific evidence exists regarding

approximately 12 percent of children

some CAM therapies, for most there are

(about 1 in 9) are using some form of

key questions that are yet to be answered

11.8%

CAM, shown in figure 1.

1

Adults
(2002)

Adults
(2007)

Children
(2007)

U
 nless noted otherwise, the statistics are for CAM use during the 12 months prior to the 2007 survey.
Comparisons from the 2002 NHIS are indicated.

National Institutes of Health
The Use of Complementary and Alternative Medicine in the United States

Figure 2

CAM Use by Age - 2007


50

44.1%

40

41.0%

40.1%

39.6%
36.3%

32.1%

30

24.2%

20

16.4%
10.7%
7.6%

10

0-4

5-11

12-17

18-29

30-39

40-49

50-59

60-69

70-84

85+

Age

Figure 3

60

Who Uses CAM Most

CAM Use by Race/Ethnicity

Among Adults - 2007

People of all backgrounds use CAM. However, CAM use among
adults is greater among women and those with higher levels of

50.3%

50

education and higher incomes. Figure 2 shows the percentage
of people using CAM by age. Figure 3 shows CAM use by

43.1%

race/ethnicity.

39.9%

40
30

25.5%

23.7%

20

CAM Therapies Used the Most
Nonvitamin, nonmineral natural products are the most commonly
used CAM therapy among adults. Use has increased for several
therapies, including deep breathing exercises, meditation, massage

10

therapy, and yoga. Figure 4 shows the percentage of people using
increases between 2002 and 2007.

Hi

sp

an

ic

k
ac
Bl

n
ia
As

W
hi

te

the most common CAM therapies and therapies with significant
Am
er
Al
as In ican
ka dia
Na n/
tiv
e

2

CAM Therapies Included in the 2007 NHIS: An
asterisk (*) indicates a practitioner-based therapy. For
definitions of these therapies, see the full report or
contact the NCCAM Clearinghouse (see page 4).
Acupuncture*
Meditation
Ayurveda*
Movement therapies
Biofeedback*
Natural products
Chelation therapy*
	
(nonvitamin and nonChiropractic or osteopathic
mineral, such as herbs
	 manipulation*
and other products from
Deep breathing exercises
plants, enzymes, etc.)
Diet-based therapies
Naturopathy*
Energy healing therapy/Reiki*
Progressive relaxation
Guided imagery
Qi gong
Homeopathic treatment
Tai chi
Hypnosis*
Traditional healers*
Massage*
Yoga

Use of Natural Products
The most popular natural products are fish oil/omega 3, glucosamine,
echinacea, and flaxseed. Figure 5 ranks the top 10 natural products
used among adults in 2007 and 2002 (note that the 2007 survey
asked about use in the last 30 days, whereas the 2002 survey asked
about use in the last year).

Health Conditions Prompting CAM Use
People use CAM for an array of diseases and conditions. American
adults are most likely to use CAM for musculoskeletal problems
such as back, neck, or joint pain. The use of CAM therapies for
head or chest colds showed a substantial decrease from 2002 to
2007. Figure 6 ranks the top 10 conditions prompting CAM use
among adults for 2007 and 2002.
The National Center for Complementary and Alternative Medicine

10 Most Common CAM Therapies Among Adults - 2007


Figure 4
20

17.7%

Therapies with significant increases
between 2002 and 2007 are

15
12.7%

	

2007

11.6%	

12.7%

Meditation	

7.6%	

9.4%

Massage	

5.0%	

8.3%

Yoga	

5.1%	

6.1%

Deep breathing	

9.4%

10

2002	

8.6%

8.3%
6.1%

5

3.6%

2.9%

2.2%

Ch

Di

Yo
g

e
M

a
et
Th -Ba
er sed
ap
ie
s
Pr
og
re
Re s
la siv
xa e
tio
Gu
n
id
ed
Im
ag
er
y
Ho
m
eo
Tr pa
ea th
tm ic
en
t

30

2007*

30

2002*

24.1%
21.1%

19.9% 19.8%

12.0% 11.8% 11.7%
10.5%

Gi

Su

a
ce
na
hi
Ec

*Percentages among adults who used natural products in the last 30 days.

9.4%

lo
ba
pp G
ar
le l
m ic
en
Gl
ts
uc
os
am
St
in
.J
e
oh
n’
sW
or
Pe
t
pp
er
m
i
Fi nt
sh
Om O
eg il/
a
3
Su
pp Gin
le ge
m r
So
en
yS
ts
up
pl
em
en
ts

10

g

8.7%

Fi
s
Om h O
eg il/
a
Gl
3
uc
os
am
in
e
Ec
hi
Fl
na
ax
ce
se
a
ed
Oi
l/P
ill
s
Gi
ns
en
Co
g
m
bi
He nat
io
Gi rb P n
nk
ill
s
go
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lo
ba
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on
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pp G
le arl
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zy
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Q10

10

14.9%

Bi

11.3% 11.2% 11.0%

en

13.0%

go

14.1%

nk

15.9%

19.9%

20

ns

20

40.3%

40

37.4%

Gi

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De

10 Most Common Natural Products Among Adults

Figure 5
40

as
sa
g

tio
n
iro
Os pra
te cti
op c 
at
hi
c

ita
M

ed

Br
ea
ep

tu
ra
l

Pr
od

th
i

uc

ts

ng

1.8%

*Percentages among adults who used natural products in the last 12 months.

Diseases/Conditions for Which CAM Is Most Frequently Used Among Adults


Figure 6
20

20
17.1%
16.8%

15

2007

15

2002
9.5%

10

10

6.6%

5.2%

1.4%

4.9%

4.5%

3.7%

3.1%

2.4%

2.2%

H
Ch ea
es d o
tC r
ol
Ne d
ck
Pa
in
Jo
in
tP
ai
n
Ar
An
th
xi
rit
et
is
y/
De
pr
es
sio
St
n
om
Se
ac
h
ve
Up
re
se
H
or ead t
M ac
Re igra he
cu
i
rri ne
ng
Pa
in
In
so
m
m
ia

1.6%

Pa
in

1.8%

Ba
ck

2.0%

Ch Hea
es d o
tC r
M
ol
us
d
cu
O
Se losk th
ve
el er
et
re
al
H
or ead
M ac
ig he
ra
in
In e
so
m
ni
a

er
ol

y

2.1%

es
t

is

4.9%

5

2.8%

An
x

rit

Ar
th

tP
ai
n

Jo
in

Pa
in

Ne
ck

Ba
c

k

Pa
in

3.5%

ie
t

5

Ch
ol

5.9%

3
The Use of Complementary and Alternative Medicine in the United States

10 Most Common Therapies Among Children

Figure 7

The 2007 NHIS asked selected adult respondents about CAM
use by children in their households. Overall, approximately
12 percent of children use some form of CAM. Use is greater
among:

3.9%

4

2.8%

3

• Children whose parents used CAM (23.9%)
• 
Adolescents aged 12-17 (16.4%), compared to
younger children
•  hite children (12.8%), compared to Hispanic
W
children (7.9%) and black children (5.9%)
•  hildren whose parents had higher education
C
levels (more than high school: 14.7%)
• Children with six or more health conditions (23.8%)
•  hildren whose families delayed conventional care
C
because of cost (16.9%)

2.2%

2
1.3%
1.1%

1.0%

1.0%

0.8%

1

Yo
ga
m
eo
Tr pa
Tr
ea th
ad
tm ic
iti
en
on
t
al
He
al
er
s
M
as
sa
ge
M
ed
it
Di atio
et
n
Th -Ba
er sed
Pr a p i
og es
Re res
la siv
xa e
tio
n

0.5%

Na
Ch Pro tura
iro du l
c
Os pra ts
te cti
op c 
De
ep ath
ic
Br
ea
th
in
g

Figures 7-9 show survey findings on CAM use by
children, including top therapies, natural products, and
diseases/conditions.

Most Common Natural Products Among Children*

Figure 8
About NCCAM

2.1%

NCCAM’s mission is to explore complementary and alternative healing
practices in the context of rigorous science, train CAM researchers, and
disseminate authoritative information to the public and professionals.

40

To Obtain the Report

30

The report’s citation is Barnes PM, Bloom B, Nahin R. CDC National Health
Statistics Report #12. Complementary and Alternative Medicine Use Among
Adults and Children: United States, 2007. December 2008. It is available,
along with a press release and graphics, at nccam.nih.gov/news/camstats.htm.
People who do not have access to the Internet can contact the NCCAM
Clearinghouse (see below) for a copy.

Ho

CAM Use Among Children

20

37.2%
30.5%

17.9%

Co

Fl

ax
s
Oi eed
l/P
ill
s

m
bi
n
He ati
rb on
Pi
lls

Fi
s
Om h O
eg il/
a
3

Ec

hi

na

ce

a

The NCCAM Clearinghouse provides information on CAM and NCCAM,
including publications and searches of Federal databases of scientific and
medical literature. The Clearinghouse does not provide medical advice,
treatment recommendations, or referrals to practitioners.
Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site: nccam.nih.gov

16.7%

10

For More Information
NCCAM Clearinghouse

*Percentages among children who used natural products in the last 30 days.

E-mail: info@nccam.nih.gov

Additional Reports

Figure 9

NCCAM plans to collaborate with NCHS on further analyses of
the survey findings. Among the areas of interest to the researchers are
CAM costs and spending, dietary supplements, and reasons for CAM
use. Future reports will be published by NCHS and posted on the
NCCAM web site.

D
 iseases/Conditions for Which CAM Is
Most Frequently Used Among Children

8
6.7%

7

6.6%

6
4.8%

5

4.2%

4
2.5%

3
U.S. Department of Health
and Human Services

In

so

m

ni
a

D
AD
H

lo Ot
sk he
el r
et
al
cu
us
M

Pa
in

Ch He
es ad
tC o
ol r
d
An
xi
et
y/
St
re
ss

Created December 2008 D424

*D424*

Ne
ck

National Center for Complementary
and Alternative Medicine

1

ck
/

National Institutes of Health

1.8%

2

Ba

4

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Cam use in usa

  • 1. National Center for Complementary and Alternative Medicine The Use of Complementary and Alternative Medicine in the United States In December 2008, the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) released new findings on Americans’ use of complementary and alternative medicine (CAM). The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under. A similar CAM section was included in the 2002 NHIS, providing the opportunity to examine trends in CAM use, too.1 questions such as whether these therapies are safe and whether they work for the purposes for which they are used. NCCAM’s mission is to explore CAM practices using medicine is used together with conven- rigorous scientific methods and build an tional medicine, and alternative medicine evidence base for the safety and effective- is used in place of conventional medicine. ness of these practices. Integrative medicine combines conven- 36.0% CAM is a group of diverse medical and of conventional medicine. Complementary 38.3% through well-designed scientific studies— ucts that are not generally considered part C AM Use by U.S. Adults and Children About CAM health care systems, practices, and prod- Figure 1 How Many People Use CAM tional and CAM treatments for which there is evidence of safety and effectiveness. In the United States, approximately 38 percent of adults (about 4 in 10) and While scientific evidence exists regarding approximately 12 percent of children some CAM therapies, for most there are (about 1 in 9) are using some form of key questions that are yet to be answered 11.8% CAM, shown in figure 1. 1 Adults (2002) Adults (2007) Children (2007) U nless noted otherwise, the statistics are for CAM use during the 12 months prior to the 2007 survey. Comparisons from the 2002 NHIS are indicated. National Institutes of Health
  • 2. The Use of Complementary and Alternative Medicine in the United States Figure 2 CAM Use by Age - 2007 50 44.1% 40 41.0% 40.1% 39.6% 36.3% 32.1% 30 24.2% 20 16.4% 10.7% 7.6% 10 0-4 5-11 12-17 18-29 30-39 40-49 50-59 60-69 70-84 85+ Age Figure 3 60 Who Uses CAM Most CAM Use by Race/Ethnicity Among Adults - 2007 People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of 50.3% 50 education and higher incomes. Figure 2 shows the percentage of people using CAM by age. Figure 3 shows CAM use by 43.1% race/ethnicity. 39.9% 40 30 25.5% 23.7% 20 CAM Therapies Used the Most Nonvitamin, nonmineral natural products are the most commonly used CAM therapy among adults. Use has increased for several therapies, including deep breathing exercises, meditation, massage 10 therapy, and yoga. Figure 4 shows the percentage of people using increases between 2002 and 2007. Hi sp an ic k ac Bl n ia As W hi te the most common CAM therapies and therapies with significant Am er Al as In ican ka dia Na n/ tiv e 2 CAM Therapies Included in the 2007 NHIS: An asterisk (*) indicates a practitioner-based therapy. For definitions of these therapies, see the full report or contact the NCCAM Clearinghouse (see page 4). Acupuncture* Meditation Ayurveda* Movement therapies Biofeedback* Natural products Chelation therapy* (nonvitamin and nonChiropractic or osteopathic mineral, such as herbs manipulation* and other products from Deep breathing exercises plants, enzymes, etc.) Diet-based therapies Naturopathy* Energy healing therapy/Reiki* Progressive relaxation Guided imagery Qi gong Homeopathic treatment Tai chi Hypnosis* Traditional healers* Massage* Yoga Use of Natural Products The most popular natural products are fish oil/omega 3, glucosamine, echinacea, and flaxseed. Figure 5 ranks the top 10 natural products used among adults in 2007 and 2002 (note that the 2007 survey asked about use in the last 30 days, whereas the 2002 survey asked about use in the last year). Health Conditions Prompting CAM Use People use CAM for an array of diseases and conditions. American adults are most likely to use CAM for musculoskeletal problems such as back, neck, or joint pain. The use of CAM therapies for head or chest colds showed a substantial decrease from 2002 to 2007. Figure 6 ranks the top 10 conditions prompting CAM use among adults for 2007 and 2002.
  • 3. The National Center for Complementary and Alternative Medicine 10 Most Common CAM Therapies Among Adults - 2007 Figure 4 20 17.7% Therapies with significant increases between 2002 and 2007 are 15 12.7% 2007 11.6% 12.7% Meditation 7.6% 9.4% Massage 5.0% 8.3% Yoga 5.1% 6.1% Deep breathing 9.4% 10 2002 8.6% 8.3% 6.1% 5 3.6% 2.9% 2.2% Ch Di Yo g e M a et Th -Ba er sed ap ie s Pr og re Re s la siv xa e tio Gu n id ed Im ag er y Ho m eo Tr pa ea th tm ic en t 30 2007* 30 2002* 24.1% 21.1% 19.9% 19.8% 12.0% 11.8% 11.7% 10.5% Gi Su a ce na hi Ec *Percentages among adults who used natural products in the last 30 days. 9.4% lo ba pp G ar le l m ic en Gl ts uc os am St in .J e oh n’ sW or Pe t pp er m i Fi nt sh Om O eg il/ a 3 Su pp Gin le ge m r So en yS ts up pl em en ts 10 g 8.7% Fi s Om h O eg il/ a Gl 3 uc os am in e Ec hi Fl na ax ce se a ed Oi l/P ill s Gi ns en Co g m bi He nat io Gi rb P n nk ill s go Bi lo ba Ch on dr oi tin Su pp G le arl m ic Co en en ts zy m e Q10 10 14.9% Bi 11.3% 11.2% 11.0% en 13.0% go 14.1% nk 15.9% 19.9% 20 ns 20 40.3% 40 37.4% Gi Na De 10 Most Common Natural Products Among Adults Figure 5 40 as sa g tio n iro Os pra te cti op c at hi c ita M ed Br ea ep tu ra l Pr od th i uc ts ng 1.8% *Percentages among adults who used natural products in the last 12 months. Diseases/Conditions for Which CAM Is Most Frequently Used Among Adults Figure 6 20 20 17.1% 16.8% 15 2007 15 2002 9.5% 10 10 6.6% 5.2% 1.4% 4.9% 4.5% 3.7% 3.1% 2.4% 2.2% H Ch ea es d o tC r ol Ne d ck Pa in Jo in tP ai n Ar An th xi rit et is y/ De pr es sio St n om Se ac h ve Up re se H or ead t M ac Re igra he cu i rri ne ng Pa in In so m m ia 1.6% Pa in 1.8% Ba ck 2.0% Ch Hea es d o tC r M ol us d cu O Se losk th ve el er et re al H or ead M ac ig he ra in In e so m ni a er ol y 2.1% es t is 4.9% 5 2.8% An x rit Ar th tP ai n Jo in Pa in Ne ck Ba c k Pa in 3.5% ie t 5 Ch ol 5.9% 3
  • 4. The Use of Complementary and Alternative Medicine in the United States 10 Most Common Therapies Among Children Figure 7 The 2007 NHIS asked selected adult respondents about CAM use by children in their households. Overall, approximately 12 percent of children use some form of CAM. Use is greater among: 3.9% 4 2.8% 3 • Children whose parents used CAM (23.9%) • Adolescents aged 12-17 (16.4%), compared to younger children • hite children (12.8%), compared to Hispanic W children (7.9%) and black children (5.9%) • hildren whose parents had higher education C levels (more than high school: 14.7%) • Children with six or more health conditions (23.8%) • hildren whose families delayed conventional care C because of cost (16.9%) 2.2% 2 1.3% 1.1% 1.0% 1.0% 0.8% 1 Yo ga m eo Tr pa Tr ea th ad tm ic iti en on t al He al er s M as sa ge M ed it Di atio et n Th -Ba er sed Pr a p i og es Re res la siv xa e tio n 0.5% Na Ch Pro tura iro du l c Os pra ts te cti op c De ep ath ic Br ea th in g Figures 7-9 show survey findings on CAM use by children, including top therapies, natural products, and diseases/conditions. Most Common Natural Products Among Children* Figure 8 About NCCAM 2.1% NCCAM’s mission is to explore complementary and alternative healing practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. 40 To Obtain the Report 30 The report’s citation is Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 2008. It is available, along with a press release and graphics, at nccam.nih.gov/news/camstats.htm. People who do not have access to the Internet can contact the NCCAM Clearinghouse (see below) for a copy. Ho CAM Use Among Children 20 37.2% 30.5% 17.9% Co Fl ax s Oi eed l/P ill s m bi n He ati rb on Pi lls Fi s Om h O eg il/ a 3 Ec hi na ce a The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. Toll-free in the U.S.: 1-888-644-6226 TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 Web site: nccam.nih.gov 16.7% 10 For More Information NCCAM Clearinghouse *Percentages among children who used natural products in the last 30 days. E-mail: info@nccam.nih.gov Additional Reports Figure 9 NCCAM plans to collaborate with NCHS on further analyses of the survey findings. Among the areas of interest to the researchers are CAM costs and spending, dietary supplements, and reasons for CAM use. Future reports will be published by NCHS and posted on the NCCAM web site. D iseases/Conditions for Which CAM Is Most Frequently Used Among Children 8 6.7% 7 6.6% 6 4.8% 5 4.2% 4 2.5% 3 U.S. Department of Health and Human Services In so m ni a D AD H lo Ot sk he el r et al cu us M Pa in Ch He es ad tC o ol r d An xi et y/ St re ss Created December 2008 D424 *D424* Ne ck National Center for Complementary and Alternative Medicine 1 ck / National Institutes of Health 1.8% 2 Ba 4