Is There An Alternative Therapy Type

Fifteen women and six men took part in this study. In general this distribution reflects the higher female rates of participation in alternative health care reported in Canada (Achilles et al. 1999), the US (Eisenberg et al. 1998) and the UK (Fulder 1996). As Sharma (1990:128) concludes: "There is consistent evidence that higher proportions of alternative medicine patients are female."4 For instance, 21 percent of Canadian women, in contrast to 17 percent of Canadian men, used alternative health care in 2000/2001 (Canadian Institute for Health Information 2002; Gill 2003) and according to the Canada Health Monitor (1993), among a sub-sample5 of users of alternative health therapies they surveyed, the female/male ratio was one point five to one. Similarly, in their UK study, Thomas et al. (2001) found that just over 56 percent of female and 43 percent of males reported using alternative therapies. The male/female gap in user-ship is narrower in the US with 52 percent of women and 48 percent of men reporting participation in alternative health care (Eisenberg et al. 1998).

However, Eisenberg et al. (1993:248, 1998) argue that there are "no significant differences according to sex" in their US research and Northcott and Bachynsky (1993) found that the female/male ratio in their Canadian study was almost one to one. Further, Blais (2000) reports that male participation in alternative therapies is on the rise in Quebec. It is also likely that male rates of usership of alternative health care are under-represented in much of the research on these therapies. Males are vulnerable to under-representation if only for the fact that many men are unwilling to discuss issues relating to their health and health care, and are therefore less likely to take part in research concerned with such issues (Trypuc 1994).6 In addition, it is well documented that women access all forms of health care more frequently than men do (Miller and Findlay 1994). Thus whether one is male or female has less to do with participation in alternative therapies than it does with gendered patterns of health-seeking behaviour in general.

The people who spoke with me ranged in age from twenty-six to fifty-nine years, with fourteen of them falling between forty-one and fifty-nine years of age. This age distribution is similar to findings reported in the literature on alternative therapy use in the West up until the mid-1990s. In Canada, research shows that usership of alternative health care is distributed over the lifespan; however, the majority of those participating in alternative therapies are aged between thirty and forty-five years (Blais 2000; Wellman 1995). Similarly, in the US, Glik (1988) concludes that participation in alternative therapies is most frequent among the middle-aged. For example, Eisenberg et al. (1993:248) found that "the use of unconventional therapy in the US is significantly more common among people twenty-five to forty-nine years of age" than in any other age groups. In a later study, Eisenberg et al. (1998) report that most users of alternative therapies fall in the thirty-five to fifty year range. And in their UK study of people using acupuncture, homeopathy, or osteopathy, Vincent and Furnham's (1996:40) subjects ranged in age from thirty-eight to forty-seven years.

While the ages of the people who spoke with me correspond to the findings in this literature, I have my suspicions that they under-represent participation in alternative health care among young people. For instance, more recent national surveys in Canada indicate that the highest rate of usership is among those in younger age groups (Achilles et al. 1999). More specifically, Ramsay et al. (1999) report that the most frequent participation in alternative therapies is amongst those eighteen to twenty-four years old. In addition, studies of users of these therapies tend to focus on the clients of chiropractors, naturopaths, and homeopathists. However, due to their youth, users of alternative therapies under thirty have fewer occasions to visit practitioners who specialize in muscular/skeletal problems such as chiropractors. Moreover, young people may be unable to afford the fees charged by alternative practitioners such as naturopaths or homeopaths. Yet people under thirty years of age may well identify themselves as users of alternative therapies when they buy Echinacea, or practice yoga, or participate in meditation as forms of self-care. Thus age is more likely an indicator of consumption of health care in general, and of the ability to pay for alternative therapy, than it is reflective of whether or not someone uses alternative therapies.

All of the informants in this study were white. Eighteen identified themselves as Canadians of British or Celtic heritage; two were British; and one, while born in Poland, grew up in Holland and Kenya. Likewise, national survey research from the US reports that up to 82 percent of those who use alternative therapies are white (Eisenberg et al. 1998). However, this is not to imply that using alternative approaches to health and health care is restricted to whites. For example, the informants who took part in Pawluch et al.'s (1998b) study of people coping with HIV/AIDS through the use of complementary therapy came from a diverse range of ethnic and racial backgrounds. Furthermore, the relationship between use of alternative approaches to health and healing and ethnic background is greatly dependent on cultural context (Low 2001b). For instance, Asians who make use of Chinese herbal medicine may well define it as traditional rather than alternative and would thus be under-represented in surveys of alternative health care use.

All but two of the participants in this research identified themselves as middle class or upper-middle class, and all had completed some form of post-secondary education. These demographic characteristics are consistent with the bulk of Canadian research (Blais 2000; Canada Health Monitor 1993; Northcott and Bachynsky 1993; Ramsay et al. 1999). A similar pattern is found in the US (O'Connor 1995). For instance, Eisenberg et al.(i993:248, 1998) found that use of alternative therapies is "significantly more common among persons with a college education," and

McGuire and Kantor (1987:221) conclude "that nonmedical forms of healing are ... rather widespread among educated, fully acculturated, economically secure people." In the UK people who participate in alternative therapies come predominately from the professional classes (Fulder 1996).

However, Sharma (1990:128) argues that studies have found only slight variations in socio-economic status (SES) between users of alternative therapies and the general population, and in some cases "no differences at all." Furthermore, many surveys concerned with the use of alternative therapies contain questions about visits to alternative practitioners, the most expensive participation in these approaches to health care (Fulder and Munro 1985). Therefore, the finding that those in higher SES ranges use alternative health care more frequently is more likely a reflection of their ability to pay rather than a lack of desire for alternative approaches to health and healing on the part of those in lower SES categories.

The informants in this study came from a variety of religious backgrounds. Six identified themselves as Protestant and six as agnostic or as having no religion. Three are Buddhist, two practice Wicca, two are Catholic, and one is Mennonite. This distribution of religious affiliation is similar to that found by Wellman (1995) in her Canadian study of clients of chiropractors and therapists who practice the Alexander technique. It is also consistent with the Canada Health Monitor's (1993:124) findings that most respondents who answered yes to the question, "In the past six months, have you used any of the following alternative therapies?" reported that they had no religion or espouse a religion outside mainstream Judaeo-Christian faiths. Moreover, while fifteen of the people who spoke with me identified themselves as belonging to one or other form of Christianity, or as having no religion, it became clear during the interviews that nine of these people also espoused what Creedon (1998:44) calls "pastiche spirituality or religion a la carte," what I call, for lack of a better term, new age spirituality. For example, Lorraine described her religious beliefs as follows:

The whole point ofbeing born on earth is to grow in your spirituality. Each person is on that particular rung of the ladder; when you're ready to learn, your teacher will enter your life. I am Anglican, but whoever went to church on the street, that's who I went with. So I've been to Salvation Army, Delta Tabernacle, United, Methodist, Catholic. But this has helped me. I have not become mind-locked into any religion. God is here in my heart. God is within me, not in some building.

Similarly, Marie told me that while she was brought up a Catholic, she now follows her own spiritual path. In her words: "I'm a recovering Catholic. I was raised in the Catholic faith but I am very spiritualistic and I got in touch with my own spiritual beliefs, which took a great deal of searching, personal work, and a great deal of healing." Likewise, Simon identified himself as a Catholic but later on in the interview told me: "It's the balance, it's the harmony. I've become a fundamentalist Taoist I guess. I just feel that things are going to come up but I don't fight things either. I liken myself to a stick or a log floating down a river." Lindsay's agnosticism includes a smattering of several religious belief systems.

Well, mind and spirit in the sense that I believe a lot of Oriental philosophy of really seeking within your self and being really quiet and balanced within yourself. I have a belief that there are people out there who have a higher power than ours. I don't believe that one person created the universe. I wouldn't say that I'm an atheist; I may be slightly agnostic.

Some of these informants saw a relationship between their spirituality and their use of alternative health care. For example, Jane told me: "I'm into a lot of other things like spirituality that's not mainstream minded, so this [alternative therapy] is just part and parcel of the package." And Grace said: "My father was from a Mennonite background and we did try things that weren't tradition." However, while participation in alternative spirituality may predispose one to explore alternative therapies, using alternative approaches to health and healing does not necessarily imply participation in alternative spirituality. Sharma (1992:45) makes the same point more generally, concluding that "using 'alternative' medicine ... is not necessarily associated with adherence to an 'alternative' culture or lifestyle, but some cultural and recreational activities are more likely than others to channel information about non-orthodox medicine."

The Canadian Medical Association concludes that there is nothing distinguishing about the population of users of alternative therapies; rather, they are representative of the general population (CMAJ 1991)7 Similarly, Sharma (1990:128) contends that "users come from a wide range of backgrounds." This holds true for the people who participated in this research. There was little if any variation by sex, age, ethnic category, or SES—neither in terms of accessing alternative therapies, of beliefs about alternative approaches to health and healing, nor of the impact participation in alternative health care had on informants. Rather, the user of alternative therapies is no different from any other person engaged in health-seeking behaviour, and arguments that those who participate in alternative forms of health care are particular types of people remain unconvincing.

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