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Research ArticleOriginal Research

Generational Differences in Complementary and Alternative Medicine (CAM) Use in the Context of Chronic Diseases and Pain: Baby Boomers versus the Silent Generation

Tiffany F. Ho, Anastasia Rowland-Seymour, Eitan S. Frankel, Susan Q. Li and Jun J. Mao
The Journal of the American Board of Family Medicine July 2014, 27 (4) 465-473; DOI: https://doi.org/10.3122/jabfm.2014.04.130238
Tiffany F. Ho
From the Johns Hopkins University School of Medicine, Baltimore (TFH); Division of Internal Medicine (ARS), Johns Hopkins Hospital, Baltimore; and Department of Family Medicine and Community Health (ESF, SQL, JJM), Perelman School of Medicine at University of Pennsylvania, Philadelphia.
BS
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Anastasia Rowland-Seymour
From the Johns Hopkins University School of Medicine, Baltimore (TFH); Division of Internal Medicine (ARS), Johns Hopkins Hospital, Baltimore; and Department of Family Medicine and Community Health (ESF, SQL, JJM), Perelman School of Medicine at University of Pennsylvania, Philadelphia.
MD
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Eitan S. Frankel
From the Johns Hopkins University School of Medicine, Baltimore (TFH); Division of Internal Medicine (ARS), Johns Hopkins Hospital, Baltimore; and Department of Family Medicine and Community Health (ESF, SQL, JJM), Perelman School of Medicine at University of Pennsylvania, Philadelphia.
BS
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Susan Q. Li
From the Johns Hopkins University School of Medicine, Baltimore (TFH); Division of Internal Medicine (ARS), Johns Hopkins Hospital, Baltimore; and Department of Family Medicine and Community Health (ESF, SQL, JJM), Perelman School of Medicine at University of Pennsylvania, Philadelphia.
MS
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Jun J. Mao
From the Johns Hopkins University School of Medicine, Baltimore (TFH); Division of Internal Medicine (ARS), Johns Hopkins Hospital, Baltimore; and Department of Family Medicine and Community Health (ESF, SQL, JJM), Perelman School of Medicine at University of Pennsylvania, Philadelphia.
MD, MSCE
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    Figure 1.

    Use of complementary and alternative medicine in the past year by adults with chronic diseases: baby boomers versus the silent generation.

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    Figure 2.

    Use of complementary and alternative medicine in the past year by adults with painful conditions: baby boomers versus the silent generation.

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    Table 1. Characteristics of Participants: Baby Boomers versus the Silent Generation
    CharacteristicsBaby Boomers (n = 7734)Silent Generation (n = 4682)P Value
    %SE%SE
    Demographics
        Sex.003
            Male48.270.6444.840.91
            Female51.730.6455.160.91
        Educational attainment<.001
            High school or less41.240.7256.631.01
            Some college or technical school27.530.6321.090.74
            College or more advanced31.230.7722.280.82
        Race/ethnicity<.001
            Non-Hispanic white73.850.7180.350.69
            Non-Hispanic black11.400.488.940.44
            Hispanic10.550.487.230.48
            Asian4.200.283.480.28
        Census region.44
            Northeast17.450.6518.500.85
            Midwest24.131.0024.470.98
            South36.520.9836.541.15
            West21.900.7620.480.89
    Clinical Factors
        Body mass index<.001
            Normal (<25 kg/m2)32.000.6234.510.76
            Overweight (25–29.99 kg/m2)37.390.6940.000.77
            Obese (≥30 kg/m2)30.620.6825.480.72
        Chronic disease26.070.6251.300.86<.001
            Heart disease*5.420.3318.520.74<.001
            Diabetes9.530.3919.050.69<.001
            Cancer†5.540.3116.010.65<.001
            Lung disease‡10.050.3913.210.61<.001
            Stroke2.460.236.790.43<.001
        Painful condition52.200.6956.070.93<.001
            Neck pain15.960.5014.700.59.10
            Lower-back pain28.260.6029.280.76.28
            Facial pain4.860.292.760.27<.001
            Head pain13.160.485.700.39<.001
            Joint pain34.720.6843.140.90<.001
    • ↵* Heart disease includes coronary heart disease, heart attack, other heart condition.

    • ↵† Cancer includes any cancer except nonmelanoma cancer.

    • ↵‡ Lung disease includes asthma, emphysema, or chronic bronchitis in the past 12 months.

    • SE, standard error.

    • View popup
    Table 2. Use of Complementary and Alternative Medicine (CAM) in the Past 12 Months: Baby Boomers versus the Silent Generation
    CAM UseBaby BoomersSilent GenerationP Value
    %SE%SE
    Any CAM therapy43.050.8136.410.91<.001
    Alternative medical systems4.540.282.160.23<.0001
        Acupuncture2.090.181.170.18.001
        Ayurveda0.07—0.05—.68
        Homeopathy2.280.180.820.14<.001
        Naturopathy0.510.100.310.10.12
        Traditional healers*0.340.110.13—.02
    Biologically based23.300.6822.390.76.32
        Chelation therapy0.09—0.09—.91
        Herbs20.670.6320.890.72.80
        Special diets†4.380.292.720.29<.001
    Manipulative and body based17.400.611.640.60<.001
        Chiropractic/osteopathic10.160.448.090.51.002
        Massage9.570.434.810.39<.001
        Movement based‡1.510.160.350.11<.001
    Mind–body21.060.6913.730.58<.001
        Biofeedback0.230.070.08—.10
        Meditation11.450.546.720.42<.001
        Guided imagery3.230.351.130.18<.001
        Progressive relaxation4.320.311.690.22<.001
        Deep breathing15.080.619.530.48<.001
        Hypnosis0.450.090.15—.02
        Stress management1.170.150.310.07<.001
        Support groups2.370.211.090.17<.001
        Yoga5.900.332.200.28<.001
        Tai chi1.060.121.050.17.94
        Qi gong0.410.080.220.07.10
    Energy healing/Reiki0.870.120.320.09.001
    • ↵* Traditional healers include curandero, espiritista, hierbero, shaman, botanica, Native American healer, and sobador.

    • ↵† Special diets include vegetarian, macrobiotic, Atkins, Pritikin, Ornish, The Zone, and South Beach.

    • ↵‡ Movement-based therapies include Feldenkreis, Alexander technique, Pilates, and Trager.

    • SE, standard error.

    • View popup
    Table 3. Independent Predictors of Complementary and Alternative Medicine (CAM) Use Among Baby Boomers and the Silent Generation
    Predictors of CAM UseUnivariate AnalysesMultivariate Model*
    OR95% CIAOR95% CI
    Generation
        Silent generationReferenceReference
        Baby Boomer1.321.20–1.451.301.17–1.44
    Sex
        MaleReferenceReference
        Female1.461.35–1.581.521.40–1.65
    Education attainment
        High school or lessReferenceReference
        Some college or technical school2.161.95–2.402.011.79–2.25
        College or more advanced2.592.33–2.882.692.40–3.02
    Race/ethnicity
        Non-Hispanic whiteReferenceReference
        Hispanic0.450.39–0.520.520.44–0.60
        Non-Hispanic black0.450.39–0.520.510.44–0.60
        Asian0.750.56–1.010.680.49–0.93
    Census region
        NortheastReferenceReference
        Midwest1.211.05–1.391.161.01–1.34
        South0.850.74–0.980.890.78–1.02
        West1.511.32–1.721.481.28–1.70
    Chronic disease
        No chronic diseaseReferenceReference
        Have chronic diseases0.990.91–1.091.040.94–1.15
    Painful condition
        No painful conditionReferenceReference
        Have painful conditions2.191.97–2.432.262.03–2.52
    • ↵* Model adjusted for demographics, chronic diseases, and painful conditions.

    • AOR, adjusted odds ratio; CI, confidence interval; OR, odds ratio.

    • View popup
    Table 4. Complementary and Alternative Medicine (CAM) Use for Specific Conditions Among Baby Boomer and the Silent Generation
    ConditionsUnivariateMultivariate*
    OR95% CIOR95% CI
    Chronic disease1.401.20–1.631.381.17–1.63
        Heart disease1.461.09–1.961.551.15–2.10
        Diabetes1.531.17–2.001.641.25–2.15
        Cancer1.601.23–2.071.601.22–2.10
        Lung disease1.250.97–1.611.220.93–1.60
        Stroke1.110.72–1.721.080.68–1.72
    Painful condition1.481.31–1.671.381.21–1.57
        Neck pain1.511.21–1.901.501.18–1.90
        Lower-back pain1.211.02–1.441.160.97–1.39
        Facial pain2.581.56–4.252.071.18–3.64
        Head pain1.601.12–2.281.591.11–2.28
        Joint pain1.561.36–1.781.431.23–1.65
    • ↵* Multivariate analyses adjusted for demographic factors.

    • CI, confidence interval; OR, odds ratio.

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The Journal of the American Board of Family     Medicine: 27 (4)
The Journal of the American Board of Family Medicine
Vol. 27, Issue 4
July-August 2014
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Generational Differences in Complementary and Alternative Medicine (CAM) Use in the Context of Chronic Diseases and Pain: Baby Boomers versus the Silent Generation
Tiffany F. Ho, Anastasia Rowland-Seymour, Eitan S. Frankel, Susan Q. Li, Jun J. Mao
The Journal of the American Board of Family Medicine Jul 2014, 27 (4) 465-473; DOI: 10.3122/jabfm.2014.04.130238

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Generational Differences in Complementary and Alternative Medicine (CAM) Use in the Context of Chronic Diseases and Pain: Baby Boomers versus the Silent Generation
Tiffany F. Ho, Anastasia Rowland-Seymour, Eitan S. Frankel, Susan Q. Li, Jun J. Mao
The Journal of the American Board of Family Medicine Jul 2014, 27 (4) 465-473; DOI: 10.3122/jabfm.2014.04.130238
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