Objective: Westerners increasingly use complimentary and alternative (CAM) methods for curing illness and promoting health. The central ideas of CAM appear to resonate with large segments of the general public. Little is known about CAM use in Iceland. The purpose of the study was to assess the scope of utilization of CAM providers and the likely explanatory factors.

Material and methods: The data come from a national postal health survey that took place during the Fall of 2006. A sample of Icelandic adults, age 18-75, was randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate.

Results:Almost 32% of the respondents had used a CAM provider in the past 12 months, an estimated increase of 6% since 1998. Women and high income individuals were more likely to use a CAM provider than men and lower income individuals. Physical and mental distress was also related to the likelihood of CAM use. Individuals having negative or positive attitude toward physician services were more likely to use a CAM provider than those expressing a neutral attitude. Finally, repeated physician visits were related to an increased likelihood of CAM use.

Conclusions: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. It appears that some clients regard the care they receive in the general health system as insufficient. Most CAM users appear to use CAM treatments as a supplement to the care received in the general health system.

 

Table I. Percentage of respondents using different CAM providers in the past 12 months

 

¹ n_i refers to number of individuals visiting a particular CAM provider, and n_k refers to number of individuals answering the question.

Table II. Percentage of respondents using a CAM provider by explanatory variables

Variables		%	ni/nk1	Phi / Cramér's V
Gender
	Male	22.6	153/678
	Female	41.3***	272/659	0.201
Age
	18-24	33.8	67/198
	25-34	36.2	96/265
	35-44	33.1	96/290
	45-54	32.8	83/253
	55-64	26.2	50/191
	65+	24.4	33/135	0.083
Marital status
	Married/Cohabiting	31.8	303/954
	Single	31.7	84/265
	Divorced	31.3	26/83
	Widowed	26.3	5/19	0.014
Parent to a child under 18
	No	31.5	218/693
	Yes	32.0	201/629	0.005
Education
	Primary	28.5	59/,207
	Secondary	30.0	221/736
	Tertiary (University level)	37.2*	135/363	0.073
Employment
	Not employed	32.7	48/147
	Less than 40 hrs pr week	35.0	116/331
	More than 40 hrs pr week	30.4	234/770	0.043
Annual individual income (Icelandic Krónur)
	0 - 1699 thousand	36.4	136/374
	1.7 – 3.4 million	30.5	113/370
	3.5 – 5.4 million	28.0	80/286
	5.5 million or more	29.0	53/183	0.07391
Residence
	Reykjavik Metropolitan Area	32.7	280/855
	Countryside	30.1	145/482	-0.027
Belongs to a religious denomination
	No	31.8	34/107
	Yes	32.3	369/1144	0.003
I believe in God
	Rather or strongly agree	33.5	324/966
	Rather or strongly disagree	27.6	87/315	-0.055

 

Table II. (continued)
Variables		%	ni/nk1	Phi / Cramér's V
I am a religious person
	Rather or strongly agree	33.1	301/910
	Rather or strongly disagree	28.5	105/369	-0.045
Disabled
	Yes	56.0	28/50
	No	31.2***	376/1205	-0.104
Chronic medical condition (confirmed by an MD)
	No chronic condition	26.4	168/637
	1 chronic condition	33.5	94/281
	2 chronic conditions	39.1	66/169
	3 or more chronic conditions	39.0***	97/249	0.119
Psychophysiological distress
	Little or moderate	27.8	288/1037
	High	46.7***	119/255	0.162
Depression
	Little or moderate	29.6	309/1045
	High	42.1***	102/242	0.105
Anger/Aggression
	Little or moderate	29.3	289/987
	High	39.4***	132/335	0.095
Anxiety
	Little or moderate	30.0	322/1074
	High	39.3**	94/239	0.078
Perceived stress
	No, little, or moderate	29.5	297/1008
	High	40.2***	125/311	0.098
Negative life events
	No event	27.8	141/507
	1 event	34.6	123/356
	2 or more events	34.1*	158/464	0.068
Ongoing difficulties
	No difficulties	23.5	12/51
	1-2 difficulties	23.7	22/93
	3 or more difficulties	32.9	309/1185	0.062
Number of physician  visits in past 12 months
	No visit	20.7	56/271
	1 visit	23.7	68/287
	2-3 visits	31.8	131/412
	4 or more visits	46.2***	157/340	0.208

 

Table II. (continued)
Variables		%	ni/nk1	Phi / Cramér's V
Number of visits to psychiatrists in past 12 months
	No visit	31.5	405/1285
	1 or more visits	42.6	20/47	0.044
Satisfaction with last physician visit
	Rather/very satisfied	32.4	431/1077310/956
	Neither satisfied nor dissatisfied	32.8	66/20184/219
	Rather/very dissatisfied	34.3	37/10845/116	0.011
Attitude towards visiting  …
physicians
	Rather or strongly disapprove	71.4	5/7
	Neither approve nor disapprove	25.2	34/135
	Rather or strongly approve	321.8*	382/1166	0.079
psychiatrists
	Rather or strongly disapprove	40.9	9/22
	Neither approve nor disapprove	19.4	32/165
	Rather or strongly approve	33.9***	380/1120	0.106
complimentary or alternative health providers
	Rather or strongly disapprove	16.3	14/86
	Neither approve nor disapprove	18.0	67/372
	Rather or strongly approve	40.2***	339/844	0.230
1 ni refers to number of individuals visiting a particular CAM provider, and nk refers to number of individuals answering the question. * p<0.05; ** p<0.01; *** p<0.001 (two-tailed test)

 

 

Tafla III. Logistic regression of CAM use on explanatory variables (N=1110).

Explanatory variables	B	se	OR  (Exp B)
Gender (1=female)	0.826***	0.154	2.284
Annual individual income
1.7 – 3.4 million	-0.160	0.178	0.852
3.5 – 5.4 million	-0.028	0.197	0.973
5.5 million or more	0.440	0.237	1.553
Psychophysiological symptoms (score)	0.042**	0.014	1.043
Anger/Aggression (score)	0,072*	0.029	1.075
Attitude towards physician visits
Positive	-0.341	0.252	0.711
Negative	2.142	1.192	8.519
Attitude towards CAM use
Positive	1.171***	0.187	3.226
Negative	-0.047	0.386	0.954
Number of physician visits	0.074***	0.022	1.077
Constant	-2.297***	0.297	0.101
-2 Log Likelihood	1229.58
df	1098
* p<0.05; ** p<0.01; *** p<0.001 (two-tailed test)