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      Inequalities in access to integrative and complementary health practices in Brazil: National Health Survey, 2019

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          Abstract

          Aim

          Integrative and complementary practices (PICs) can be important health care strategies, mainly because they consider the integrality of the person. The objective of this article was to verify the inequality in the access to PICs of the Brazilian population based on data from the National Health Survey (PNS).

          Subject and methods

          This is a population-based cross-sectional study, with data from the 2019 PNS. The use of PICs in the past 12 months was investigated. Adjusted analysis was performed using Poisson regression and the Slope Index of Inequality (SII) and the Concentration Index (CIX) were used to assess absolute and relative inequality.

          Results

          The prevalence of PIC use in Brazil was 5.4% (95%CI 5.3; 5.5). Individuals from the richest quintile, with higher education and with health insurance were more likely to use PICs in general, except for medicinal plants/herbal medicine. When observing the magnitude of inequalities, this was more positively accentuated in those with higher education and who had a private health plan.

          Conclusion

          The results reveal social inequalities in the access to integrative practices, where the most elitist are more accessed by people with better socioeconomic conditions.

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          Most cited references33

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          Medicinal plants: traditions of yesterday and drugs of tomorrow.

          Ameenah Gurib-Fakim (2006)
          Plants have provided Man with all his needs in terms of shelter, clothing, food, flavours and fragrances as not the least, medicines. Plants have formed the basis of sophisticated traditional medicine systems among which are Ayurvedic, Unani, Chinese amongst others. These systems of medicine have given rise to some important drugs still in use today. Among the lesser-known systems of medicines are the African and Australian, Central and South American amongst others. The search for new molecules, nowadays, has taken a slightly different route where the science of ethnobotany and ethnopharmacognosy are being used as guide to lead the chemist towards different sources and classes of compounds. It is in this context that the flora of the tropics by virtue of its diversity has a significant role to play in being able to provide new leads. Nonetheless the issue of sovereignty and property rights should also be addressed in line with the Convention for Biological Diversity (CBD). This paper highlights the above, provides an overview of the classes of molecules present in plants and gives some examples of the types of molecules and secondary metabolites that have led to the development of these pharmacologically active extracts. The paper also presents some data on the use of plant products in the development of functional foods, addresses the needs for validation of plant extracts and always stressing on safety, efficacy and quality of phyto-medications.
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            Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe.

            J P Mackenbach, A E Kunst (1997)
            In this paper we review the available summary measures for the magnitude of socio-economic inequalities in health. Measures which have been used differ in a number of important respects, including (1) the measurement of "relative" or "absolute" differences; (2) the measurement of an "effect" of lower socio-economic status, or of the "total impact" of socio-economic inequalities in health upon the health status of the population; (3) simple versus sophisticated measurement techniques. Based on this analysis of summary measures which have previously been applied, eight different classes of summary measures can be distinguished. Because measures of "total impact" can be further subdivided on the basis of their underlying assumptions, we finally arrive at 12 types of summary measure. Each of these has its merits, and choice of a particular type of summary measure will depend partly on technical considerations, partly on one's perspective on socio-economic inequalities in health. In practice, it will often be useful to compare the results of several summary measures. These principles are illustrated with two examples: one on trends in the magnitude of inequalities in mortality by occupational class in Finland, and one on trends in the magnitude of inequalities in self-reported morbidity by level of education in the Netherlands.
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              Is Open Access

              Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants

              Laura Kemppainen, Teemu T. Kemppainen, Jutta Reippainen … (2017)
              Aims: The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. Methods: The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. Results: In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Conclusions: Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.
              Article 0 comments Cited 114 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Karla Pereira Machado:
                ORCID: https://orcid.org/0000-0003-1765-1435
                karlamachadok@gmail.com
                Cristina Santos Paludo:
                ORCID: http://orcid.org/0000-0002-4522-7415
                cspaludo@gmail.com
                Journal
                Journal ID (nlm-ta): Z Gesundh Wiss
                Journal ID (iso-abbrev): Z Gesundh Wiss
                Title: Zeitschrift Fur Gesundheitswissenschaften
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 2198-1833
                ISSN (Electronic): 1613-2238
                Publication date (Electronic): 11 March 2023
                Pages: 1-8
                Affiliations
                [1 ]GRID grid.411221.5, ISNI 0000 0001 2134 6519, Post-Graduation Program in Nursing, , Federal University of Pelotas, ; Gomes Carneiro, 1. Balsa, Pelotas, RS 96010-610 Brazil
                [2 ]GRID grid.411598.0, ISNI 0000 0000 8540 6536, Post-Graduation Program in Health Sciences, , Federal University of Rio Grande, ; Visconde de Paranaguá, 102. Centro, Rio Grande, RS 96200-190 Brazil
                [3 ]GRID grid.411221.5, ISNI 0000 0001 2134 6519, Post-Graduation Program in Epidemiology, , Federal University of Pelotas, ; Mal. Deodoro, 1160. Centro, Pelotas, RS 96020-220 Brazil
                Author information
                https://orcid.org/0000-0003-1765-1435
                https://orcid.org/0000-0002-5390-3823
                http://orcid.org/0000-0002-4522-7415
                https://orcid.org/0000-0001-7160-0642
                https://orcid.org/0000-0003-4370-5556
                https://orcid.org/0000-0001-6798-9130
                https://orcid.org/0000-0001-7225-1552
                Article
                Publisher ID: 1869
                DOI: 10.1007/s10389-023-01869-6
                PMC ID: 10008017
                SO-VID: 44c63c0c-99f8-4a74-bedc-98856bc2cef9
                Copyright © © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 10 January 2023
                Date accepted : 23 February 2023
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: complementary therapies,cross-sectional studies,health surveys,health status disparities
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: complementary therapies, cross-sectional studies, health surveys, health status disparities

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