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LETTER |
Yali A. Bair and Ellen B. Gold are with the Department of Epidemiology and Preventive Medicine, University of California Davis. Gail A. Greendale is with the Division of Geriatrics, University of California Los Angeles. Barbara Sternfeld is with the Department of Epidemiology and Biostatistics, Division of Research, Kaiser Permanente, Oakland, Calif. Shelley R. Adler is with the Department of Anthropology, History and Social Medicine, University of California San Francisco. Rahman Azari is with the Department of Statistics, University of California Davis. Martha Harkey is with the Division of Medical Pharmacology and Toxicology, School of Medicine, University of California Davis.
Correspondence: Requests for reprints should be sent to Yali A. Bair, Department of Epidemiology and Preventive Medicine, University of California Davis, 1 Shields Ave, TB 168, Davis, CA 95616 (e-mail: yabair{at}ucdavis.edu).
We would like to thank Drs. Laws and Carballeira for their informative comments on our study of complementary and alternative medicine (CAM) use by women enrolled in the Study of Womens Health Across the Nation (SWAN). Laws and Carballeira found, using a detailed, ethnically driven survey, that a much higher proportion of Latina women are using CAM than we reported in our study. We agree that using measures appropriate to specific ethnic groups is a valid and useful way to measure CAM use. However, in our study, we set out to describe differences in the use of broad categories of CAM among 5 very diverse ethnic groups across the nation (White, Black, Chinese, Japanese, and Hispanic, which consisted largely of Puerto Rican, Dominican, and Cuban women). It was not possible, in our preliminary study, to obtain detailed information about the CAM remedies used almost exclusively by 1 ethnic group. From an analytic standpoint, comparisons across ethnic groups would probably be somewhat problematic, given the small proportion of overlap in the use of some herbs and healing methods that are specific to particular ethnic groups. In 2002, we began gathering detailed, ethnically appropriate data at each of SWANs study sites. In the future, we plan to conduct ethnicity-specific analyses to describe more precisely the current trends in CAM use among women from diverse ethnic backgrounds as they experience the menopausal transition.
We are pleased to note the increasingly frequent appearance of reports, such as those of Drs. Laws and Carballeiro, examing specific types of CAM use in specific subgroups of the population. The relatively high prevalence of CAM use underscores the need for increasing our understanding and consideration of the effects of these nonprescription remedies on health. The findings from these and other ongoing studies and trials should prove very useful in providing women with culturally appropriate care options during the menopause transition.
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