Which Americans Use Chiropractic the Most?
In the 1990s, estimates of chiropractic use were in the range of 10%-11%. However, more recent studies have shown rates of chiropractic usage to be lower. Current estimates generally range from 7% to 10%. Using a 2008 survey, a team of researchers has estimated the prevalence of chiropractic use among adults in the U.S., adding to our knowledge about which sociodemographic, demographic, and health characteristics predict chiropractic usage.
Overall, the use of chiropractic treatments (defined as at least 1 visit to a chiropractor during the 2008 calendar year) is estimated to be 5.2%. This estimate is considerably lower than estimates reported in the 1990s, but in line with recent studies looking at chiropractic usage rates. This study validates previous data concerning rates of chiropractic usage while adding to our knowledge about who is most likely to utilize chiropractic treatments.
The prevalence of chiropractic usage was found to be less for men than women, and 68% higher for those with arthritis compared to those without. People from high-income families were found to be more likely to utilize chiropractic services compared with those from middle-income or low-income families. The prevalence of chiropractic use is highest in small metropolitan areas in the Midwest and Northeast. Overall, regional rates appear highest in the Midwest (8.0%), followed by the West (5.9%), Northeast (4.95), and the South (3.2%). The study suggests that the effect of geographic location on chiropractic use may be more complex than currently understood.
The rate of chiropractic service usage was lower for Asians, Hispanics, and Blacks compared with whites. They pose several explanations for this disparity: lack of diversity among chiropractic practitioners, cultural beliefs, and location of chiropractic offices.
Another recent study showed racial disparities in chiropractic use among Medicare beneficiaries. That study, using data from Medicare beneficiaries who received chiropractic treatments between 2002 and 2008, found that 96-97% of the patients utilizing chiropractic care were white, and only 1-2% were black, while other racial backgrounds accounted for 1% or less of chiropractic users. The researchers concluded that the findings of that study "suggest the possibility that barriers may exist for minorities' access to chiropractic care."
Those disparities could also be related to insufficient insurance coverage for chiropractic services. Many patients using complementary and alternative therapies like chiropractic pay for their services out-of-pocket due to a lack of insurance coverage. That gap in coverage could be behind plateauing rates of healthcare spending on CAM therapies.
Clearly, more work is needed to expand both insurance coverage and access to chiropractic services. That process could significantly cut costs for many patients since studies suggest that chiropractic is often more cost-effective than traditional treatments for musculoskeletal conditions.
Zodet MW and Stevans JM. The 2008 Prevalence of Chiropractic Use in the US Adult Population. Journal of Manipulative and Physiological Therapeutics 2012; 35(8): 580-88.