The proceedings of a November 2000 conference convened by the Josiah Macy Jr Foundation provide an exciting introduction to this issue of Family & Community Health (26:1). We know that the use of nontraditional forms of medicine is not new. Ancient societies used herbs, touch, movement, and so forth to comfort and heal. Today, the area of complementary and alternative medicine (CAM) is growing rapidly in use, popularity, and knowledge by the general public as well as health providers. At the present time, at least half of the people in the United States indicate on surveys that they use one CAM remedy. 1 Users spend approximately $21 billion annually of their own money for CAM services and remedies and make more visits to CAM providers than to primary care physicians. If one accepts the notion that you can tell what persons value by how they spend their time and money, then there is no question that Americans value CAM.

According to the participants in the Josiah Macy Jr Foundation, there is no one commonly agreed on definition of CAM. In general CAM includes "health practices that range from the use of vitamins, herbal remedies, and massage therapies to the ancient traditions of Ayurveda and Chinese medicine, along with chiropractic, naturopathy, homeopathic medicine, meditation, hypnosis, acupuncture, and a host of other lesser known approaches to health and health care" 2^(p1)

Interestingly, although most of us are familiar with and use CAM procedures and supplements, most have not been rigorously tested. Why is it that we ingest herbs, vitamins, minerals, and other supplements and participate in treatments that have not been scientifically tested? Likewise, why is that we typically pay for these remedies out of pocket since most are not covered with health care insurance or other payment forms? Perhaps we do so because it allows us to take charge of our lives and our health. Also, CAM remedies often offer hope of feeling better and of either reducing discomfort or promoting health in general. Most CAM users do so as an adjunct to their use of conventional medical and health care practices. We must remember and remind others that their health care providers must know what CAM practices they use so that traditional and nontraditional medicine can interact positively.

Interestingly, the use of CAM practices is somewhat higher among women, among people with more education, among those who live on the West coast, and slightly lower among African Americans. Use cuts across all age and economic levels, with the "baby boomers" being frequent users; the population under age 30 comprises the most frequent users. 1

Given the widespread use of CAM practices, it is essential that our health professional schools include content related to this important and growing area. The incorporation of CAM information in curricula is also a way to teach students to value history. That is, many CAM practices are really not new; they were tried and used successfully both by earlier generations and across the world in many cultures.

This issue of Family & Community Health provides interesting information about CAM use with common, widespread health problems. The articles should guide students, educators, and practitioners in some of the uses and cautions with CAM.

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