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AUST R A L I A N BUR EA U OF STA T I S T I C S

EMBA R G O : 11 . 3 0 A M (CAN B E R R A T IME ) WED 23 JUL 2008

Australian Social Trends

2008

Article: Complementarytherapies

w w w . a b s . g o v . a u

Complementary therapies – such as thosepractised by naturopaths, chiropractors andacupuncturists – have become increasinglypopular in Australia over the last few decades.Interest initially coincided with enthusiasmfor alternative lifestyles,1,2 while immigrationand increased contact and trade with Chinahave also had an influence.3 The status ofcomplementary therapies is being re-visited ina number of areas: legal regulation; thestances of doctors' associations; theirinclusion in medical education; and scientificresearch into their efficacy.3,4,5 With theexception of acupuncture, complementarytherapies are not routinely funded throughMedicare, so there is little administrative dataregarding their use. However, the ABS hassome data about the use of complementarytherapies which can help inform discussion.

Increase in practitionersAccording to the census, 8,600 people wereemployed as complementary health therapistsin 2006. This was 80% higher than the numberin 1996 (although some of the increase wasdue to classification changes). The leadingoccupations were naturopaths (2,980) andchiropractors (2,490), up 56% and 45%respectively from 1996. The fastest growinggroup was osteopaths, tripling in numberbetween 1996 and 2006. Over the same period,the Australian population increased by 12%and the total number of health professionalsrose by 31%.

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Complementarytherapies

Data sources and definitionsThis article draws on data from recent Censuses ofPopulation and Housing and from the ABS 2004–05National Health Survey.

The term 'complementary therapy' is used to covera wide range of health treatment methods. Thisarticle covers visits to selected, common types ofcomplementary therapist only and the therapistscovered vary between the two data sources used.

Data are available from the 2006 Census ofPopulation and Housing on the characteristics ofpeople employed as: Chiropractors; Osteopaths;Acupuncturists; Homeopaths; Naturopaths; andTraditional Chinese Medicine Practitioners (andother occupations not elsewhere classified or notfurther defined). See ANZSCO – Australian and NewZealand Standard Classification of Occupations,First edition 2006 (ABS cat. no. 1220.0) for details.While there is an occupation group within ANZSCOtermed 'complementary health therapists' thisarticle has a wider scope, covering in additionchiropractors and osteopaths, historically part ofthe natural therapies movement and commonlyregarded as complementary therapists.2, 6

In the 2004–05 National Health Survey people livingin private dwellings (i.e. excluding hospitals andcared accommodation) were asked about theirvisits in the previous two weeks to 23 selectedtypes of health professional. These included:Chiropractor; Osteopath; Naturopath;Acupuncturist; Herbalist; Traditional healer; andHypnotherapist. See ABS National Health Survey2004–05: Users' Guide – Electronic (ABS cat. no.4363.0.55.001) for definitions.

Some people in these occupations may not regardthemselves as complementary therapists, and,likewise, some people in other health occupationsmay use complementary therapy techniques.

In 2004–05, 748,000

people consulted one

of seven common types

of complementary

health therapists in a

two week period.

(a) Includes other complementary health professionals whose occupations were not elsewhere classified or not furtherdefined. In 1996 and 2001 homeopaths and traditional Chinese medicine practitioners were among these occupations. In2006, some additional occupations were moved into this category, contributing 485 people (or 10 percentage points) tothe increase in 2006. These were hypnotherapists and dance, drama and music therapists.

Source: ABS 1996 to 2006 Census of Population and Housing.

79.58 5956 3434 787Total(a)

n.a.236n.a.n.a.Homeopath

n.a.480n.a.n.a.Traditional Chinese medicine practitioner

201.9776429257Osteopath

106.1948675460Acupuncturist

56.12 9822 5141 910Naturopath

45.42 4882 0731 711Chiropractor

%no.no.no.

Change 1996–2006200620011996

Complementary health therapists

Characteristics of therapists

Women predominated among naturopaths(79%) and homeopaths (76%). Theyaccounted for almost half of acupuncturistsand osteopaths (about 49% in each case).They were least prominent among traditionalChinese medicine practitioners (42%) andchiropractors (33%).

Just over one-half (54%) of acupuncturists,and 72% of traditional Chinese medicinepractitioners, were born overseas. Mostoverseas-born acupuncturists and traditionalChinese medicine practitioners were born inNorth-East Asia (60% and 76% respectively).Among the other types of complementaryhealth therapist, the proportion bornoverseas ranged from 22% (osteopaths) to35% (homeopaths).

The proportion who reported having abachelor degree or higher qualification (inany field of study) was highest forchiropractors and osteopaths (92% and 87%respectively); around 72% for acupuncturistsand traditional Chinese medicinepractitioners; and lowest for naturopaths andhomeopaths (both 43%).

Part-time work was relatively common amongcomplementary health therapists, especiallyhomeopaths (75% worked part-time) andnaturopaths (60% worked part-time), inkeeping with the higher proportion ofwomen in these occupations. TraditionalChinese medicine practitioners were the leastlikely to be working part-time (40%).

The majority of each type of complementaryhealth therapist were owner managers,ranging from 91% of homeopaths to 72% ofnaturopaths.

Visits to therapistsAccording to the National Health Survey, in2004–05, 3.8% of the population (748,000people) had consulted one of seven selectedcomplementary health therapists in theprevious two weeks, compared with about 2.8%in 1995. The most commonly consulted werechiropractors (433,000 visitors), naturopaths(134,000 visitors) and acupuncturists (90,600visitors). Also consulted were osteopaths,herbalists, traditional healers (identified forthe first time in 2004–05) and hypnotherapists.The number of people visiting osteopathsincreased by 88% to 60,000 over the period.

In comparison, in 2004–05, 32% of thepopulation (6.4 million people) hadconsulted a doctor, dentist, chemist or one of13 other commonly used health professionalssuch as a physiotherapist, psychologist oraudiologist, the same proportion as in 1995.

…demographic characteristicsWhile females comprised half the populationin 2004–05, they accounted for 62% of peoplewho had visited a complementary healththerapist in the previous two weeks and 56%of people who had visited other healthprofessionals.

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(a) Age reported in whole years.(b) In any field of study.(c) Of those who had worked in the week prior to census.(d) Of incorporated and unincorporated enterprises.(e) Includes other complementary health therapists whose occupations were not elsewhere classified or not further defined.

Source: ABS 2006 Census of Population and Housing.

16.631.523.325.44046.1All employed people

79.451.867.832.44256.9Total(e)

84.740.172.171.94741.7Traditional Chinese medicine practitioner

72.359.843.127.84379.0Naturopath

90.774.543.334.95075.8Homeopath

86.049.972.953.74449.5Acupuncturist

88.238.686.921.83348.7Osteopath

84.143.292.326.13832.6Chiropractor

%%%%years%

Ownermanagers(d)

Employedpart-time(c)

Bachelordegree or

higherqualification(b)Overseas bornMedian age(a)Female

Complementary health therapists — 2006

People who visit health professionals tend tobe older than the general population,because illness increases with age. However,the proportion of the population who visitedcomplementary health therapists was highestbetween the ages 25 and 64 years. The lowerrates for people aged 65 years and overcontrasted with the rate of visits to otherhealth professionals which increased steadilywith increasing age. The reasons for thisdifference might include lower levels ofacceptance of complementary therapies byolder people. Alternatively, older people mayhave different treatment priorities than do

younger people because their health onaverage is worse while their incomes aregenerally lower.

People aged less than 18 years accounted for9% of those who had consulted acomplementary health therapist. These 66,000people aged less than 18 years included 46,000who had consulted a chiropractor or osteopathand 21,000 who had consulted a naturopath,acupuncturist, herbalist or traditional healer.

…health-related characteristicsPeople with certain serious health conditionsare known to use complementary therapies.For example, some cancer patients make useof relaxation, diet, vitamins, positive imageryand faith healing.7 The 2004–05 NationalHealth Survey collected information aboutwhether or not people had a condition fromone of Australia's national health priority areas:arthritis; asthma; diabetes; cardiovasculardisease; injuries; cancer; and mental andbehavioural problems. These seven broadhealth areas – together with the risk factorobesity – have been prioritised by AustralianHealth Ministers because they addsignificantly to the burden of disease whilehaving potential for improvement.8

Of people who had visited a complementaryhealth therapist in the previous two weeks,42% reported that they had one of the priorityhealth conditions. This was higher than therate for the total population (33%) but lowerthan the rate for people who had consultedother types of health professional (46%). Ofthese conditions, arthritis (20%), asthma (14%)and mental or behavioural disorders (13%)were the ones most commonly reported bypeople who had visited a complementaryhealth therapist. These were also the leadingthree conditions for the total population.

Self rating of health has been found to be agood general indicator of mental and physicalcondition. Close to one-fifth (18%) of peoplewho had visited a complementary healththerapist in the previous two weeks rated theirown health as 'fair' or 'poor'. This was aboutthe same as for the total population (16%),but lower than the rate of self-reported fair orpoor health among people who hadconsulted other types of health professionalin the previous two weeks (26%).

The lower rates of illness and self-assessedfair or poor health among people who hadvisited a complementary health therapistcompared with those who had visited othertypes of health professional in part reflectsthe younger age profile of the former group.

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(a) People in private dwellings who visited health professionals in the previous two weeks as aproportion of the population living in private dwellings.

(b) People who had consulted a complementary health professional may also have consultedother types of health professional in the previous two weeks.

(c) People who had consulted any of 16 other types of health professionals in 2004–05. Threeadditional types were included in 2004–05 compared with 1995. A total of 97,500 peopleconsulted one of the three types of health professional added in 2004–05.

Source: ABS 1995 and 2004–05 National Health Surveys.

100.019 681.518 061.1Total people in private dwellings

32.46 367.15 725.4Other health professional(b)(c)

3.8748.4497.0Any of the above(b)

—*9.7*4.8Hypnotherapist

0.232.6—Traditional healer

0.356.741.3Herbalist

0.360.332.1Osteopath

0.590.654.2Acupuncturist

0.7133.6112.9Naturopath

2.2432.6286.3Chiropractor

%(a)‘000‘000

2004–052004–051995

People who had visited complementary health therapists inthe previous two weeks

(a) As a proportion of the population of each age group.

Source: ABS 2004–05 National Health Survey.

0–14 15–24 25–34 35–44 45–54 55–64 65–74 75+Age group (years)

%

1

2

3

4

5

6

People who consulted complementary health therapists(a) —2004–05

Of those who had visited a complementaryhealth therapist in the previous two weeks,15% were assessed as having high/very highlevels of psychological distress according tothe Kessler scale – based on informationsupplied by the respondent about negativeemotional states experienced in the previousfour weeks. This was similar to the rate ofhigh/very high psychological distress scores inthe total population (13%) but lower than therate for people who had consulted othertypes of health professional (19%). Peoplewho had visited a complementary healththerapist, however, were more likely to betaking medication for mental wellbeing (35%)than either the total population (19%) orpeople who had consulted other types ofhealth professional (28%).

Of people who had consulted a complementaryhealth therapist, 18% had been admitted tohospital in the previous 12 months. This washigher than the rate for the total population(15%) but it was not significantly different tothe rate for people who had consulted othertypes of health professional (22%).

…did they also visit doctors?One of the concerns regardingcomplementary therapies is that people mayundergo risky treatments, or fail to accessproven treatments from the mainstreamhealth system.3 It is therefore of interest toknow whether people used complementarytherapists together with, or as an alternativeto, the health care offered by generalpractitioners or specialists. Just underone-third (32%) of people who had visited a

complementary health therapist had alsovisited a doctor in the previous two weeks,rising to 63% who had visited a doctor in theprevious three months. Of people who hadvisited an acupuncturist during the last twoweeks, 45% reported that they had also seen adoctor during this time. While these peoplemay have discussed either the same ordifferent conditions with their doctor andcomplementary therapist, they werenevertheless in touch with mainstreammedicine.

…private health insurancePrivate health insurance ancillary cover oftenincludes chiropractic and osteopathy, andsometimes other complementary therapies. In2004–05, 61% of people who had visited acomplementary health therapist in theprevious two weeks had ancillary coverage,including 66% of those who had visited achiropractor and 60% of those who hadvisited an acupuncturist. These rates werehigher than the rates of ancillary coverage forthe total population (42%) or for people whohad consulted other types of healthprofessional in the previous two weeks (43%).

…healthy lifestyles?People who had visited a complementaryhealth therapist in the previous two weekswere more likely to have certain healthybehaviours than were either the totalpopulation, or people who had consulted anyother health professional. These behavioursincluded eating the recommended minimum

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(a) Arthritis; asthma; diabetes; cardiovascular disease; injuries; cancer; and mental and behavioural problems.(b) Restricted to people aged 15 years and over.(c) Restricted to people aged 18 years and over.(d) Chiropractor, naturopath, acupuncturist, osteopath, herbalist, traditional healer or hypnotherapist.(e) People who had consulted any of 16 other types of health professionals in 2004–05. People who had consulted a complementary health professional may also

have consulted other types of health professional in the previous two weeks.

Source: ABS 2004–05 National Health Survey.

41.814.822.913.015.932.9Total population

43.221.870.619.325.846.5Other health professional(e)

60.618.431.615.318.142.0Complementary healththerapist(d)

59.617.545.119.226.145.7Acupuncturist

57.323.030.219.719.041.6Naturopath

66.318.927.311.615.140.8Chiropractor

%%%%%%Type of practitioner

With privatehealth

insuranceancillary cover

Had beenadmitted tohospital in

previous 12months

Had visited a GPor specialist in

the previous twoweeks

High/Very highlevels of

psychologicaldistress(c)

Assessed ownhealth as

fair/poor(b)

Had a selectedhealth

condition(a)

People who had visited complementary health therapists in the previous two weeks — 2004–05

serves of fruit and vegetables, exercising athigh or moderate level, and not smokingregularly. As an example, almostthree-quarters (73%) of people who hadconsulted a naturopath during the last twoweeks reported eating at least two serves offruit a day, compared with 54% of the totalpopulation. There was little difference amongthe three groups with regard to risky alcoholconsumption over a seven-day period, with84% of people who had visited acomplementary health therapist in the lowrisk category, compared with 87% of the totalpopulation and 88% of people who hadvisited any other type of health professional.

Looking aheadAn issue related to the use of complementarytherapists is people's use of vitamins andminerals and herbal or natural substances. See2004–05 National Health Survey: Summary ofResults, Australia (cat. no. 4364.0) for someinformation on people's use of these in treatingNational Health Priority Area conditions.

In addition to the therapies described in thisarticle, there is a vast array of other therapiesdescribed as 'complementary, 'alternative' or'natural' (one Australian natural therapy sitelists close to 100 types).9 There are practicallimits on collecting statistical data on lesscommonly used therapies. If some of thesebecome more popular, statistical collections will reflect this, for example by separatelyidentifying additional types of therapist in thecensus and in surveys.

Endnotes1 Webb EC et al 1977, Report of the Committee of

Inquiry into Chiropractic, Osteopathy,Homeopathy, and Naturopathy. Canberra:AGPS.

2 Jacka J ‘Fifty Years of Change’ viewed 20December 2007, <www.anta.com.au>.

3 Benoussen A and Myers SP 1996, Towards asafer choice: The Practice of TraditionalChinese Medicine in Australia, Faculty ofHealth, University of Western Sydney,Macarthur, viewed 20 June 2008,<www.health.vic.gov.au/archive2006/chinese/report/contents.html>.

4 Vivian Lin et al (2006) The Practice andRegulatory requirements of Naturopathy andWestern Herbal Medicine, La Trobe UniversitySchool of Public Health, Bundoora viewed 20February 2008, <www.health.vicgov.au/pracreg/naturopathy.htm>.

5 'Complementary medicine gets a boost', Pressrelease 30 March 2008 by Senator the Hon. JanMcLucas, viewed 6 May 2008,<www.health.gov.au>.

6 Devereux E P 1998, History of Chiropracticfrom a New South Wales Perspective(1969–1982) Australasian Chiropractic andOsteopathy (ACO) Vol. 7 No. 2, pp 68–79.

7 Cancer Institute NSW, 'Frequently askedquestions about complementary therapies',viewed 13 May 2008,<http://www.cancerinstitute.org.au/profes/comp_therapies_faq.html>.

8 Australian Institute of Health and Welfare'National Health Priorities' and 'Risk factors'viewed 15 May 2008,<www.aihw.gov.au/nhpa/index.cfm>.

9 Natural Therapy Pages, viewed 5 April 2008,<www.naturaltherapypages.com.au>.

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(a) Restricted to those aged 18 years and over.(b) Body Mass Index from 18.5 to less than 25.0, based on self-reported weight and height.(c) Based on reported alcohol consumption previous week (see ABS National Health Survey 2004–05: Users' Guide – Electronic (ABS cat. no. 4363.0.55.001)).(d) Chiropractor, naturopath, acupuncturist, osteopath, herbalist, traditional healer or hypnotherapist.(e) People who had consulted any of 16 other types of health professionals in the previous two weeks. People who had consulted a complementary health therapist

may also have consulted other types of health professional in the previous two weeks.

Source: ABS 2004–05 National Health Survey.

86.514.454.043.929.678.7Total population

87.915.256.842.128.280.7Other health professional(e)

84.421.363.345.635.884.8Complementary healththerapist(d)

86.125.558.650.634.491.3Acupuncturist

86.526.572.749.644.287.2Naturopath

83.520.558.644.333.684.7Chiropractor

%%%%%%Type of practitioner

Did not haverisky or highrisk alcohol

consumption(c)

Ate five or moreserves of

vegetables per day

Ate two ormore serves of

fruit per dayNormal

weight(b)

Exercised atmoderate to

high levelNot current

daily smokers

People(a) who had visited complementary health therapists in the previous two weeks — 2004–05

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© Commonwealth of Australia 2008Produced by the Australian Bureau of Statistics

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