Alternative, Complementary, and Integrative ... Health Article

CONVENTIONAL MEDICINE AND PUBLIC HEALTH

Traditionally, public health relies extensively on conventional (allopathic) medicine in its mission to prevent and treat disease. It accepts reductionistic methods to identify the origin of illness at the cellular and subcellular level, and then applies these principles in assessing and addressing risk factors in populations. This results in a three-tiered approach to the delivery of public health services: (1) primary prevention, which involves efforts to reduce exposure to risk factors for injury and illness; (2) secondary prevention, which involves the identification and control of disease in its early stages; and (3) tertiary prevention, which attempts to control the impact of existing illness and injury through prolonged treatment and rehabilitative services.

Paralleling the growth of technology-based medicine (and its effectiveness), however, has been a simultaneous rise in chronic illnesses that are resistant to current treatment modalities and very costly to society. Leading causes of morbidity in the early 1900s, such as trauma and infectious disease, have been supplanted by chronic conditions such as cancer, heart disease, and HIV (human immunodeficiency virus) infection. This requires the development of a new model of health care that is multidimensional and that recognizes all factors influencing health and illness. At a public health level, multidimensional problems require multidimensional interventions, which is the basis of the integrative medical approach.

COMPLEMENTARY AND ALTERNATIVE MEDICINE

In 1948, the World Health Organization (WHO) defined health as "a complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity." The public increasingly embraces "holistic" medicine when seeking treatment for chronic medical conditions. This philosophical shift has led to a sharp increase in the use of complementary and alternative medicine (CAM), defined as modalities (e.g., acupuncture, herbal therapy, massage therapy), employed in place of, or as adjuncts to, conventional medical therapies. Surveys reveal that almost half of the U.S. population turns to such modalities, with acceptance and use of CAM expanding during the 1990s. Studies showing that CAM use tends to be higher among patients with diseases (e.g., cancer, arthritis), that are often inadequately treated by conventional approaches may suggest an inherent dissatisfaction with Western medicine. Research suggests, however, that the public is actually turning to CAM because its doctrines parallel their own personal values and belief systems. For example, patients want physicians who regard them as whole persons—minds and spirits as well as bodies—and who believe in the healing power of nature. In fact, although CAM therapies are very diverse, ranging from well-established cultural traditions (e.g., Chinese traditional medicine) to quasi-allopathic modalities marginally supported by current science (e.g., chelation therapy), most share common underlying philosophies. These include a belief in the interconnectedness of mind and body and respect for the innate mechanisms of healing.