| Relatively little is known about the spatial and social factors, the why and where, of unconventional health care in the United States. This study expands that limited knowledge base. It begins with a discussion of alternative medicine, and previous research on practitioner distribution and alternative health care. It then focuses on California, Oregon and Washington.;Practitioner distribution is examined at two scales: regional, using county-based health care catchments; and urban, looking at point-pattern distribution in Eugene, Oregon; Fresno, California; and Olympia, Washington.;Alternative practitioners in each city were also surveyed. Interested practitioners then distributed postcards to patients, who could request a questionnaire. Sixty-nine practitioners and 107 patients completed surveys.;Maps of regional distribution, by catchment, show the highest practitioner-population ratios in secondary urban areas: California's central coast, central Oregon, and southeastern Washington. This may indicate that alternative practitioners here function as generalists.;At the urban scale, analyses of both practitioner and patient point maps show little evidence for clustering, indicating that unconventional practitioners and patients are widely distributed in these communities.;For the survey analyses, practitioners were divided by type (chiropractors, Oriental medicine practitioners, other Western practitioners) and by city. Analyses indicate that each group, by type and city, is distinct and has unique characteristics.;In contrast, patients from the three cities differed little. Based on survey data, the characteristic (modal) patient is a married, middle-aged white woman who attended college and is employed at a white-collar job. She suffers from one or more chronic conditions, first visited an unconventional practitioner when she was between 18 and 34 years old, and has strong opinions about how behavior, spiritual beliefs and exercise affect health. She also believes health care is a right and is in favor of employer-based health insurance.;The mapping and the survey results suggest directions for further research. Questions about distribution, about relationships between alternative and conventional health care, and about the diffusion of unconventional health care seem particularly fruitful. This study points the way to a rich vein for future inquiry. |
