Factors affecting use of chiropractic services in seven midwestern states of the United States

Although chiropractic is used by approximately 10 percent of the U.S. popul ation, predictors of its use have not been definitively described. Previous studies have suggested that chiropractic suers differ from nonusers in a n umber of sociodemographic characteristics, but their findings are inconsist ent, perhaps because of differences in populations sampled and dates of dat a collection, most of which are prior to 1990. Regional studies have been c onducted in rural areas based on the premise that rural residents are more likely than non-rural residents to use chiropractic; however, this premise has not been definitively documented. The purpose of this study was to prov ide clarification of these sociodemographic predictors of chiropractic use in Illinois, Iowa, Minnesota, Missouri, Nebraska, South Dakota and Wisconsi n by characterizing chiropractic users and nonusers in terms of sociodemogr aphics, including rural or non-rural residence, and presence of low back pa in. Data from 1,511 respondents to a 1994 population-based survey, conducte d by the University of Iowa Social Science Institute, were analyzed. Uncond itional logistic regression was used to derive odds ratios and 95 percent c onfidence intervals for univariate and multiple regression models. Overall, 15.1 percent of respondents had used chiropractic within the last year, mo st often for low back pain (57 percent). Chiropractic uses was less likely in African Americans, Hispanics adn Asians than whites, less likely by non- rural than rural residents, and less likely in Catholics than Protestants i n states other than Iowa and South Dakota. Overall, 42.7 percent of workers with low back pain reported using chiropractic, and use increased with age but remained significantly related to race, rural or non-rural residence, state of residence and religious preference. Race, rural or non-rural resid ence, state of residence and religious preference, independently of low bac k pain, affect use of chiropractic in seven Midwestern states.