Distinguishing complementary and alternative medicine: the role of religion, healthcare system satisfaction and country context

Aim: This study aims to distinguish between the usage of complementary medicine and alternative medicine often jointly referred to as CAM. Furthermore, the analysis focuses on the role of religion, healthcare system satisfaction and the country of residence. Subject and methods: The analysis uses data of the International Social Survey Programme 2021 "Health and Health Care II" (ISSP 2021) to estimate the prevalence of complementary medicine and alternative medicine. A nested logistic regression model was applied to distinguish between no medicine use, conventional medicine, complementary medicine and alternative medicine. Results: The findings indicate that complementary medicine is significantly more prevalent than alternative medicine, though substantial cross-country differences are observed. While religious affiliation alone does not show a significant relationship with CAM usage, individuals who attend religious services regularly are more likely to use CAM in a complementary manner, alongside conventional medicine. Individuals who are dissatisfied with the health care system also are more likely to use both complementary medicine and alternative medicine. Higher levels of education are negatively associated with the use of alternative medicine. Younger individuals are more likely to use CAM and specific alternative medicine, compared to older age groups. Being female is consistently associated with a higher chance of CAM usage overall. Discussion: Treating complementary and alternative medicine as distinct reveals different prevalence rates and influencing factors. Religion, satisfaction with the healthcare system, education, age, and gender play varying roles depending on whether CAM is used alongside or instead of conventional medicine. Cross-country differences point to cultural and health system influences. For public health, distinguishing between complementary and alternative use can support more targeted strategies to promote safe integration and reduce risks from substituting conventional treatment.