The 2012-edition of NAFKAMs national survey was carried out by Ipsos MMI at the turn of the month November/December 2012. It brought data from telephone interviews with a total of 1002 residents aged 15 years and over. Original analysis and reporting was done by Vinjar Fønnebø and Ola Lillenes. The report was first published on Jan 7, 2013.
In November 2022, the data were re-analysed by Agnete E. Kristoffersen, for increased comparison with the other editions of this survey. The report was therefore upgraded in January 2023 due to this and requirements for universal design and accessibility. From then on, this report provides knowledge based on 947 telephone interviews with residents aged 18 and over.
At the end of 2012, according to Statistics Norway, the total population for this age group was 3,867,645 people, divided into 1,925,408 men (49.8%) and 1,942,237 women (50.2%). In our survey, the proportion of men was slightly lower (48.3% men) and the proportion of women correspondingly higher (51.7%) than the actual proportions in the population.
Main results from 2012
This year, a total of 45.3% reported having used complementary and alternative medicine (CAM), in one or more of the following forms:
- Received one or more CAM therapies from a practitioner (36.6%), and/or
- used herbs/ natural remedies (12.0%), and/or
- used self-help techniques (12.4%)
This year, the total use of CAM was more common among women than men: 53.7% of the women in the survey stated that they had used such treatment, compared to 36.3% of the men. The user group was thus divided into 39% men and 61% women.
The average cost for everyone who stated having used CAM in 2018 was NOK 2,609.6. The average cost for male users was NOK 2,394.1, and among female users it was NOK 2,745.4.
Transferred to the population level, this corresponds with 1.752 million Norwegians aged 18 or older using CAM in 2012, at a total cost of NOK 4.572 billion.
A closer look at the data shows that:
CAM therapy from a provider in 2012
36.6% of the respondents stated that they had received one or more CAM therapies from providers inside or outside the public health care system. Treatment from a provider was more common among women (45.5%) than among the men in the survey (27.1%). The user group was thus divided into 36% men and 64% women.
The average cost for those who had received treatment from a provider was NOK 2,497.8 per user. For male users, the average cost was NOK 2,565.0 and for female users it was NOK 2,461.2.
Transferred to the population level, this corresponds with 1.415 million Norwegians aged 18 and over receiving CAM in 2012, at a total cost of NOK 3.536 billion.
Most used CAM therapies in Norway, 2012 (Table):
The differences in usage of the predefined therapies were minor, except for massage therapy, which also in 2012 constituted a significantly higher proportion than the others. "Other CAM" has been corrected by NAFKAM for any medical treatments. You can read more about this in our general article on NAFKAM's population survey.
Use of herbs/ natural remedies in 2012
12.0% reported having used herbs/natural remedies (for example, ginseng, garlic, ginger etc) for health purposes. Treatment with herbs was more common among women (14.5%) than among the men in the survey (9.4%). The user group was thus divided into 38% men and 62% women.
The average cost for those who used herbs as treatment was NOK 1,482.9 per user. For male users, the average cost was NOK 1,700.7 and for female users it was NOK 1,346.0.
Transferred to the population level, this corresponds with 464 000 Norwegians aged 18 and over using herbs as treatment in 2012, at a total cost of NOK 688.3 million.
Use of self-help techniques in 2012
A total of 12.4% reported using self-help techniques (such as yoga, mindfulness, meditation etc) for health purposes. Such treatment was more common among women (17.3%) than among the men in the survey (7.0%). The user group was thus divided into 27% men and 73% women.
The average cost for those who used self-help techniques as treatment was NOK 927.6 per user. For male users, the average cost was NOK 440.0 and for female users it was NOK 1,142.7.
Transferred to the population level, this corresponds with 479 600 Norwegians aged 18 and over using self-help techniques as treatment in 2012, at a total cost of NOK 444.8 million.
CAM users' experiences in 2012 (table)
The 45.3% who stated having used CAM were also asked follow-up questions about their experiences with this; related to whether they had experienced any worsening of their health condition which they linked to their use of alternative treatment:
The 2012 survey showed that only a small number (2%) reported poorer health after using CAM. Converted to the population aged 18 or older in 2012, this still represented 77 300 individuals. In our view, this indicates that patient safety must still be taken seriously within CAM.
Please note that the answer option "has not experienced deterioration" expresses the absence of perceived deterioration. The proportion who answered "no" here cannot automatically be interpreted as "having experienced improvement".
Gender differences in CAM use, 2012
The 947 respondents aged 18 or over consisted of 457 men and 490 women. In 2012, women's use of CAM was generally larger than men's use.
The largest observed difference between the sexes concerned their total use of CAM (17.4 pp difference), and the smallest difference concerned the use of herbs/natural remedies (5.1 pp).
While female users' total costs for CAM use were NOK 351,3 higher than the men's, and for self-help techniques NOK 702,7 higher, male CAM users spent more money than women on treatment from a provider (NOK 103,8) and on herbs (NOK 354,7).
Self-evaluated health in 2012
We asked all respondents how they considered their own health situation, and asked them to rate it from "very good" to "very bad":
Almost 80% rated their health as good or very good, regardless of whether they used CAM or not. CAM users generally rated their health slightly worse than non-users.
Use of dietary supplements in 2012
Though ordinary use (in line with the directions for use) of dietary supplements (vitamins, minerals, trace elements etc) to strengthen health is not perceived as CAM, NAFKAM measures the Norwegian population's use of such products on assignment from the health authorities.
A total of 70,4% reported having used dietary supplements in 2012. Similar to CAM usage, the use of supplements was more common among the women in the survey (74,3%) than among the men (66,4%). The user group was thus divided into 45% men and 55% women.
Transferred to population level, this corresponded to 2,723 million Norwegians aged 18 and over using dietary supplements in 2012, at a total cost of NOK 3,178 billion.
Discussion
The findings in this survey are not initially comparable with the ones from the 2007 survey. This is mainly because the category "other CAM therapies" was defined differently, plus that in 2012 we also included self-treatment with herbs/natural remedies and self-help techniques as forms of CAM.
However, removal of the "use of other CAM therapies" findings from both surveys make the proportions who received therapy from providers comparable: 33,9% in 2007 and 34,8% in 2012. We interpret the small difference of 0,9 percentage points (pp) as that the proportion who received CAM therapies from providers remained unchanged from 2007 to 2012.
Also in 2012, providers listed in the official Practitioner Register were exempted from VAT for their health-related treatments offered, and could thus offer their services at lower prices than non-registered providers. Comparing 2012 to 2007, the number of registered providers is now almost tenfold.
A substantial amount of self-treatment with herbs and/ or self-help techniques was found in the 2012 survey (12%), constituting 450-500 000 individuals. Further, Norwegians' usage of dietary supplements for maintaining health was high; at more than 70% (2,7 million people).
Take-home message
Norwegians' usage of CAM in 2012 must be considered as in line with comparable countries; constituting a substantial proportion of Norwegian patients' total health care strategies. NAFKAM will follow the development of usage of and costs related to CAM providers, and look for potential preferences for registered/ unregistered providers. Also, the substantial amount of self-treatment with self-help techniques and herbs; without advice or follow-up from a professional should be monitored, as new elements to consider in patient safety work within alternative treatment.
Det samme kan sies for befolkningens bruk av kosttilskudd. Nordmenns bruk av dette er fremdeles trolig knyttet mest til tran, vitaminer, fiskeolje og lignende som her til lands har lange tradisjoner som strategi for å generelt opprettholde god helse; ikke som behandling av spesifikke helseproblemer.