Abstract
Objectives
This study adds to the geography of complementary and alternative medicine (CAM) literature by comparing the spatial-temporal patterns of five types of CAM within 19 cities in light of clustering benefits from localization economies.
Methods
CAM office location points and nearest neighbour, standard distance, local spatial autocorrelation, and Mann–Whitney analyses are utilized to test potential clustering tendencies of CAM types over time.
Results
It is shown that ‘within’ (chiropractors near chiropractors, for example) and ‘amongst’ (chiropractors proximate to other CAM types) spatial clustering occurs in 2007 and 2017. This implies the persistent influence of localization economies.
Conclusions
Continued clustering of CAM within urban locations already replete with CAM offices will widen spatial disparities through time. This has implications for policy-makers concerned with dispersing medical resources over space for better accessibility.
-
Research funding: None declared.
-
Author contributions: The author accepts responsibility for the entire content of this submitted manuscript.
-
Competing interests: None declared.
References
1. Esmail, N. Complementary and alternative medicine: use and public attitudes 1997, 2006, and 2016. Vancouver: Fraser Institute; 2017. Available at: https://www.fraserinstitute.org/sites/default/files/complementary-and-alternative-medicine-2017.pdf.Search in Google Scholar
2. Albert, D. New York and Colorado as critical states in the diffusion of state licensing of naturopathic physicians. Compl Health Pract Rev 2009;14:59–69. https://doi.org/10.1177/1533210109337002.Search in Google Scholar
3. Albert, D, Butar, FB. Distribution, concentration and health care implications of naturopathic physicians in the United States. Complement. Health Pract Rev 2004;9:103–17. https://doi.org/10.1177/1076167503252944.Search in Google Scholar
4. Meyer, SP. Spatial-temporal trends in complementary and alternative medicine (CAM) offices in Ontario, Canada. Can Geogr 2020;64:323–35. https://doi.org/10.1111/cag.12590.Search in Google Scholar
5. Williams, AM. The diffusion of alternative health care: a Canadian case study of chiropractic and naturopathic practices. Can Geogr 2000;44:152–66. https://doi.org/10.1111/j.1541-0064.2000.tb00699.x.Search in Google Scholar
6. Adams, D, Dagenais, S, Clifford, T, Baydala, L, King, JW, Hervas-Malo, M, et al.. Complementary and alternative medicine use by pediatric specialty outpatients. Pediatrics 2013;131:225–32. https://doi.org/10.1542/peds.2012-1220.Search in Google Scholar
7. Barbadoro, P, Chiatti, C, D’Errico, MM, Minelli, A, Pennacchietti, L, Ponzio, E, et al.. Complementary and alternative medicine (CAM) among adults in Italy: use and related satisfaction. Eur J Integr Med 2011;3:319–26. https://doi.org/10.1016/j.eujim.2011.09.001.Search in Google Scholar
8. Bertomoro, P, Renna, S, Cottone, M, Riegler, G, Rossa, F, Giglio, L, et al.. Regional variations in the use of complementary and alternative medicines (CAM) for inflammatory bowel disease in Italy: an IG-IBD study. J Crohns Colitis 2010;4:291–300. https://doi.org/10.1016/j.crohns.2009.12.009.Search in Google Scholar
9. Meyer, SP. The spatial pattern of complementary and alternative medical offices across Ontario and within intermediate-sized metropolitan areas. Urban Geogr 2008;29:662–82. https://doi.org/10.2747/0272-3638.29.7.662.Search in Google Scholar
10. Meyer, SP. A spatial analysis of acupuncture practitioners in Ontario, Canada: assessing regional and intra-metropolitan trends. In: Saad, M, editor Acupuncture: concepts and physiology. Rijeka: InTech; 2011:189–206pp.Search in Google Scholar
11. Meyer, SP. Naturopaths in Ontario, Canada: geographic patterns in intermediately-sized metropolitan areas and integration implications. J Compl Integr Med 2017;14:1–13. https://doi.org/10.1515/jcim-2015-0092.Search in Google Scholar
12. Meyer, SP. Alternative and complementary medicine (CAM): single, multiple and high-density function locations in intermediately-sized centers in Ontario, Canada. J Altern Compl Integr Med 2017;3:1–9.10.24966/ACIM-7562/100027Search in Google Scholar
13. Pearson, H, Fleming, T, Chhoun, P, Tuot, S, Brody, C, Yi, S. Prevalence of and factors associated with utilization of herbal medicines among outpatients in primary health centers in Cambodia BMC. Complement. Alternative Med 2018;18:1–9. https://doi.org/10.1186/s12906-018-2181-1.Search in Google Scholar
14. Robinson, A, Cooper, S. Trusted information sources: the preferred option for complementary and alternative medicine users. Compl Health Pract Rev 2007;12:120–38. https://doi.org/10.1177/1533210107302776.Search in Google Scholar
15. Sanders, LJ, Aguilar, G, Bacon, CJ. A spatial analysis of the geographic distribution of musculoskeletal and general practice healthcare clinics in Auckland, New Zealand. Appl Geogr 2013;44:69–78. https://doi.org/10.1016/j.apgeog.2013.07.014.Search in Google Scholar
16. Wardle, J, Adams, J, Magalhaes, RJ, Sibbritt, D. Distribution of complementary and alternative medicine (CAM) providers in rural New South Wales, Australia: a step towards explaining high CAM use in rural health. Aust J Rural Health 2011;19:197–204. https://doi.org/10.1111/j.1440-1584.2011.01200.x.Search in Google Scholar
17. Baldwin, JR, Beckstead, D, Brown, WM, Rigby, DL. Agglomeration and the geography of localization economies in Canada. Reg Stud 2010;42:117–32.10.1080/00343400701543199Search in Google Scholar
18. Hayter, R, Patchell, J. Economic geography: an institutional approach. Toronto: Oxford; 2011.Search in Google Scholar
19. Gill, IS, Goh, CC. Scale economies and cities. World Bank Res Obs 2010;25:235–62. https://doi.org/10.1093/wbro/lkp022.Search in Google Scholar
20. InfoCanada. Canadian Business Directory. InfoCanada: Mississauga; 2007.Search in Google Scholar
21. InfoCanada. Canadian Business Directory. InfoCanada: Mississauga; 2017.Search in Google Scholar
22. Statistics Canada. Census – road network files. Ottawa: Statistics Canada; 2006. Available at: https://www12.statcan.gc.ca/census-recensement/2011/geo/RNF-FRR/index-2011-eng.cfm?year=06.Search in Google Scholar
23. Statistics Canada. Census – road network files. Ottawa: Statistics Canada; 2016. Available at: https://www12.statcan.gc.ca/census-recensement/2011/geo/RNF-FRR/index-2011-eng.cfm?year=16.Search in Google Scholar
24. Statistics Canada. 2006 census – boundary files. Ottawa: Statistics Canada; 2006. Available at: https://www12.statcan.gc.ca/census-recensement/2011/geo/bound-limit/bound-limit-2006-eng.cfm.Search in Google Scholar
25. Statistics Canada. 2016 census – boundary files. Ottawa: Statistics Canada; 2016. Available at: https://www12.statcan.gc.ca/census-recensement/2011/geo/bound-limit/bound-limit-2016-eng.cfm.Search in Google Scholar
26. Stangroom, J. Mann–Whitney U test calculator. Social Science Statistics 2018. Available at: https://www.socscistatistics.com/tests/mannwhitney/default.aspx.Search in Google Scholar
27. Ebdon, D. Statistics in geography. Cambridge: Basil Blackwell; 1987.Search in Google Scholar
28. McGrew, JC, Monroe, CB. An introduction to statistical problem solving in geography. Toronto: McGraw-Hill; 1993.Search in Google Scholar
29. ESRI. ArcGIS version 10.7. Redlands: Environmental Systems Research Institute; 2018.Search in Google Scholar
30. Sharma, C. Why this northern Ontario institution is more than just a medical school. Toronto: TVO.org; 2019. Available at: https://www.tvo.org/article/why-this-northern-ontario-institution-is-more-than-just-a-medical-school.Search in Google Scholar
31. Wenghofer, EF, Timony, PE, Gauthier, NJ. ‘Rural’ doesn’t mean ‘uniform’: northern vs southern rural physicians’ workload and practice structures in Ontario. Rural Rem Health 2014;14:1–10.10.22605/RRH2720Search in Google Scholar
32. Andrews, GJ, Shaw, D. Place visualization: conventional or unconventional practice? Complement. Ther Clin Pract 2012;18:43–8. https://doi.org/10.1016/j.ctcp.2011.08.009.Search in Google Scholar
© 2021 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Reviews
- ‘Ilāj bi’l-Tadbīr (regimenal therapy): a core mode of Unani treatment
- Understanding hormones in terms of humours (Akhlat) in Unani system of medicine
- Review Articles
- Understanding Humma-e-Wabai (epidemic fever) and Amraz-e-Wabai (epidemic disease) in the light of Unani medicine
- Emergence of antimicrobial resistance and magnitude of Unani medicine – scope and challenges
- Medicinal importance of Papra (Podophyllum hexandrum Royle) in Unani System of Medicine
- Research Articles
- Comparative effects of berberine and piperine on the neuroprotective potential of neostigmine
- Neera, a non-fermented traditional drink from coconut spadix restores the redox status in sodium fluoride intoxicated mice
- Evaluation of wound healing potential of Bhallatakadi Ghrita – cow ghee based polyherbal formulation: in-vivo excision and incision wound model
- Effects of co-administration of Unani pharmacopoeia formulations Qurs Tabasheer Sartani and Arq Hara Bhara with CAT-I antitubercular drugs in rats
- Neurotoxicity of organic solvents with emphasis on the role of iron
- Regular consumption of “Nkui”, a Cameroonian traditional dish, may protect against cardiovascular and bone disorders in an estrogen deficiency condition
- A spatial-temporal study of complementary and alternative medicine (CAM) by type: exploring localization economies implications in urban areas in Ontario
- Complementary and alternative interventions for stroke recovery – a narrative overview of the published evidence
- The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia’s public university
- Effectiveness of wet cupping therapy on relieving pain in patients with chronic migraine: an observational study
- Effect of aromatherapy massage by orange essential oil on post-cesarean anxiety: a randomized clinical trial
- Effect of Sudarshan Kriya Yoga (SKY) on daytime and situational sleep propensity in novice practitioners: a prospective cohort study
- Comparison of instability resistance training, traditional resistance training and plyometric training on athletic performance parameters
- Individualized homeopathic medicines and Urtica urens mother tincture in treatment of hyperuricemia: an open, randomized, pragmatic, pilot trial
- Association of microsomal epoxide hydrolase gene (fast genotype) with lung functions impairment in wood workers
- Dietary glycine improves urine storage symptoms in urology outpatients
- Hypoxia-induced oxidative stress in high altitude population: impact of coenzyme Q10 supplementation
- Short Communications
- Terminalia arjuna induced testicular assault through Leydig cell derangement: an in vitro approach
- Effect of acupuncture on cognitive task performance of college students: a pilot study
- Yoga for children in the new normal – experience sharing
- Effect of Arogya Raksha Panchatantra (five lifestyle principles) on hematological parameters and anthropometric measures among healthy volunteers: a pilot study
- Case Reports
- Yellow phosphorous ingestion cause liver dysfunction and internal bleeding: a case study
- Effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus
- Management of Vipadika with Mahisha Gritha Padanimajjana – a case report
Articles in the same Issue
- Frontmatter
- Reviews
- ‘Ilāj bi’l-Tadbīr (regimenal therapy): a core mode of Unani treatment
- Understanding hormones in terms of humours (Akhlat) in Unani system of medicine
- Review Articles
- Understanding Humma-e-Wabai (epidemic fever) and Amraz-e-Wabai (epidemic disease) in the light of Unani medicine
- Emergence of antimicrobial resistance and magnitude of Unani medicine – scope and challenges
- Medicinal importance of Papra (Podophyllum hexandrum Royle) in Unani System of Medicine
- Research Articles
- Comparative effects of berberine and piperine on the neuroprotective potential of neostigmine
- Neera, a non-fermented traditional drink from coconut spadix restores the redox status in sodium fluoride intoxicated mice
- Evaluation of wound healing potential of Bhallatakadi Ghrita – cow ghee based polyherbal formulation: in-vivo excision and incision wound model
- Effects of co-administration of Unani pharmacopoeia formulations Qurs Tabasheer Sartani and Arq Hara Bhara with CAT-I antitubercular drugs in rats
- Neurotoxicity of organic solvents with emphasis on the role of iron
- Regular consumption of “Nkui”, a Cameroonian traditional dish, may protect against cardiovascular and bone disorders in an estrogen deficiency condition
- A spatial-temporal study of complementary and alternative medicine (CAM) by type: exploring localization economies implications in urban areas in Ontario
- Complementary and alternative interventions for stroke recovery – a narrative overview of the published evidence
- The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia’s public university
- Effectiveness of wet cupping therapy on relieving pain in patients with chronic migraine: an observational study
- Effect of aromatherapy massage by orange essential oil on post-cesarean anxiety: a randomized clinical trial
- Effect of Sudarshan Kriya Yoga (SKY) on daytime and situational sleep propensity in novice practitioners: a prospective cohort study
- Comparison of instability resistance training, traditional resistance training and plyometric training on athletic performance parameters
- Individualized homeopathic medicines and Urtica urens mother tincture in treatment of hyperuricemia: an open, randomized, pragmatic, pilot trial
- Association of microsomal epoxide hydrolase gene (fast genotype) with lung functions impairment in wood workers
- Dietary glycine improves urine storage symptoms in urology outpatients
- Hypoxia-induced oxidative stress in high altitude population: impact of coenzyme Q10 supplementation
- Short Communications
- Terminalia arjuna induced testicular assault through Leydig cell derangement: an in vitro approach
- Effect of acupuncture on cognitive task performance of college students: a pilot study
- Yoga for children in the new normal – experience sharing
- Effect of Arogya Raksha Panchatantra (five lifestyle principles) on hematological parameters and anthropometric measures among healthy volunteers: a pilot study
- Case Reports
- Yellow phosphorous ingestion cause liver dysfunction and internal bleeding: a case study
- Effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus
- Management of Vipadika with Mahisha Gritha Padanimajjana – a case report