This dissertation examined factors impacting utilization of complementary and alternative medicine (CAM) by exploring if individuals were either pushed or pulled into using CAM. More specifically, the philosophical congruence theory and Bourdieu's habitus were tested by examining how race, ethnicity, and immigration pull individuals into using CAM. Bury's theory on chronic illnesses was tested by examining how health status and dissatisfaction push individuals towards CAM. Finally, the intersection between CAM and conventional medicine was studied in order to provide a more comprehensive understanding of how individuals use both CAM and conventional medicine.

The data were obtained from the 2002 National Health Interview Survey. The sample consisted of adults, aged 18 and older. Logistic regression, generalized ordered logit regression, zero-inflated models, and exploratory and confirmatory factor analysis were used to determine the relationship between the independent variables and use of CAM as well as use of conventional medicine.

When examining the pull factors impacting CAM utilization, only African Americans had higher odds of using CAM (2.98) and number of CAM types used (1.24) than non-Hispanic Whites. When push factors were explored, level of pain was significant and positive across every CAM domain. Individuals who delayed seeking conventional care due to cost had higher odds of using CAM (1.31) and number of CAM types used (1.19). Likewise, individuals who delayed seeking conventional care due to inaccessibility had higher odds of using CAM (1.96) and number of CAM types used (1.16).

The pull factors of philosophical congruence theory and Bourdieu's theory on habitus are at best a weak explanation of why individuals use CAM. Individuals are not pulled into using CAM based on their social construction of health. Rather, individuals are pushed into CAM because of the uncertainties surrounding conventional medicine's ability to effectively treat chronic pain and because of dissatisfaction encompassing access issues, such as the nature of managed care, as well as cost issues, given the rising cost of health care. When individuals are pushed into using CAM, they do not abandon conventional Western medicine but use CAM more in a complementary fashion and not as a replacement for conventional medicine.