chiropractic, acupuncture, faith healing, herbal remedies, and others. Estimates of what Americans have spent annually on alternative therapies range from $21 billion to $33 billion (1996 estimate). Of those who use alternative medicine, practically all use it to complement their conventional health practices.

The IOOW 2000 research study found that nearly two-thirds of Americans (64%) use vitamins and nutritional supplements as part of their personal health strategy. Forty-four percent report having used some form of muscular or skeletal bodywork, herbal medicine, acupuncture, subtle energy work, or faith-based alternatives to conventional health care. The most consistent users of all forms of alternative healthcare (including vitamins and all other alternatives) tend to be those who most frequently support an integral approach to life and to community transformation. This group tends to integrate traditional ways of expressing spirituality with an internal spiritual direction. The group that is identified with persisting against adversity also tends to use naturopathic, faith or subtle energy-based therapy, and acupuncture more than other types. In contrast, the most infrequent users of all types of alternative healthcare tend to be successful, materially oriented, and more disconnected from social concerns.

Physical and Emotional Wellness

Asked about their overall health, 18% of respondents report that they are experiencing serious problems. Asked about the most recent four weeks, 10% to 14% percent report that they have serious emotional problems, such as feeling so sad and unhappy that nothing could cheer them up, or feeling so anxious and agitated that nothing could calm them down. Eleven percent of respondents report having serious difficulties in their work life. Overall, a third (33%) report that in the past two years, immediate family members have experienced a serious physical or mental health crisis. Finally, a third of respondents (32%) say they have participated in professional counseling or psychotherapy at some time in their life.

To add to this picture, respondents were asked about whether they had ever used alcohol or controlled substances. A majority (83%) had used alcohol. More than half (63%) had used tobacco products. One third (34%) had used marijuana and 13% reported having used controlled substances other than marijuana.

Respondents who report the highest incidence of physical health problems (29%) tend to be the type described as having most likely been born outside the U.S., working hard to establish a new life, having a high