A geographic assessment of 'total' health care supply in Ontario: complementary and alternative medicine and conventional medicine

Shortages of family physicians, specialists and other personnel working within the realm of conventional medicine ( CM) concern citizens in many regions and municipalities in Canada. Complementary and alternative medicine ( CAM) approaches ( such as chiropractic, holistic, homeopathic, naturopathic, massage and acupuncture) are increasingly used in conjunction with, or in some cases as replacements for, conventional medicine. Thus, to get an idea of 'total' health care supply in a jurisdiction and to draw comparisons between locations, it is useful to understand the spatial tendencies of both CM and CAM offices. With the use of a sample that contains the location, employment and sales of 4,955 CAM and 8,709 CM offices, this study details the spatial patterns of health care supply in the Canadian province of Ontario. The analysis comprises three main parts. First, the geographic tendencies of CAM and CM office activity are revealed in per capita terms and while regional differences are detectable, the main contrast is that CAM displays a much more even distribution across the urban-rural continuum in comparison to CM. Second, through the use of location quotients and a local spatial autocorrelation analysis, it is shown that certain municipalities ( especially in Ontario's southwest and south-central regions) specialize in CAM and the most outstanding spatial feature is an '81 municipality CAM cluster' that represents arguably the pinnacle of CAM activity in the province. CM specialization is rarer and is biased towards the more populated municipalities. Third, a Spearman's correlation analysis suggests that CAM and CM health care supply are associated with community well-being indictors and urban density measures.