A Spatial Analysis of Acupuncture Practitioners in Ontario, Canada: Assessing Regional and Intra-Metropolitan Trends

Regional disparities in health care supply are typically measured in terms of accessibility to family doctors, specialists and other services associated with the conventional medical (CM) sector. Although progress is being made, research on the geographic properties of complementary and alternative medicine (CAM) remains underdeveloped by comparison. CAM’s long history of use, continued popularity and commercial success (via chiropractic, massage, acupuncture, homeopathic, naturopathic and other approaches) and slow but insistent integration with CM makes continued study not only logical but necessary. To gain a better understanding of a location’s endowment of medical resources, or indeed to compare health care supply amongst areas, it is important to assess both CM and CAM activity. To this end, study needs to evaluate the many diverse sources of medical supply from a geographical perspective. This paper appends the literature by considering the location properties of acupuncture establishments and does so at two scales: regionally throughout the Canadian province of Ontario and locally within the Greater Toronto metropolitan area. While the emphasis of this study is to describe the spatial patterns of offices listing acupuncture as its main purpose (as classified by standard industrial classification codes), for perspective these primary function acupuncture (PFA) offices are compared to the location tendencies of both CAM collectively (chiropractic, massage, acupuncture, homeopathic, naturopathic and holistic) and ‘total’ health care supply (CAM plus medical doctor offices, physiotherapists, clinics and hospitals or more generally CM). The analysis reveals that acupuncture offices have strong clustering tendencies and that the intra-Toronto concentrations occur in close proximity to Chinese ethnicity enclaves. These spatial outcomes have wider ramifications in terms of: health care policy, the increasingly debated possibility for greater integration between acupuncture, and other CAM approaches, with conventional (Western, biomedical, allopathic) medicine and in understanding the location-specific criteria that are conducive to attracting CAM activity and perhaps in fostering places of healing.