Objectives: This study examined prayer for health and eight specific reasons why Americans ages 50 and over use Complimentary and Alternative Medicine (CAM): effectiveness; cost; recommendations from health care providers; recommendations from family, friends, or co-workers; or for general health, immune function, physical performance, or energy. The analysis focused on variation associated with race or ethnicity, gender, and income. Methods: We examined praying for health by women and men ages 50+ using data from the 2007 National Health Interview Survey (10,096 respondents, representing about 89.56 million older Americans). Analyses included chi-square and multivariate logistic regression, accounting for the survey design and weighted for national representation. Ethnic groups were non-Hispanic African Americans (African Americans), Hispanics, Asian Americans, and non-Hispanic Whites (Whites). Controls included age, education, marital status, health insurance, comorbidities and changes in health status, smoking status, body mass index, and region. Results: In multivariate analyses for prayer, African Americans were more likely than Whites to report praying for health in the past 12 months (Odds Ratio, OR 2.55; 95% Confidence Interval, CI 2.16-3.03). In adjusted analyses for heath care recommendations and barriers, women were much more likely than men to use a CAM because it was recommended by a provider (OR 1.96, CI 1.72 2.45). People with high incomes were more likely than people with middle incomes to use CAM for general health (OR 1.25, CI 1.07-1.47) or energy (OR 1.61, CI 1.19-2.17). Discussion: Findings suggest that many older Americans pray for health and use CAM because: conventional medicine is too expensive or does not work; it is recommended by a health care provider or by family, friends, or co-workers; or, to improve general health and well-being. African Americans are less likely to use CAM for these reasons than Whites, women more likely than men, and people with lower incomes less likely than those with higher incomes. Older people with chronic conditions, particularly musculoskeletal conditions or depression, are also more likely to use CAM. Providing health care providers with additional CAM training may help them talk with patients about coordinating use of conventional medicine and CAM, in part to avoid potentially serious interactions between some types of CAM and conventional medicine.