Letters to the Editor
Reply: Problem Gambling in the Canadian North Neglected
Dear Editor: We thank Dr Law for his thoughtful letter, and we welcome the opportunity to reply. Our first point is that there was no a priori research decision to exclude the Territories. Rather, our focus on the 10 provinces reflected the sampling design of Statistics Canada’s Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). In a description of the survey design, an early Statistics Canada report stated that the CCHS 1.2 target population did not include “those living in the three territories, on Indian Reserves and Crown lands, clientele of institutions . . . and residents of some remote areas” (1). This sampling design was reiterated in a recent special issue of the Canadian Journal of Psychiatry, where it was nevertheless stated that the CCHS 1.2 “constitutes a comprehensive source of information on the mental health of Canadians” and that it does so at the “provincial and national levels” (2). Finally, Statistics Canada authors have also emphasized that the CCHS 1.2 “offers first-time information on problem or pathological gambling across Canada” (3). We used language to stress that we were interested in interprovincial comparisons because this is where the recent widespread increase in legalized gambling activities in Canada has occurred.
Our second point is that our primary research focus was an examination of the prevalence rates of problem gambling in different regions of the country in the wake of the introduction of newer forms of gambling (VLTs and casinos) and their availability in Canadian communities. As Dr Law points out, there are no VLTs or permanent casinos in the Territories.
It has often been said that gambling has existed in almost all cultures throughout history, and Dr Law offers some informative examples from Inuit communities. We agree with Dr Law that a national research agenda on gambling should eventually include all communities in Canada. However, it is the potentially harmful effects of the widespread introduction and ease of availability of the newer forms of legalized gambling activity that have been of particular concern to Canadian public health experts (4).
References
1. Beland Y, Dufour J, Gravel R. Sample design of the Canadian Mental Health and Wellbeing Survey. Proceedings of the Survey Methods Section Annual Meeting. Vancouver (BC): Statistical Society of Canada; 2001. p 93–8.
2. Gravel R, Beland Y. The Canadian Community Health Survey: Mental Health and Well-Being. Can J Psychiatry 2005;50:573–9.
3. Marshall K, Wynne H. Fighting the odds. Ottawa (ON): Statistics Canada; 2003. Catalogue no 75-001-XIE.
4. Korn DA. Expansion of gambling in Canada: implications for health and social policy. CMAJ 2000;163:61B4.
Brian Cox, PhD, CPsych
Nancy Yu, PhD
Tracie Afifi, MSc
Robert Ladouceur, PhD, CPsych
Winnipeg, Manitoba
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