Letters to the Editor
Problem Gambling in the Canadian North Neglected
Dear Editor: Dr Cox and others (1) should be commended for paying close attention to the rapidly rising mental and social health issues of problem gambling. I do, however, have several comments.
One is the unacknowledged limit of the study, which is described as a “national survey” of Canada. The survey, however, covered only the 10 provinces. While the research community’s marginalization of the Territories is not uncommon enough to warrant a letter, I think there is a significant risk that an article like this will lead to further neglect of the significant problem of gambling in the Territories. This neglect is particularly remarkable as the authors seem to forcefully argue that the presence of casinos and video lottery terminals (VLTs) may contribute to increased problem gambling. The fact that the Territories typically lack both may lead one to think there is no problem there. The observed reality is quite the contrary. During my 2.5 years working on Baffin Island as a psychiatrist, I heard many stories from patients, social workers, and colleagues on how gambling has created tremendous rifts in families, ruined relationships and careers, and contributed to violence and suicide. My very informal survey, using a hastily translated Inuktitut South Oaks Gambling Screen, with the staff at a social service agency showed that everyone knew someone (or more) with a “problem.” In a typical Baffin Island town of 500 people, there were generally 2 or 3 gambling gatherings every night, more on weekends and paydays. Heavy betting with snowmobiles, entire monthly salaries, and grocery monies was common. This form of socialization, turned into problem gambling, is particularly remarkable because many towns have banned alcohol; thus, people rely on gambling for entertainment. My educated guess is that problem gambling on Baffin Island, for example, is far above the reported “national” average of 2.0%. On the part of the community at large, there was a tremendous wish and hope to address this mental and social health issue. I think researchers like Dr Cox and others can greatly contribute to this much-neglected area.
The study’s emphasis on forms of commercialized gambling as predictors of problem gambling is also problematic. Although the authors acknowledge that the study is a macroanalysis of available data and propose future studies to include more longitudinal and relational issues regarding VLTs, I think more sophisticated research would include such factors as cultural attitudes toward gambling, different forms of gambling, the local meaning of gambling, and geographical determinants of gambling. For example, the game of patik is a vastly popular, relatively culturally accepted, socially attractive form of gambling for the Baffin Inuit (in addition to bingo and lottery tickets). This fast-paced card game—akin to gin and rummy and often involving intense betting—is at the root of many Inuit gambling problems. This issue will never be recognized if future studies are narrowly city and commercially focused.
References
1. Cox BJ, Yu N, Afifi TO, Ladouceur R. A national survey of gambling problems in Canada. Can J Psychiatry 2005; 50: 213–7.
Samuel Law, MDCM, FRCPC
Toronto, Ontario
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