National Surveys In Canada Research Articles

Loneliness and cannabis use among older adults: findings from a Canada national survey during the COVID-19 pandemic

BackgroundCannabis use has been increasing among older adults in Canada, particularly during the COVID-19 pandemic. This study aims to examine the association between loneliness and cannabis use among older Canadians during the pandemic.MethodsQuantitative data analyses were performed based on 2,020 participants aged 55 years and older from the Canadian Perspectives Survey Series 6, 2021: Substance Use and Stigma During the Pandemic.ResultsThis study found that participants who used cannabis in the 30 days before the survey reported significantly higher loneliness scores than those who never used cannabis after adjusting social-demographic, social interaction, and pandemic-related factors. Participants who kept using cannabis during the pandemic also reported significantly higher loneliness scores than those who never used cannabis.ConclusionThe findings about the correlation between cannabis use and greater loneliness contribute to the discourse on potential health and wellbeing harms of cannabis use among older adults.

Perceptions of the health risks of cannabis: estimates from national surveys in Canada and the United States, 2018-2019.

Few studies have compared knowledge of the specific health risks of cannabis across jurisdictions. This study aimed to examine perceptions of the health risks of cannabis in Canada and US states with and without legal non-medical cannabis. Cross-sectional data were collected from the 2018 and 2019 International Cannabis Policy Study online surveys. Respondents aged 16-65 (n = 72 459) were recruited from Nielsen panels using non-probability methods. Respondents completed questions on nine health effects of cannabis (including two 'false' control items). Socio-demographic data were collected. Regression models tested differences in outcomes between jurisdictions and by frequency of cannabis use, adjusting for socio-demographic factors. Across jurisdictions, agreement with statements on the health risks of cannabis was highest for questions on driving after cannabis use (66-80%), use during pregnancy/breastfeeding (61-71%) and addiction (51-62%) and lowest for risk of psychosis and schizophrenia (23-37%). Additionally, 12-18% and 6-7% of respondents agreed with the 'false' assertions that cannabis could cure/prevent cancer and cause diabetes, respectively. Health knowledge was highest among Canadian respondents, followed by US states that had legalized non-medical cannabis and lowest in states that had not legalized non-medical cannabis (P < 0.001). Overall, the findings demonstrate a substantial deficit in knowledge of the health risks of cannabis, particularly among frequent consumers.

Trajectories of family care over the lifecourse: evidence from Canada

AbstractIn the midst of a ‘care crisis’, attention has turned again to families who are viewed both as untapped care resources and as disappearing ones. Within this apparent policy/demographic impasse, we test empirically theorised trajectories of family care, creating evidence of diverse patterns of care across the lifecourse. The study sample, drawn from a Statistics Canada national survey of family care, comprised all Canadians aged 65 and older who had ever provided care (N = 3,299). Latent Profile Analysis yielded five distinct care trajectories: compressed generational, broad generational, intensive parent care, career care and serial care. They differed in age of first care experience, number of care episodes, total years of care and amount of overlap among episodes. Trajectories generally corresponded to previously hypothesised patterns but with additional characteristics that added to our understanding of diversity in lifecourse patterns of care. The five trajectories identified provide the basis for further understanding how time and events unfold in various ways across lifecourses of care. A gap remains in understanding how relationships with family and social network members evolve in the context of care. A challenge is presented to policy makers to temper a ‘families by stealth’ policy approach with one that supports family carers who are integral to health and social care systems.

Validation of a brief version of the Social Provisions Scale using Canadian national survey data.

The 10-item Social Provisions Scale (SPS-10) has been implemented to measure social support in a number of national surveys in Canada. The objective of this study was to reduce the SPS-10 to a brief, five-item scale (SPS-5), while maintaining adequate measurement properties. Data from individuals aged 18 years and older who responded to the Social Provisions Scale module in the Canadian Community Health Survey 2012 Mental Health Focus cycle (CCHS 2012 MH) and the Canadian Community Health Survey 2017 Annual cycle (CCHS 2017) were analyzed. We used exploratory factor analysis and item-to-total correlations from the CCHS 2012 MH data to choose items. A correlation analysis between the SPS-5, SPS-10 and related positive mental health (PMH) constructs were used to assess the criterion-related validity of the SPS-5 compared to the SPS-10. A confirmatory factor analysis using data from the CCHS 2017 was conducted to confirm the factor structure of the SPS‑5. The SPS-5 showed high internal consistency (Cronbach's alpha of 0.88) and similar correlations as the SPS-10 with related PMH constructs. The SPS-5 and SPS-10 were also very highly correlated (r = 0.97). The confirmatory factor analysis demonstrated that a single factor model of the SPS-5 fit the data well. The SPS-5 and SPS-10 yield similar estimates of high social support, of 92.7 and 91.5%, respectively. The new SPS-5 demonstrated adequate measurement properties, and functioned in a similar manner to the SPS-10, supporting a reduced version of the Scale. The SPS-5 is a feasible and valid alternative to the SPS-10 that could be used to reduce respondent burden on national health surveys.

Does noticing energy infrastructure influence public support for energy development? Evidence from a national survey in Canada

A gap exists in cross-technology and large-scale research about public support for energy infrastructure, particularly the influence of exposure on attitudes. We used a national panel sample of Canadians to explore drivers of support across ten energy technologies, comparing predictors such as exposure, political views, environmental values and sectoral employment with controls for demographics and geography. Exposure to a specific infrastructure was associated with support for four technologies, only one of which was renewable (solar); the others were nuclear, oil from non-tar sand sources and coal, the last of which had the strongest effect with exposure doubling the likelihood of support. However, noticing any infrastructure at all boosted support for all renewable technologies included as well as natural gas, increasing the likelihood of support for key renewables (wind, hydroelectricity, and solar) by 61–76%. Beyond the importance of noticing infrastructure, our results demonstrate that energy technology support follows relatively predictable lines in Canada, save for a general lack of urban–rural divide in attitudes. Results suggest that hiding energy infrastructure may be a barrier to renewable energy transitions, but first we need: more nuanced measurements of exposure and noticing, to understand the direction of causality between such variables and support; and, to explore the roles of energy literacy and gender.

Montreal Accord on Patient-Reported Outcomes (PROs) use series – Paper 5: patient-reported outcomes can be linked to epidemiologic measures to monitor populations and inform public health decisions

BackgroundA comprehensive picture of population health status can be captured by the incorporation of patient-reported outcome measures into population health monitoring. ObjectiveThe aim of the study was to identify the current state, opportunities, and future research related to the utilization of patient-reported outcome measures for population health monitoring in Canada. DiscussionsPatient-reported outcome measures can help to identify community health needs in public health topics including injury, chronic disease, and communicable disease. They are currently collected in major national surveys in Canada, while electronic medical records, personal health records, and online patient communities could facilitate rapid and cost-effective collection of population-based data. Their effective use requires well-validated measurements and consideration to the factors affecting validity and reproducibility and the modes of administering questionnaires. Methodologically, relevant public health application of patient-reported outcome measures includes analysis assessing measurement comparability across sociodemographically and clinically diverse population and the influence of physical and social environment. Research is needed to develop and apply analytical methods, harmonize patient-reported outcome measures across data sources and health jurisdictions, and link these measures to traditional epidemiologic indicators. Achieving these goals will benefit from collaboration among governmental agencies and expert groups.

Profile of a national sample of Canadian children with participation and activity limitations.

Little is known about the nature of Canadian children with participation or activity limitations. Our objective was to profile a nationally representative sample of Canadian children with report of participation or activity limitation including identifying the major medical reasons attributed to these limitations and describe their sociodemographic and functional characteristics. We used data from the Canadian 2006 Participation and Activity Limitation Survey, a post-census Statistics Canada national survey of adults and children whose everyday activities were limited because of a condition or health problem. Data were collected by telephone interview of children's (<15 years) parents. A sample of those who answered 'yes' to the 2006 Canada Census disability filter questions was chosen for follow-up. Functional ability was assessed using the Health Utility Index. Mental health (26.1%) was the most common reason reported for participation and activity limitations followed by respiratory (9.8%), neurological (5.5%), and congenital (4.6%) conditions. Having a comorbid condition was associated with each major reason for limitation. Mental health, neurological, and congenital conditions showed the highest risk of functional limitation. In conclusion, mental health conditions and those with multiple conditions should be a primary focus for interventions aimed at reducing the impact of health conditions.

Reconnecting class and production relations in an advanced capitalist ‘knowledge economy’: Changing class structure and class consciousness

Recent approaches to class analysis in advanced capitalism have been largely disconnected from the capitalist labour process. This paper has three basic goals. First, we suggest a composite Marxist model of current class structure grounded in ownership, managerial authority, specialized knowledge and value relations in the capitalist labour process. Secondly, this model is used for an empirical assessment of continuity and change in class structure, based on a series of national surveys in Canada in the period 1982–2010. Thirdly, using the same series of surveys, we use this model of class structure to evaluate the extent to which employment class positions are relevant for understanding shifting expressions of class consciousness. Within the employed labour force in this particular advanced capitalist country, we find a generally declining conventional working class and expanding proportions of managerial and professional employees. Connections between employment class positions and class consciousness can involve complex mediations. Evidence for the persistence of strong hegemonic consciousness among corporate capitalists is provided by an additional unique series of surveys. This persistence contrasts with declining working class identity and increasingly mixed class consciousness among most other employment class positions. However, pro-labour oppositional consciousness is found to dominate among unionized industrial workers and professional employees in the private goods-producing sector, who may be among the most directly exploited workers in value terms in an emergent ‘knowledge economy’. The findings suggest the continuing relevance of pursuing class analyses based on production relations in advanced capitalist economies.

Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States

ObjectiveTo compare the magnitude of, and contributors to, income-related inequalities in oral health outcomes within and between Canada and the United States over time. MethodsThe concentration index was used to estimate income-related inequalities in three oral health outcomes from the Nutrition Canada National Survey 1970–1972, Canadian Health Measures Survey 2007–2009, Health and Nutrition Examination Survey I 1971–1974, and National Health and Nutrition Examination Survey 2007–2008. Concentration indices were decomposed to determine the contribution of demographic and socioeconomic factors to oral health inequalities. ResultsOur estimates show that over time in both countries, inequalities in decayed teeth and edentulism were concentrated among the poor and inequalities in filled teeth were concentrated among the rich. Over time, inequalities in decayed teeth increased and decreased for measures of filled teeth and edentulism in both countries. Inequalities were higher in the United States compared to Canada for filled and decayed teeth outcomes. Socioeconomic characteristics (education, income) contributed greater to inequalities than demographic characteristics (age, sex). As well, income contributed more to inequalities in recent surveys in both Canada and the United States. ConclusionsInequalities in oral health have persisted over the past 35 years in Canada and the United States, and are associated with age, sex, education, and income and have varied over time.

Is multiculturalism in Russia possible? Intercultural relations in North Ossetia-Alania

IntroductionA major challenge confronting Russian society in the 21st century is finding effec­tive strategies for managing cultural diversity. Researchers have discerned some basic principles that underpin the processes and outcomes of intercultural relations in plural societies. In our survey we used three hypotheses of intercultural relations offered by Berry (2013): the multiculturalism hypothesis, the contact hypothesis, and the integration hypothesis.The basic notion of the multiculturalism hypothesis is that only when people are secure in their identities they will be in a position to accept those who differ from them. Conversely, when people feel threatened, they will develop prejudice and engage in discrimination. The multiculturalism hypothesis is confirmed in many studies. For example, in two national surveys in Canada (reviewed by Berry & Ka­lin, 2000), measures of cultural security/threat and economic security/threat were created with respect to extant diversity and the continuing flow of immigration. These two security scores were correlated with each other and with various inter­cultural attitudes. Cultural security was negatively correlated with ethnocentrism and positively correlated with multicultural ideology and with the perceived con­sequences of multiculturalism. Economic security had a similar pattern of correla­tions with these variables.Ward and Masgoret (2008) found that more frequent intercultural contact led to decreased intergroup anxiety, which, in turn, predicted lower perceptions of threat and more positive attitudes toward immigrants in New Zealand. A study of Estonian Russians showed that the high perception among Estonians that Russia presents a threat is an obstacle to the adaptation of Russians in Estonia (Kruusvall, Vetik, & Berry, 2009).Rohmann, Florack, and Piontkowski (2006) examined acculturation prefer­ences and desired intergroup contact in connection with the Integrated Threat Theory. They found that the same threats -- culture discordance and contact dis­cordance -- predicted both negative attitudes toward minority groups (Italians and Turks) among German hosts and negative attitudes toward the majority group (Germans) among immigrants. Moreover, the effects were stronger among and toward Turks than among and toward Italians. A study in the Netherlands (Van Oudenhoven, Groenewoud, & Hewstone, 1996) showed that a secure attachment style was related to a preference for integration in both immigrants and the Dutch. In Russia, Lebedeva and Tatarko (2013) studied intercultural relations between mi­grants from the Caucasus and Muscovites. They found that cultural security pre­dicted tolerance, a preference for integration, and social equality in both groups, but to a lesser extent among the Muscovites.The contact hypothesis suggests that negative attitudes held by one group to­ward another are caused by a lack of knowledge about that group. When individu­als of two groups come into positive, personal, and cooperative contact with each other, they will get to know each other, and doing so leads to the elimination or reduction of prejudice. However, there are two important conditions: there must be (1) equal status of individuals or groups in contact and (2) support for intercultural contact by the society. Under these conditions mutual attitudes and interactions will become increasingly positive -- for instance, through a growing recognition of similarities (Allport, 1954; Pettigrew, 1997).A good deal of research has been carried out to test this hypothesis (e.g., Petti­grew & Tropp 2011; Van Oudenhoven et al., 1996). An example of the application of the contact hypothesis to the migration context can be found in Voci and Hewstone (2003) in an Italian study and by Van Oudenhoven and colleagues (1996) in Dutch research; both studies demonstrated that intercultural contact significantly im­proved attitudes toward immigrants.In addition, an analysis of the research showed that cross-ethnic friendships are positively related to social competence and life satisfaction (e. …

Examining paid sickness absence by shift workers

Shift workers are at greater risk than day workers with respect to psychological and physical health, yet little research has linked shift work to increased sickness absence. To investigate the relationship between shift work and sickness absence while controlling for organizational and individual characteristics and shift work attributes that have confounded previous research. The study used archive data collected from three national surveys in Canada, each involving over 20000 employees and 6000 private-sector firms in 14 different occupational groups. The employees reported the number of paid sickness absence days in the past 12 months. Data were analysed using both chi-squared statistics and hierarchical regressions. Contrary to previous research, shift workers took less paid sickness absence than day workers. There were no differences in the length of the sickness absence between both groups or in sickness absence taken by female and male workers whether working days or shifts. Only job tenure, the presence of a union in the workplace and working rotating shifts predicted sickness absence in shift workers. The results were consistent across all three samples. In general, shift work does not seem to be linked to increased sickness absence. However, such associations may be true for specific industries. Male and female workers did not differ in the amount of sickness absence taken. Rotating shifts, regardless of industry, predicted sickness absence among shift workers. Consideration should be given to implementing scheduled time off between shift changes.

Socio-economic Inequalities and Oral Health in Canada and the United States

This paper describes and compares the magnitude of socio-economic inequalities in oral health among adults in Canada and the US over the past 35 years. We analyzed data from nationally representative examination surveys in Canada and the US: Nutrition Canada National Survey (1970-1972, N = 11,546), Canadian Health Measures Survey (2007-2009, N = 3,508), The First National Health and Nutrition Examination Survey (1971-1974, N = 13,131), and National Health and Nutrition Examination Survey (2007-2008, N = 5,707). Oral health outcomes examined were prevalence of edentulism, proportion of individuals having at least 1 untreated decayed tooth, and proportion of individuals having at least 1 filled tooth. Sociodemographic indicators included in our analysis were place of birth, education, and income. Data were age-adjusted, and survey weights were used to account for the complex survey design in making population inferences. Our findings demonstrate that oral health outcomes have improved for adults in both countries. In the 1970s, Canada had a higher prevalence of edentulism and dental decay and lower prevalence of filled teeth. This was also combined with a more pronounced social inequality gradient among place of birth, education, and income groups. Over time, both countries demonstrated a decline in absolute socio-economic inequalities in oral health.

ARE INVESTMENT EXPECTATIONS RATIONAL, ADAPTIVE OR REGRESSIVE?

I. INTRODUCTION Tests of the rational expectations hypothesis (REH) outside the experimental laboratory typically utilize two types of data: quantitative measures of expectations about publicly observed variables such as inflation, usually elicited from small samples of professional forecasters; and qualitative measures of expectations about privately observed variables such as personal income, elicited from large samples of households. Analyses of both types of data have produced varying levels of support for the REH. For example, Keane and Runkle (1990, 1998) find evidence in favor of the REH using the first type of data, while Bonham and Cohen (2001) in part overturn their results after accounting for the nature of cross-correlations inherent in a group of individuals forecasting the same publicly observed integrated time series. Next, using household survey data, Das and van Soest (1997, 1999) and Das et al. (1999) find evidence against the REH. In contrast, Benitez-Silva et al. (2008) furthered the econometric analysis of such data and presented evidence in favor of the REH. In employing publicly available professional forecaster data several concerns related to pooling, data revisions, and the possibility of signaling on the part of forecasters have been raised. (1) Further, Pesaran and Weale (2006) review a large and growing literature on survey expectations of households and the attendant econometric and substantive issues in analyzing qualitative response expectations data from such surveys. They conclude for myriad reasons that it remains the case that the analysis of individual responses to such surveys, and in particular to those who collect only qualitative information, is underdeveloped. These issues can be addressed in part by data on quantitative expectations about privately observed variables; this paper employs data from two new survey sources that provide such information. The resulting panel of 775 firms in Canada contains quantitative information on expectations about purchases of new machinery and equipment (investment), as well as realized levels of investment, over 7 yr. The data are particularly useful because they avoid some of the issues raised for previous studies and their analysis helps to contribute, on the firm side, to the agenda laid out by Manski (2004) who sees a critical need for basic research on expectations formation. [FIGURE 1 OMITTED] Estimation results suggest that investment expectations are not rational if the assumed underlying loss function is assumed to be symmetric. That is, the usual unbiasedness and efficiency requirements for rational expectations, clearly elucidated for instance by Lovell (1986), do not hold for the collected data. Further, hypothesis tests on statistical models implied by conventional adaptive expectations do not suggest the prevalence of such behavior in the data. However, a particular version of such extrapolative expectations, namely, regressive expectations formation, does find support in the data. The paper is structured as follows. Section II discusses the data on 775 manufacturing plants over 7 yr that was compiled by merging two national surveys in Canada. In Section III, the statistical models (and attendant hypothesis tests) as implied by various expectations formation assumptions are described followed by their estimation results. Section V concludes. II. THE DATA Data were compiled from two confidential, proprietary surveys conducted by Statistics Canada: the Capital Expenditures Survey (CES) and the Annual Survey of Manufactures (ASM) over 7 yr (1986-1992). (2) The CES contains data on one-step ahead expected ([Expect.sub.it]) and realized (Actualit) capital expenditures on machinery and equipment (i.e., investment), and the ASM on shipments ([Shipment.sub.sit]). (3) Owing to the lumpy and long-term nature of construction expenditures, this variable was excluded. Finally, only manufacturing sector records were selected for both surveys. …

Rural‐Urban Differences in Environmental Concern in Canada

Abstract Distinctions between rural and urban populations are well documented in environmental sociology literature. Rural and urban places may exert different influences on participation in environmentally supportive behavior (ESB) as well as on other forms of environmental concern (EC). The influence of these distinct geographies may be due to present circumstances or because of childhood socialization in these places. Using data from a national survey in Canada (n=51 664), we use cognitive (basic values, environmental worldview, and environmental attitude) and behavioral indicators (public and private sphere) of EC to explore differences among rural and urban populations and we include analyses accounting for place of socialization. We extend the conventional private sphere category of ESB by including stewardship behaviors. Results showed few differences between rural and urban residents on indicators of EC. Rural residents, however, scored higher on altruistic values, placed a higher priority on the environment, and reported higher participation in recycling and stewardship behaviors. Analysis that included place of socialization showed differences on environmental worldview, basic values, and some ESB. In terms of ESB, we conclude that residence and place of socialization may be less of a factor than opportunity and highlight the importance of providing services and facilities. We recommend future research on residence and ESB include a variety of behaviors that reflect opportunities for both rural and urban residents.

The Association between Pathological Gambling and Attempted Suicide: Findings from a National Survey in Canada

To examine the association between pathological gambling (PG) and attempted suicide in a nationally representative sample of Canadians. Data came from the Canadian Community Health Survey, Cycle 1.2, conducted in 2002, in which 36 984 subjects, aged 15 years or older, were interviewed. Logistic regression was performed with attempted suicide (in the past year) as the dependent variable. The independent variables were PG, major depression, alcohol dependence, drug dependence, and mental health care (in the past year), as well as a range of sociodemographic variables. Survey weights and bootstrap methods were used to account for the complex survey design. In the final logistic regression model, which included terms for PG, major depression, alcohol dependence, and mental health care, as well as age, sex, education, and income, the odds ratio for PG and attempted suicide was 3.43 (95% confidence interval, 1.37 to 8.60). PG (in the past year) and attempted suicide (in the past year) are associated in a nationally representative sample of Canadians. However, it is not possible to say from these data whether this represents a causal relation.

Men's life course trajectories: Exploring the differences by cohort and social class

Abstract Making use of retrospective information gathered through a 2001 national survey in Canada, we examined the timing of transitions and life course trajectories starting from events experienced early in life to events that usually happen later in life. The subjects of the study were men born from 1926 to 1975, and the analyses were done by 5‐year birth cohorts and by social status. Results of the analysis showed that there have been significant changes over cohorts and that the life course trajectories of the poor were different from those economically better off. Men from higher social class were more likely to experience family life events ‐ such as start of regular work and entry into union ‐ at older ages, and were also more likely to follow a normative life course trajectory. We explore the factors affecting such differences in the context of constraints on decision‐making.

Problem Gambling and Attempted Suicide are Associated in a National Survey in Canada

Problem Gambling and Attempted Suicide are Associated in a National Survey in Canada

Measuring Obesity in Young Children

Child obesity is currently an important policy problem in Canada. Making the best evidence-based policy choices in response requires having the best possible evidence. Yet, we point out how easy it can be to make serious mistakes when measuring child obesity, particularly for young children. We demonstrate that parental reports of child height and weight very likely overestimate obesity prevalence for very young children. Given the importance of child obesity as a policy issue, our main conclusion is that it is critical for national surveys in Canada to provide interviewers with appropriate equipment and ask them to weigh and measure children very accurately. While this would certainly increase survey costs, the costs to society of making less than the best policy choices are likely to be even higher.

Measurement of household food security in the USA and other industrialised countries

To describe the history and current status of household food security measurement. In the 1980s evidence of rising levels of hunger was a concern for many, but disputed by some, Americans. Acknowledgement and quantification of hunger was hindered by the lack of an accepted definition and measure of hunger. Qualitative research at Cornell provided a conceptual framework, description, definition and survey items for hunger. The Community Childhood Hunger Identification Project developed an instrument used in numerous communities. Based upon these initiatives, widely accepted definitions of hunger and food insecurity, and the US Household Food Security Module for its measurement, now exist. The module classifies households as food-secure, or food-insecure without hunger or with moderate or severe hunger, and contains household-, adult- and child-referent items. Its inclusion in the Current Population Survey (CPS) since 1995 has yielded annual estimates of food insecurity. A six-item short form of the module, for surveys with severe time constraints, classifies households only as food-secure or food-insecure without or with hunger and contains no child-specific items. Surveys using the 18-item or short-form module can compare results with published national data from the CPS. Information about the module is available at http://www.ers.usda.gov/briefing/foodsecurity and http://www.fns.usda/fsec. Current research on food security measurement includes measurement of individual food insecurity and hunger, module performance regarding hunger duration and frequency, performance of the module in population sub-groups, and the effect of translations on module meaning and performance. National surveys in Canada, New Zealand and Australia also have measured food security.

Antidepressant use in the elderly population in Canada: results from a national survey.

There are few epidemiologic studies of the rate of antidepressant use in the elderly population, especially for community residents. We report findings on antidepressant use in the elderly population using data from a national survey in Canada which drew samples from both the community and institutional settings. Data for the present study came from the Canadian Study of Health and Aging (CSHA), a national prevalence study of dementia in which information was collected from 2914 elderly subjects on current drug use, place of residence (community, institution), depression, dementia, and self-reported health. Survey weights were constructed to reflect the national population and data were analyzed using the SUDAAN statistical software package. The rate of antidepressant use was 4.1% (community 3.1%, institution 16.5%). Of those who were depressed, 9.4% were taking an antidepressant (community 4.2%, institution 36.0%). A logistic regression analysis showed that female gender, living in an institution, the presence of dementia, and the presence of a chronic physical disease, but not depression, were associated with increased antidepressant use. Our findings on the rate of antidepressant use in the elderly population are consistent with and extend previously published reports. We found evidence of underutilization of antidepressants in the treatment of geriatric depression, especially for community residents. However, this evidence needs to be interpreted with caution as the CSHA data on depressive symptoms were incomplete.