Poverty, Gender and Well-Being: An Urban-Rural Perspective William H. Laverty, PhD1; Ivan W. Kelly, PhD2; & Bonnie L. Janzen, PhD3 2Department of Mathematics and Statistics, 2Department of Educational Psychology & Special Education, 3Department of Community Health & Epidemiology University of Saskatchewan RESULTS BACKGROUND Analysis and Conclusions Our main objective was to determine if there are any significant Urban-Rural differences in the dependent variables (Life Satisfaction, Happiness, Sense of Belonging, Mastery, Self-Assessment of Health, Self-Assessment of Health and Self-Assessment of Mental Health). In addition we are also searching for significant interaction effects of the Urban-Rural factor with other demographic variables (Age, Gender, Marital Status and Aboriginal Status) on the group of dependent variables. The statistical technique that was used was a weighted Analysis of Variance using a type III sum of squares. Significant interactions with the Urban-Rural factor are identified displayed below graphically. The vast majority of studies examining the social and economic patterning of prescribed psychotropic drug use in general populations utilize only main effects. On average, these studies have shown use of antidepressants to be greater among women, those who are widowed/divorced/separated, and those of lower socioeconomic positions (SEP). Few studies have examined how various indicators of SEP (ie., education and income) may interact with family and work roles to influence use of antidepressants. Significant Interactions with Urban-Rural Factor Life Satisfaction Urban-Rural by Age, (F = 2.57, p-value = 0.0362) Figure 1 Happiness Urban-Rural by Age by Aboriginal Status, (F = 5.52, p-value = 0.0002) Figure 2 Urban-Rural by Age, (F = 2.5, p-value = 0.0409) Belonging Urban-Rural, (F = 18.74, p-value = 0) Urban-Rural by Age by Gender, (F = 2.55, p-value = 0.0378) Figure 3 Urban-Rural by Age by Gender by Aboriginal, (F = 2.47, p-value = 0.0431) Mastery Urban-Rural by Age by Aboriginal, (F = 3.05, p-value = 0.016) Figure 4 Self -Assessed Health Age, (F = 3.52, p-value = 0.0072) Only significant Factor Self –Assessed Mental Health Urban-Rural by Age, (F = 3.18, p-value = 0.0129) Urban-Rural by Gender by Marital Status, (F = 3.5, p-value = 0.0303) Figure 5 Urban-Rural by Aboriginal Status by Marital Status, (F = 3.78, p-value = 0.0229) Urban-Rural by Age by Aboriginal Status by Marital Status, (F = 3.27, p-value = 0.0205) Table 2 RESEARCH OBJECTIVE To examine, using logit models, whether gender, SEP, and work and family role occupancies interact in their association with antidepressant use in a representative sample of working age Canadians. METHODS Data source: Statistics Canada’s 2002 Canadian Community Health Survey (Cycle 1.2, Mental Health and Well-being). Participants: 20-59 year old men and women (n= 20,974). Dependent variable: Self-reported use of antidepressants in the previous year. Independent variables: gender, age, income adequacy, educational attainment, employment , parental status, and partner status. Analysis: A logit (logistic regression) model was fitted the data to determine statistically significant main effects and interactions (combinations of levels of the independent variables which result in high (and low) anti-depressive use that are masked among the main effects of the variables on anti-depressant use). All analyses were conducted using the sampling weights provided by Statistics Canada. A post-hoc analysis was utilized to determine the effect of additional factors (e.g. Major Depressive Episode history) on antidepressant use. To determine the effect of additional factors (e.g. Major depressive Episode history) on antidepressant use Table I: Demographic Data Table 2: Urban-Rural by Age by Aboriginal Status by Marital Status on Self Assessed Mental Health LIMITATIONS CONCLUSIONS This analysis showed very complex interaction effects of the demographic variables on antidepressant use as illustrated in Tables I and II. Of note in Table II, the 20+ percent estimated use of antidepressants for: males, aged 20-39, low income adequacy, unemployed and less than high school education and females, aged 40-59, low income, unemployed and post secondary graduate. Many of the very high and very low antidepressant use frequency cells would have been missed by looking at simply main effects. Groups that are particularly vulnerable to high antidepressant use would not have been identified. Table III shows antidepressant use amongst those who have never suffered an MDE or suffered an MDE in either their lifetime or in the last 12 months. In the demographic cells where increased antidepressant use occurs there is increased antidepressant use that is independent of MDE history. REFERENCES Beck, C.A., Patten, S.B., Williams, J.V.A., Wang, J.L., Currie, S.R., Maxwell, C.J., & El-Guebaly, N (2005) Antidepressant utilization in Canada. Soc Psychiatry Psychiatr Epidemiol, 40:799-807. Beck, C.A., Williams, J.V.A., Wang, J.L., Kassam, A., El-Guebaly , N., Currie, S.R., Maxwell, C.J., & Patten, S.B., (2005) Psychotropic medication use in Canada. The Canadian Journal of Psychiatry, 50:605-613. Nielsen, M.W., Hansen, E.B. & Rasmussen, N. K., (2004) Patterns of Psychotropic medicine use and related diseases across education groups: national cross-sectional survey, European Journal of Pharmacology, 60, 199-204. Patten, S.B., Wang, J.L., C.A., Williams, Lavorato, D. H. , Beck, J.V.A. & Bullock, A. Gm., (2010) Frequency of Antidepressant use in relation to recent and past major depressive episodes. The Canadian Journal of Psychiatry, 55:532-535. Rao, J.N.K. and Thomas, D.R. (1988). The analysis of cross-classified categorical data from complex sample surveys. Sociological Methodology, 18: 213-269. Statistics Canada (2004) Canadian Community Health Survey: Mental Health and Well Being; Catalogue no. 82-617-XIE. Table II: Multiway Frequency Table Illustrating Five-factor Interaction Effects of Age, Income Adequacy, Gender, Job Status and Education on Antidepressant Use