Gambling harm is everybody's business: A public health approach and call to action

Abstract

There is a growing consensus that gambling is a public health issue and that preventing gambling related harms requires a broad response. Although many policy decisions regarding gambling are made at a national level in the UK, there are clear opportunities to take action at local and regional levels to prevent the negative impacts on individuals, families and local communities. This response goes beyond the statutory roles of licencing authorities to include amongst others the National Health Service (NHS), the third sector, mental health services, homelessness and housing services, financial inclusion support. As evidence continues to emerge to strengthen the link between gambling and a wide range of risk factors and negative consequences, there is also a strong correlation with health inequalities. Because the North of England experiences increasing health inequalities, it offers an opportunity as a specific case study to share learning on reducing gambling-related harms within a geographic area. This article describes an approach to gambling as a public health issue identifying it as needing a cross-cutting, systemwide multisectoral approach to be taken at local and regional levels. Challenges at national and local levels require policy makers to adopt a 'health in all policy' approach and use the best evidence in their future decisions to prevent harm. A whole systems approach which aims to reduce poverty and health inequalities needs to incorporate gambling harm within place-based planning and draws on the innovative opportunities that exist to engage local stakeholders, builds local leadership and takes a collaborative approach to tackling gambling-related harms. This whole systems approach includes the following: (1) understanding the prevalence of gambling related harms with insights into the consequences and how individuals, their family and friends and wider community are affected; (2) ensuring tackling gambling harms is a key public health commitment at all levels by including it in strategic plans, with meaningful outcome measures, and communicating this to partners; (3) understanding the assets and resources available in the public, private and voluntary sectors and identifying what actions are underway; (4) raising awareness and sharing data, developing a compelling narrative and involving people who have been harmed and are willing to share their experience; (5) ensuring all regulatory authorities help tackle gambling-related harms under a 'whole council' approach.

Treatment and help services for gambling during COVID-19: Experiences of gamblers and their concerned significant others

“…If national and local policymakers accept that substance use disorders may require several intervention components, they should accept them also in gambling issues (Jemberie et al, 2020). A public health model addresses not only individual harm, but also the commercial and social determinants of harm, such as availability, accessibility, marketing, and risk factors that also cause harm amongst low and moderate risk gamblers (Griffiths et al, 2009;Johnstone & Regan, 2020). According to the prevention paradox argument, most harm accrues to the low or moderate risk population who also benefit most from interventions (e.g., .…”

The Gambling Behaviour and Attitudes to Sports Betting of Sports Fans

“…A growing body of evidence has started to address the factors that lead to sports betting being perceived as an everyday part of sports, fostering its uptake. This is aligned with an increasing focus within broader gambling research on the influence of the environment and social determinants on people’s behaviour, as opposed to concentrating on a problem or pathology within the individual (Johnston and Regan, 2020 ).…”

A qualitative study of gambling, deprivation and monetary motivations

“…Public health issues within areas of socio-economic disadvantage, including poorer mental health (Wickham et al, 2014); health issues and inequalities (Williams, 2017); and loneliness and isolation (Macdonald et al, 2018) are likely implicated. Indeed, problem gambling is also associated with mental health symptoms (Dowling et al, 2019); health inequalities (Johnstone & Regan, 2020); and loneliness (John et al, 2019) -and a 'whole systems approach' has been called for in tackling gambling-related harm within areas of deprivation (Johnstone & Regan, 2020). While recognising the importance of this, this current study takes an individualised perspective, as perceived relative deprivation is a highly individualised construct (Mishra & Novakowski, 2016), which focusing solely on social/public-health perspectives can overlook (Delfabbro & King, 2020).…”