Is There a Health Inequality in Gambling Related Harms? A Systematic Review

Abstract

Objective: Here we present a systematic review of the existing research into gambling harms, in order to determine whether there are differences in the presentation of these across demographic groups such as age, gender, culture, and socioeconomic status, or gambling behaviour categories such as risk severity and play frequency. Primary and Secondary Outcome Measures: Inclusion criteria were: 1) focus on gambling harms; 2) focus on harms to the gambler rather than affected others; 3) discussion of specific listed harms and not just harms in general terms. Exclusion criteria were: 1) research of non-human subjects; 2) not written in English; 3) not an empirical study; 3) not available as a full article. Search: We conducted a systematic search using the Web of Science and Scopus databases in February 2020. Assessment of quality took place using Standard Quality Assessment Criteria. Results: 56 studies published between 1994 and 2019 met the inclusion criteria. These were categorised into thematic groups for comparison and discussion. There were replicated differences found in groups defined by age, socioeconomic status, education level, ethnicity and culture, risk severity, and gambling behaviours. Conclusion: Harms appear to be dependent on specific social, demographic and environmental conditions that suggests there is a health inequality in gambling related harms. Further investigation is required to develop standardised measurement tools and to understand confounding variables and co-morbidities. With a robust understanding of harms distribution in the population, Primary Care Workers will be better equipped to identify those who are at risk, or who are showing signs of Gambling Disorder, and to target prevention and intervention programmes appropriately.

Harm-to-self from gambling: A national study of Australian adults

“…This study also identifies subgroups who are most at-risk of gambling harm. As found elsewhere (Raybould et al, 2021;Tu et al, 2014), gambling in Australia presents a health inequality problem because gambling harm may increase health disparities amongst already disadvantaged or vulnerable populations, including Aboriginal or Torres Strait Islanders, those who speak a language other than English at home, younger people and those with less education. This inequity in the distribution of gambling harm may present a social justice issue that disadvantages people and limits their chances of living healthier lives.…”

“…From a health equity perspective, knowing whether gambling exacerbates health disparities amongst already disadvantaged and marginalised groups should shape policy decisions about gambling availability and access. Nonetheless, there is abundant evidence that First Nations peoples, ethnic minority groups, people in poorer socio-economic circumstances, young people, and people affected by comorbid conditions continue to bear a disproportionate amount of gambling harm ( Abbott, 2020 ; Browne, Rockloff et al., 2020 ; Hing, Breen, Gordon, & Russell, 2014 ; Paterson et al, 2019 ; Raybould, Larkin, & Tunney, 2021 ; Rockloff et al., 2019 ; Stevens et al., 2019 ; Tu, Gray, & Walton, 2014 ; Williams et al., 2021 ). Beyond this, a knowledge of individual characteristics associated with increased risk is important to inform the provision and tailoring of public education, treatment, and support.…”

Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority – A National population-based study in Sweden

“…53 There has been an increased interest in health inequalities resulting from gambling-related harm, suggesting that some EM groups have worse outcomes from gambling than others. 54 This is relevant to public health policy as gambling is rarely examined and discussed in studies on refugee/migrant health.…”

A critical qualitative inquiry of the social practices of older adult gamblers: implications for public health risk prevention

“…The majority of participants in this study lived in areas with moderate to high socio-economic advantage. Given that there are a range of well-recognised inequities in gambling-related harm (Goyder et al, 2020;Raybould et al, 2021), with economic and social factors linked to older adults' experiences of gambling-related harm (Guillou Landreat et al, 2019;van der Maas et al, 2021), there is a need for critical qualitative inquiries that specifically investigate how older adults' experiences of social disadvantage may influence their gambling practices. It should also be noted that the participants from this study gambled in the Australian states that have EGMs within community venues.…”