Public Health Implications of Gambling

Gambling is the act of putting something of value (usually money) on an event that relies on chance with the intention of winning a prize. It can be done through many different means such as lottery tickets, cards, bingo, slot machines, instant scratch-cards, horse racing, dog races, dice games, roulett and sports events. It is a worldwide activity that is part of our culture and heritage. However, it is important to understand that gambling has negative and positive effects on society. Negative effects include the direct costs to gamblers, their families and others as well as the indirect costs associated with the gambling industry and the wider economy. Positive impacts include the entertainment value of gambling and the role it plays in building community cohesion and social capital.

Gambling has existed in virtually every society since prerecorded history and is embedded in many cultural traditions, customs and rites of passage. It is widely accepted that it can be a fun and enjoyable pastime, but some people become addicted to gambling, leading to serious personal, family and financial problems. The addictive nature of gambling results in a cycle of recurrent losses and increased reliance on the activity as an escape from stressful life circumstances.

While research has focused on the negative impacts of gambling, there is a growing recognition that positive impacts also exist and are important to consider. A growing role for evaluating patient gambling behaviors in primary care settings has been identified based on their health-related quality of life impact. The purpose of this article is to review complementing and contrasting views of gambling impacts and their implications on the population, using a public health approach.

Negative gambling impacts are categorized into three classes: financial, labor and health. The financial impacts are the most visible and can be measured based on the amount of money spent by gamblers. In addition, these impacts can be quantified using health-related quality of life weights known as disability weights. These measures can reveal hidden costs to gamblers and their significant others.

In contrast, the interpersonal and community/society level impacts are mainly nonmonetary and less easy to quantify. Consequently, they have received comparatively little attention in the literature. These impacts can be analyzed using a health-related quality of life framework that takes into account both functional and psychological dimensions. They can help to uncover costs to the gambler and their significant others that are not readily apparent when concentrating solely on pathological or problem gambling alone. This can lead to a more comprehensive understanding of gambling impacts and the need for future research. It can also help inform the design of a methodological approach to calculating gambling costs and benefits.