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Public health effects of gambling – debate on a conceptual model | BMC Public Health | Full Text
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Gambling impact studies can help researchers and policymakers compare the health and social costs and benefits of different gambling policies and can be used when considering which gambling policies will reduce or increase costs or benefits the most.
In a public health approach, the impacts of gambling, negative and positive, are assessed across the entire severity spectrum of the activity.
Although some studies have created basic principles for conducting impact studies, a theoretical model is currently lacking.
The aim of this debate is to review complementing and contrasting views on the effects of gambling to create a conceptual model, where a public health perspective is applied.
Main text The effects of gambling can be structuralized using a conceptual model, where impacts are divided into negative and positive; costs and benefits.
Costs and benefits are categorized into three classes: financial, labor and health, and well-being.
These classes manifest in personal, interpersonal, and societal levels.
Individual impacts cause effects on a personal level to gamblers themselves.
The temporal level refers to the development, severity and scope of the gambling impact.
These include general impacts, impacts of problem gambling and long-term impacts of gambling.
Conclusions The conceptual model offers a base on which to start building common methodology for assessing the impact of gambling on the society.
While measuring monetary impacts is not always straightforward, the main issue is how to measure the social impacts, which are typically ignored in calculations, as are personal and interpersonal impacts.
The reviewed empirical work largely concentrated on the costs of gambling, especially costs on the community level.
The Model can be used to identify areas where research is scarce.
Filling the gaps in knowledge is essential in forming a balanced evidence base on the impacts of gambling.
Ideally, this evidence could be the starting point in formulating public policies on gambling.
Gambling can be defined as betting money on an outcome of see more results to win money.
Gambling is typically viewed as a continuum, with most people gambling only occasionally or not at all and some gambling more frequently.
Problem and pathological gamblers are usually called problematic gamblers.
There are, however, much more people suffering from gambling-related harms.
Overall, there are several main purposes for conducting impact studies on gambling.
First, to demonstrate that gambling has major social and economic impacts.
Impact studies can also help researchers and policymakers compare the impact of different health and social problems and benefits; for example, gambling impacts can be weighed against alcohol impacts.
Different approaches have been used to study the impacts of gambling.
In this approach, monetary value is also assigned to intangible harms harms not necessarily monetary in nature, e.
A theoretical model is still lacking, although some studies have created basic principles for conducting socioeconomic impact studies.
By doing this, Williams et al.
While quantifying the economic impacts is reasonably straightforward e.
Thus, studies have mostly ignored social impacts, choosing to measure only the economic costs or benefits that are quite easily quantifiable.
This approach, however, presents a very biased view of the situation.
There are no established ways to define the social impacts of gambling.
Based on Williams et al.
They also defined that social cost must be social, rather than personal.
According to these definitions, when a gambler becomes ill because of excessive gambling, their suffering should not be counted as a social cost as long as someone in society gains from high roller casino excessive gambling and gamblers do not demand any treatment that would cause costs to society.
In our study, rather speaking of social impacts, we use the term nonmonetary impacts i.
Costs and benefits refer to overall negative or positive gambling impacts and not only those with does casino development have a positive effect on economic growth? value.
We also state that impacts should be examined at the societal, individual, and interpersonal levels.
The Model emphasizes the public health perspective, which is somewhat different from the one in costing studies.
The model includes a temporal dimension, which refers to the development and severity of gambling behavior.
From the public health perspective, it is not presumed that costs and benefits result only from problem gambling; instead we are interested in the whole spectrum of gambling behavior.
Studies have usually concentrated on impacts of problem gambling while ignoring the entire continuum of gambling.
This debate argues for a conceptual theoretical model based on the gambling impacts literature, where a public health perspective is applied.
Personal level refers to the gamblers themselves and interpersonal level to people close to the gambler: friends, family and work colleagues.
Impacts can be individual or external.
Individual impacts induce effects on a personal level to the gambler.
Gambling creates costs and benefits that others must pay for or can exploit.
Thus, it is of utmost importance that impacts are examined on multiple levels.
In the model, impacts can be divided into negative and positive.
However, impacts can simultaneously be both negative and positive.
In the model, benefits Fig.
These classes manifest on personal, interpersonal, and societal levels.
Financial impacts, for example, include gambling revenues, tourism, impacts on other industries, and infrastructure cost or value change.
On the personal and interpersonal levels, financial impacts can be changes in financial situations.
Overall, financial impacts contribute to economic activity and economic growth.
Labor impacts include gambling effects on work, such as changes in productivity, absenteeism, reduced performance, inability to work, job gains and losses, and unemployment.
Health and well-being impacts include the effects that gambling has on physical, psychological, and social health and well-being.
Temporal level refers to the development, severity and scope of the gambling impact.
These include general impacts, impacts of problem gambling and long-term impacts of gambling.
General impacts usually result from non-problematic recreational and at-risk gamblers gambling.
For example, gambling can be a leisure time option that takes time and money from other activities.
Personal and interpersonal level costs are mostly nonmonetary in nature, including invisible individual and external costs that are general, costs of problem gambling and long-term cost.
Most of the time, however, these costs remain unrecognized.
Personal level impacts Financial impacts Financial harms are common, especially among problem gamblers.
However, causality between financial losses and gambling is not always simple.
Factors like ill-health may effect both gambling and poverty, and poverty may lead to problematic gambling and vice versa.
The most serious forms of financial harms because of gambling include bankruptcy and homelessness.
While the negative financial consequences of gambling are evident, studies have also observed positive financial impacts.
Problem gambling can affect employment in many ways.
Among Finnish treatment-seeking gamblers, does casino development have a positive effect on economic growth? evaluated that their work performance got worse due to tiredness or distraction, and among those who gambled within the last 12 months, 1% had used work time to gamble and 0.
However, lack of work may not necessarily be because of gambling, although the literature has indicated that problem gamblers were more likely to report poorer work performance.
Employment has critical financial and interpersonal impacts because employment is the primary or major source of household income.
Reduced performance in work life can have short- and long-term effects on the life of the individual and their family.
Employment also causes effects at the community and societal levels.
The causality of these health consequences is not clear because gambling can cause negative health outcomes, but is also a coping mechanism to escape physical, emotional, and substance use problems.
In Finland, 5% of treatment-seeking problem gamblers had attempted suicide, whereas read more was 0.
The literature also demonstrates the positive effects of gambling.
Participants with an Asian cultural background had significantly higher employment impacts than their non-Asian counterparts.
Health and well-being impacts Financial difficulties can lead to relationship problems, which is common.
In Finland, among the population sample, only 0.
Petty theft from that big top casino codes consider members and illicit lending are relative common forms of interpersonal harm.
Violence associated with gambling is an extreme form of interpersonal harm.
This, however, constitute only a small amount of the total partnership violence.
Experiencing isolation and self-blame is common among significant others.
When new forms of gambling have significant negative impacts on other forms of gambling and states continue to benefit from revenues from the new forms, the net revenues may not change.
Gambling can also impact other industries.
Studies have also found work-related costs because of problem gambling.
Health and well-being impacts Governments are typically responsible for regulating gambling operations.
In a society where gambling is legal, anyone could suffer from gambling harms.
Thus, resources are required to prevent this phenomenon from occurring.
Government revenues are also used to improve public services e.
In Macao, as a result of casino introduction, more social welfare and benefits have been given to the local people.
In Macao, earning money from the casino business was regarded as easier and faster than having a higher education.
Increased gambling opportunities are also associated with increases in social inequality.
In Germany, the lowest income quintile spent an average of 12% of their net income on gambling, compared with only 2% in the highest quintile.
Overall, 50% of gambling turnover was borne by 12.
The conceptual model developed in this article offers a base on which to start building common methodology for assessing the impact of gambling on the society — a target explicated by, e.
In the discussion about the best methodological and theoretical approaches for analyzing the impacts of gambling, the main issue is how to measure the social impacts.
Most of the social impacts are nonmonetary by nature and are often difficult to measure and thus ignored in calculations.
Similarly, personal and interpersonal impacts have often been excluded from calculation, largely for the same reason as social impacts.
Except for the most obvious positive impact of gambling, namely, gambling revenues for communities, studies have often concentrated on the negative side of gambling impacts.
The central focus has been on problem gambling; thus, many gambling harms have been ignored although gambling-related harms also occur among those who are not problem gamblers and nongamblers within harms reach, such as significant others and the wider community.
These methodological deficiencies are common in the gambling impacts literature and cause a significant bias in current knowledge.
As mentioned earlier, gambling causes external impacts that affect more people than just the gambler.
Thus, it is of utmost importance that impacts are examined on separate levels.
Additionally, these impacts can have long-term effects and create a change in the life course of an individual, and even pass between generations.
Key methodological challenges relate to what portion of impacts are the effects of gambling and how these should be measured.
These studies have been primarily conducted in North America, and the majority of analyses concerns casino impacts.
Although the PHIGam model attempts to be as universal as possible, it is important to note the context in which gambling takes place is critical when examining gambling impacts.
Opening a casino in an area where gambling opportunities have been limited has a greater impact than in area where gambling has been widely available.
Financial harms of gambling have been shown to be more common among deprived areas, whereas in Macao, the nominal wages of people working in gambling and related industries has increased because of casino liberalization.
Additionally, the type of gambling presented affects impacts because it was shown that some games create more debt than others.
Finally, it is important to understand how revenues are derived and disbursed.
The debate leading to the formation of the model on Public Health Impacts of Gambling utilized existing theoretical and empirical literature to form a structure that can be used to locate individual pieces of research.
As shown in the Does casino development have a positive effect on economic growth?, empirical work has largely concentrated on the costs of gambling, especially costs on the community level.
The Figures can be used to identify areas where research is scarce: for example, no research was found analyzing financial or labor benefits to the significant others of gamblers.
Filling the gaps in knowledge is essential in forming a balanced evidence base on the impacts of gambling.
Ideally, this evidence could be the starting point in formulating public policies on gambling.
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Funding The study was financially supported by the Ministry of Social Affairs and Health, Helsinki, Finland the 52 Appropriation of the Lotteries Act.
The funder had no further role in the writing the article or in the decision to submit it for publication.
TLa drafted the first version of the manuscript and TLi and AKo were involved in critical revision for important intellectual content.
All authors read and approved the final manuscript.
Corresponding author Correspondence to.
Ethics approval and consent to participate Not applicable.
Consent for publication Not applicable.
Competing interests The authors declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.
The Creative Commons Public Domain Dedication waiver applies to the data made available in this article, unless otherwise stated.
Cite this article Latvala, T.
Public health effects of gambling — debate on a conceptual model.
BMC Public Health 19, 1077 2019 doi:10.

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The effects of a casino in an urban area