For an individual and affected people around, the impact of running into difficulties with gambling on health and wellbeing is well documented. For instance, gambling harms are linked with depression, anxiety, debt, possible involvement with the criminal justice system, housing crises, education and employment, and the burdens of stigma.


Public Health overviews of societal determinants of preventable illbeing generally focus upon alcohol, tobacco, drugs, and the industrial practices behind them. To these, gambling should become more prominent.


No single determinant occurs in a vacuum. All industrial determinants of illbeing occur within wider contexts such as those listed below.


1. The humanitarian crisis of the housing emergency sees a huge lack of housing stock; steady and significant rises in rent and mortgage; insecure tenancies; large waiting lists for social housing; for many, very poor accommodation containing a variety of detriments to health.


2. Inadequate income exacerbated by the cost of living crisis ensures the inaffordability of basics such as rent and good quality food.


3. High rates of preventable physical and emotional illbeing across populations, intensfied in ‘data zones’ characterised by deprivation of even basic human rights to ensure decent living standards.


4. Immense strains on health and social care provision which now fails both to ensure wellbeing throughout the life journey and to address immediate health issues.


5. A culture reinforced by ideological power to ‘blame the victim’: powerful voices such as of the mass media, political rhetoric and neo-liberal government policies downplay or ignore entirely environmental detrminants of health and celebrate the idea of ‘personal responsibility’ for an individual’s course through life.


6. Social stratification whereby the bottom fifth percentile of the population is ignored in policy making: those in greatest need receive least support and attention.


7. Gross inequality is a greater determinant of illbeing than important wealth distribution. Nations with (increasing) inequality such as the USA and Britain have more prisons and harsh justice systems; poorer access to cultural and educational and health capital. Inequality results from structural elements in power systems which by design deliver inequality.


Individuals within organisations work very hard to address some of the above, often to breaking point for those same factors ensure completely inadequate funding and human resources. Without the dedicated work of those in third sector and statutory organisations, many thousands simply would not survive under what is virtually an economic dictatorship.


While it is very true that for the majority who enjoy some relative immunity, stability and comfort within society enjoyment from moderate use of alcohol and other drugs, gambling, and consumption of foods which carry a health warning, such enjoyment is incorporated into lives which also enjoy to varying degrees source of pleasure, satisfaction and flourishing. However, history demonstrates clearly that stability is precarious and, economically, the better off in secure employment are now feeling stresses of insecurity. History also shows clearly, of course, that the wealthiest are far from immune to ruin from drugs like alcohol, eating disorders and gambling – including on investments and spread betting.


But for the many who are structurally located in a life where the full force of inequality is experienced the risks of falling prey to the vultures of profit and power it is understandable that generaational sources of a little relief such as through alcohol and gambling are attractive, especially when this attraction is exploited by corporate entities through incessant marketing stratgies.


Gambling harms come more to individuals already suffering significant harms. (That, it must be emphasised, is far from ignoring the fact that gambling harms occur across the whole population: middleclass academics or bank mmanagers are ‘as ‘vulnerable’ as the crudely conceptualised ‘Vulnerable’).This can be seen as one example or manifestation of a society imbued with wider determinants of preventable illbeing.



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