The Nature and Prevalence of Gambling Harms
Individuals v. Population Data
In this section we highlight the scales of gambling harms and the competing interpretations of differing figures from data collection.
We look at what these harms are. Significantly, the number of people harmed by gambling is far greater than the number of people who suffer direct harms from their gambling behaviours. Families, friends, communities suffer too.
While discussions around gambling harms often see a ivision between ‘safe gambling’ and ‘at risk’ or ‘problem gambling’ we suggest the issue is more complex. Industry is fond of repeating that only 0.5% of the population are ‘problem gamblers’ an this rate has held steady for many years. It’s suggested below that figures like this do not provide an adequate description. Further, we suggest that the ‘gambling careers’ of each gambler vary considerably: for example, someone may gamble moderately for years then plunge into harmful gambling, for instance in reaction to stressors; others may ‘binge’ with months between; some may continuously bet low amounts which have serious impacts on low incomes. The latter example points to ‘attritional harms’, harms which are ‘sub-clinical’ and which allow an individual and those close to them to achieve a relative functional survival but which over years may eat away at wellbeing – and put the individual and people close at high risk of encountering severe risks.
The Prevalence of Gambling Harms
There are many sources of ‘facts’ and statistics regarding gambling harms in the UK. Reminding us that these are to be seen in a global context, the World Health Organisation’s discussion paper on the prevalence of ‘gambling disorder’ AND gambling related harms makes the following key points:
There has been massive, unprecedented growth in commercial gambling in recent decades. This is expected to continue, expanding in new, high-risk populations and fuelled globally by ready on-line access
.This growth has been associated with a substantial increase in problem gambling, associated morbidities and other gambling-related harm. Adult past year problem gambling prevalencerates range from range from 0.1% to 6.0%, with two to three times as many people experiencing less serious sub-clinical problems
.The gambling-related burden of harm appears to be of similar magnitude to harm attributed to major depressive disorder and alcohol misuse and dependence. It is substantially higher than harm attributed to drug dependence disorder.•Serious problem gambling, referred to as pathological gambling, was first included in the DSM-III in 1980. In the DSM-V it was renamed gambling disorder and placed in the new ‘Addictions and Related Disorders’ category. It is the only non-substance addiction included.•Despite the global increase and extent of gambling-relating morbidity and harm, and long recognition of problem gambling as a mental health disorder, it has rarely been seen as a public health issue or priority
.There is an urgent need to place gambling on national and international public health agendas and strengthen evidence-based policy and prevention strategies, as well as greatly extend early intervention and treatment provision. These measures are critical to reduce current and future harm and social costs associated with commercial gambling
The WHO gobal figures estimate that in parts of the world gambling related health conditions are as high as almost 6%.
In the UK, the figures range from 0.5% to 2.7%. The lower figure is sometimes used by those who wish to minimise the scale of harms; they also claim that the figure has been steady for decades. In fact, methods of gathering data are evaluated and improved through time. So, for instance, bith the UK government and the Gambling Commission are currently working on new methods. The Gambling Commission reports on this while focusing upon the crucial distinction between, in their words, ‘problem gambling’ and ‘gambling related harms’:
‘Problem gambling’ means gambling to a degree that compromises, disrupts or damages family, personal or recreational pursuits. We currently measure problem gambling prevalence rates via a number of screening tools including the Problem Gambling Severity Index (PGSI). This screen measures the number of problem gamblers, moderate risk gamblers and low risk gamblers in a population. On this screen:
Problem gamblers are defined as ‘gamblers who gamble with negative consequences and a possible loss of control’.
Moderate risk gamblers are defined as ‘gamblers who experience a moderate level of problems leading to some negative consequences’
Low risk gamblers are defined as ‘gamblers who experience a low level of problems with few or no identified negative consequences’.
However, there are a number of limitations relating to ‘problem gambling’:
No screen for problem gambling is perfect
‘Problem gambling’ refers to the gambler only. Prevalence estimates do not take into consideration the effects that gambling can have on others such as gamblers’ friends and family
The term ‘at-risk’ can imply that people who are classified as low or moderate risk gamblers on the PGSI are not experiencing harm now but will do in the future when in fact they are showing some signs of problematic behaviour now but remain below the threshold for ‘problem’ gambling.
The term ‘at-risk’ can also imply that people who are classified as low or moderate risk gamblers on the PGSI will progress up the scale to a ‘problem gambler’ however evidence from existing longitudinal studies (such as the Quinte Longitudinal Study of Gambling and Problem Gambling and the New Zealand National Gambling Study) suggests that some do and some don’t.
Despite their limitations, the existing practice of measuring problem gambling prevalence rates do provide useful, if narrower, information on the scale of the problem.
Gambling-related harms are the adverse impacts from gambling on the health and wellbeing of individuals, families, communities and society. These harms impact on people’s resources, relationships and health.
Negative effects can include loss of employment, debt, crime, breakdown of relationships and deterioration of physical and mental health. At its worst, gambling can contribute to loss of life through suicide.
Harms can be experienced not just by gamblers themselves. They can also affect their children, partners, wider families and social networks, employers, communities and society as a whole.
Why it’s important?
It is important to move from simply identifying the numbers of people classified by screening tools as problem gamblers, moderate risk gamblers and low risk gamblers and consider how we will measure the real personal and societal costs which result from gambling.
Understanding and measuring gambling-related harms is therefore one of the Gambling Commission’s top priorities in order to make better and faster progress to reduce gambling harms. This will allow us to demonstrate the scale of gambling-related harms, understand what types of action is required if they are to be reduced, and monitor progress over time.
The current practice of assessing the extent of gambling-related harms by problem gambling prevalence rates can be misleading. Prevalence rates fail to capture a number of important dimensions of harm, including those experienced by others than gamblers themselves (affected others). This means they are potentially underestimating the scale of the problem.
Where do we want to get to?
Ultimately, we need to move towards a fuller understanding of how people are affected by gambling. The terms ‘problem gambler’ and ‘at risk’ represent an individualising concept and we therefore recommend the population affected (including affected others) should be referred to ‘those harmed by gambling’.
So. Firstly we need to recognise that figures are not sacrosanct. Nor, by attempting to give the number of ‘problem gamblers’ do we acchieve a full understanding of the scale of gambling harms on populations.
The most immediate attention must be given not to gamblers but to the people around them who experience distress. Estimates vary between six and ten people affected by somebody’s issues with gambling. Spouses, children, friends. Given that current ‘official’ figures for the number of people in Scotland who meet the criteria for diagnosis as a disordered gambler is 45,000,, at the upper limit of affected others almost half a million people in Scotland suffer immediate harms. Or five million people in the UK.
A web event in February 2021 organised by the Beacon Counselling Trust focuses upon ‘affected others’. A recording of the event is available here. It features testimony from four people affected in different ways. Such harms include depression, anxiety, shame, debt, family breakdown, housing precarity and possibly dealing with crime.
We are all affected to by the economic costs of gambling harms. While it needs to be understood clearly that gambling does not have a necessary link with crime, it does so disproportionally. A December 2020 study by Forward Trust found that 4% of people in prison were there because of gambling, while 23% of prisoners self-identified as having problems with gambling. To the economic costs of the criminal and judiciary services need to be added the costs to mental health services. Lost work productivity and unemployment also add to costs to society, A 2016 report concluded that total costs came to £1.2 billion.
The dimensions of gambling harms and their prevalence are complex and should not be reduced to over-simplified descriptions.
Children and Young People
An alarmng figure is that almost one in fifty 11 – 16 year olds in the UK are identified as ‘problem gamblers’. Those in the 16 – 25 year range are characterised by heavier gambling than the general population. These cohorts are ‘digital natives’ who grew up in a world where gambling is promoted as a normal ‘fun’ leisure activity. For many, interacting with broadacst sport, especially football, involves online betting.
We also know that children who grow up in a family where gambling is prominent are more likely to develop gambling problems, especially when compounded with peer behaviour, advertising and marketing enticements.
As it is difficult to obtain an understanding of current gambling participation and harms which change rapidly, it is impossible to project the situation for the future. However, a precautionary attitude suggests that problems will increase and interventions are needed now.
Education is often mooted as a way to combat harms. We have a section discussing education. Here it may be noted that education is largely funded by the gambling industry. Its effectiveness is under-evaluated, but it serves to reinforce attention to individual behaviours and ‘responsibility’ while skewing attention away from broader elements such as the regulation and laws around industry practices including advertising, VIP schemes, social media marketing and enticements and product design.
We have a section on young people and education which you can visit by clicking here.
We suggested above as we do across the site that each individual’s quality and extents of distress are unique to them which has long been recognised by work to promote person-centred health a care support.
We may talk legitimately about the health of the Scottish population, adopt a public health approach to developing better health for all. But when it comes to an individual, obviously identifying that they are Scottish is not relevant to them in health or other contexts.
We proceed with caution and sensitivity when categorising people by group. ‘Women’ could be seen as a group in discovering generalised differences between male and female gambling behaviours, experience of harms , access to support etc. but clearly outside very narrow and explicitly defined contexts, to identify a person primarily as ‘woman’ is degrading and dehumanising – though this has not prevented the continuing, if reducing, stigma that women face. Still, with care we should be aware that in general women experience gambling harms differently than men, paradoxically it may be argued, at least partly because of internalised stigmas about how a woman ‘should be’. We know from ttestimonies, the voices of lived experiences, of different challenges women face. They are generally likey to feel deeper shame for not being the god mothering family figure, for instance. Stigma is more likely to stop them coming fr support. Groups such as Gamblers Anonymous tend to be male dominated and this can discourage women attending. But every woman is far more than a woman, is a person deserving and needing support based around their unique individuality; womanhood may or may not be a factor in this.
New in-depth research examining the experience of women and gambling finds female
problem gamblers more likely to be from a BAME background, be an ‘affected other’ and
to cite stigma as a main barrier to treatment women-and-gambling-press-release
“I went to a Gamblers Anonymous meeting and thought I’d walked into a men’s toilet.”
Similary, to talk of ‘BAME communities’ can itself be a fertile ground for stereotyping and stigmatising. An article about the acronym is here. On the other hand, from perspectives of injustice, inequality, dsicrimination and public health concerns, we proceed with the clear knowledge that BAME communities suffer dispropotionally. We are touching only on a very big social, economic and cultural set of important issues relating to work based on ameliorating harms people suffer, campaigning, policies, research, controversies and strong disagreements. While insisting upon the fundamental right of every individual to be seen as a unique person first, we are able to refer to the nature of differences which tend to correlate with different groups. See for example,
Research following a report that found gambling harms are:
7.4 times higher among those from Black/Black British
• Five times higher among those from Asian/Asian British
groups mixed or other ethnic groups,
• 6.9 times higher among those from mixed or other
ethnic groups. BAMEgambling-report
A report presents the findings of a study to explore the usage of, and demand for,
treatment and support services among gamblers and those affected by another’s
gambling. The report focuses specifically on gamblers from Black, Asian and Minority
Ethnic (BAME) communities. In addition to describing their usage of and demand for
treatment and support, the report presents detailed demographic and behavioural profiles
of gamblers and those affected by another’s gambling. The research was conducted by
YouGov on behalf of GambleAware. BAME treatment and support
A report from GambleAware showing how Disproportionate Burdens of Gambling Harms
Amongst Minority Communities minority ethnic communities
Both ‘women’ and ‘BAME’ are othered in that in practice they are outside the ‘norm’ which is male and white. As here they are more often written about, analysed etc. and less heard from with their own voices. But that is the problem with putting a complex individual, history or community into a box or umbrella term. It’s equally true that any concepts such as white male are hopelessly inadequate at indicating the vast variety of individuals so identified. And, of course, many men suffer as much from the pressures to conform to ‘being a man’ as women, for instance, struggle against the social constructions of what being a woman ‘should be’.
There are many sub-populations and within them many different communities in which are many diferent people. Identifying groups by age as sub-population groups is common in research and health policies. Obviously, individuals in an age group will also be embedded in other ‘groups’, and each person will be unique. It is especially imporatn to identify age groups 11-16 and 16-25. These groups are born into digital world where digital gambling is normalised. Evidence shows that almost 2% of 11-16 year olds are what the dominant terminology refers to as ‘problem gamblers’. The immediate concerns here are only matched by considering how young people growing up may reinforce and reproduce gambling behaviours thus further normalising gambling for following generations.
The young adults grouping reveals heavier than average gambling, more gambling harms and more suicides.
In one sense, with the accelerating saturation of a digital world, we are all members of a ‘global village’. In the cases of mental health and gambling for instance, communities of interest unite the developed and developing nations. Gambling harms are evident everywhere – the World Health Organisation claiming almost 7% of the world’s people suffer from them. Our site tries to suuggest how a local geographical community is shaped in significant way by national and global factors relating to governments, business pratices and the imperatives of ‘the global economy’.
Our everyday lives, though, while changed in various ways and to varying degrees by digital technology, are fixed in the ‘small world’ of our immediate communities including geographical location, social networks, norms and values specific to the community. We tend to locate gambling harms and other health issues within urban communities which is fine but we may forget about the geographically much larger regions outside the big centres. There is discussion of gambling in rural ares, as well as being a good overview of key contemporary issues around gambling, here.
So singular are communities that in, for instance, campaigning to address gambling harms stigma may have some success in one place but not another. Ideally, projects and initiatives need designing to fit a particular community, involving the people of the community. Nevertheless, with the same cautions noted above, there are generalised profiles of communities labelled ‘deprived’ (which is itself an unfortunate term) or disadvantaged or suffering disproportionately from injustice, inequality, poverty, lack of facilities, few cultural opportunities, and low level crime arising from these conditions. Numerically, on a population basis, people have more alcohol, drugs and gambling problems as well as suffering from unsatisfactory mental and phyical health, and life expectancy as much as 20 years lower than citizens in wealthier places.