The Often-Unrecognized Public Health Impact of Gambling
December 15, 2022
According to the National Council on Problem Gambling, approximately 85 percent of U.S. adults have gambled at least once in their lives. States benefit from revenue generated by legalized gambling and those funds are often used for specific public good, like education. However, States must recognize another reality, that problem gambling harms individuals and communities (problem gambling has the highest rate of suicide of any addictive disorder) creating a public health challenge that requires funding to prevent or ameliorate.
Gambling is common to almost every culture and has been part of human life for thousands of years. According to the National Council on Problem Gambling, approximately 85 percent of U.S. adults have gambled at least once in their lives; 60 percent in the past year. That percentage is even higher for high school students – between 60 percent and 80 percent report having gambled for money in the past year. Many people can enjoy gambling as a fun social activity but for some it can become an addiction.
Problem gambling, or gambling addiction, includes all gambling behavior patterns that compromise, disrupt, or damage personal, family, or vocational pursuits. Problem gambling has the highest rate of suicide of any addictive disorder, with one in five problem gamblers attempting suicide. It is estimated that one problem gambler affects at least seven other people—spouses, children, extended family members, friends, and the broader community. With these considerations, it becomes clear that problem gambling is a public health concern and should be treated as such. Yet, no jurisdiction has created a gambling regulatory system that explicitly tackles these public health concerns.
In a good first step, a variety of state and national organizations regularly conduct gambling prevalence studies. Most recently, the National Council on Problem Gambling reported that the risks for gambling addiction overall have grown 30 percent from 2018 to 2021. This increased risk of problem gambling can especially be seen in people with substance use disorders, seniors, youth, veterans, low-income, and BIPOC individuals. Numerous studies have shown that gambling disorder is more prevalent among non-white groups, especially African Americans who experience a prevalence of disordered gambling double that of white gamblers. The convergence of stigma, targeted marketing, and social conditions in BIPOC communities has resulted in disparate harm from problem gambling.
There are common recommendations across the various prevalence studies, including:
- allocate more preventive and treatment resources to target sociodemographic groups (e.g., African Americans) with a higher prevalence of problem gambling and probable disordered gambling;
- integrate education programs aimed at substance abuse with those aimed at gambling disorder, as there is a large body of evidence showing that gambling disorder and substance abuse often co-occur;
- broaden the reach of advertisements for resources promoting responsible gambling and services for those suffering; and
- to accomplish this, allocate funding to increase the capacity and reach of the organizations charged with helping to promote responsible gambling and create a broader enforcement scheme that holds the industry accountable.
States benefit from revenue generated by legalized gambling and those funds are often used for specific public good, like education. States must recognize another reality—problem gambling harms individuals and communities, creating a public health challenge that requires funding to prevent or ameliorate. If legislators and regulators genuinely took this dynamic into consideration, we would likely see more effective, comprehensive measures in place to prevent youth gambling initiation, reduce prevalence of problem gambling, and support rehabilitation for problem gamblers.
As more states mature into and expand legalized gambling—including the new wave of online sports betting—the public health community must give voice to these challenges and advocate for regulatory measures that prioritize community health.
This post written by Blair Inniss, J.D., M.A., Senior Staff Attorney, Network for Public Health Law – Eastern Region Office.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.