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A public health approach to problem gambling
A public health approach promotes long-term solutions that can help to stop problem gambling occurring in the first place.

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Problem gambling

This is a guest post by Emily Medhurst, a recent Health Policy Masters graduate, who is interested in using a public health approach to tackle healthcare challenges.

Problem gambling in the UK

Problem gambling is defined as gambling that causes harm to the individual and others around them. It is estimated that 0.7-3% of the UK population are problem gamblers, and it is estimated to cost the UK government over £1.2 billion a year. Problem gambling has many negative consequences, such as poor mental health, increased rates of crime and reoffending, and other addiction issues. Family and friends of problem gamblers are also negatively affected, with an estimated 2 million people in the UK being classified as affected others. Affected others also experience poor mental health and are more likely to be victims of domestic violence and theft. Problem gambling puts a huge strain on a range of systems, such as the NHS and justice system, but there is little to no policy in place to protect people from gambling harms. The Gambling Act 2005 helped to regulate the gambling industry but it did little to consider gambling harms and how they should be reduced.

Public Health

A Public Health approach uses organised, cross-sector cooperation to improve the health and wellbeing of a population, while ensuring health equity. Gambling harms are wide reaching and have negative effects on: health, crime rates, family and friends, and young people. A public health approach that involves all these sectors and uses different levels of intervention to address problem gambling could be beneficial in reducing rates of problem gambling.

Problem gambling isn’t insular; it is created by a person’s environment, income, and education. Those on a lower income are more likely to be problem gamblers, and more deprived areas of the UK have higher rates of problem gamblers than the national average. The idea that a person’s behaviour and outcomes are affected by their environment is a cornerstone of public health theory. Considering and tackling the social determinants that can contribute to problem gambling is a vital step in using a public health approach.

Public Health in Practice

As public health uses a multi-sector approach, policy needs to be all-encompassing and consider all the elements that contribute to problem gambling. Peers for Gambling Reform, a bipartisan group from the House of Lords, are aiming to implement the changes suggested by the Select Committee on the Social and Economic Impact of the Gambling Industry. The proposed changes emphasise the negative affect the gambling can have on people’s health and wellbeing, and how the industry and government have done little to nothing to control this.

60% of the gambling industry’s profits come from the 5% of users who are problem gamblers, or are at risk of becoming so. The committee suggests a mandatory 1% tax on the industry that will be used for RET (research, education, and training) for gambling harms and problem gamblers. This levy will increase funding for treatment across the NHS, while also developing research into gambling harms and their long-term effects. This is a great example of a public health approach to a complex problem; it is working across sectors to improve the well-being of the general public and taking the responsibility off of the individual and onto the industry that has caused the harms. This has been done in other sectors, such as alcohol and tobacco, to reduce harms and improve research into the areas. Gambling addiction is still a new area of study which means there are few evidence-based, long-term solutions. This proposed levy aims to change this.

The committee have also made sure that their recommendations won’t affect recreational gambler’s play. This is another key element of a public health approach; interventions and solutions shouldn’t negatively affect those who are not the target community for the intervention.

Problem gambling has only recently been recognised as having wide-spread negative effects, and its effects on affected others are still being discovered. A public health approach not only considers treatment-based outcomes, it also focuses on the root cause of problem gambling. This comprehensive approach can allow for long-term solutions that can help to stop problem gambling occurring in the first place. The tides are slowly turning and the UK government is recognising that The Gambling Act 2005 is no longer fit for purpose, and that more needs to be done to tackle gambling harms.


Thanks to Erik McLean for kind permission to use the header image in this post which was previously published on Unsplash.

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