"I always walked out with an empty purse." Older adults' engagement with electronic gambling machines in Victoria, Australia

What is known about population level programs designed to address gambling-related harm: rapid review of the evidence

BACKGROUND

Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level.

METHODS

The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.

RESULTS

One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective.

CONCLUSIONS

Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.

Older adults' perceptions of the risks associated with contemporary gambling environments: Implications for public health policy and practice

INTRODUCTION

Rapid changes in the Australian gambling environment have amplified the risks for gamblers and pose significant threats to public health. Technological advances, saturation of marketing, and the embedding of gambling in sport have all contributed to significant changes in the gambling risk environment. Older adults have witnessed the changes to the way gambling is provided and promoted in public spaces, but little is known about how these changes have shaped the way they conceptualize the risks associated with gambling.

METHOD

Guided by critical qualitative inquiry, semi structured interviews were conducted with 40 Australian adults aged 55 years and older, who had gambled at least once in the last 12 months. Reflexive thematic analysis was used to interpret the data.

RESULTS

Participants discussed gambling environments in Australia and how they had changed through the proliferation of gambling products, environments, and opportunities; the risks posed through the embedding of gambling in community and media environments; the role of technology in gambling environments; and the role of marketing and promotions in the changing gambling environments. Participants recognized that these factors had contributed to gambling environments becoming increasingly risky over time. However, despite the perception of increased risk, many participants had engaged with new gambling technologies, products, and environments.

DISCUSSION

This research supports the adoption of public health responses that include consideration of the environmental, commercial, and political factors that may contribute to risky gambling environments.

A scoping review of the individual, socio-cultural, environmental and commercial determinants of gambling for older adults: implications for public health research and harm prevention

Gambling is a global public health issue that can cause harm to individuals, families, and communities. Older adults are vulnerable to gambling harm due to life-stage experiences. This study aimed to examine current research relating to individual, socio-cultural, environmental, and commercial determinants of gambling among older adults. A scoping review was conducted (PubMed, PsycInfo, SocIndex, CINAHL Complete, Web of Science, Social Science and Sociology databases available in ProQuest, Google Scholar, citation searching), with peer reviewed studies included that were published between 1 December 1999 and 28 September 2022. Included studies were published in English in peer-reviewed journals that examined the determinants of gambling in adults aged 55 and over. Records were excluded if they were experimental studies, prevalence studies or had a population wider than the required age group. Methodological quality was assessed using JBI critical appraisal tools. Data was extracted using a determinants of health framework and common themes were identified. Forty-four were included. Most literature examined individual and socio-cultural determinants including reasons for gambling, risk management strategies, and social motivations for gambling. Few studies investigated environmental or commercial determinants, and those that did focused on accessibility of venues or promotions as pathways to gambling. Further research is needed to understand the impact of gambling environments and industry, and effective public health responses for older adults.

"Aussies love a bet": Gamblers discuss the social acceptance and cultural accommodation of gambling in Australia

OBJECTIVE

This study aimed to explore regular gamblers' perceptions of the social acceptance and cultural accommodation of gambling in Australia, which are two dimensions of the normalisation of gambling.

METHODS

Qualitatively focused online survey with 363 adults in New South Wales and Victoria who gambled in a typical month. Open-text responses about the link between gambling and Australian culture were interpreted using reflexive thematic analysis to construct themes from the data.

RESULTS

Gambling was perceived to be a culturally significant part of Australian life due to existing traditions, the perception that gambling was central to the Australian identity, and perceived economic benefits. Participants considered that gambling was a common and socially accepted activity that was embedded in the activities of social networks. Participants also stated that gambling products, venues and marketing were embedded in everyday environments, although some believed that the embedding of gambling in society was harmful. Conclusion and public health implications: This study demonstrated that regular gamblers largely viewed gambling as being a socially accepted and culturally accommodated activity in Australia. There is scope for governments to develop comprehensive programs to denormalise gambling, including learning from research, evidence and experience in other areas of public health.