Gambling harm – a driver of widening health inequalities

Gambling is another addictive product in our society that can have a devastating effect on the most vulnerable and can widen existing inequality. In this blog, Organisational lead for Public Health Networks Ann Conacher highlights a new programme of work in Public Health Scotland to address gambling harm.

Despite its relatively small population size, the UK has one of the largest gambling markets in the world. The UK public lost £14.1 billion of their money to the gambling industry in 2021-22. In Scotland, we see that gambling premises are concentrated in our most deprived communities. So, those that are least able to afford the monetary losses are exposed the most. As a result, the additional burden to health arises.

Recent research shows how the cost of living crisis is exacerbating the harm from problem gambling, with betting shops being used as warm banks and people on universal credit and disability benefits gambling as a means to make additional money to cover their bills

The gambling landscape has changed significantly due to deregulation through the Gambling Act (2005) and the introduction of new technologies, with online gambling now the most common way to gamble. This was accelerated by the COVID-19 pandemic.

24/7 accessibility to gambling means that greater numbers are now at risk from harm. Public Health England (PHE) published an evidence review (updated January 2023) which shows the many health and social harms associated with gambling – homelessness, crime, broken relationships, mental health problems and suicide. The review also shows that in England, although the most socio-economically deprived and disadvantaged groups gamble less, they have the highest levels of harmful gambling. There is potential for gambling to make existing health inequalities worse.

Furthermore, recent research by YouGov and GamCare shows how the cost of living crisis is exacerbating the harm from problem gambling, with betting shops being used as warm banks and people on universal credit and disability benefits gambling as a means to make additional money to cover their bills.

New programme of work to address gambling harm

There is very little data collected routinely, so understanding of the extent of the problem in Scotland is limited. This relates not only to people who are experiencing problem gambling, but also those ‘at risk’ and those affected by the gambling of others, i.e. family members and our communities. A cross-organisational project group has been formed in Public Health Scotland to identify and understand what data is currently available, undertake its analysis to inform future developments (primarily linking Scottish Health Survey data), and lay the foundations of future surveillance systems for gambling harm. This work will support our discussions with Scottish Government and any working group which will be established now that the white paper in response to the Gambling Act review has been published.

We are also working with partners in Glasgow to pilot a whole system approach to mitigate the impact of gambling harm in a local authority area. We’ve formed a multi-agency group chaired by Glasgow City Council with membership from Glasgow Life, Glasgow Health and Social Care Partnership (HSCP), Glasgow Council for the Voluntary Sector (GCVS), the Health and Social Care Alliance. Public Health Scotland has helped build additional capacity within the local system by supporting two, temporary part time roles in GCVS and the HSCP. By having dedicated people on the ground, working together to build relationships and networks, the whole system project has supported the implementation of a community fund and the development of a multi-agency action plan.

Gambling is another addictive product that can have a devastating effect on the most vulnerable in our society and can widen existing inequality

Recognising the vital inclusion of the lived experience voice in all our work, we are also working with the Glasgow HSCP to develop composite stories highlighting the harms experienced by different, vulnerable groups. These stories will be used to raise awareness throughout our communities of the harm from gambling and address stigma which prevents many from seeking help. 

Public Health Scotland's work on gambling harm is relatively new, but the problem it seeks to address is unfortunately all too familiar. Gambling is another addictive product that can have a devastating effect on the most vulnerable in our society and can widen existing inequality. As such, we can learn much from the experience we have in addressing the harms from tobacco, alcohol and drugs. We know that prevention and addressing poverty is key to tackling all these harms. We will continue to work with Scottish Government and local partners to identify future public health approaches to addressing gambling harm.

Sources:

1. Gambling Commission Industry Statistics – November 2022 (gamblingcommission.gov.uk)

2. Graph is by Scott Kilgariff, Principal Information Analyst at PHS. Addresses of gambling premises were obtained from the Gambling Commission’s “register of gambling premises” (https://www.gamblingcommission.gov.uk/public-register/premises/download) on 17th Nov 2022. This register listed 9,147 UK wide gambling premises. Each premise was categorised under one of the premise activities as recorded in the table. A small number had no premise activity recorded against them (these have been omitted from the plot). Further analysis revealed that 950 of these premises were located in Scotland. The postcodes for the 950 Scottish gambling premises were used to obtain the SIMD quintile (based on the SIMD 2020 calculations) for each premise.

3. Office for Health Improvement and Disparities. The economic and social cost of harms associated with gambling in England, evidence update. 2023.

4. GamCare, March 2023 Cost-of-living crisis: new research lays bare the challenges facing gamblers - GamCare