Gambling
Healthy Lives
Behavioural Risk Factors
Problem Gambling
Public Health Interventions
Treatment for Gambling Disorders
Gambling Legislation
Community Awareness
Introduction
The general definition of gambling is to stake or risk something of material or monetary value on an event, without being guaranteed to achieve the desired outcome. The Gambling Act 2005 - which is currently under review - defines gambling more specifically as gaming, betting, or participating in a lottery, both via land-based avenues (such as a bingo hall) and online spaces (a betting app).
For many people, gambling is an enjoyable leisure activity, undertaken from time to time often as part of celebrating a social or family event. An example is the annual Grand National race, a popular pastime that is largely played recreationally.
For some people, however, gambling can lead to serious and significant problems including compromised individual socio-economic and health outcomes, alongside the effects on wider social networks. Gambling-related harm (GRH) is the adverse impact from gambling on the health and wellbeing of individuals, families, communities, and society.
Gambling-related harm has been widely considered the ‘invisible’ or ‘silent’ addiction.
Why is it important to Population Health?
Gambling-related harm (GRH) is crucial to population health for many reasons:
Gambling & Health Inequalities: There is a social gradient attached to GRH. Although those with smaller amounts of disposable income are less likely to participate in gambling, the harms experienced in these groups are significantly greater. In contrast, gambling frequency is greater in more affluent areas, despite the manifestation of harms being less severe. Those experiencing gambling problems are seven times more likely to use gambling products as a way of alleviating money pressures, demonstrating the link between gambling, financial exclusion, and the wider determinants of health. GRH can have negative repercussions on entire communities; Gordon Moody highlight that for every single harmful gambler, between 6-10 others are directly impacted. In recent times, it is suggested that gambling premises have been used as ‘warm banks’, emphasising the connection between vulnerable communities and the location of gambling outlets. A population health lens is therefore crucial for mitigating GRH.
Types of Gambling: The emergence of online (virtual/remote) gambling and the diversity of products has resulted in a clear shift towards people being able to gamble freely, with 24-7 accessibility, in a solitary environment such as their own home, or amongst friends in a social setting. Online gambling is more prevalent amongst the male population, although vast expenditure and harms are pervasive in all groups. Generally, online gambling in the form of online casino is the most lucrative for the industry, evident in high turnover of games (can start and finish some games within 7 seconds), and minimal restrictions on stake limits.
Gambling & Suicide: The devastating social and cultural effects of GRH should not be underestimated. Evidence suggests that harms associated with gambling is a risk factor for suicide ideation and deaths by suicide. Approximately 250-650 deaths by suicide are directly attributed to gambling. Gambling-related harm has been explicitly mentioned in the latest Suicide Prevention 5-year Cross-Sector Strategy1.
Young People & Gambling: In the UK, young people are more likely to be experiencing gambling problems compared to smoking or using e-cigarette products (11% compared to 6%). The blurring of gambling and gaming has provided a gateway into the feelings and experiences felt when gambling, such as anticipating a win. Many video games have the option to spend real money for in game purchases. Loot boxes are digital items that a player can pick up for free in the game or by paying for them using real, tangible cash. A loot box replicates a gambling activity such as a scratch-card. As with all gambling, loot boxes create an element of suspense, with the value of loot boxes based on chance and the outcome of chasing a desired outcome. Longitudinal studies have shown that brain development in young people continues up to the age of 25 and the area of the brain related to decision making and addictive behaviour is among the last areas to develop, therefore young people can be particularly vulnerable to harmful gambling and gambling-related harms.
Gateway Products: Many smartphone ‘freemium’ games are free to download but cannot be fully enjoyed unless the player pays for in-app boosts. Candy Crush and 8-Ball Pool are examples of how games designers have monetised games to encourage the consumer to spend tangible money, which is then converted into the game’s currency, to spend on more turns or to upgrade the character you are playing with (mimicking gambling as these in-game boosts do not guarantee success!). Cryptocurrency can be used as a form of capital to deposit money onto a gambling account, in a similar way to depositing money from a bank account. The notion of cryptocurrency itself is not technically gambling, in a similar way to stocks and shares investing (regulated by the Financial Conduct Authority). Like gambling, cryptocurrency trading and investing can be addictive, MPs concluded. The process of betting on the volatile price of unbacked assets such as bitcoin could lead consumers to lose life-changing sums of cash.
In summary, GRH is a significant population health concern due to its links to income disparities, with lower-income individuals experiencing more severe harms despite less frequent gambling, while wealthier individuals gamble more frequently but encounter milder harms. Online gambling, especially among men, is on the rise, particularly in online casinos. GRH is associated with suicide risk, and young people are vulnerable due to the blurring of gaming and gambling. Gateway products like freemium games and cryptocurrency trading can lead to financial losses and addictive behaviours. All of these factors emphasise the urgent need to address GRH from a population health perspective.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of gambling within The Derbyshire Population Health Approach:
Working to ensure that residents in Derbyshire are aware of the potential harms that come with being exposed to gambling products through awareness-raising and information sharing, with an emphasis on identifying those at-risk of GRH to alleviate unfair and unjust differences in health outcomes.
Taking a population-centred approach to gambling with a focus on training relevant frontline staff who support vulnerable users on a day-to-day basis, with overlapping issues such as living with a long-term condition, debts, tenancy support, health and wellbeing, and welfare benefit maximisation. Soft touch interventions through mini-screening exercises conducted as part of a wider assessment. Clinical and medical support, advocating the need to refer directly or professionally to the NHS’s specialist gambling clinic in Derby.
Understanding the effectiveness of specialist treatment for long-term recovery and how to use intelligence to inform identification and intervention. Gathering of independent and impartial data to target intervention in localities or smaller-scale areas across Derbyshire.
Deep understanding that GRH links to other environmental, social, physical, mental and financial population health issues, and that co-morbidity is usually present in people who experience gambling problems. Gambling can also develop and manifest throughout the life-course, and specific life events can trigger harms.
Collaboration is essential in the population health approach to gambling. It is essential that continued support is made available to the work of Derbyshire NHS Foundation. This is to ensure that the delivery of the East Midlands specialist gambling clinic occurs. Also, to advocate the need for experts by lived experience involvement. Additionally, playing an active role in the East Midlands GRH shared learning group and to continuing to develop a network of stakeholders across Derbyshire’s health system. Finally, it is vital that in-house services to embed gambling screening are fully supported across the system.
Latest Derbyshire Data
Trend data
Derbyshire Quilt
Prevalence Maps of Derbyshire
The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.
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In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly. |
Slope Index
This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.
Further Analysis & Assessments
Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.
Coming soon…
More Information & Resources
Here is a list of useful resources and information to help prevent issues related to gambling. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address gambling-related harm.
- Derbyshire County Council’s Gambling Support Webpage
- East Midlands Specialist NHS Clinic: A free NHS service has been launched to offer specialist treatment and support to people in the East Midlands who are struggling with a gambling problem. The East Midlands Gambling Harms Service, which is based in Derby, will provide specialist therapies, treatment, and recovery to those affected by gambling addiction and gambling problems in Derbyshire, either face-to-face, over the phone, or virtually.
- Training for front-line professionals: This population health gambling awareness training focuses on the state of play when it comes to gambling in the UK, its prevalence, harms, and risk factors. It covers identifying those at risk, how to intervene appropriately in the short-term, and formulating action plans to ensure long-term recovery.
- GamCHAT: Research suggests that for every person experiencing gambling problems, 6 to 10 others are directly or indirectly impacted. Derbyshire Alcohol Advice Service (DAAS) offers a programme for those affected by someone else’s gambling problems called GamCHAT.
- Gambler’s Anonymous: Gamblers Anonymous is a 12-step programme of abstinence, a fellowship where others with lived experience can support the recovery journey. In Derbyshire, local meetings include Derby city and Chesterfield.
- National Gambling Helpline - a 24-hour service: The National Gambling Helpline gives confidential information, advice, and support for anyone affected by gambling harms in England, Scotland and Wales. You can speak with an adviser one-to-one over the phone or on live chat 24-hours-per-day, every day of the year, tel: 0808 8020 133. GamCare also offer a live chat option.
- Nottingham City Council Health Needs Assessment
- OHID’s review into the economic and social cost of harms associated with gambling in England
- Greater Manchester’s 2023-2026 Action Plan for Reducing Gambling Harms, a Toolkit for Local Authorities
- High stakes: gambling reform in the digital age (gov.uk)- Gambling Act Review, the White Paper proposing reform measures.
Contributors
Greg Stenson, Service Development Officer, Wider Determinants Team