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Is gambling really such a big public health issue?

Last week, the president of ClubsAustralia, Peter Newell, addressed the National Press Club (speech available here).

Today, it was Independent MP Andrew Wilkie’s turn, and he has reportedly given the PM until Budget day in May 2012 to put gambling limits on pokies or he’ll withdraw his support for the government.

Wilkie has also joined forces with GetUp in this campaign to push for mandatory pre-commitment (where pokie players, before they start gambling, must set their own daily limit: a maximum amount they are prepared to lose for the day. )

So what do public health experts make of all this?

Dr Charles Livingstone, Senior Lecturer and Deputy Head of the Department of Health Social Science at Monash University, says it is well past time that governments tackled the preventable harm caused by gambling.

***

Why the gambling industry is a serious public health threat

Dr Charles Livingstone writes:

Commercial gambling now permeates our society. In Australia, pubs, clubs, newsagents and casinos sell gambling products, and Australians spend (or, it might be said) lose around $19 billion a year, $12 billion of it on poker machines (also known as electronic gambling machines, or EGMs).

Gambling businesses sponsor elite sports and good causes; state governments reap around $6 billion per year from the proceeds of gambling.

But at any one time hundreds of thousands of Australians are directly affected by the consequences of excessive or ‘problem’ gambling, and many times that number of family members, employers or loved ones are affected by the gambling problems of others with whom they have a connection.

At least 40% of the money that is spent on EGMs comes from people with a serious problem, and another 20% from those with a developing or moderate problem.

The consequences of excessive gambling include physical and mental ill-health, family breakdown, the neglect and abuse of children, financial ruin, crime and associated incarceration, and in some cases self-harm and suicide.

These are not trivial, and it is clear that commercial gambling in its current form presents a serious threat to health and wellbeing.

However, unlike many other such threats, those presented by commercial gambling are highly avoidable, and highly amenable to a full range of public health interventions.

The current approach to gambling problems adopted by the gambling businesses, regulators and governments, generally known as ‘responsible gambling’, shifts the focus of gambling problems and the responsibility for them on to the individuals affected.

Although the counselling and other support services currently offered are important and should be continued, the approach currently employed to address the harms of problem gambling has been focused on the ‘pathologised’ individual.

This approach minimises the responsibility of gambling businesses and governments, whose revenue shares would be adversely affected by serious upstream action against gambling.

A comprehensive public health approach to gambling is necessary if we are to reduce these harms and generate social conditions which support health and wellness.

These include changes to regulation to ensure that gambling devices are safe and that the interest of those who use them are well protected, technological interventions to allow gamblers to much better track and control their expenditure of time and money, systems to allow the earliest possible identification of those with a developing gambling problem, and to facilitate early intervention, and prohibitions on dangerous marketing such as promotions involving children, free food and drink, or rewards for gambling expenditure.

The 2010 Productivity Commission report on gambling recommended that such initiatives were long overdue.

It urged governments to implement pre-commitment (permitting gamblers to set binding limits on gambling expenditure BEFORE they start to gamble) and reductions in maximum bets and other regulated parameters, designed to make machines safer, less voracious, and more likely to provide low risk entertainment. All of these interventions are feasible and can be achieved at modest cost, and within a relatively short timeframe.

It is well over time to address this eminently avoidable harm. There are many public health measures which cannot be well addressed at present, but we know a great deal about how to effectively reduce gambling related harm using public health measures. All that has been lacking, until now, is political will.

***

For more info: The Public Health Association of Australia policy statements on Gambling and Health, and Gambling Industry Funding, are here.