Cheryl Currie: Refocusing our Efforts to Promote Responsible Gambling: The Importance of a Public Health Lens
Session 4B
Presented at the New Horizons in Responsible Gambling Conference in Vancouver, January 27-29, 2014
Cheryl Currie: Refocusing our Efforts to Promote Responsible Gambling: The Importance of a Public Health Lens
1. Cheryl Currie, PhD
Alberta Translational Health Chair & Assistant
Professor of Public Health, University of Lethbridge
2. What is done to resolve a
particular societal matter depends
on how it is framed
(Korn, 2002)
• All Canadian provinces provide funds to
promote responsible gambling
• But are we framing the matter in ways that
guide effective action?
3. What is Public Health?
Science of prevention
To fulfill society’s interest
in assuring conditions in
which people can be
healthy.
4. A Public Health Lens
Describe
gambling in
populations
Action
Determinants
of PG
6. Population Health Focus
Individual Focus
Chasing losses
Cravings to gamble
Health problems
Financial problems
Population Focus
844,000 PGs in Canada
(2.4%)
Higher in males
Prevalence lowest in
Quebec, east coast
Low treatment seeking
15. Findings – Anderson (2010)
“...the effects on meth use are statistically
indistinguishable from zero.”
Campaign did not contribute to a decrease in meth
use among youth.
To better guide the allocation of resources this study
calls for a focus on the determinants of meth use.
16. What are the problems with
educating people?
1. Educating people on ‘how to behave better’
is often not that effective in eliciting
lasting behaviour change.
2. Some education-based behaviour change
theories are popular, but not necessarily
evidence-based.
18. What are the problems with
educating people?
3. New people continue to enter the
population at an unaffected rate - who then
have to be
educated on “how
to behave better”
(Syme, 2008)
19. A shift in focus to reducing incidence not
prevalence
21. Wealth Distribution
Divide the 34 million people in Canada into 5 groups
each with 6.8 million people
Wealthiest 20%
Upper middle
Middle
Lower middle
Bottom 20%
Question: What % of wealth is owned by each quintile?
23. Big Picture Thinking
Gambling redistributes $$ randomly among
participants.
How could gambling revenues $$ be used to
redistribute wealth in society?
24. How can we structure the
gambling environment
To make individual’s
default decisions about
gambling responsible?
27. Rose - Preventative Medicine
Personal lifestyle is socially conditioned.
It makes little sense to expect individuals
to behave differently than their peers.
It is more appropriate to seek a general
change in the circumstances which
facilitate behavioural adoption.
30. Where do the High-Risk come from?
Most
responsible
Average gambling
behaviour
Least
responsible
31. What Determines the Population Average?
The more
widespread a
cause, the less it
explains the
distribution of
cases.
Most
responsible
The hardest
causes to identify
are those
universally
present.
Average gambling
behaviour
Least
responsible
38. The Problem
Increased PG Inequalities
Those with higher SES derive more benefit
from whole population approaches
Not addressed – underlying mechanisms in
society that lead to mental health inequalities
in various groups.
44. Developing a Framework for
Responsible Gambling
1. Focus: Primary, secondary, tertiary prevention?
2. Strategies: Based on scientific theory & evidence?
3. Targets: Causes of cases or incidence?
45. Responsible Gambling
Where are We Now?
1. PG prevention programs not generally informed by
research evidence.
2. Most widely employed strategies are the least
effective (education, responsible gambling features,
self-exclusion)
3. No magic bullet strategy in PG literature.
Williams, Simpson & West (2012): Report Link
47. Refocusing Our Efforts to Promote
Responsible Gambling
Cheryl Currie, PhD
AIHS Translational Health Chair &
Assistant Professor of Public Health, University of
Lethbridge, cheryl.currie@uleth.ca