Gambling and Public Health – How to Operationalise the Concept of Gambling Related Harm

Gambling is the act of taking part in any game of chance or skill that involves risk, with a hope to gain a prize or money from it. It can take place in many different locations including casinos, gas stations, sports grounds, church halls and on the internet.

The concept of gambling has long been a point of debate in health and social policy. It is recognised that gambling has negative impacts on people who gamble, and on their family and community. These include a range of harms such as financial loss, relationship breakdowns, emotional and psychological harms and poor health outcomes.

It is also known that gambling can lead to criminal acts, such as theft of property and financial fraud. It is important that we understand the harms of gambling so that we can prevent them or reduce their impact.

Historically, the term ‘harm’ has been used in this field to describe a range of experiences and consequences of gambling that can occur within the person who gambles, their family and friends and the broader community. However, the concept of harm has been problematic in that it is ambiguous, subject to a wide range of interpretations and often lacks a measurable scale or consistent definition.

This has resulted in a number of definitions of gambling related harm to be proposed, both within Australia and internationally. Some, such as the Queensland Government’s, are very vague and do not capture the broad range of potential harms that can occur within a person’s life. Others are much more specific and can be interpreted by health professionals as describing specific behaviours, clinical diagnoses or risk factors.

The New Zealand definition of gambling related harm is a much more explicit description of harms that can occur and does not imply that the harms are caused by the person who gambles. It is also more sensitive to a range of other issues such as underlying causes, risk factors and the environment in which gambling occurs.

One of the key challenges in operationalising the concept of gambling related harm is the complexity and subjectivity of how harms are experienced by a person who gambles, their family and friends, and the broader community. Using a functional definition that is able to be operationalised within a public health context, could help ensure a clear and coherent understanding of harm across treatment providers, researchers and policy makers.

A grounded theory approach was utilised throughout this study, with focus groups and interviews conducted in person (n = 20), and semi-structured telephone interviews conducted with participants who identified as a person who gambled or affected others (n = 25). Data were then analysed sequentially first and then synthesized to produce initial codes for a taxonomy of gambling related harms as they were experienced by the person who gambles, their family and their community.

The resulting taxonomy of gambling related harms can be used to inform research, policy and practice in order to improve prevention and treatment. It also provides a framework for measuring gambling related harms in the context of standard epidemiological protocols used in public health.