Gambling

Problem gambling is a disorder rather than a disease that directly causes ill health or death, but evidence shows that it can lead to significant adverse health and wellbeing outcomes. This is a definition of the criteria for gambling disorder. The Problem Gambling Severity Index (PGSI) is a standardised measure of atrisk behaviour in problem gambling. An example question is: “Have you bet more than you could really afford to lose?” A PGSI score of 1-7 indicates ‘at-risk gambling’ and a score of 8+ indicates ‘problem gambling’. PHE estimated that 3.8% of the population are classified as at-risk gamblers and 0.5% as problem gamblers. As the PGSI score increases, the level of harm experienced is expected to increase, with those classified as problem gamblers experiencing the highest level of harm.

Impact of gambling harm

Suicide - Problem gambling is a risk factor for suicide. The leading causes of death associated with problem gambling are suicide and domestic homicide/filicide. Gambling severity, increasing losses and unmanageable debt are predictive of a greater tendency to suicide.

Financial harm - Financial harm related to problem gambling is often severe and affects both the gambler and those closest to them, especially partners. Gambling has been associated with poor concentration at work and tardiness, eventually leading to resignations, demotions, or termination of employment. PHE identified bankruptcy, housing problems and homelessness associated with gambling. Financial harm is also an important risk factor in negatively impacting relationships, mental health, and criminal behaviour.

Relationships - At-risk and problem gambling is associated with a reduction in both social support and family functioning. Gambling is associated with arguments, relationship strain and domestic abuse. Relationships with those closest as well as wider friendship networks are negatively affected.

Mental Health - Problem gambling has a negative impact on mental health. People experiencing gambling harm described experiencing shame, guilt, loneliness, sleep difficulties and low self-esteem. Close associates similarly reported negative emotions and poor sleep.

Affected others - Around 7% of Great Britain have been negatively affected by someone else’s gambling. Affected others are most commonly women. Of those affected, partners/spouses accounted for 48% of those affected, followed by a parent gambler (41%) and a child gambler (38%).

Vulnerable groups

Vulnerable groups for harmful gambling include those who misuse alcohol and drugs, have mental health difficulties, lower socio-economic status or are unemployed. There is also a high prevalence of gambling harm found in young men and offender populations.

Alcohol

PHE identified a clear association between harmful gambling and increased alcohol consumption. This association is evident for overall gambling participation but is greater for at-risk and problem gambling. The association is not clear to as whether alcohol misuse leads to participation in problem gambling, problem gambling leads to alcohol misuse, or both.

Between 2015-18, an estimated 25.2% of North Tyneside’s residents drank more than the recommended alcohol limit (14 units/week), compared to 25.1% in the North East and an England average of 22.8%. Estimates and modelling suggest that 1.63% of North Tyneside residents are dependent on alcohol, which is over 2,600 adults.

Poor mental health

After alcohol, poor mental health is the strongest predictor of harmful gambling over other health behaviours. In the borough, 5.4% of people reported low wellbeing satisfaction, compared to the national average of 5.6%. Out of the 12 local authorities in the North East, North Tyneside was ranked 4 th in 2022-23. For young people, depression and impulsivity were identified as risk factors for subsequent harmful gambling. One in six children (0-19 years) nationally have a probable mental health condition, which equates to around 7,500 children and young people in North Tyneside.

Socio-economic status

From a gambling participation perspective, people are more likely to be employed, from less deprived groups and with higher academic qualifications. Overall gambling participation is highest in the White and White British ethnic group (60.8%). However, the socio-economic breakdown of gambling differs from general participation to at-risk and problem gambling participation. The most socioeconomically deprived and disadvantaged groups in England have the lowest gambling participation rates, but the highest levels of harmful gambling and they are also the most susceptible to harm. 

There is also a higher prevalence of harmful gambling in people who are unemployed and live in deprived areas. Therefore, harmful gambling is related to and is likely to exacerbate health inequalities. In North Tyneside, 9.3% (19,019) residents live in neighbourhoods judged to be in the 10% most deprived in England.

Young people

Young people are a vulnerable, higher prevalence group and being young and male is a strong predictor of developing problems with gambling. Young men of lower socio-economic status are particularly vulnerable. Problem gambling in children and young people is associated with poorer mental health, particularly anxiety and depression.