Pathological Gambling A Critical Review (1999) / Chapter Skim
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3: Pathological and Problem Gamblers in the United States
3: Pathological and Problem Gamblers in the United States
Pages 63-106
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From page 63... ...
This chapter also makes comparisons with the prevalence rates of alcohol and drug abusers, to help put the magnitude of excessive gambling and related problems into perspective. The committee thanks Matthew N
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Most of the prevalence research on pathological and problem gambling is specific about the population or area represented, but the time frames within which gambling behavior is assessed vary widely. This variation is troublesome because the information of greatest policy relevance is generally the prevalence of current pathological or problem gambling, that is, estimates over a relatively recent but behaviorally representative time frame (e.g., the past year)
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DETERMINING NATIONAL PREVALENCE Perhaps the most serious limitation of existing prevalence research is that the volume and scope of studies are not sufficient to provide solid estimates for the national and regional prevalence of pathological and problem gamblers, or to provide estimates of changes in prevalence associated with expanded gambling opportunities and other recent secular trends. Only three studies have attempted to measure the prevalence of pathological or problem gambling in the United States for more than one or a few states.
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The study found that lifetime prevalence rates among adults in the general population for both nations together were estimated at 1.60 percent for Level 3 gamblers and 5.45 percent for Levels 2
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As described in more detail in the following sections, the median prevalence rates found in those studies were as follows: · Lifetime prevalence rates: 1.5 percent for Level 3 gamblers and 5.4 percent for Levels 2 and 3 combined. · Past-year prevalence rates: 0.9 percent for Level 3 gamblers and 2.9 percent for Levels 2 and 3 combined.
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Table 3-1 also shows that a variety of survey instruments for identifying pathological and problem gamblers was used in these studies. However, the South Oaks Gambling Screen (SOGS)
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They found, however, that there was neither a statistically significant relationship between that score and reported prevalence rates nor meaningful differences between unweighted prevalence means and those weighted by methodological quality. In light of these findings and the relatively small number of recent U.S.
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Lottery participation was highest, with the lowest proportions found among games of skill, pari-mutuel betting, gambling in financial markets, and charitable games. Pathological and Problem Gamblers Table 3-3 summarizes the prevalence rates of Level 2 (problem)
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pathological gamblers, respectively, among only those who have gambled in the last year. The other numbers in Table 3-3 represent the proportions of problem and/or pathological gamblers among all respondents in the sample, whether or not they have gambled within the indicated time frame.
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NORC estimated the lifetime prevalence of pathological gamblers at 0.9 percent (compared with 1.5 percent estimated from the studies in Table 3-3) and the past-year prevalence at 0.6 percent (compared with 0.9 percent from Table 3-3~.
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1) and the percentage of problem and pathological gamblers (Levels 2 and 3 combined)
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, racetrack betting, sports betting, and casino games. Gambling Expenditures Eight of the studies listed in Table 3-3 reported the responses of gamblers to questions about their net monthly gambling expenditures.
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provides data collected in 1990-1992 from a national probability sample of noninstitutionalized persons ages 15 to 54 for DSM-IIIR psychiatric disorders. Table 3-5 shows the prevalence rates for alcohol and drug dependence compared with those for pathological gambling.
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: 1997 data Kessler et al., 1994 Kessler et al., 1994 0.9 percent for Type E pathological gamblers by the NORC survey (National Opinion Research Center, 1999) , we see an increase of 0.13 percent.
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In Iowa, riverboat casinos were opened and slot machines were permitted at the state's racetracks (Cox et al., 1997~; in Minnesota, American Indian casino gambling was established (Emerson and Laundergan, 1996~; in Texas, a state lottery was instituted, and in Connecticut, American Indian gambling was established with the opening of the immense Foxwoods Casino. In all of these states, the prevalence rates for pathological, problem, and pathological and problem gambling combined showed increases for past-year and/or lifetime gambling activities.
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Both observed that the results of state-level prevalence studies conducted in more recent years have shown higher prevalence rates than those conducted in the 1980s. VULNERABLE POPULATIONS Several populations are of particular interest because of the possibility that they may be especially likely to develop gambling problems or, if such problems develop, because they may be especially vulnerable to their harmful effects.
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The median value of 73 percent suggests that most adolescents not only gamble, but also have gambled fairly recently. The estimates for specific types of gambling show that the most frequent activities are card games and sports betting.
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For pathological gamblers only, the estimates ranged from 1.2 percent to 11.2 percent, with a median of 5.0 percent. AcknowIedging again the difficulty in interpreting these data, we observe that, in comparison to the proportions of adult pathological and problem gamblers presented earlier, by the prevailing operationalizations, the proportion of pathological gamblers among adolescents in the United States could be more than three times that of adults (5.0 versus 1.5 percent)
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As noted earlier, while this report was in its final stages, preliminary results were released from the national survey conducted by NORC for the National Gambling Impact Study Commission. One component of that study was a survey of 500 youths ages 16 and 17.
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Comparisons with Drug and Alcohol Problems Some perspective on the magnitude of the prevalence rates for pathological and problem gambling among adolescents is provided by comparing them with the rates for other problem behaviors in the same population. Six of the studies identified in Table 3-7 not only examined the prevalence of gambling problems but also asked respondents about other problem behaviors (Volberg, 1993, 1998a; Volberg and Boles, 1995; Allen, 1995; Steinberg, 1997; Westphal et al., 1997~.
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These results are summarized in Table 3-10. The Elderly and Other Age Groups Seventeen of the studies identified in Table 3-1 provided breakdowns for gamblers without problems and for problem and pathological gamblers in a form that permitted comparison across age groups.7 As discussed above, virtually all of those break 7Emerson et al.
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These instances occur roughly in the 40-60 age group, not in the most elderly categories, and the differences are relatively modest. In the remaining 14 studies, all groups over age 30 are proportionately larger among the gamblers without problems than among the problem or pathological gamblers.
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Minorities Eighteen of the studies identified in Table 3-1 provided breakouts of the comparative proportions of at least one ethnic group for gamblers without problems and problem and pathological gamblers.9 Of those, 17 studies included either white or nonwhite as one category. These studies suggest that, in general, minorities who gamble are at risk for developing gambling problems.
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In particular, the median percentage of the pathological and problem gamblers with income under $25,000 per year was 33 percent compared with 27 percent of the gamblers without problems. Only seven of the studies in Table 3-1 compared problem and pathological gamblers and gamblers without problems with regard to employment status.
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Eighteen studies provided breakouts of educational background for the groups of gamblers without problems and problem and pathological gamblers. These data show that education has a moderately strong relationship to the risk for problem and pathological gambling.
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Across subpopulations, therefore, we would expect the prevalence rates for pathological and problem gambling to be highest for minority men, especially adolescents, with relatively low levels of income and education. The gambling behavior of adolescents has been more frequently studied than that of other vulnerable populations.
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complicate any attempt to directly compare adolescent and adult prevalence rates. Nonetheless, the best available evidence indicates that pathological and problem gambling among adolescents is a significant problem.
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For purposes of constructing national prevalence estimates for pathological and problem gambling and breaking out important subpopulations, the existing research provides only limited and uncertain information. As a basis for informed policy discussion, therefore, the available prevalence data are incomplete.
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1989 The prevalence rates of pathological gambling: A look at methods. Journal of Gambling Behavior 5~1~:22-41.
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press Alcohol Health and Research World. National Opinion Research Center 1999 Overview of the National Survey and Community Database Research on Gambling Behavior: Report to the National Gambling Impact Study Commission.
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1994 The prevalence and demographics of pathological gamblers: Implications for public health. American Journal of Public Health 84:237241.
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American Journal of Psychiatry 146~12~:1618-1619. 1988b Refining prevalence estimates of pathological gambling.
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Zitzow, D 1996 Comparative study of problematic gambling behaviors between American Indian and non-Indian adolescents within and near a northern plains reservation.
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