Matthew Stevens Funded by the Community Benefit Fund

1. Betting on the evidence: The case of gambling-related problems amongst the Indigenous population of the Northern Territory Matthew Stevens Funded by the Community Benefit Fund

2. Recent political climate in the NT • Little Children are Sacred(Wild & Anderson 2007) • Gambling mentioned 36 times and in all instances except one, in the same sentence as alcohol, drug abuse and pornography • Closing the Gap on Indigenous disadvantage: A Generational Plan of Action(NTG, 2008) • A belated NT government response

3. Recommendations and Responses

4. Scholars divided:Positive and Negative Impacts • Late 70’s to early 80’s seen as relatively benign activity (unregulated) • e.g. distributes income and social/fun activity, equated with hunting and gathering (Altman 1985, Goodale 1987) • Other social/medical researchers tended to emphasise the negative impacts • Impacts on child nutrition, financial stress & increased family tensions (Hunter 1993, Hunter and Spargo 1988, Brady 2004) • Association with other community contexts e.g. alcohol/drug abuse (McKnight 2002)

5. Gambling as a political concern • It is common to see gambling lumped with other social “vices” in government policy and research • Public health/harm minimisation verse associated gambling related problems within the sphere of the individual • Different policy approaches across jurisdictions (>40 codes of practice) • Limited regulatory government intervention & proactive positioning of industry are central regulatory principle in the NT • Codes limited by resource constraints (Fogarty and Young 2008)

6. A public health approach • Examples: alcohol, pornography, crime (community safety), tobacco • Laws to limit access to certain available goods and services (e.g. drinking restrictions, TV/movies /literature classifications, fines etc.) • An informed public health approach requires an evidence base

7. National Definition of Problem Gambling Problem gambling is characterised by difficulties limiting money and/or time spent on gambling, which leads to adverse consequences for the gambler, others or the community. (Neale et al. 2005)

8. Is gambling problematic now? • Early 90’s increasing patronage of casino – indications of gambling phases (Foote 1996) • Card playing viewed by Aboriginal people as positive (social, distributive), but tended to view pokies as problematic (McMillian and Togni 2000) • Problem gambling 2-3 times higher based on two estimates (SOGS: 4.0% v. 1.9%; CPGI: 7.9% v. 2.5%) (SSPR 2006, Young et al. 2007) • Indigenous more likely to be monthly poker machine players (47% cf. 33%) • Variation between communities in attitudes to gambling including cards (McDonald and Wombo 2006)

9. NEGATIVE LIFE EVENTS SCALE2002 NATSISS and GSS • Gambling problems • Alcohol or drug related problems • Witness to violence • Abuse or violent crime • Trouble with the police • Divorce or separation • Not able to get a job • Lost job, made redundant, sacked • Death of family member or close friend • Serious illness or disability • Serious accident

10. 2002 Reported gambling problems

11. Aims • What is the relationship between gambling problems and other items in the Negative Life Events Scale (NLES)? • What are the demographic, socioeconomic and socio-cultural correlates of reported gambling problems in the NT?

12. Methods • Australian Bureau of Statistics data • 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) • 2002 General Social Survey (GSS) • Factor Analysis of NLES items • Logistic regression used to assess adjusted associations between gambling problems and demographic, socio-economic, socio-cultural and other explanatory variables

13. Results: NT NLES Factor Analysis x = Loadings greater than 0.50; o = Loading greater than 0.40

14. NATSISS: Significant multivariate adjusted correlates of gambling problems: Figure 1

15. NATSISS: Significant multivariate adjusted correlates of gambling problems: Figure 2

16. GSS: Significant multivariate adjusted correlates of gambling problems: Figure 1

17. Comparison of NATSISS & GSS • Identify any differential associations between Indigenous and general population analysis • Variables with same directional association • Cash flow problems • Participation in social/recreational activities • Victim of threatened of physical violence • Variables with different directional association • Household income and source of income • Self-assessed health

18. Caveats to the analysis • Different scope between the GSS and NATSISS (non-remote v. all NT) • Estimates biased up in discrete community sample because of greater social connectedness  skin groups • Confounding through unmeasured variables (e.g. community size/location)

19. Key messages • Broader social context important • Structural factors such as housing shortages • Gambling problems do situate with other public health concerns such as: • alcohol and drug abuse, and • Crime and law and order issues • Differences in associations between Indigenous and non-Indigenous population targeted policy

20. Concluding comments • NTG response to gambling in communities located the problem predominantly with individuals • Gambling counselling expansion, education • Clearly gambling is interconnected with a range of social and structural contexts & placing gambling in isolation in policy is unlikely to have much effect on negative aspects of gambling • Programs addressing the structural influences are more likely to influence the negative aspects of gambling, particularly in remote communities

21. Thank you • Questions