From the Front Lines Against Predatory Gambling

Nelson Acquilano photoA Stop Predatory Gambling National Day of Action in Geneva NY 26 September 2015 was co-sponsored by  CAGNY, Women’s Interfaith Institute, Geneva Assembly of God “Celebrate Recovery,” Phelps Baptist Church, and Concerned Citizens of Seneca County (CCSC).       Nelson Acquilano. LMSW, MPA, MA gave the audience his views on the untrue assertion that making  predatory gambling more convenient benefits the community and the region.  Mr Acquilano (pictured) is on the Board  of Directors of CAGNY.

” My name is Nelson Acquilano. Many of you know me because of the work I have done in the Finger Lakes and because of the many different human service groups and agencies I have worked with over these past 40 years.

We have a terrible problem in New York. Our families, our communities are in great crisis. But this is not an economic problem. No, New York has a Quality of Life Problem… and it is a real crisis for our families and our community.  It will only further decline if we allow it.

New York has a high rate of crime…. a high rate of divorce, high rates of child abuse, academic underachievement, teen pregnancy, and drug abuse.….. our jails are full, our schools are faltering, and our families are failing. Now given this background, the introduction of gambling in New York is contra-indicated.

Given these community problems, to allow a known environmental carcinogen such as gambling into an otherwise delicately balanced community… to take a powerful risk factor, a known risk factor — and allow it to flourish will only further undermine the healthy families and healthy communities we are trying to build and maintain.

Gambling is one of the most destructive dynamics that can be introduced into a community, and when it is – it spreads like a cancer – like an epidemic, leaving broken lives, broken families, and broken communities in its path.

All states that have legalized gambling have found subsequent dramatic increases not only in the incidence of compulsive gamblers, but in crime, family dysfunction, divorce, bankruptcy, and mental illness. But by then it’s too late. Once legalized, communities cannot reverse the trend and control the increase in the gambling addiction and negative consequences.

Compulsive gambling leads to many thousands of personal and family bankruptcies each year. It leads to lost homes, broken families, lost savings accounts, lost college funds, and to a dramatic increase in crime including embezzlement at business. It is strongly correlated with mental illness, and also seriously affects the spouse, children, parents, and friends of the problem gambler.

Some states have reported that divorce tripled after the introduction of casinos. Others reported an explosion in domestic violence.

Other research shows that gambling is indirectly subsidized by the taxpayers. For every dollar that gambling contributes in taxes, it usually costs the taxpayers at least 3 dollars (and higher numbers have been calculated) because of major increases in the welfare system, mental health system, and the criminal justice system. The ultimate cost in broken families and disintegrated communities from gambling never even comes close to justifying it as a means to raise revenue.

Gambling is exploding across America but America is not ready for the consequences.

The National Council on Problem Gambling has found that pathological gamblers have a suicide rate twenty times higher than non-gamblers.

Now if we could stop an epidemic – something that would destroy tens of thousands of families wouldn’t we have an imperative – a compelling moral and ethical responsibility to serve and protect our families?

And that is why I am against gambling anywhere in New York State, but especially in the Finger Lakes. Studies show that the negative consequences impact not just upon the host community, but all communities within a 50 mile radius…. the region I have served for the last 40 years. Gambling is simply the worst strategy for a delicate community.

I would like to leave you with a few final points:

1) It never ceases to amaze me how the moral and ethical implications of gambling are so easily dismissed. When I see casino owners say that the future of gambling is with our youth and we need to have more youth gamble, when I see a casino that comes out and targets women to get more women to gamble, when I see a casino develop a youth program to get more college students to the tables….. then I need to question the morality of that entire industry.

In fact, one college Chaplin told me he is increasingly experiencing college students with a high percent of gambling issues – losing their tuition and room and board monies.

And by the way, a couple of years ago, researcher Natasha Schull who wrote the book “Addiction by Design” was in Rochester. She explained how the gambling industry models psychological experiments on rats for behavior modification techniques on humans, to increase time – and money spent – sitting and playing at slot machines.

She explained extensive studies on Time-on-Device, on algorithms of “Intermittent Positive Reinforcement”, and on how the gambling industry studies the best variance of high-frequency low payout wins and low-frequency high payout wins to keep you gambling. These are some of the strongest shapers of human behavior.

And today’s slot machines are actually learning your preferred method of play….. it hasn’t reached the level of artificial intelligence yet, but according to Natasha… the machines are studying YOU.

There are some 30 organizations opposed to casino gambling in New York, including:- The Institute for American Values

The New Yorkers Family Research Foundation

        and
–   the Roman Catholic Church

– the Episcopal Church

– the United Methodist Church…

– the Baptists….
– the Interfaith Impact of New York State, and

– the New York State Council of Churches!

The Catholics….. Methodists, Baptists and Episcopal Churches are all publicly on record as denouncing the expansion of gambling…..   and I don’t know about you… but I prefer to listen to them for my spiritual health and wellness.

2) Second, the gambling industry follows a business model – that model is all about growth and expansion….. to survive, profits need to grow, which means more and newer ways to gamble… and more and newer ways to get non-gamblers to the table.

At the Senate Hearing one gambling company was asked if they are concerned about the proliferation and saturation of gambling, and their response was “no”, that is not a concern of ours.

Well let me say that it is a concern of ours! And it is already happening. There are all types of efforts to expand gambling throughout New York State. We’ve opened Pandora’s Box.

There is one Italian City, Pavia, that has so much gambling, that it has surpassed most every other city for debt, bankruptcies, depression, domestic violence and broken homes.
It is devastating to the community, and now the people said they have had enough and are trying to pass legislation to curb gambling.

3) And third, if you take a look at the true voting outcome for Proposition I, even with all the manipulation and irregularities to get the voters to vote for it….. Proposition I was voted DOWN in the central Finger Lakes region:

If you include….. Ontario County, Cayuga County, Monroe, Onondaga, Schuyler, Seneca, Wayne and Yates Counties….. 125,031 voted to pass Prop I, but over 126,648 voted against it!

Developers wanted to put a casino in Rochester, but the people defeated it….. they wanted to put a casino in Syracuse, and the people defeated that…. And now they are trying to put one here in the Finger Lakes….

I believe that local citizens groups should be honored, not demonized, for their fight against a proposed casino.

You know, Governor Cuomo accepted some $715,000 from the gambling industry prior to changing the constitution, although he did not include gambling in his pre-election platform. According to Common Cause, over $47 million had been spent on lobbying and campaign contributions to other senators and assemblymen by the gambling industry prior to the changing of the NYS Constitution.

And there have been other discrepancies and irregularities, even with Proposition I itself.

I have reviewed over 100 gambling studies and articles, and I have yet to find one that says that gambling helps to build positive youth development. I have yet to see one that says that gambling supports healthy families. I have yet to see one that says that gambling builds strong communities… in fact, they all say exactly the opposite.

When local groups t recognize the real environmental impact – the human costs, and decide to commit themselves to fight such a devastating dynamic as casinos present, then I applaud their work….. and ask our representatives to remember that the fundamental purpose of public service is for the health, safety and welfare of our residents… and there is nothing about gambling that supports the health, safety and welfare of the people.

Thank you.”

Permission is hereby given to reproduce the words of the above text in whole or part as long as the above permalink is cited and Nelson Acquilano is credited as author.

Hidden social costs of predatory gambling

 

Under the rug

Under the rug

Statement of Stephen Q, Shafer MD MPH to the Gaming Facility Location Board of the New York State Gaming Commission at the hearing in Poughkeepsie on Sept 23, 2014

My name is Stephen Shafer. A retired physician who now lives in Saugerties, I am Chairperson of Coalition Against Gambling in New York. I was born and brought up in Dutchess County, where my daughter and her family now reside.

Hudson Valley Casino and Resort has presented an analysis of health impacts as incomplete as an analysis of vehicle traffic limited to trucks. The report finds regional health care facilities ready for a slight increase in physical maladies of visitors and perhaps a slightly larger population. The impact of predatory gambling on society, however, goes far beyond in-casino heart attacks, The report ignores socio-economic impacts of pathological and problem gambling such as lowered productivity at work, administration of the justice system, “abused dollars” and social services. Outside those quantifiable costs are other costs too abstract to have a dollar value. Most are related  to problem and pathological gamblers, who yield about half the revenue of the average casino. These costs include family breakup, psychological hurt, and suicide. Casino promoters are not obliged to tell you about what they call “emotional” costs when they talk money but they should tell you that predatory gambling tolls society in estimatable dollars much more than the trifle Hudson Valley Casino concedes.

The application is mute on how many new problem gamblers and addicted gamblers a casino in Newburgh might generate, It gives not even an order of magnitude figure for the annual cost to society associated with each new problem or pathological gambler.  The only costs acknowledged due to gambling are for treatment and prevention. It is assumed that all foreseeable increases in these costs due to the casino would be covered by present Office of Alcohol and Substance Abuse Services programs plus an annual 1.5 million dollars to be collected by the state for treatment and prevention from 3000 gambling positions @$500/yr. The report writer must think this money would go back to Orange County dollar for dollar. Not so; it would be divvied up across the state.

The applicant is wrong to pretend that 1.5 million dollars would begin to cover the socio-economic costs attendant on a new casino in Newburgh.  Here is one estimate of the quantifiable socio-economic costs, neither best-case nor worst-case:

Within a fifty mile radius of the proposed site live at least 2.5 million adults. At least 1.14% (28,500) of them are pathological gamblers now [ Shaffer et al meta-analysis ref 1 ]. If the allure of a Newburgh casino were to notch up the 1.14% by just 15%, that’s 4275 new pathological gamblers. If the quantifiable socioeconomic cost per year of one pathological gambler is 12,790 dollars ( Grinols ref 2 ) the total cost for new pathological gamblers only (not counting problem gamblers) would be $54.7 million/year.

My attack on this proposal does not mean that I think there’s a proposal in Region 1 or anywhere in the state that has such a better analysis of societal health costs and benefits that it merits a license instead of Hudson Valley Casino.   A cost-benefit analysis that gave due regard to societal health would find that none of the sixteen proposals passes. The Upstate Gaming Act authorized up to four casinos in “upstate;” it did not mandate them. No proposed casino deserves a license.  Thank you.

The opinions expressed  are the speaker’s own and do not necessarily reflect those of any or all members of Coalition Against Gambling in New York .  Permission is granted to reproduce text or image in whole or part as long as the permalink above is cited.

Nowhere

Rainbow's end

Rainbow’s end

Nowhere

Most people assume that the New York State Gaming Commission has to award four new casino licenses in 2014 or 2015.  This assumption has made some individuals and groups in “regions eligible for gaming” hesitant to speak against particular proposals. They worry lest opposition in one place push the site selection to another locale no better suited. Think of the “Far Side” cartoon where a bear in the crosshairs points emphatically at another bear by his side.

It’s not true, however, that the Commission must sign off on four licenses. Coalition Against Gambling in New York (CAGNY) calls the attention of press and public to the fact that the Gaming Commission is not required to award even one casino license now or ever.  The passage of “Prop 1” in 2013 and its enabling legislation, the Upstate New York Gaming Economic Development Act of 2013, authorized the Gaming Commission to award up to four licenses “upstate.”   The law did not mandate a single one.

The law states (Title 1 §1300 ¶ 4) that “The state should authorize four destination resort casinos in upstate New York.”    Note the wording: “should” is used, not “shall,” “will” or “must.”

Further, in Title 2 §1311 the law reads : “The Commission is authorized to award up to four gaming facility licenses . . .”   Again, the language is permissive.

CAGNY observes that if the Gaming Commission has a green light from the legislature for up to four licenses, it also has the prerogative to award fewer. When the built-in drawbacks to casinos, like unchecked problem gambling, are compounded by the current fiscal woes of market saturation and leapfrogging interstate competition, not even one casino is called for. Columnist Fred Lebrun wrote thus of our state’s rush to expand casino gambling: “We’re embracing a corpse.”

Persons who speak against a particular proposal at the hearings on  September 22-24 2014  should make that point loud and clear. If someone asks “Supposing the proposal you’re fighting does not get a license, where should that license go?”   the reply is “Nowhere.”

 

 

Photo image “It’s just an illusion” from FlickrCC  4490566126_9ce7b24272

Permission to use this post  in whole or part is hereby granted  as long as the  permalink above is cited.  The opinions expressed are those of the writer, Stephen Q. Shafer MD MPH,  and are not necessarily shared by any or all members of Coalition Against Gambling in New York.

Caesars at Woodbury: Problem Gambling ? No Problem

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Summary: This is a critique of Attachment IX.A.2.a_A2  in  section  07 – IX.A. Assessment of Local Support and Mitigation Local Impact  of the  application by Caesars Entertainment to the New York State Gaming Facilities Location Board.    Being an epidemiologist and physician familiar with problem gambling as a public health problem,  I found  Attachment IX.A.2.a_A2  extremely biased in downplaying,  to near zero.  the possible health impacts  of a new Woodbury Casino.   The report asserts  as follows:

  • no socio-economic costs of pathological gambling and problem gambling warrant $ consideration, as none can be quantified so that all parties are close to agreement.
  • making casinos more convenient hardly  increases the prevalence of pathological gambling and problem gambling in the surrounding population in the long run.
  • the only population within a 50 mile radius of Woodbury that is  at theoretical  risk of having even a temporary surge in prevalence of pathological gambling and problem gambling  is that of Orange, Dutchess and Putnam Counties.
  • efforts by Caesars elsewhere to address “problem gambling” have been highly successful and will minimize “problem gambling” in southern New York State.

The  report greatly understates the possibility of harm to residents of the region due to a casino in Woodbury to residents of the region.  This essay addresses the first three  points in the above order.  The fourth  I have discussed in an e-mail to the NYS Gaming Commission last April.

 

In reading the Caesars Entertainment Inc application for a Woodbury casino I focused as a physician versed in public health  on the 40- page report   Study of Addiction and Public Health Implications of a Proposed Casino and Resort in Woodbury New York by Bo J. Bernhard Ph.D., Khalil Philander Ph.D., and Brett Abarbanel Ph.D.

The authors are all experienced consultants for gambling-related  enterprises. Two are senior members of the International Gaming Institute (IGI) at University of Nevada at Las Vegas. This is a highly polished presentation by experts who know the field but hide large tracts of it from view.   It  dismisses or never mentions four crucial facets of the ecology of pathological gambling and problem gambling. The report basically concludes that

  • socio-economic costs of pathological gambling and problem gambling don’t warrant consideration, as none can be quantified so that all parties are close to agreement.
  • making casinos more convenient does not much increase the prevalence of pathological gambling and problem gambling in the surrounding population in the medium  run of 2 to 4 years.
  • the only population within a 50 mile radius of Woodbury that is now under-served by racinos or casinos (and hence at theoretical  risk of having even a temporary surge in prevalence of pathological gambling and problem gambling) is that of Orange, Dutchess and Putnam Counties.
  • efforts by Caesars elsewhere to address “problem gambling” have been highly successful and can be relied on to minimize “problem gambling” in southern NY

The report nowhere mentions a statistic often cited by opponents of predatory gambling but never addressed head-on by casino advocates and never refuted: 40-50% of revenue at the average casino comes from pathological and problem gamblers, who comprise perhaps 12-15% of its customers, maybe 4% of all adults. [ http://cagnyinf.org/wp/april-9-2014-central-stat-of-casino-revenues] For the casino lobby to refute the statistic (if it is refutable) they would have to acknowledge that they can spot pathological and problem gamblers among their “visitors” while those persons are still active customers. This means before the person has loudly threatened suicide within an employee’s hearing or left town suddenly or thrown an ugly scene on the “gaming floor” or been arraigned or jumped.

Casinos will not acknowledge they have any  ability to spot problem or pathological gambling signs and symptoms that are not florid and end-stage. Why not? To move in even gently on such persons would risk offending them so they would go elsewhere or sending them to premature recovery before they have been “played to extinction.” [ https://www.youtube.com/watch?v=9C2BPZYLW_U ] .  To recognize the problem gamblers before they are end-stage yet not do anything for them  would reveal how insincere are the “preventive measures.” .

The casino cartel does not deny that its net revenues follow the Pareto principle: most come from a small proportion of gamblers. What casino promoters won’t say is what proportion on the average of that small proportion are pathological gamblers or problem gamblers. The promoters just do not want to know who among their customers is a problem gambler or pathological gambler until the gambler hits bottom or worse.   Promoters and detractors alike recognize that not everyone who loses a lot of money over time at casinos is a problem gambler. Anti-casino activists hold that most are; the American Gaming Association counters that most are affluent people having fun with their disposable income.

Assuming the central statistic is close to truth, casinos are not motivated to sincerely counter problem gambling and pathological gambling.  A successful effort to do so would lower their revenues by 40-50%.  Nor is government motivated; lower casino gross gaming revenues   would reduce  government’s share  by a like amount.

The report prepared for Caesars (in this no different from all the literature on problem gambling) also does not recognize that “unchanging prevalence” of problem and pathological gambling requires the formation of replacement problem gamblers and pathological gamblers to fill the shoes of those who have recovered, died, moved far away or are no longer free-living. What might appear a steady state is built on creating new problem gamblers. The more effective  the casino is at encouraging current problem gamblers and pathological gamblers into lasting recovery before they have fiscally and emotionally wiped out themselves and and ten people around them, the faster it must generate replacement problem and pathological gamblers to keep up its high profit margins.

I will now cover the first three bullet points above in more detail. The fourth bullet point I wrote about in the above-mentioned letter to the Gaming Commission.

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Revenue Enhancement via Problem Gambling

Revenue Enhancement Via  Problem Gambling

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The operational approach of the NY State Legislature to problem gambling is horribly clear from the voting records on S7833 (passed 55 to 4 on June 20 2014) and the Assembly “same as” (A 10075 , Goldfeder sponsor) which  passed 119 to 9 on June 19.  The approach is to exploit problem gamblers, not help them recover.  The bill, not signed by the Governor yet,  allows racinos to close their  video lottery terminal (VLT) floors  at  6 AM instead of (previously) 4 AM.  It also  increases “free” play credits.   The memo is below in italics.

BILL NUMBER: S7833

SPONSOR: KLEIN
TITLE OF BILL: An act to amend the tax law, in relation to the

authorized hours of conducting video lottery gaming and the amount of

free play authorized therefor

PURPOSE OR GENERAL IDEA OF THE BILL:

The purpose of this bill is to enhance the revenues of video lottery

gaming facilities in New York.

SUMMARY OF PROVISIONS:

Section 1: Amends section 1617-a (b) of the tax law to allow video

lottery gaming facilities to operate until 6:00 a.m.

Section 2: Amends section 1617-a (f)(3) of the tax law to increase the

annual value of free play allowance credits authorized for use by a

video lottery gaming facility from ten to fifteen percent of the total

amount wagered on video lottery games after payout of prizes.

Section 3: The effective date.

JUSTIFICATION:

This bill is needed to provide incentive for individuals to visit the

video lottery gaming facilities in order for these facilities to enhance

revenues and attendance.

PRIOR LEGISLATIVE HISTORY:

This is new legislation.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None noted.

EFFECTIVE DATE: immediate

Comment by CAGNY editor: At 3:50 A.M. those racino VLT users who don’t want to stop at 4 o’clock are not the exhilarated, beaming young couples in racino advertisements. They are mostly problem gamblers and addicted gamblers who, if forced out at 4 A.M., would on the average leave less of the money they are using that morning than if they stayed until 6.  S 7833 was written deliberately to exploit that thin stratum of casino users (perhaps 12%) who provide about half the “net revenue” of the average casino.

Coalition Against Gambling in New York honors the insight and courage of the few legislators who voted NO.

 

The opinions expressed are those of the writer, Stephen Q. Shafer MD MPH and are not necessarily shared by any or all other members of CAGNY.  Permission is given hereby to quote or copy in whole or in part as long as the above permalink is cited.

The picture is from creative commons  2269211810_030e548987PHLSunrise.jpg

Whose Problem are Problem Gamblers ?

Central Statistic

Graphic by Dave Colavito, 2014 data from Grinols and Omorov 1996-97

On 24 April 2014  I sent to the Director for Policy,  Development and External Affairs of the NYS Gaming Commission the following  e-note with two attachments, one of which was   posted yesterday on the CAGNY web site below a copy of the April 24  cover e-note, repeated here.

Dear Sir,

Attached are two documents I earnestly hope the Chairman and all the Commissioners will read carefully and discuss with the  GFLB.  Both are about “problem gambling,” the subject of the April 9 forum convened by the Gaming Commission. Watching the videotape and reading the transcript (everyone should thank the GC for providing these so fast) I saw  that “problem gambling” was an elusive term.  The extreme importance to the casino economy of net losses from problem gamblers was nowhere mentioned except when the speaker from Caesars deflected  the issue.  Yet around the “central statistic of casino revenues,” on which I have written to the Commission, is the “central dilemma” of regulation: the better the regulation is at preventing problem gambling, the lower is the casinos’ profit margin.

Selected prevalence statistics were presented as if they are the be-all and the end-all of gambling behavior studies.  They are about all we have, but a poor stand-in for what we really want to know about time trends in social impacts, i.e.  incidence and duration.  Under the placid surface of what looks like stable prevalence,  much new damage continues; as problem gamblers recover or die, new ones must be recruited to take their places.

As I have offered before, I’m  [ready]  almost any time to meet with the Commissioners and staff to explain the critiques in more detail and to talk about “the central statistic.”

Thank you for your attention.

Sincerely, etc.

Stephen Q. Shafer, MD, MA,  MPH Chairperson, Coalition Against Gambling in New York 917 453 7371 http://cagnyinf.org  [ Cover note ends here]

 

No surprise,  the Commission has not responded to these  unsolicited comments. Does that mean the Commissioners have all accepted the assurances (see below) of  the Executive from Caesars Entertainment that the organization does not make money from “problem gamblers” and does ” not want them in [their] venues?”  If yes, it is a monumental  mistake.  I cannot speak for Caesars Entertainment in particular, but it would  be unique  if it does not make money from what most people call problem gamblers To  wrongly  assume Ms Shatley’s artful  discounting  of problem gamblers fits all casinos  would be an easy stretch  to make,  even if Caesars is unique. It would be worse yet if the attitude “casinos don’t want problem gamblers” were communicated to the Gaming Facilities Location Board members.  The GFLB is charged to consider plans by applicants to address problem gambling. The Board must understand how important problem gamblers are to the casino exchange.

Below is the text of the second attachment  that was sent to the Gaming Commission  on April 24, slightly revised.  The text of the other attachment sent the same day  was posted yesterday on this web site along with the cover e-note.

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“Replacement problem gamblers”

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On 24 April 2014  I sent to the Director for Policy,  Development and External Affairs of the NYS Gaming Commission the following  e-note with two attachments:

Dear Sir,

Attached are two documents I earnestly hope the Chairman and all the Commissioners will read carefully and discuss with the  GFLB.  Both are about “problem gambling,” the subject of the April 9 forum convened by the Gaming Commission. Watching the videotape and reading the transcript (everyone should thank the GC for providing these so fast) I saw  that “problem gambling” was an elusive term.  The extreme importance to the casino economy of net losses from problem gamblers was nowhere mentioned except when the speaker from Caesars deflected  the issue.  Yet around the “central statistic of casino revenues,” on which I have written to the Commission, is the “central dilemma” of regulation: the better the regulation is at preventing problem gambling, the lower is the casinos’ profit margin.

Selected prevalence statistics were presented as if they are the be-all and the end-all of gambling behavior studies.  They are about all we have, but a poor stand-in for what we really want to know about time trends in social impacts, i.e.  incidence and duration.  Under the placid surface of what looks like stable prevalence,  much new damage continues; as problem gamblers recover or die, new ones must be recruited to take their places.

As I have offered before, I am[ready]  almost any time to meet with the Commissioners and staff to explain the critiques in more detail and to talk about “the central statistic.”

Thank you for your attention.

Sincerely, etc.

Stephen Q. Shafer, MD, MA,  MPH Chairperson, Coalition Against Gambling in New York 917 453 7371 http://cagnyinf.org

To no one’s surprise,  the Commission has not responded to my unsolicited comments. Does that mean the Commissioners have all accepted  the ” adaptation hypothesis” [summarized in the next paragraph]   that  gambling expansion has  little long-term population impact?  If they have, ” this  was a grievous fault,”  but unless NYS media call them out  sharply  on it,  the Commission will not have to answer it grievously. If,  as I hope,  they have not bought it,  one sign will be that  the  Facilities Location Board  questions searchingly all applicants for a casino license on  what they will really do that will really  stop new cases of problem gambling.

Gentlemen of the Gaming Commission, how say you?

[Scientists from the Division on Addictions of the Cambridge Health Alliance have proposed an “adaptation hypothesis,” which acknowledges that new gambling opportunities may lead to a temporary increase in prevalence of problem gambling  for the surrounding population. Then, so goes the hypothesis, novelty fades,  individuals become more “responsible” in their gambling behaviors and  the crest subsides.]

One of the two attachments, slightly revised a month later,  is below. It begins with Summary.   It concerns the public health profile  of “problem gambling.”    The other, related to an operational definition of “problem gamblers”  and to their fiscal significance,  will soon be posted on the CAGNY web site.

Summary: “Problem gambling” is not a fixed uniform term. In his introduction to the April 9 forum on Problem Gambling, Dr. Gearan seems to take it, as I do, to mean both strata of gambling disorder combined, not just the less severe stratum often referred to as “problem gambling.” Statistics on the prevalence of “problem gambling” or its subgroup “pathological gambling” are often used to reassure policy-makers that gambling expansion has not worsened problem or pathological gambling. These statistics can be challenged on several grounds, but even if prevalence as a proportion of the population is truly unchanged in the long term, there are hundreds of thousands of new cases nationally hidden in it, millions of individuals affected. To keep prevalence stable there have to be new pathological gamblers brought on to take the place of those who died or entered recovery. Opponents of big tobacco use the term “replacement smokers.”  We extend this concept to “replacement” problem gamblers.   Tobacco companies need replacement smokers; society does not.  Casinos need replacement problem gamblers; society does not.  Quite the reverse.

Introduction  In the April 9th 2014 Problem Gambling forum hosted by the New York State Gaming Commission two speakers, Dr. Sarah Nelson and Ms Christine Reilly, used lack of change over time in “the prevalence of problem gambling”   to argue that expanded gambling opportunities do not increase endemic harms to public health. I will challenge that premise as an epidemiologist by digging into the population dynamics of “prevalence.”  With problem gambling, as with most chronic conditions, prevalence is more easily measured than the rate at which new cases develop. That does not mean it’s a perfectly valid marker of causation.  It hides new cases, the replacement problem gamblers that predatory gambling must endlessly cultivate to keep profits high.   To speak of the prevalence of “problem gambling” requires first defining the latter term. In the second and third sections of this narrative I will talk about the pitfalls of prevalence to assess “problem gambling” in a population.

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The Crying of Prop. 1, 2013

The Crying of Prop. 1

Stephen Q. Shafer, M.D., M.A. , M.P.H.

Chairperson, Coalition Against Gambling in New York

 

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Summary Social costs due to  increased  problem gambling after  “up to seven” new casinos open in New York State will almost certainly exceed revenues from the State’s taxing new casinos.  These costs are real but externalized,  thus easily hidden or denied.  Just a 10% increase in the statewide prevalence of problem gambling would almost wipe out the gains in revenue to the State treasury and create thousands more gambling addicts than “permanent good jobs.”   A  25%  increase would nearly negate the entire sum ($1.2 billion)  targeted for recovery via in-state casinos.  In their quest for revenue without increases in conventional taxes,  state officials implied by silence  that  the number of  new problem gamblers anticipated either cannot be estimated or need not be. It is a nullity, off  the board.

No public policy can be evaluated properly without considering costs. Yet that’s what happened in the legislature and on the campaign trail.  This paper gives a public health physician’s   viewpoint of  the dishonesty in marketing “Proposal 1” right into the polling booth.

Introduction  The victorious campaign to legalize casinos in New York State  played up  hoped-for benefits and  played down  likely costs.  While conceding when pressed that problem gambling is a problem, promoters never  acknowledged  the flip side to making casinos more convenient to New Yorkers.  This step, to become law on January 1,  will (not might, will) create new addicted gamblers and new problem gamblers as well as service current ones.  Costs quite possibly in the hundreds of millions of dollars per year  will extend  to society from this sector.

Neither government nor business interests have made public any consideration whatsoever of   these costs.  The deliberate silence moved me, as a physician trained in public health, to compare these costs to the much-publicized  benefits.  I focused on a narrow question:  will the inflow of casino money to the State Treasury equal or outweigh the costs of the new casinos, externalized to New York’s people?  This is only one type of benefit, only one category of costs.

Analysis   What inflow is expected?    Proposal 1 promoters  have repeatedly said that gamblers from  NY  “spend”  $ 1.2 billion / yr  at  casinos in adjoining states and Canada.  [1]   The basis for this figure is not known to me.  In 2012 patrons from NY left behind at the two Indian casinos in Connecticut $259 million. [2]   Presumably the other billion was left behind in Pennsylvania, New Jersey, and Canada.  If this amount were lost in NYS  instead of elsewhere,  taxing it at the rates in Table 1  would yield to the State treasury the following amounts:.

 

                                                       Abbreviations used in the textNYS     New York StateQSEC   Quantifiable Socio-Economic Costs

 

Table 1.  Division of  $1.2 billion  “spent”  in out-of –NYS  casinos between State Treasury and  casino  ownership if all  $1.2 billion were kept in NYS.

Tax rate     State Treasury                Owners

$ millions               $ millions

20%                   240                            960

25%                   300                            900

30%                   360                            840

35%                   420                            780

40%                   480                            720

45%                   540                            660

At  30%  (reasonable guesstimate for NYS non-tribal casinos with 70% slots 30% other), the State Treasury would gain $360 million.  This is not the only possible benefit to the state, but is the most easily measured and the most talked-about, as in  “educating our children,” “property tax relief.”

Now to costs:   the principal (but far from the only) cost of “up to seven” casinos is the creation of new addicted and problem gamblers through a “distance  effect. ”     For a brief review of the literature, see pages 2-4 of a Dec 2012 paper which looked at the hypothetical scenario of five new casinos in New York City   [3]

The entry of  new gamblers during a specified time (incidence) into a category like “addicted”  is not well  measured by the prevalence (proportion active at a given time) [4].  This is because individuals leave the active prevalence pool over time through recovery, death, imprisonment, totally disabling illness or out-migration.  As hard as it is to measure the  prevalence of problem gambling,  it is far harder to measure incidence. Thus prevalence, fraught with methodological problems,  is the usual benchmark.

To assess costs of new addicted gamblers and problem gamblers we need  head counts and  per-head figures for cost.  The cost figures cited most often are from Earl L. Grinols, Distinguished Professor of Economics at Baylor. His book shows clearly how he came to them. [5]   I call these Quantifiable Socioeconomic Costs  (abbrev. QSEC), though Grinols does not use that term.  In  2012 dollars  QSEC  are $13787 / yr  per pathological (addicted ) gambler; those per problem Gambler are $3600 /yr .  Note well:  QSEC do not include suicide, divorce,  mental anguish, family disruption.  The costs of   these calamities are un-quantifiable; no monetary values can be assigned.  Thus they are even easier to disregard than QSEC.

Regarding the head count: the number of active addicted gamblers in NYS can be estimated by applying to a rounded-off figure of 15 million adults statistics for prevalence among adults of addicted (1.14%) and of problem gamblers (2.8%).  These are not recent but are well-established from a meta-analysis. [6]   In a national sample reported in 2004 [7] the prevalence of pathological and problem gamblers combined was 3.5% .

If at baseline there are 171,000 active addicted gamblers (15 million * 1.14%) and prevalence goes  up  by 5%, NYS  has  at least 9,000 new addicts.  Table 2 shows the number of new cases for a given increment in prevalence,  and the QSEC attached.  Table 3 works the same way for problem gamblers.  Table 4 combines the QSEC  for both types, arrayed by % increase.

Table 2.  Number of  new addicted  gamblers in NYS and Quantifiable Socioeconomic Costs of new addicted gamblers, by increase in prevalence  over baseline.  e.g. 9,000 * $13,787 /yr = $ 124 million/yr

Increase                       New addicted  gamblers   QSEC of increase in $ millions/yr

5%                                             9,000                         124

10%                                         17,000                         234

15%                                         26,000                         358

20%                                         34,000                         469

25%                                         43,000                         593

30%                                         51,000                         703

Table 3.  Number of new problem gamblers in NYS and Quantifiable Socioeconomic Costs of new problem gamblers, by increase in prevalence  over baseline. e.g. 21,000 * $3,600 /yr = $ 76 million/yr

Increase                       New  problem  gamblers   QSEC of increase in $ millions/yr

5%                                           21,000                         76

10%                                         42,000                         151

15%                                         63,000                         227

20%                                         84,000                         302

25%                                       105,000                         378

30%                                       126,000                         454

Table 4.  Quantifiable Socioeconomic Costs of new addicted  gamblers + new problem gamblers by increase in prevalence  over baseline.  e.g. for 5% increase in both,  total is $124 + $76 = $200 million/year.

Increase                       QSEC of increase, in $ millions/yr

5%                                           200

10%                                         385

15%                                         585

20%                                         771

25%                                         971

30%                                       1157

From Table 4 we see that if prevalence of addictive gambling and of problem gambling both  rise by only 10%, the QSEC attached to that rise are more than the $360 million the State would recover by taxing 1.2 billion at 30%.

We must consider, though, that persons who became gamblers because of the convenient casinos (some addicted,  some  problem gamblers, most in neither type) will also lose money there  that can be taxed.  How much might that add to State treasury  revenue?  Would that be enough to “cover” the QSEC springing from new casinos?  To answer that we need an estimate for  losses by type of gambler.

Grinols and Omorov in a 1996 paper [7]  estimated annual losses to casinos by persons living within 35 miles of  Las Vegas or Atlantic City  at $14,200/year (1992 dollars)  per one hundred  persons.    This includes people who do not go to a casino from one year to the next.  Converting to 2012 dollars gives   $ 23, 400 per 100 persons.  This figure was used in my Dec 2012 paper to reckon that losses to casinos by the 8 million residents of Greater New York came to $1.87 billion/year. I assumed that all losses were to casinos outside the reach of NYS taxation.   If  $23, 400 were applied to the entire NYS population it would mean that losses to casinos come to  $3.5 billion /year,  three times higher that of the commonly-cited  estimate of 1.2 billion /year.  Assuming that  $ 1.2 billion for the whole state is correct, a likely explanation is that since no resident of Greater NY  lives within 35 miles of a full-service casino,   the $23,400/100 persons/yr  figure was high; the longer distance lowers willingness to travel then spend.

$1.2 billion lost at out of state casinos by residents of NYS means that the average loss per year is $1.2 billion/15 million, or $8000/100 persons/year.  I took liberties with the famous table in Grinols and Omorow [8] , keeping the ratios of annual loss per gambler between types very much like those in the original but lowering the values so that the annual loss / 100 persons comes out to $8000, not $23,400.  The results in dollars of 1992 are in Table 5.

Table 5.  Hypothetical structure of casino revenues in 1992 dollars, by type of gambler   This table is formatted like the one in Grinols and Omorov [ref 8]  but the input values  in columns 1 and 3 have been altered, producing figures in column 4 very  different from those in the original.  Percentages in column 5 are similar to those in the original.

Prevalence in population

Type of gambler

Annual loss per gambler

Annual loss per 100 adults

Cumulative % of casino gross

1.14%

Addicted

1480

1687

35

2.8%

Problem

250

700

49

6.06%

Heavy bettor

118

715

64

50%

Light bettor

35

1750

100

40%

Non-bettor

0

0

100

100%

All types

 

4852

 

 

Converting  $4852 dollars of 1992 to $8006 dollars of 2012 gives the amount lost last year out of state /100 persons in population. For a population of 15 million the annual out of state loss is reckoned at $1.2 billion.  If new casinos caused no rise in prevalence of problem gambling AND stopped 100% of leakage,  this table could also represent the gamblers’ losses ( ~ = “gaming revenue”)  at casinos in New York after new casinos are at full steam.  Of this $1.2 billion the State Treasury gets  $360 million at 30% tax rate.

Leaving the baseline of  Table 5, consider the changes in  losses at casinos by gamblers after new casinos open in state,  assuming a 10% rise in prevalences of gambling addiction and problem gambling.  In Table 6,  note  new figures in column 1, same figures in column 3.  The annual loss to casinos rises, as does the revenue to the state treasury.

Table 6.  Hypothetical structure of casino revenues in 1992 dollars, by type of gambler, reflecting changes in relative frequencies of type in population due to new casinos    Assumption: compared to baseline there is a 10 % increase in prevalence of all types of gambler and a decrease in proportion of non-bettors from 40% at baseline to 34%.

Prevalence in population

Type of gambler

Annual loss per gambler

Annual loss per 100 adults

Cumulative % of casino gross

1.25%

Addicted

1480

1850

35

3.08%

Problem

250

770

49

6.7%

Heavy bettor

118

791

64

55%

Light bettor

35

1925

100

34%

Non-bettor

0

0

100

100%

All types

 

5336

 

 

 

Converting $5336 to dollars of 2012 gives $8804 / 100 adults/yr .  This, multiplied by 15 million adults,    yields $1.32 billion as the amount that would be lost by gamblers from New York at casinos in  New York after new casinos are built.  In this scenario the non-tribal New York casinos realize from the losses of  new gamblers an extra $120 million  ( = $1.32B – $1.2B) of which the State gets by taxation 30 % , or $ 36 million.

If  the prevalences of addicted gambling and problem gambling rise by 25% with new casinos, not just by 10%, the annual loss to casinos rises in proportion.  See Table 7.

Table 7.  Hypothetical structure of casino revenues in 1992 dollars, by type of gambler, reflecting changes in relative frequencies of type in population due to new casinos   Assumption: compared to baseline there is a 25% increase in prevalence of  all types of gambler  and a decrease in proportion of non-bettors from 40% at baseline to 29%.

Prevalence in population

Type of gambler

Annual loss per gambler

Annual loss per 100 adults

Cumulative % of casino gross

1.43%

Addicted

1480

2116

36

3.5%

Problem

250

875

51

7.8%

Heavy bettor

118

920

64

62.5%

Light bettor

35

2188

100

25%

Non-bettor

0

0

100

100%

All types

 

6099

 

Converting $6099 to dollars of 2012 gives $10063 / 100 adults/yr. This figure, multiplied by  15 million adults,  yields $1.51 billion as the amount that would be lost at New York casinos by New Yorkers.  Casinos take  in $310 million above baseline (=$1.51B – $1.2B) from the new gamblers, of  which  the State Treasury collects 30%  or $93 million above the baseline intake of $360 million.

Discussion The QSEC to New York society associated with generating 17,000 new addicted gamblers and 42,000 new problem gamblers (10% increase in prevalence of both) are  $385 million, very nearly as much as the revenue to the state ($396 M) from taxing the losses by established and new gamblers at its new casinos.    If the State attended to costs, not just to revenues,  it would see this barely breaks even. The QSEC to New York society associated with generating 43,000 new addicted gamblers and 105,000 new problem gamblers (25% increase in prevalence of both)  are  $971 million, more than twice as much  as much as the revenue to the state ($450 million) from taxing the losses by established and new gamblers at its new casinos. If the State paid attention to costs,  it would see a fiasco.  This $971 million quantifiable cost almost equals the total of  $1.2 billion supposedly at stake.

The advertisements run by NY JOBS NOW implied that every dollar of the 1.2 billion that is lost to a casino in New York rather than across a border will benefit New York.    One ostensible benefit,  outweighed by QSEC,  is tax revenue to be disbursed  back to the populace as “aid to education” or  “property tax relief.”  Another,  not touted so loudly,  might be  to keep the rest of the money within the state where  it will go to overhead and profits of businesses with structures in NYS..  Much of that overhead will, we presume, pass to persons now living in the state as wages and as property tax paid to municipalities (if no abatements).  This would be a benefit to the state.  In fairness and transparency, however,  it  must still be weighed against QSEC, which in the 25% increase scenario may equal or exceed it.   That leaves profit.  Is this a benefit to NYS?    The casino buildings  will be in our state.  Where will the profit-takers be?

It  is too early to know if any of the owners will be NY companies.  Front-running candidates as of  Nov 18  include  Foxwoods, a Connecticut company;  Claremont Partners, “ a partnership of  mostly offshore investors based in the  Isle of Man;”  EPR Properties, based in Kansas City;  Empire Resorts, based in Kuala Lumpur; Concord Associates, New York; Muss Development, New York City; and Jeff  Gural, who lives in New York City.  RH Land Development has its New York State location in Rochester.  Traditions at the Glen Resort has one location, in Johnson City.    Vista Hospitality has its American offices in Binghamton. Caesar’s Entertainment, Las Vegas, is reported to be interested after having been dismissed in Massachusetts.  Rumor says the Stockbridge-Munsee Tribe of Wisconsin is interested. A list like this will change week-to-week.

Conclusion It is sad indeed that voters were sold the amendment by being shown none of the debits, only the income.  In place of a cost-benefit analysis,  the electorate got the travesty of a benefit-only analysis.  New York State’s leaders and legislative followers sought  revenue at any cost, as long as the latter was out of sight.

Most of the debit side of the ledger springs from the formation of new gambling addicts and problem gamblers, creating a public health problem never recognized as such.  In a progressive state such as New York has been and should be, this would have been addressed by Health in All Policy.  HiAP is a fairly new concept, not the law of the land but gaining ground in North America (e.g. California and Ontario).  It came out of a 1998 resolution by the World Health Organization .  Basically, it requires that large – scale governmental policy have a health impact assessment before adoption.  New York State deliberately bypassed the responsibility to offer voters a traditional cost-benefit analysis of policy.  Just as deliberately the state passed up the challenge of  applying innovative HiAP.

It is impossible to predict exactly how many new problem gamblers will develop in the “up to seven casinos” future.  It is also impossible  that there will not be more of  them as our state gets more convenient casinos. Legislators hinted at the threat by putting some funding for treatment and prevention into the Upstate Gaming and Economic Development Act passed last June.  Then they withdrew attention.  No one in Albany made any estimate of the scope of the problem, thus zeroing it away.  If it has no size, it’s nothing.

200px-A-dressing_the_White_Queen

“Alice laughed: “There’s no use trying,” she said; “one can’t believe impossible things.”
“I daresay you haven’t had much practice,” said the Queen. “When I was younger, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”     Lewis Carroll,   Through the Looking Glass

 

 

Afterword on prevalence Even if the prevalences of  addiction  and  problem gambling could be shown by a crystal ball to be absolutely stable over (say) four years following the introduction  of casinos, that first phase has created  new disordered gamblers.   Every year, some gambling addicts and problem gamblers leave the “active prevalence” pool  through  recovery, death,  imprisonment, disabling illness or out-migration. Suppose this rate is truly 10% a year;  after  four years,  prevalence of active addiction  that began at (say)  1.14% should be down to 0.75%.  If  it is not, “replacement addicts” have entered the pool,   Some are in-migrants, some relapses, many newly-minted.

 

Studies that purport to find no statistically significant increase in the prevalence of (say) problem gambling over time after exposure rises may also be underpowered.  A study to detect with reasonable statistical power a near-doubling of  prevalence from 1.14% to a prevalence of 2.17% would require 2000 interviews at each point.  This is impossibly expensive for a public agency to do.  A study to detect a 25% increase from 0.0114 to 0.0142 would require 20,000 interviews at each point.  The increase seems less than minuscule, yet in a population of 15 million it represents 43,000 new addicts.  No wonder the gambling promoters have no fear of someone’s proving an increase in the prevalence of addiction and thus no fear of being held responsible for any ominous trends.

References

  1. From the Home Page of  NY Jobs Now http://www.nyjobsnow.com/index.php#benefits

NEW JOBS. MONEY FOR SCHOOLS. LOWER PROPERTY TAXES.

New Yorkers currently spend more than $1.2 billion a year at destination casinos in neighboring states. Allowing casinos in New York will keep a lot of that money right here in New York where it belongs — helping to generate economic activity, fund our schools, and provide tax relief.

On the ballot this November, Proposal 1 will ask voters to approve the casino plan passed by Governor Andrew Cuomo and the State Legislature this spring.

2. Center for  Policy Analysis, University of Massachusetts at Dartmouth: New England Casino    Gaming Update 2013.  Economic Development series no. 74

3. Shafer, Stephen Q. New Commercial Casinos Will Mean Thousands of New Gambling Addicts  Dec. 2012  http://cagnyinf.org/wp/new-casinos-equal-1000s-of-gambling-addicts/

4. Shafer, Stephen Q.  Measure Something: Prevalence of Pathological and of Problem Gamblers. http://cagnyinf.org/wp/9_nov_2013_measure_prevalence/

5. Earl L. Grinols. Gambling in America Cambridge University Press 2004 pp. 171-174.

6. Shaffer HJ, Hall MN, Vander Bilt J. Estimated Disordered Gambling Behavior in the United States and Canada Report to National Gambling Impact Study Final Report 1999  https://divisiononaddictions.org/html/publications/meta.pdf

7.  Welte JW et al. The Relationship of Ecological and Geographic Factors to Gambling Behavior.  J. Gambling Studies ( 2004) 20: 405-442

8. Grinols EL and  Omorov  JD.  Development or Dreamfield Delusions? Assessing Casino Gambling’s Costs and Benefits.  J. Law and Commerce 1996-97, vol 16 p 59

The drawing is captured from Wikipedia.  Original by John Tenniel for  Through the Looking Glass and What Alice Found There, by Lewis Carroll

photograph of buckets is by Kevin Krebs from clickr.com photos 8561188366_eda5d758cf_

The author retired in 2010 as Clinical Professor of Neurology at Harlem Hospital Center, Columbia University. He has an M.P.H. in Epidemiology and an M.A. in Political Science gained while (1976-78) a Robert Wood Johnson Clinical Scholar in the Department of Medicine,  Columbia College of Physicians and Surgeons.  He is Chairperson of Coalition Against Gambling in New York,  a non-profit  registered in Buffalo.

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“Measure Something:” Prevalence of Pathological and of Problem Gamblers

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Most American adults gamble not at all (20-30%) or so little they get no damage from it. The gigantic social costs of legalized gambling move almost entirely through current “pathological gamblers,” who enmesh and drain their families, employers, employees and associates, and   through current “problem gamblers.”   Problem gamblers, more common,  impose each a smaller social cost. The two groups combined make up 4 % of the U.S. and Canadian adult (>18) population.1   Lower estimates for prevalence are also in the literature. 2, 3     CAGNY reports  use the 4% from the update of the Shaffer et al 1997 meta-analysis 4  as it is based on over a hundred studies, not a single survey.

Pathological gamblers (addicts) and problem gamblers combined generate almost all the costs of legalized gambling. Pathological (addicted) gamblers make up conservatively 1.14% of adults in North America; problem gamblers, at least 2.8%. In the U.S. that’s 2.5 million pathological gamblers (addicts) and 6.5 million problem gamblers.

Prevalence is not a good marker of the rate at which new cases occur. If it seems  stable over time, that does not mean no new  problem gamblers are forming. Not at all. To maintain the same prevalence of current pathological gambling, replacement pathological gamblers must  take the place of those who have recovered or died or disappeared.

Prevalence is usually given as the proportion (can be %) of a population that has the condition of interest (in this case a certain level of gambling) at a given moment or at some point in a time interval.  Prevalence can also be a count. It is not the same thing as incidence. Incidence is a rate,  the number of new cases in a time divided by the number at risk. It too can be correctly given as a count of cases.  Incidence, a rate,  must  be written per <time interval>  e.g  ” per year.”

Prevalence is governed by incidence  and  duration. Cases prevalent at a certain time will not be all the same ones as at a different time. Individuals leave the active ( = “past-year”) prevalence pool by out-migration, recovery, death, incarceration or disabling illness. New cases enter the pool. If prevalence, accurately measured,   is  steady over (say)  ten years,  that stability requires  replacement problem gamblers in the stead of those who died; or recovered (one estimate is that 1/3 recover 5 ); or went to jail (more than half of PGs commit prosecutable crimes); or moved to another country. The lifetime prevalence pool is depleted only by death or out-migration.

There are very few figures on incidence of pathological or problem gambling in adults, though in adolescents and college students these are available, and horrifying.  Estimates of incidence of pathological gambling in North American adults must be drawn from changes in prevalence, full of pitfalls. Rapid climbs in past-year or even lifetime prevalence imply relatively high incidence; rapid drops suggest high rates of recovery or death combined with low replacement.

References and notes to “Prevalence of Pathological and of Problem Gamblers”

1. Shaffer HJ, Hall MN Updating and Refining Prevalence Estimates of Disordered Gambling Behaviour in the United States and Canada. Canadian J Pub Health 2001 92(3): 168-172

2. Gerstein D et al Gambling Impact and Behavior Study. Research done by NORC for NGISC http://govinfo.library.unt.edu/ngisc/reports/gibstdy.pdf .

3. Petry N, Stinson FS, Grant B Comorbidity of DSM-IV Pathological Gamblers and Other Psychiatric Disorders. J Clin Psychiatry 2005. 66(5): 566-574

[ NOTE:In this report the lifetime prevalence of pathological gambling is 0.6% and of problem, 2.3%. A past-year figure would be lower.]

4. Shaffer HJ, Hall MN, Vander Bilt J Estimated Disordered Gambling Behavior in the United States and Canada Report to National Gambling Impact Study Final Report 1999  https://divisiononaddictions.org/html/publications/meta.pdf

Using these past-year prevalence figures the Shaffer et al study projected the following figures in millions of persons who were in each category (based on US pop in 1997)

Table 1. Number of persons classed as Problem or Pathological Gamblers, by age group,  USA , millions

 

ADULT                                  YOUTH (age 16-17)   ADULT & YOUTH

Prob     Pathol Both                Prob     Pathol Both                Prob     Pathol Both

5.3       2.2       7.5                   5.7       2.2       7.9                   11        4.4      15.4

IMPORTANT NOTE On p. 43 of Shaffer et al are figures showing an increase in the prevalence of past-year level 3  (abbreviated here to PYL3) between the earlier years covered by their meta-analysis (1977-1993) and the most recent three years (1994-1997). PYL3 in adults went from 0.84% to 1.29%, a statistically significant increase (p<.05). Comparing the same two epochs, lifetime level 2 in adults went from 2.93% to 4.88% (p < .05). The absolute increase in prevalence of PYL3 in adults was 0.45% , the relative increase 154%. When the authors merged all the studies, earlier and later, the higher prevalence figure (1.29%) was lost to view. The lower figure of 1.14 is probably too conservative.

A later paper (Shaffer and Hall Can J Pub Health 2001, referenced above as ref 1 found strong evidence that PYL3 continued to rise in the last years of the study interval. The authors updated the library of studies to review, adding ones published since 1997 and also some 91 studies that had never been published, furnished by their authors. 139 studies with at least one prevalence estimate (some compared two instruments) were analyzed for the 2001 paper. For adults only  Past year level 3 1.46%  lifetime level 3 1.92%.  There was a  positive correlation (r = .313, p<.05) for later year and higher prevalence. The authors found fifteen geographic areas in which earlier and later estimates had been done by the same methods. PYL3 averaged 1.02% in the earlier look, 1.33% in the second (p < .05)

5. Slutske WS Natural Recovery and Treatment –Seeking in Pathological Gambling. Am J. Psychiatry 2006: 163:297-502  The researcher looked at the past-year experience of the 201 persons who had met criteria for lifetime pathological gambling in one of two surveys, found that about a third no longer met criteria for the preceding year. The two surveys are in refs 2 and 3

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photo image from flickr creative commons titled “16/17”  1925077643_a9ec21bcb4_m

A Christian Faith Perspective on Gambling

Where there's Muck there's Brass 2295584401_e68196285a_m

 

Sermon – September 29, 2013 by the Rev. Michael Phillips, Interim Rector,  Trinity Episcopal Church, Saugerties,  New York

Consider these two scenarios:

Number 1: Four men gather at the club house of a local golf course for their monthly outing.  They have been playing together for years and always make a friendly wager.  Each golfer puts $20 into the kitty and then at the end of the round they tally their scores, weighted for each player’s handicap, and distribute the money like this: out of the $80 total, the golfer with the best score gets $50, the second place golfer gets $20, the third place golfer gets $10, and the loser gets nothing.

Number 2: The four golfing buddies decide to take a Saturday and drive to a casino resort where they can try their luck.  When they arrive, they find a parking spot in the huge lot and walk to the casino entrance past rows and rows of buses and cars.  They enter the bright, lively, bustling main room of the casino and wonder where to start.  Each one of the men decides to gamble with $20 and keep gambling until it’s gone.  One guy starts by taking $10 and getting a roll of quarters for the slot machines.  He goes through most of his quarters until he hits a jackpot and walks away with $50.  He takes the $50 and moves to the black jack table where after a few games, wins again, this time $2,500.  He takes his $2,500 to the roulette table and by the end of the night walks away with $50,000.  His buddies were not so fortunate.  One went home with $50, and the other two, after a lackluster evening of ups but mostly downs, lost everything.

What’s the difference between these two scenes? Both have winners and losers.  Both involve making an initial investment with the hope of gaining more.  However, they also have significant differences.  For example, in the first scene, the winnings are modest, at the most $50.  The second place golfer gets his ante back and the third place golfer gets half of his orginal investment back.  Only the last place golfer loses everything.  But also and more importantly, the winning is based upon the skill of the golfer.  Even though they have handicapped the scoring, it turns out that the winner is the golfer who spent hours at the driving range and on the putting green, working on the details of his game.  The loser is the guy who only plays a few times each summer and doesn’t really take the game that seriously. With his handicap he sometimes comes in third and once on a really good day he actually came in second. But for the most part, the dedication and commitment of the serious golfer pays off.

In the second scene, gambling, it’s a “no skills required” environment.  Practicing pulling the lever of a slot machine does not increase or decrease your chances of winning. Winning big at gambling is a matter of pure, dumb, luck.  The other difference is that one person won big, really big, $50,000 big, while most of the thousands of people who came to the casino that night walked away losers.  But even though the one guy won $50,000, the truly big winner, consistently, every night, at every casino without question is “the House.”  The House never loses.  The House will share some of its profit with a few random individuals to keep people coming back, and when I say “people,” I mean, contributors to the House coffers.  The House knows exactly how much to share to keep gambling appetites whetted, and how much to keep for itself.  Casinos do not exist for the gambler.  They exist for the House.

So let’s take a look at the proposed casino legislation in New York State from a faith perspective.

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