Gambling is a common social activity that involves wagering something of value on an event whose outcome is uncertain. Often this has the potential to cause harm to the person who gambles, their family and friends, and the broader community.
The main form of gambling is the wagering of money on a game or an event where the winner receives a sum of money as a prize. However, there are also many forms of gambling that involve the use of materials that do not contain any monetary value. Examples include marbles games, Pogs, and Magic: The Gathering.
Harm to people who gamble can be broadly categorized into six different thematic categories: financial harms, harms relating to relationships, harms affecting the person’s health, impacts on work, study or economic activity, and criminal acts. This thematic classification was developed from data gathered from an in-depth qualitative research project that surveyed people with problem gambling, their family and friends.
A further important aspect of the definition is that it allows for a range of instances of harm to be included, from the first experience of gambling through to legacy and intergenerational harms. This broadens the scope of harm that can be considered and provides a foundation for future measurement in gambling related harm from a public health perspective.
The primary function of the definition is to operationalise harm from a public health perspective, to allow for the inclusion of comorbidities within measurements and to allow for gambling related harm to be measured in a way that is consistent with standard public health approaches. This is critical in enabling harm minimisation and prevention.
Another significant function of the definition is to capture the complex interaction of a range of social and environmental factors that lead to gambling related harm. This is important in the context of the current global nexus of gambling-related harms and its impact on health and wellbeing.
Developing and implementing measures to measure gambling-related harm are key challenges in public health and gambling treatment. There is currently a paucity of gambling-related harm measures that are both valid and reliable. This is largely because of the lack of a consistent and well understood definition of gambling-related harm.
In addition, the lack of a definition that is grounded in a public health approach, as well as a broader conceptualisation of the breadth and experience of gambling-related harms, are both barriers to developing and implementing effective measurement tools for gambling-related harms.
These challenges, together with the lack of a consensus among treatment providers and policy makers regarding the best and most appropriate ways to measure gambling-related harms, are contributing to a mismatch between the definition and the measurement of gambling-related harm in the public health sector. This is a gap that can only be filled by developing a more systematic and coherent understanding of gambling-related harms in the public health setting.
There is a need for gambling related harm to be defined in a manner that is consistent with the World Health Organisation (WHO) definition of health and that is grounded in a public health perspective. This will contribute to the development of effective public health approaches to addressing gambling related harm.