Special Report: Casino

Toronto Board of Health Recommends Against Expanding Casino

Toronto's Chief Medical Officer of Health concludes that a new Toronto Casino will increase the risk of problem gambling and exacerbate its serious public health impacts.

By Ryan McGreal
Published November 21, 2012

this article has been updated

Toronto's Chief Medical Officer of Health has recommended against expanding gambling in Toronto with a new casino. The Ontario Lottery and Gaming Corporation (OLG) has identified Toronto as an expansion zone to build a new casino facility, and Toronto City Council is currently debating the issue.

In a report [PDF] for the Toronto Board of Health titled "The Health Impacts of Gambling Expansion in Toronto", Toronto Chief Medical Officer David McKeown cites research from the Centre for Addiction and Mental Health to conclude that problem gambling is a serious problem that an expanded casino will exacerbate.

The report defines problem gambling as:

gambling behaviour which includes continuous or periodic loss of control over gambling; preoccupation with gambling and money with which to gamble; irrational thinking; and continuation of activity despite adverse consequences.

It notes that between 1.2% and 3.4% of Ontarians suffer from problem gambling, with the negative effects felt more widely by gamblers' families, friends and colleagues. Another 3% are considered at risk of problem gambling, and their risk is correlated with their proximity to gambling facilities.

It is also widely regarded that these numbers are conservative, since problem gambling is "largely an invisible addiction and one that is often actively hidden".

Hosting a new casino in Toronto is anticipated to increase the frequency and severity of problem gambling in the city, and the associated negative health impacts on individuals, families and communities.

There is currently no casino in Toronto, and the nearest casinos are in Port Perry, Brantford, Niagara, and Orillia, with slots at Ajax Downs and Flamboro Downs.

Higher Risks

Some groups are at higher risk of problem gambling than others. The research indicates that youths, seniors, First Nations people and people with low incomes are over-represented among problem gamblers. These groups are also more vulnerable to the loss of income that accompanies problem gambling, and so the expansion of gambling serves to "exacerbate social inequities".

"Gamblers tend to gamble close to home."

The research clearly indicates that access to gambling facilities increases the risk of problem gambling: "Research shows that availability of casinos and other gambling venues is associated with elevated gambling participation and typically, higher rates of problem gambling." More to the point, the addition of new gambling facilities is associated with an increase in the incidence of problem gambling in several studies.

One interesting result from the study is that casino employees are three times as likely to experience problem gambling as the general population. The reasons for this "include higher rates of gambling participation among new employees and people with a history of gambling being attracted to the casino industry."

Health Impacts and Treatment

Problem gambling is also associated with significant negative health impacts, including: lower self-reported general health and wellbeing; colds and influenza; headaches; fatigue and sleep problems; stress; depression, mood, anxiety and personality disorders; alcohol, tobacco and drug use; substance abuse/addiction; suicidal ideation and suicide; financial problems; traffic fatalities; family breakdown; spousal abuse and family violence; and child neglect.

The cost to treat problem gamblers is significant an can cost between $9,000 and $50,000 per problem gambler. This is a significant social cost that must be taken into consideration given the role gambling plays in Ontario's public revenues.

The research into treatment and prevention of problem gambling strongly suggests that individual prevention and treatment is not very effective, and that the more effective strategy is to restrict access to gambling. That includes "situating gambling venues away from vulnerable communities and those with dense residential and commuter populations."

Ironically, a study from Montreal found that a public service message on "responsible gambling" did not reduce problem gambling and actually served to promote and normalize gambling.

One area that shows promise is messaging to educate the public that increased gambling leads to increased losses, not increased gains: "in other words, the more you play, the more you bet, the more you lose."

Public Health in Hamilton

Like Toronto, Hamilton has been identified as an OLG expansion area. Currently, Hamilton has a slots operation at Flamboro Downs, but OLG has indicated that it wants to expand this into a full casino, signalling strongly that a casino would be located downtown.

Raise the Hammer has contacted Hamilton's Department of Public Health to ask whether it will be publishing a report on the public health impacts of a downtown casino. A casino report has not been on the agenda for any of the Board of Health meetings this year.

Tara Hall from Public Health has advised RTH that this past Monday, the Board of Health asked staff for a report on the health impacts of gambling (this will go to Council next week in the minutes from the Board of Health meeting). The report will be presented at the December 3 Board of Health meeting. Hall notes, "the information is for the health impacts of gambling regardless of where a facility may be located."

In the meantime, a research report prepared by Sarah V. Wayland for the Hamilton Roundtable on Poverty Reduction concluded, "Hamilton's low income households are likely to bear significant social, economic, and other costs should a casino be built downtown."

Update: The Hamilton Department of Public Health has responded to our request for information. You can jump to the added paragraph.

Ryan McGreal, the editor of Raise the Hammer, lives in Hamilton with his family and works as a programmer, writer and consultant. Ryan volunteers with Hamilton Light Rail, a citizen group dedicated to bringing light rail transit to Hamilton. Ryan wrote a city affairs column in Hamilton Magazine, and several of his articles have been published in the Hamilton Spectator. His articles have also been published in The Walrus, HuffPost and Behind the Numbers. He maintains a personal website, has been known to share passing thoughts on Twitter and Facebook, and posts the occasional cat photo on Instagram.


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By Borrelli (registered) | Posted November 21, 2012 at 13:02:09

Thanks for that info re: the Board of Health, Ryan. Will be good to see what they say, and I'm still eagerly waiting for the SPRC to weigh in on this issue.

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By RenaissanceWatcher (registered) | Posted November 21, 2012 at 23:12:06

This Nov 20/12 article titled "Hamilton asks for health report on gambling" by Kevin Werner on the Hamilton Community News website contains some information about the request by the Hamilton Board of Health for such a report. http://www.hamiltonnews.com/news/hamilto...

In addition to the the report being sought by Councillor McHattie examining health issues associated with gambling, Councillors Clark and Whitehead want OLG to shed more light on the substance of the casino proposal before the City of Hamilton can properly consider and make a "Yes" or "No" response. For example, under its new modernization plan, OLG and the casino operator of its choice would install gaming tables (i.e. poker, roulette, pai gow, etc.) in a new Hamilton casino yet the City of Hamilton would receive no share of the gaming table revenues. The gaming tables are where the largest bets are made, where bettors suffer the greatest personal economic loss and where the municipalities would end up dealing with the heaviest social costs. It would therefore be unconscionable for OLG and the casino operator not to share some gaming table revenues with the municipalities. This type of issue needs to be addressed by OLG before the municipalities move through their deliberaton processes.

Comment edited by RenaissanceWatcher on 2012-11-21 23:13:21

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By me, me and me! (anonymous) | Posted November 22, 2012 at 05:55:03

I'm curious how our Governments pay for all these reports.

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By No more reports, action please (anonymous) | Posted November 22, 2012 at 13:50:00

It is mind boggling to me that peoople wait for these reports, yet history tells us that changes to social programs did not come form reports but the groundswell of people organizing, as with the 1919 Winnipeg General Strike and many other battles fought on the front lines. People died in these exchanges.

Given the presentation from the Mac students at the anti poverty Caucus, I just shake my head in despair, that we have the young, paying big dollars for an education, yet all they are yes people to the corporate agenda who fail to do research and bring forward real facts about the changes that have been made systemically since the Mulroney days, in all levels of government.

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By Ted Mitchell (registered) | Posted November 27, 2012 at 23:01:46 in reply to Comment 83119

Jon Stewart says science has a liberal bias. Or was that reality has a liberal bias?

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By RenaissanceWatcher (registered) | Posted November 24, 2012 at 09:32:45

In the Weekend Reader (Forum) section of the Hamilton Spectator today, there is an opinion piece by Kyle Caldwell titled "Casino centophobia (i.e. fear of new ideas)": http://www.thespec.com/opinion/columns/a...

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By RenaissanceWatcher (registered) | Posted November 27, 2012 at 07:54:19

The opinion piece titled “Casino centophobia” by Kyle Campbell in the Hamilton Spectator on Nov 24/12 has elicited these letters to the editor published in today’s Hamilton Spectator:

“A glittering tax machine, nothing more” by Paul Gauthier http://www.thespec.com/opinion/letters/a...

“Casino article superficial and patronizing” by Syd Hielema http://www.thespec.com/opinion/letters/a...

“Casino article exposed closed minds” by Pat Stevens http://www.thespec.com/opinion/letters/a...

Comment edited by RenaissanceWatcher on 2012-11-27 07:59:48

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By Borrelli (registered) | Posted November 27, 2012 at 09:30:20

Thanks for posting those follow-ups to Campbell's weak-sauce casino sales-pitch in Saturday's Spec.

Comment edited by Borrelli on 2012-11-27 09:30:28

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By RenaissanceWatcher (registered) | Posted November 29, 2012 at 08:13:57

There are two casino-related articles and two opinion pieces on the CBC Hamilton website today:

"Brantford casino could be Hamilton's future" by Samantha Craggs http://www.cbc.ca/hamilton/news/story/20...

"What's the social cost of a casino in Hamilton? Brantford knows" by Samantha Craggs http://www.cbc.ca/hamilton/news/story/20...

"CasiNO: Let's be clear on what this is NOT" by Matthew Green http://www.cbc.ca/hamilton/talk/story/20...

"The casual gambler" by Larry DiIanni: http://www.cbc.ca/hamilton/talk/story/20...

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By RenaissanceWatcher (registered) | Posted December 02, 2012 at 23:54:52

Given that the Ottawa city council voted 19 to 5 in favour of a new casino on October 31, 2012 and it has a pre-existing slots facility at Rideau Carleton Raceway, the Ottawa casino decision-making process has become the “canary in a coal mine” for Hamilton city council in deciding whether to vote “Yes” or “No” to a casino and, either directly or indirectly, for the future of Flamboro Downs.

This Ottawa Sun article titled “Game on for Ottawa casino bidders” by Jon Willing and published yesterday reports that OLG issued the request for pre-qualifications of bidders for the Ottawa casino on Noven=mber 30, 2012 and the pre-qualification stage will close on March 7, 2013. http://www.ottawasun.com/2012/11/30/game...

Here is the deal being offered by OLG to the potential bidders for the Ottawa casino: -a licence to operate 2,000 slot machines and 600 gaming tables -a $30 Million annual management fee -70% of all gaming revenues above a revenue threshold suggested by the casino operators in their bids -20% of all gaming revenues generated from VIP customers from outside of Canada -all revenues from restaurants, concerts, and retail activities in the casino complex -the option of running the casino at Rideau Carleton Raceway or moving it to a more “convenient location” in the gaming zone

Here is the deal being offered by OLG to the City of Ottawa: -a share of slot gaming revenues (approximately 5.25%) -no share of table gaming revenues -city council must sign off on a new location for a casino

Here is the deal being offered by OLG to existing OLG employees at Rideau Carleton Raceway slots: -a transition to the casino operator who must employ them for at least 12 months

Although the article is silent on the future of the horse racing employees and suppliers of Rideau Carleton Raceway, it is clear that the OLG partnership with the horse racing tracks is over when the Slots At Racetracks Program ends on March 31, 2013.

The upshot of the Ottawa casino decision is the Ottawa city council is allowing OLG to choose the casino operator and the casino location (even though the city would still have to sign off on the final casino plan) and, in addition to 2,000 slot machines for which the city will receive a 5.25% share of revenues, council is inviting also 600 gaming tables into their city without receiving any compensation. Even without factoring in other issues such as the social costs of gambling and the tenuous future of the local horse racing industry, Ottawa city council has already made a bad deal on the casino file. It is incumbent upon Hamilton city council and city staff to take the time to obtain sufficient information to make a thoroughly considered decision that is best for our community and not to blindly follow the path foisted upon the City of Ottawa by OLG.

Comment edited by RenaissanceWatcher on 2012-12-02 23:56:55

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By RenaissanceWatcher (registered) | Posted December 03, 2012 at 22:45:05

According to an article by Samantha Craggs on the CBC Hamilton website today, OLG pro-casino advertisements are coming to a television, radio or movie theatre near you: http://www.cbc.ca/hamilton/news/story/20...

It is doubtful that the Ontario Ministry of Health will mount a similar advertising campaign on the medical and social costs of gambling. They have been missing in action throughout the casino debate.

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By RenaissanceWatcher (registered) | Posted December 04, 2012 at 07:58:05

Here is the link to an article titled "Don't make casino 24 hours, says Hamilton's top doc" by Samantha Craggs on the CBC Hamilton website today: http://www.cbc.ca/hamilton/news/story/20...

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