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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.

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