Casinos and Public Health

(My column from today's Saipan Tribune).

I’ve thought it rather witty that those who don’t support the casino have been calling it the “casiNO,” and I’ve been surprised that we haven’t yet seen the “caSINo” signs. I also fully expect to see that the supporters, who are touting “Economic Jackpot” will soon be putting up “CASHino” signs. What spin we see when elections near!

With the signs going up, and the ballots being prepared for the vote on the casino issue, I decided to do a little research of my own on the health effects of casinos on a community.

There is actually quite a bit of experience and hard data on the issue, particularly from Canada, where provincial governments have about ten years experience with the effects of casinos on their communities. It’s recognized that casinos (and gambling in general) bring problems. The motivating factor for communities to allow gambling is always money. No one says, “Wow, this is a socially beneficial activity, so let’s bring it into our community.” They say, “We need the money, so let’s allow gambling.” When government revenues decrease, as have ours, people start to look to gambling as a way to increase government income, and it works! To the extent that governments either tax the revenues, or are shareholders in the gambling operations (such as in state run lotteries, or government owned casinos) government revenue does increase. Gambling, can indeed be an “economic jackpot.”.

Now, in order for that to happen, the casino users, MUST lose money. It’s how the casinos make profit. In order for the gambling operation to be profitable, the gambler must lose money, and so all the games and the machines are designed to make you, collectively, lose. It’s simple math. In fact, it has been said, that lotteries and casinos and other gambling operations are a way to tax people who don’t understand math.

Communities that allow gambling almost immediately experience an increase in both the number of people in the community who gamble, and the amount of money spent on gambling. For example, in Niagara, the year before their casino opened, 11% of the population had gambled. A year later, 43% had gambled. The amount of money spent per individual on gambling increased five times during this same period. That’s great news for the casino and the government, but not good news for the people who are spending (and losing) their money.

Most people who gamble don’t develop any problems (other than losing money). However, a small, but significant segment of the population will experience adverse effects from gambling. According to a study looking at public health perspectives of gambling in Ontario, “problem gamblers” are defined as those individuals that “have a continuous or periodic loss of control over gambling, a preoccupation with gambling and with obtaining money to gamble, irrational thinking, and a continuation of these behaviors despite adverse consequences.”

How many people are affected by problem gambling, and what effect does a casino have on this number? In Niagara, the percentage of residents with gambling problems before the casino was 2.5%. After the opening of the casino, the number doubled. If we apply those numbers to the CNMI indigenous population, presuming about 20,000 indigenous residents, we would end up with about 1,000 people with gambling problems after the opening of a casino. That sounds like a big problem for a small tightly knit interrelated community.

The health and social problems of gambling have been well documented, and we have experience already with this problem here in the CNMI. HealthUnit.org describes the health effects of gambling as follows:

Problem gambling, while providing additional revenues, also results in significant costs to the individual, his or her family, and society as a whole. Uncontrolled spending, the resulting debts and the strategies used to gain more money to gamble has a significant impact on many determinants of health and can cause marital conflict, child neglect, poor work performance, multiple addictions, stress-related physical ailments, crime and even suicide. Children of pathological gamblers are two times more likely to attempt suicide, have lower grades than their peers and have higher rates of substance abuse.

The cost of problem and pathological gambling does not only affect individuals and their families. Society also bears the brunt of gambling, with the overall cost to taxpayers estimated at $56,000 for each problem gambler, including cost of treatment, health-related costs, absenteeism at work and time spent in courts.

Problem gamblers are more likely than the general population to be involved in other forms of addictive behavior such as alcohol or drug abuse. Stress-related ailments such as ulcers, colitis, high blood pressure, heart disease, migraines and skin problems are also much more common among problem gamblers. Even more serious is the rate of attempted suicide, which is higher among pathological gamblers than among all other addictive behaviors. A Québec study of college students found that 26.8% of pathological gamblers had attempted suicide compared to 7.2% of college students with no gambling problem.

Crime is also an issue between problem and pathological gamblers and becomes a viable option to support gambling habits when all other resources are exhausted. "Studies show that two out of three pathological gamblers commit crimes to pay off debt or to continue gambling. While the majority of crimes are nonviolent and involve embezzlement, cheque forgery, stealing credit cards, tax evasion, fencing stolen goods, insurance fraud, bookmaking, and/or employee theft, in some cases they involve violence and armed robbery." (National Council on Welfare, 1996, p.28)

So, there is no question that casinos bring increased revenue to their shareholders and to the government. There is also no question that casinos bring social and health problems into their communities. There is no need denying the financial benefits, nor the problems. Where you stand on the casino issue depends on how you weigh the benefits against the problems. Either way, there are trade-offs. You give something and you get something. Either you give up the money, and maintain social and mental health; or you give up social and mental health and get money. That’s a definite. It’s been studied and shown in communities that have the experience with casinos. Casinos bring more money. And they bring more problems. No matter how you vote, you will be giving something up. Just have your eyes open to this fact.

As for me, I see enough social ills and health problems on a daily basis in our community. I don’t want to see any more. If we follow the pattern of other communities that bring in casinos (and there is no reason to think we won’t), within a year of casinos we will have twice the number of people suffering from problem gambling and the economic and mental devastation it brings to their families. From my perspective, the money just isn’t worth it.