In 2019, the Department of Health and Social Care commissioned PHE to undertake a review of the evidence on gambling harms. The review includes the most comprehensive estimate of the economic burden of gambling on society to date, revealing that the harms associated with gambling cost at least £1.27 billion in 2019 to 2020 in England alone. This analysis includes the first estimate of the economic cost of suicide (£619.2 million) and provides an updated cost of homelessness associated with harmful gambling (62.8 million).
Gambling related harms in the analysis range from financial such as bankruptcy and employment issues, to family issues, and health harms such as suicide.
The review also shows that people at risk of gambling harms are concentrated in areas of higher deprivation, such as the North of England, and may already be experiencing greater health inequalities. The review found a clear link between higher levels of alcohol consumption and harmful gambling, with only 35.4% of non-drinkers participating in gambling compared to 74.4% of those consuming over 50 units of alcohol (equivalent to 16 pints of beer or large glasses of wine) per week. Alcohol use in children and young people was also found to be a risk factor for subsequent harmful gambling.
The review also highlights the link between gambling and mental health issues. The report found that gambling can increase the likelihood of some people thinking about, attempting or dying from suicide. Evidence suggests that people with gambling problems are at least twice as likely to die from suicide compared to the general population, with one overseas study showing that people with a gambling disorder had a 19 times increased risk of dying from suicide.
The review also found that gender and poor mental health were the strongest indicators of gambling related harm:
- men were 4.2 times more likely than women to be gambling at levels of elevated risk of harm
- people identified as having some mental health issues were twice as likely to participate in harmful gambling than people with no mental health issues
- those who indicated they had a mental health condition were 2.4 times more likely to be a gambler experiencing gambling-related harms
The evidence suggests that harmful gambling should be considered a public health issue because it is associated with harms to individuals, their families, close associates and wider society with an approach that focuses on prevention, early intervention and treatment. The new Office for Health Improvement and Disparities (OHID) will work closely with other government departments, including the Department for Digital, Culture, Media and Sport (DCMS) and key stakeholders to develop a workplan to address the knowledge gaps identified in this review, improve data collection, and deliver an effective response to gambling-related harm.
Rosanna O’Connor, Director of Alcohol, Drugs, Tobacco and Justice at PHE, said:
There is so much more at stake from gambling than just losing money – from the toll on mental health to the impact on those around the gambler.
The evidence is clear – harmful gambling is a public health issue and needs addressing on many fronts, with an emphasis on preventing these harms from occurring as well as with help readily accessible for those directly and indirectly affected by the wide ranging and long lasting negative impacts of gambling.
Minister for Mental Health, Gillian Keegan said:
Whilst the economic costs of harmful gambling are stark, the cost to individuals as a result of their addiction, and those around them, cannot be overstated.
We are working to protect vulnerable people from the damaging impacts gambling can have, including through specialist NHS gambling addiction clinics and investing at least an extra £2.3 billion a year by 2023 to 2024 to expand mental health services.
I encourage anyone who is struggling to reach out – support is there for you.
Gambling Minister Chris Philp said:
We are gathering all the necessary evidence to reset the balance between giving adults the freedom to choose how they gamble safely, with the right protections for those at risk of harm.
We are determined to protect vulnerable people from exploitation by aggressive advertising or unfair practices that entrench problem gambling.
Jim McManus, Vice President, Association of Directors of Public Health said:
This evidence review from PHE paints a stark picture of the avoidable harms from gambling to the economy, society and the individual. Again, we see that existing regional inequalities are exacerbated by these harms with those from poorer areas at higher risk from the negative impacts.
A public health approach, with cross-government support, properly funded, is essential to reducing harmful gambling and all the negative consequences highlighted by this research in relation to debt, relationships and jobs.
Tim Miller, executive director at the Gambling Commission said:
We are pleased to welcome this important independent report from Public Health England.
Protecting people from gambling harms is a priority for the Gambling Commission, and we take a public health approach to do so. Public Health England’s work will help to support the continuing collaboration of a wide range of bodies under the National Strategy to Reduce Gambling Harms.
Faculty of Public Health President Professor Maggie Rae said:
Harmful gambling is a major public health issue which seriously impacts on health in a number of ways. As well as suicide and severe mental health problems, this report highlights harms caused by gambling including financial, employment, relationships, physical health, and criminal activity.
Gambling organisations are preying on people’s addictions, and we see that the burden of gambling harms is born by those already facing disadvantage, serving to widen existing health inequalities. This report is welcome as it highlights the wide range of harms caused by gambling, and calls for concerted action to tackle this major public health problem. This urgent call is especially timely as we have seen these problems exacerbated by the COVID-19 pandemic.