Defining a threshold of harm from gambling for population health surveillance research

Abstract

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm – reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 – demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors.

Keywords:

• harm
• population health
• problem gambling symptoms
• receiver operating characteristics

Acknowledgements

This project is funded by a grant from the Ontario Problem Gambling Research Centre. The authors wish to acknowledge the assistance of Anja Karvinen and Amanda Wilhelm who helped in manuscript preparation and Jeanne Williams for statistical consultation.