The Health Impacts of Gambling Expansion in Toronto

Dr. David McKeownMedical Officer of Health

January 22, 2013

OLG Strategic Business Review

“Modernizing Lottery and Gaming in Ontario”

Highlights:

1.Expansion of lottery sales

2.Consolidation of gaming sites (closures)

3.Improve access to slots machines

4.2 new casinos in Ontario; 1 in GTA

5.Consistent fee model for host municipalities

6.Shift gaming operation to the private sector

7.Build internet gaming site

A Casino in Toronto

Process for establishing a new casino:• OLG will review business cases• OLG will only proceed with municipal support• Municipalities must consult with their residents

Possible Toronto locations:• Exhibition Place • Metro Toronto Convention Centre• Portlands• Woodbine Racetrack (north-west)

Proposed Benefits of a Casino

• Provincial + municipal revenue generation

• Possible re-investment in health, education and community programs

• Job creation/employment

• Catalyst for economic growth

Ontario Lottery and Gaming Corporation (2011). Strategic business review: Modernizing lottery and gaming in Ontario. Available at: http://www.olg.ca/assets/documents/media/strategic_business_review2012.pdf

Possible Harms Associated with a Casino

• The main indicator of the health and social impact of casinos is the association with problem gambling (Williams, Rehm & Stevens, 2011)

Other Impacts:• Social service• Crime• Local businesses• Traffic

5

Problem Gambling

• Problem gambling occurs when a person’s gambling harms themselves, their family or friends or others in the community

• How measured?

• CCHS module

• PGSI

Prevalence of Problem Gambling

• Some estimate that the Ontario prevalence of problem gambling (including both moderate risk and problem gamblers) is between 1.2% and 3.4%

• Toronto Public Health focused on the most severe form of problem gambling - estimated 11,000 people aged 18+ (0.2%E) in the GTA and 25,000 (0.3%) in Ontario*

• At-risk gamblers - approximately 129,000 people aged 18+ (2.8%) in the GTA and 294,000 (3.0%) in Ontario*

E – Moderately high sampling variability; interpret with caution.

* Data Source: Canadian Community Health Survey, 2007/08. Statistics Canada, Share File, Knowledge Management and Reporting Branch, Ontario Ministry of Health and Long-Term Care.

Effects of Problem Gambling

Prepared by: Toronto Public Health. Adapted from Wyndham City. Responsible Gambling Strategy 2012-2014.

Effects of Problem Gambling

For every problem gambler, about 3 to 4 other people are negatively impacted*

* Williams, R.J., Rehm, J. & Stevens, R.M.G. (2011). The social and economic impacts of gambling. Final report prepared for the Canadian Consortium for Gambling Research. March 11, 2011. Images from http://dapinographics.com/license-info

Health Impacts of Problem Gambling

Self-Reported Health and Mental Health by Type of Gambler, Aged 18+, Ontario, 2007/08

Notes: (1) Gambling classifications are based on a modified version of the nine-item Problem Gambling Severity Index (PGSI), part of the Canadian Problem Gambling Index (CPGI). (2) Error bars (I) denote 95% confidence intervals. E – Moderately high sampling variability; interpret with caution. Low-risk and Moderate-risk gamblers were combined due to small sample sizes. See Appendix for the full data table.Data Source: Canadian Community Health Survey, 2007/08. Statistics Canada, Share File, Knowledge Management and Reporting Branch, Ontario Ministry of Health and Long-Term Care.Prepared by: Toronto Public Health

Health Impacts of Problem Gambling

Health Impacts Reported "At least Sometimes" in Past 12 Months by Type of Gambler, Aged 18+, Ontario, 2007/08

Notes: (1) Gambling classifications are based on a modified version of the nine-item Problem Gambling Severity Index (PGSI), part of the Canadian Problem Gambling Index (CPGI). (2) Error bars (I) denote 95% confidence intervals. (3) "At least sometimes" is an aggregate of almost always, most of the time and sometimes in the past 12 months. E – Moderately high sampling variability; interpret with caution. Low-risk and Moderate-risk gamblers were combined due to small sample sizes. Gambling caused health problems and financial problems are part of the PGSI and were used to classify type of gambler. Given this, we would anticipate significant differences between gambler types, These differences are still meaningful and illustrate the differentiation in behaviour between problem gamblers and lower risk gamblers. Data Source: Canadian Community Health Survey, 2007/08. Statistics Canada, Share File, Knowledge Management and Reporting Branch, Ontario Ministry of Health and Long-Term Care. Prepared by: Toronto Public Health

Implications of a New Casino in Toronto

• Overall evidence indicates that problem gambling tends to: – increase with availability– increase with proximity to a venue currently our

closest casino is Port Perry – 80 km away– be unevenly distributed in the community males,

youth, those with low-income, etc., are among the most vulnerable; all potential sites have vulnerable groups nearby

• Size of impact is hard to predict

• Toronto’s large size, diversity, low baseline access and prevalence of problem gambling could mean greater impacts

Conclusions

• Problem gambling has negative health impacts on individuals, families and communities

• Any expansion in gambling access in the GTA will likely increase health risks from problem gambling for Toronto and nearby communities, with a greater effect on closer communities compared to those further away

• Board of Health – OLG should not be invited to establish a new casino in Toronto

Toronto Public Health Position Statement on Gambling and Health

• Limit gambling availability• Mitigate impact on problem gambling by:

– limiting hours of operation

– restricting electronic gaming machine numbers, speed and operation

– eliminating casino loyalty programs

– prohibiting ATMs

– prohibiting credit

– reducing maximum bet size

– mandating daily loss maximum

– strengthening self-exclusion

– issuing monthly statements

– restricting alcohol purchase

Next Steps

• February 11 report to Toronto’s Board of Health on Community Health Impacts

• Public consultation ends January 25• www.toronto.ca/casinoconsultation• City Manager report to Executive Committee

March 20• City Council decision (April 3, 4)

The Health Impacts of Gambling Expansion in Toronto

Dr. David McKeownMedical Officer of Health

January 22, 2013