Gambling is making us sick. This was a theme given in Dr Lance O’Sullivan’s key note speech at the recent International Gambling conference. In this presentation, he set the scene for the current state of gambling in Aotearoa, its inequities which disproportionately impact Māori, and its effect on health for individuals and their whānau. He explained that, “it’s bad enough that we have diseases of poverty in a first-world country like New Zealand, but to see them exacerbated by pokies is extremely frustrating. This is the definition of a preventable epidemic".
As an attendee, what really stood out to me in this presentation, was how gambling is regarded as an individual behaviour but it stems from wider environmental and systematic stress. It is this which creates a cycle of deprivation. This contrasts with common representations given in mainstream media of gambling being the fault of the individual; a result of personal failing and lack of self-control.
But if gambling stems from larger structural issues like predatory placement of gambling facilities, what can one person do to make a difference?
It has to be all individuals across sectors making a concerted effort towards gambling reduction. For example, gambling is a social and economic concern but its roots are firmly entrenched in public health. This was reiterated in Dr Vladimir Poznyak’s presentation on gambling and public health. He discussed the bi-directional relationship with gambling and other mental and behavioural disorders, and what was striking to me was how gambling has been found to precede mood disorders and substance abuse. Gambling has also been associated with suicidal thoughts and behaviour- another issue which is top of list for us on our Māori public health agenda.
If the determinants of gambling are social, then so should be its solutions.
Dr Poznyak’s extended on this by addressing the regulation and monitoring of social media due to its potential to expose rangatahi to simulated gambling activities. For example, 54% of games on Facebook have gambling elements and these games tend to be owned by gambling operators. Unfortunately, conflict of interest makes it impossible to meaningfully discuss harm reduction with producers.
It would be ambitious to propose that one sector alone is equipped to address the complex and multifaceted issue of gambling that disproportionately affect Māori today. While working together across sectors, we cannot forget to prioritise the voices of those we need to hear most- our whānau in communities who are hit hardest by gambling. How can we include their stories in our work in a way that is mana- enhancing? When we use labels like “complex” and “difficult”, we run the risk of further disempowering and marginalising those who need our support most. It also helps me when recognise that I could easily have been that person if I were born into, exposed to, or living in those same circumstances.
In New Zealand’s current political climate, we are now more than ever considering how to measure whether our population is thriving. While the standard measure this far has been economic wellbeing, this conference has confirmed to me that a better answer may be health status. This paradigm shift is a necessary and crucial step to a more equitable Aotearoa.