Assessing gambling-related harm in Victoria: A public health perspective

The Victorian Responsible Gambling Foundation engaged CQU’s Experimental Gambling Research Laboratory to develop a framework and a methodology for understanding and measuring gambling-related harm in the Victorian population. The aim of the project was to systematically investigate gambling-related harm in Victoria, and assess the aggregate ‘Burden of Harm’ caused by gambling in Victoria with reference to different levels of problem gambling, and other comparable conditions. This improved understanding of the quality and quantity of harm will help to better target efforts to prevent or reduce the potential negative consequences of problematic gambling. The project was designed to accomplish these goals by adopting a public health perspective towards gambling; most notably in adopting the summary health measures, specifically health state valuation methodology, to assess the impact of gambling harms. Our premise was that the diverse set of gambling harms experienced by individuals ultimately contributes to a decrement to a person’s health-related quality of life (HRQL). We conducted expert and community consultations with Victorians, and combined this with the extant literature, to develop a definition, conceptual framework, and detailed taxonomy of harms – organised within eight broad domains. These results provided the basis for a comprehensive survey on the prevalence of specific harms, with respect to different gambling risk profiles. The experiences of individuals across the continuum of gambling risk profiles were then represented as descriptive vignettes, and evaluated by experts and the general public in terms of HRQL impact via established health state valuation protocols as used in burden of disease (BoD) studies. These quantitative harm estimates at the individual level were then aggregated based on recent Victorian prevalence data, and analysed with respect to domains of harm, PGSI categories, demographics, and with respect to the harm caused by gambling relative to other health conditions.