Is there a health inequality in gambling related harms? A systematic review

Jodie N. Raybould, Michael Larkin, Richard J. Tunney*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


BACKGROUND: Here we present a systematic review of the existing research into gambling harms, in order to determine whether there are differences in the presentation of these across demographic groups such as age, gender, culture, and socioeconomic status, or gambling behaviour categories such as risk severity and participation frequency.

PRIMARY AND SECONDARY OUTCOME MEASURES: Inclusion criteria were: 1) focus on gambling harms; 2) focus on harms to the gambler rather than affected others; 3) discussion of specific listed harms and not just harms in general terms. Exclusion criteria were: 1) research of non-human subjects; 2) not written in English; 3) not an empirical study; 4) not available as a full article.

METHODS: We conducted a systematic search using the Web of Science and Scopus databases in August 2020. Assessment of quality took place using Standard Quality Assessment Criteria.

RESULTS: A total of 59 studies published between 1994 and 2020 met the inclusion criteria. These were categorised into thematic groups for comparison and discussion. There were replicated differences found in groups defined by age, socioeconomic status, education level, ethnicity and culture, risk severity, and gambling behaviours.

CONCLUSION: Harms appear to be dependent on specific social, demographic and environmental conditions that suggests there is a health inequality in gambling related harms. Further investigation is required to develop standardised measurement tools and to understand confounding variables and co-morbidities. With a robust understanding of harms distribution in the population, Primary Care Workers will be better equipped to identify those who are at risk, or who are showing signs of Gambling Disorder, and to target prevention and intervention programmes appropriately.

Original languageEnglish
Article number305
JournalBMC Public Health
Issue number1
Publication statusPublished - 6 Feb 2021

Bibliographical note

© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
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Funding Information:
Funding for this research was provided by Aston University through a studentship for JR. Aston University were not directly involved in the research.


  • Age
  • Culture
  • Gambling
  • Gambling behaviour
  • Gambling disorder
  • Gambling harms
  • Gender
  • Harms
  • Harms measures
  • Health inequality
  • Online gambling
  • Pathological gambling
  • Problem gambling
  • Risk severity
  • Socioeconomic status


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