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Prevalence of problem gambling in the institutionalized Warsaw homeless population

Gambling

Łukasz Wieczorek Ph.D., Justyna Klingemann Ph.D., Institute of Psychiatry and Neurology, Department of Studies on Alcoholism and Drug Dependence, Warsaw, Poland
Publicerad 6 Aug 2019

Problem gambling among the homeless population is a significant social and public health concern in Poland. This is the first study conducted in Central and Eastern Europe, which provides information on the prevalence of problem gambling and frequency and type of gambling among the homeless population utilizing rehabilitation shelters and night shelters in an urban setting.

There are more than 400 000 homeless individuals in the European Union. It is known that the causes of homelessness stem from an interaction between individual factors like poverty, family problems, mental health and substance misuse problems on one hand, and structural factors, mainly the availability of low-cost housing on the other. In 2015, the number of homeless persons in Poland reached 36 161. 37% of the homeless population was living in the 18 biggest Polish cities while the remaining portion lived in smaller cities and towns. In the year 2015, the highest absolute number of homeless persons was living in Warsaw. Polish data from 2015 show that 60% of the homeless population stayed in rehabilitation shelters and night shelters, 4% in health care institutions, 6% in prisons and detention, and less than 1% in sobering-up stations. 29% of the homeless lived “on the streets” (squats, garden sheds and other places not suitable for residence).

First study of its kind

In 2014 general population study was conducted and showed that 34,2% of the respondents (15 years or older) gambled at least once and 7,1% at least a few times a week, during the 12 months prior to the study. 5,3% of Poles scored at least one point on PGSI, among them almost 4% indicated a low level of risk (1-2 points), 0,7% a moderate level and 0,7% indicated problem gambling (8 and more points). Therefore, the prevalence rate of problem gambling in Poland is similar to other European countries: 0,6% in Germany and Finland, 0,7% in the United Kingdom and Norway and 0,9% in Sweden.

While homelessness and problem gambling are recognized as social and public health concerns and the prevalence of addictive disorders among the homeless population tends to be high, these areas of research have predominantly been studied independently. Therefore, a quantitative self-report survey was conducted in the rehabilitation shelters and the night shelters in Warsaw. This was the first study conducted in Central and Eastern Europe, which provided information on the prevalence of problem gambling and frequency and type of gambling among the homeless population utilizing rehabilitation shelters and night shelters in an urban setting. The core component of the questionnaire was a nine-item screening test – the Problem Gambling Severity Index (PGSI) based on the Canadian Problem Gambling Index (CPGI).

More men than women

The majority of the surveyed persons had not gambled during the last twelve months. However, 30,2% of the respondents scored more than 1 point in the PGSI screening test. The results show that the prevalence of problem gambling in the population of the homeless people amounts to 11,3%, and is sixteen times higher than in the general population. The observed high prevalence of gambling disorders underlines the necessity to step up efforts to identify and address gambling problems in the homeless population.

The prevalence of problem gambling among men was higher than for women. Problem gamblers were the youngest group in the whole sample – mean age for this group of respondents was 43,3 years and most often had vocational or secondary education level. The mean time remaining in homelessness for problem gamblers was 5,9 years. Statistical analysis showed that in Poland men had much greater chances than women to be involved in problem gambling. Also, the younger gamblers had a greater chance of experiencing a gambling disorder; this chance decreases every ten years about a third.

Lotteries – the most popular gambling game

More than 40% of the homeless population gambled more than one type of game. Similar to the general population in Poland, the most popular gambling games in the homeless population were lotteries. However, the homeless people gambled with lotteries almost three times more often: 58,7% versus 20,5% noted in the general population study. 25,6% of respondents gambled on slot machines, and 18,9% on SMS lotteries and private card games (offline, outside casino). The least popular form of gambling were online bets (4,7%) and horse racing, dogs racing or fighting (5,7%).

The lotteries lose their popularity status when problems occur, as the nature of the gambling triggers shift into more addictive variants. Homeless problem gamblers gambled most often on slot machines, lotteries and cards privately. The least popular were horse racing, dogs racing or fighting bets, online bets and SMS lotteries.

Conclusions

The findings of the study suggest that problem gambling among the homeless can be viewed as a significant social and public health concern. Higher prevalence rates of gambling disorder among homeless compared to the general population show that it is a group particularly vulnerable on their development. Staying in homelessness and young age are risk factors that increase gambling activity and may trigger development of gambling disorder. Among the homeless population lotteries are most popular, however, along with the development of gambling disorder, homeless people choose gambling games with greater addictive potential. High rates of prevalence of problem gambling in the homeless population show the need to identify and monitor this problem and to provide access to gambling treatment or prevention programs.

Read the published article in its fullness in Nordic Studies on Alcohol and Drugs.

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Keywords

homelessness, PGSI, Poland, problem gambling

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