Objective: To investigate associations between neighbourhood accessibility to gambling outlets (non-casino gaming machine locations, sports betting venues and casinos) and individual gambling behaviour in New Zealand.
Design: A Geographical Information Systems (GIS) measure of neighbourhood access to gambling venues. Two-level logistic regression models were fitted to examine the effects of neighbourhood access on individual gambling behaviour after controlling for potential individual- and neighbourhood-level confounding factors.
Setting: 38 350 neighbourhoods across New Zealand.
Participants: 12 529 respondents of the 2002/03 New Zealand Health Survey.
Results: Compared with those living in the quartile of neighbourhoods with the furthest access to a gambling venue, residents living in the quartile of neighbourhoods with the closest access were more likely (adjusted for age, sex, socio-economic status at the individual-level and deprivation, urban/rural status at the neighbourhood-level) to be a gambler (OR 1.60, 95% CI 1.20 to 2.15) or problem gambler (OR 2.70, 95% CI 1.03 to 7.05). When examined independently, neighbourhood access to venues with non-casino gaming machines (gambling: OR 1.67, 95% CI 1.28 to 2.18; problem gambling: OR 2.71, 95% CI 1.45 to 5.07) and sports betting venues (gambling: OR 1.67, 95% CI 1.28 to 2.18; problem gambling: OR 2.71, 95% CI 1.45 to 5.07) were similarly related.
Conclusions: Neighbourhood access to opportunities for gambling is related to gambling and problem gambling behaviour, and contributes substantially to neighbourhood inequalities in gambling over and above-individual level characteristics.
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Funding: The research was funded by the New Zealand Ministry of Health. We recognise the Crown as the owner, and the New Zealand Ministry of Health as the funder, of the 2002/03 New Zealand Health Survey.
Competing interests: None declared.
Ethics approval: Details of ethical approval not required.