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Gambling and gender: A public health perspective
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0003-1867-724X
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Prevalence studies around the world show that men are the largest group at risk of becoming problem gamblers and that men gamble more than women. However, gambling research has long been gender blind. The gambling market is rapidly changing, with the Internet making gambling more accessible. Further, despite the well-documented presence of health, social and financial problems among the concerned significant others (CSOs) of someone close with gambling problems in clinical and help-seeking samples, there is little research investigating on this population. This thesis aims to examine the relation between gender and problem gambling among regular gamblers and CSOs, and to determine whether there was a convergence of men’s and women’s gambling behavior between 1997/98 and 2009/10 in Sweden. A further aim is to examine health problems associated with Internet gambling and CSOs.

The data collections were taken from three different but linked gambling and health representative national population based studies in Sweden, all using the same methods: telephone interviews supplemented by questionnaires. The studies are as follows: 1) prevalence study 1997/98, age 15-74 years, n = 10,000, response rate 72% (n = 7,139) 2) prevalence study 2008/09, age 16-84 years, n = 15,000, response rate 63% (n = 8,165); and 3) incident study 2009/10, the 8,165 participants from the 2008/09 prevalence study were contacted again, response rate 74% (n = 6,021).

Gambling was generally merged into domains based on the axis chance-strategy and public-domestic. The dichotomy of public and private spheres is relevant in since there is a link between the public sphere and notions of masculinity and a link between the private and femininity. Further, the literature suggests that men are attracted to gambling that involves features of strategy, whereas women generally prefer game of chance. Problem gambling was measured using SOGS-R and PGSI. Health variables included measures such as self-reported health, psychological stress, social support, alcohol consumption, and financial situation as a determinant of health.

There were very few indications of a convergence between men’s and women’s gambling behavior. Men and women generally gambled in different domains. Men gambled more than women and dominated all domains except the domain of chance-domestic, a domain associated with less risk and Internet gambling. However, men and women who gambled regularly were just as likely to be problem gamblers. No gender differences were found in the score from separate PGSI analyses in the chance-public domain (games of chance in public spaces, such as gambling machines and bingo in halls). This domain was also the only domain associated with problem gambling for women who gambled regularly. Men and women were just as likely to report that they were CSOs and they constituted a large proportion of the Swedish population (18%). CSOs experienced a range of social, economic and health related problems including psychological stress, risky alcohol consumption, exposure to violence, and separations. For women who were CSOs, no relation with own problem gambling was found.

This thesis suggests that the presence of gambling machines must be addressed to prevent problem gambling and that separate analyses for men and women are required to identify important differences between genders. The findings indicate that gambling domains produce and reinforce gender. Further, to be able to prevent problem gambling we require further knowledge about these gendered processes. However, it is also important to see the overall similarities between men and women to avoid reinforcing stereotypical images of gender which would have an negative impact on the preventive work. Male and female gamblers are both very heterogeneous categories where the specific gambling site, context and life circumstances must be acknowledged.

Prevention, research and interventions should also target CSOs if a public health approach is applied because they require help and support in their own right. CSOs also play an important to the problem gambler. More qualitative research is required to understand gendered processes in gambling, as well as further research on interventions that go beyond the individual and address gambling and problem gambling at various levels. When addressing the harmful effects of gambling from a public health perspective, it is imperative to recognize the ethical principles of justice, autonomy, doing no harm and beneficence.

Place, publisher, year, edition, pages
Östersund: Mid Sweden University , 2013. , 70 p.
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 149
Keyword [en]
Gender, problem gambling, concerned significant others, relatives, PGSI, SOGS-R, Internet, public health, social support, incidence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:miun:diva-19046ISBN: 978-91-87103-74-2 (print)OAI: diva2:625208
Public defence
2013-06-14, F229, Mittuniversitetet, Östersund, 11:50 (English)
Available from: 2013-06-04 Created: 2013-06-04 Last updated: 2013-12-10Bibliographically approved
List of papers
1. Gendered gambling domains and changes in Sweden
Open this publication in new window or tab >>Gendered gambling domains and changes in Sweden
2011 (English)In: International Gambling Studies, ISSN 1445-9795, E-ISSN 1479-4276, Vol. 11, no 2, 193-211 p.Article in journal (Refereed) Published
Abstract [en]

The study examines two Swedish replication prevalence studies (n = 10,000 and n = 15,000) with the aim of exploring evidence for a feminization of gambling in Sweden between 1997/1998 and 2008/2009. Gambling domains were classified based on the games' basic orientation towards strategy and chance, as well as on each game's setting in either a public place or a home environment. The criterion for a domain was that the respondent had gambled at least twice a month in any mode of gambling within the domain. Logistic regression analysis showed no signs of a feminization. Instead, the gender order in gambling seems to be reinforced. Preferences for the different types of domains were still highlygendered, despite the fact that men in 2008/2009 tended to gamble more on games of chance, especially in public places. The implications of the findings in relation to gender equality and constraints on women's leisure activities are further discussed. © 2011 Taylor & Francis.

Gambling, gender
National Category
Medical and Health Sciences
urn:nbn:se:miun:diva-14730 (URN)10.1080/14459795.2011.581676 (DOI)2-s2.0-79961011100 (Scopus ID)
Available from: 2011-11-14 Created: 2011-11-14 Last updated: 2017-12-08Bibliographically approved
2. Incidence of Internet gambling in Sweden.: Results from the Swedish longitudinal gambling study
Open this publication in new window or tab >>Incidence of Internet gambling in Sweden.: Results from the Swedish longitudinal gambling study
2011 (English)In: International Gambling Studies, ISSN 1445-9795, E-ISSN 1479-4276, Vol. 11, no 3, 357-375 p.Article in journal (Refereed) Published
Abstract [en]

In the present study, Internet gamblingwas studied with data fromthe first twowaves of the Swedish longitudinal gambling study. Self-reported gambling problems, alcohol consumption,smoking,mental health, social support, gender and other socio-demographic factors were evaluated with respect to the prevalence of Internet gambling in 2008 and 2009 and the incidence in 2009. Multivariate logistic regression was used. In 2009 most Internet gamblers (72%)weremen.However,women seemto have becomemore involved in Internet gambling. In 2009, 62.5% of new Internet gamblers since 2008 were men. Mental health, alcohol, smoking and social support were not predictive factors for incident Internet gambling. Self-reported gambling on regulated Internet sites showed higher prevalence rates of problem gamblers than gambling on land-based forms in 2008, but not in 2009. At both time-points, unregulated sites had the highest rates of problemgambling. The findings suggest that a gender perspective on Internet gambling is needed as well as carefully designed policies and research related to the regulation of Internet gambling.

Internet gambling, gender, health, longitudinal, regulation
National Category
Social Sciences
urn:nbn:se:miun:diva-15013 (URN)10.1080/14459795.2011.629203 (DOI)2-s2.0-84859236395 (Scopus ID)
National Institute of Public Health has funded the studyAvailable from: 2011-12-02 Created: 2011-12-02 Last updated: 2017-12-08Bibliographically approved
3. Regular male and female gamblers in a population based study: analyzing PGSI-items in gendered gambling domains
Open this publication in new window or tab >>Regular male and female gamblers in a population based study: analyzing PGSI-items in gendered gambling domains
(English)Manuscript (preprint) (Other academic)
Abstract [en]

A subsample of regular gamblers (n=3191) from a nationally representative sample was used to examine how features of problem gambling correspond with gender and four gambling domains based on chance, strategy, public and domestic. The study confirms that men more often participate in games of strategy and gamble in public places. However, regular male and female gamblers had similar levels of problem gambling (women 7.9%, men 7.5%) and were similar in the endorsement of problem gambling items within respective domains. Still, men were more likely to try to win back their money while women were more likely to bet morethan they had afforded. Women who gambled games of strategy in public places didexperience financial problems but did not report health problems or gambling problem which could be an indication that some gambling may be perceived as emancipatory by female gamblers in the domain. Regular female and male gamblers are heterogeneous groups which has implications for both research and prevention. The study suggests games such as gambling machines and bingo, are important arenas for prevention.

National Category
Health Sciences
urn:nbn:se:miun:diva-19062 (URN)
Available from: 2013-06-04 Created: 2013-06-04 Last updated: 2013-11-01Bibliographically approved
4. Concerned significant others of people with gambling problems in a national representative sample in Sweden: a follow-up study
Open this publication in new window or tab >>Concerned significant others of people with gambling problems in a national representative sample in Sweden: a follow-up study
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Research on the impact of problem gambling in close social networks is scarce as most studies only include help-seeking populations. To date only one study has examined concerned significant others (CSOs) from an epidemiological perspective; however, it did not include a gender perspective. The aim of this study is to examine the health, social support, and financial situations of CSOs in a Swedish representative sample and to look at gender differences.

Methods: A population study was conducted in Sweden in 2008/09 (n = 15,000,response rate 63%). Respondents were defined as CSOs if they reported that they had someone close who had or previously had problems with gambling. The group of CSOs was further examined in a 1-year follow up (weighted response rate 74% from the 8,165 respondents in the original sample). Comparisons were also made between those defined asCSOs only at baseline (47.7%, n = 554) and those defined as CSOs at both time points. Results: In total, 18.2% of the population were considered CSOs, with no difference between women and men. Male and female CSOs experienced, to a large extent, similar problems including poor mental health, risky alcohol consumption, economic hardship, and arguments with people close to them. Female CSOs reported less social support than other women and male CSOs had more legal problems and were more afraid of losing their jobs than other men. One year on, several problems remained even if some improvements were found. Both male and female CSOs reported more negative life events in the 1 year follow-up.

Conclusion: Although we do not know the relationship between the CSOs and the individuals withgambling problems or the causal relationships between being a CSO and the range of problems that are associated with being a CSO, the results indicate that gambling problems does not only affect the gambling individual and the close family but the larger social network. A large proportion of the population can be defined as a CSO, and half of them are men. While male and female CSOs share many common problems, there are also gender differences to consider in prevention and treatment.

National Category
Health Sciences
urn:nbn:se:miun:diva-19064 (URN)
Available from: 2013-06-04 Created: 2013-06-04 Last updated: 2013-11-01Bibliographically approved

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