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In this piece, we explore the issue of problem gambling from a public health perspective, specifically through a health equity lens, and share important considerations and action items as we work to reduce stigma and address the disproportionate impact of problem gambling on Black, Indigenous, and People of Color (BIPOC) and other marginalized communities.

Gambling is a human phenomenon that has existed for nearly as long as humans. can be found among ancient artifacts in many civilizations. It is present in all identities, cultures, and social strata. And as long as there has been gambling, there has also been problem gambling. Problem gambling is as any gambling behavior patterns that compromise, disrupt or damage personal, family, or vocational pursuits, and can include sports and race betting, lottery, online gambling, and bingo.

Problem gambling has broad social, economic, and health impacts on individuals, families, and communities and does not have to meet for gambling disorder to cause problems. It is sometimes called 鈥溾�� as it has no physical symptoms, though it frequently co-occurs with other mental health and substance use disorders. As many as also meet criteria for another mental illness. Research suggests that , compared to 0.7% of the population. The National Council on Problem Gambling that $7 billion is spent annually in the U.S. related to the social costs of problem gambling, including job loss, criminal justice involvement, and healthcare expenditures. Currently, about of the US adult population struggles with problem gambling, with many more at risk.

Why Problem Gambling is a Public Health and Health Equity Issue

Problem gambling, along with other process disorders or compulsions, can be difficult to understand. The physiological and neurological responses to gambling behavior are similar to those that occur in substance use and can result in clinical addiction for those who are predisposed. As with other behaviors, an individual鈥檚 gambling is also influenced by family, community, culture, and social conditions. At the population level, increased risk of problem gambling can be seen in people with substance use disorders, seniors, youth, veterans, low-income, and BIPOC individuals. The convergence of , targeted marketing, and social conditions in marginalized communities has resulted in disparate harm from problem gambling. Since problem gambling is intertwined with mental health, substance use, and systemic racism, using a public health approach with an equity-informed lens considers both prevention and treatment while focusing on the systemic inequities that contribute to the disproportionate burden of problem gambling on marginalized communities

Addressing Barriers to Treatment

There are numerous barriers to addressing the issue of problem gambling. Some of the most evident barriers to treatment are:

• Low awareness about problem gambling, its symptoms, and available treatment among providers and the general public;
• Limited capacity among qualified behavioral health providers to deliver problem gambling treatment services, particularly care that is linguistically appropriate, culturally competent, and inclusive of intersecting identities; and
• Stigma and shame prevent individuals from self-identifying as having problem gambling and seeking treatment.

Since problem gambling often co-occurs with substance use and mental health disorders, some examples of a public health and equity-informed approach would:

• Increase awareness and build screening and treatment capacity among existing behavioral health providers;
• Partner with BIPOC-serving organizations to increase awareness and serve as trusted messengers in the community;
• Engage authentically with individuals who have lived experience to inform approaches, tailor messaging, and identify potential gaps in care.

Building the capacity needed to address problem gambling in the U.S. will require substantial strategic investment and coordination.  However, unlike other behavioral health issues, . Instead, investments and funding decisions are left to state and local governments. As of , 43 states (including Washington, D.C.) have invested in infrastructure to support problem gambling (). Of these, 30 states fund one or more full-time state employees to administer problem gambling programs, with a median spending of just . In states with limited or no infrastructure, people in need of services are unlikely to be screened; if they are, their treatment options are limited to whatever is covered through their insurance providers. Since BIPOC folks are than their White counterparts to have sufficient health care coverage, this further widens health inequities.

The commercial gambling industry continues to grow rapidly, with U.S. 2025 revenue reaching (up from in 2021). In 2023, Massachusetts saw the . With the broad expansion of legalized gambling opportunities (casinos, online gambling, etc.), gambling has become more accessible than ever. Growing public and clinical concern around problem gambling led to the launch of Problem Gambling Awareness Month.

Problem Gambling Awareness Month (PGAM)

is a grassroots effort led by the (NCPG) that aims to increase public awareness of problem gambling and encourage healthcare providers to screen clients for problem gambling annually during March. Its primary goal is to increase public awareness of problem gambling and the availability of prevention, treatment, and recovery services. Building on PGAM, the established Gambling Disorder Screening Day in 2014, now held every year on the second Tuesday of March. Providers who wish to learn more about screening for problem gambling can access the from the Cambridge Health Alliance鈥檚 Division on Addiction. People who think that they might have problem gambling can take this from the Massachusetts Problem Gambling Helpline.

Considerations and Action Steps

Understanding the insidiousness and burden of problem gambling should be an area of focus throughout the year. Whether you work specifically in public health or are touched by this issue in your personal life, there are several action steps we all can take:

• Call a Gambling Helpline if you, a friend, or family member needs support. 麻豆视频 manages the and Helpline, which links people to recovery services. Or check out this .
• Build awareness and capacity around problem gambling among your colleagues. Demystifying problem gambling and understanding its relationship to other conditions and disproportionate burden in BIPOC communities can reduce stigma and reframe problem gambling within the larger public health field. Several of 麻豆视频鈥檚 problem gambling capacity building initiatives that offer free resources:
  • The supports two 麻豆视频-led initiatives: the , which builds capacity among providers to identify and treat problem gambling, and , a problem gambling workforce development program. In addition to building the problem gambling workforce, M-TAC administers the Massachusetts Problem Gambling Specialist (MA-PGS) program, the official gambling treatment certificate in the Commonwealth, and PBU provides grant and scholarship opportunities to become MA-PGS certified and pursue professional development opportunities to strengthen the capacity of the behavioral health workforce to provide or promote gambling treatment services. Learn more about M-TAC in our impact story.
• Engage authentically with impacted communities and people with lived experience so that approaches and messaging are driven and validated by those most affected. Authentic engagement ensures that problem gambling prevention and treatment efforts are appropriate (linguistically, culturally, and informed by lived experience) and support the intended outcome. This approach has been for problem gambling as well as other related mental health conditions. The Suicide Prevention Resource Center offers many on how to engage people with lived experience. 麻豆视频鈥檚 blog post on community engagement through assessment is just one helpful resource available to support this important work.
• Advocate for policy and systems change around problem gambling: Policy and systems change provide the backbone infrastructure for prevention and recovery efforts. However, there is a lack of consistent and sustained infrastructure and funding for problem gambling around the U.S. NCPG provides on how to advocate for increased funding and stronger policies to address problem gambling.

Resources

麻豆视频 is committed to supporting and transforming the fields of problem gambling and public health. In the last several years, our assessment, evaluation, capacity building, training, and helpline services have contributed to amplifying voices with lived experience, creating and implementing comprehensive curricula for providers, directing those in need to services, and examining trends and patterns to guide data-informed strategic initiatives, all with a focus on health and racial equity.

Learn more about problem gambling and some examples of various initiatives by visiting the resources below:

• MA Problem Gambling Helpline:
• MA Technical Assistance Center on Problem Gambling:
• Project Build Up:
• IL Problem Gambling Helpline:
• Behavioral Health and Racial Equity (BeHERE) Initiative:

Updated March 3, 2026.