Abstract
Multiple studies show an increased prevalence of gambling disorder among African Americans compared to whites. However, few studies take an analytic approach to understanding differences in risk factors by race/ethnicity. Income is inversely associated with gambling disorder; we hypothesized that this association would vary by race/ethnicity. The main objective was to evaluate whether the association between income and gambling disorder varies by race/ethnicity. With data from the baseline visit of a prospective cohort study, Prevention and Etiology of Gambling Addiction Study in the United States, we used multivariable logistic regression analysis to determine whether the association between income and gambling disorder varies by race/ethnicity. 1164 participants were included in the final analyses. Measures included: demographics (age, sex, race/ethnicity, education, employment, annual household income), veteran status, marital status, homelessness, smoking, substance abuse, alcohol abuse, marijuana use, and lifetime gambling disorder diagnosis as derived from Alcohol Use Disorder and Associated Disabilities Interview Schedule. There was no evidence of effect modification by race/ethnicity in the association between income and gambling disorder (global p value = 0.17). Income was associated with increased odds of gambling disorder, but only for those with low income (< $15,000; OR 2.27, 95% CI 1.46, 3.53). There was no evidence that the effect of income on gambling disorder varies by race/ethnicity. For all race/ethnicities combined, low income was associated with significantly increased odds of gambling disorder (OR 2.27, 95% CI 1.46, 3.53). Further research is needed to better understand racial/ethnic differences in gambling disorder.
Highlights
Background and RationaleGambling is common to almost every culture (Okuda et al 2016) and has been part of human life for thousands of years (Schwartz 2013)
African American participants had the highest proportion of gambling disorder (55.6%), while white participants had the lowest proportion of gambling disorder (21.2%)
Regarding the remaining independent variables, notable differences included the white group having the highest proportion of alcohol abuse, the ‘Other’ race/ethnicity group being the youngest, and the African American group having the highest proportion of women, those with less than high school education, unemployed, veteran status, divorced/separated/widowed, current smoker, and substance abuse
Summary
Background and RationaleGambling is common to almost every culture (Okuda et al 2016) and has been part of human life for thousands of years (Schwartz 2013). Numerous studies have shown that gambling disorder is more prevalent among minority groups than whites (Alegría et al 2009; Barnes et al 2017; Gerstein et al 1999; Welte et al 2001). In a study from a large, nationally representative survey done in 2001–2002, Alegría et al (2009) found that the lifetime prevalence of gambling disorder [using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria] in African Americans was more than double that of whites (0.9% vs 0.4%) with a similar difference seen when using the more broadly defined “problem gambling” (2.2% vs 1.2%). Similar findings have been noted by other studies with different samples and varying definitions of gambling disorder (Gerstein et al 1999; Shinogle et al 2011; Welte et al 2001)
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