Pennsylvania Gov. Ed Rendell's angry outburst on CBS' "60 Minutes" was more than unexpected. It was factually wrong.
In a segment on slot machine gambling, Rendell lashed out at CBS reporter Lesley Stahl, when she asked about the "downside" of expanding casino gambling. The outgoing Democratic governor, who signed legislation to allow slot machine gambling in 2004 and table games in 2010, said the "biggest downside is that some people lose their paychecks." But he became visibly angry at Stahl for asking if he had second thoughts about signing legislation that caused "new gamblers" and brought additional "suffering."
Rendell: You’re not getting it. Those people would lose that money anyway. Don’t you understand? You guys don’t get that.
Stahl: I do get that.
Rendell: You’re simpletons. You’re idiots if you don’t get that.
At the risk of incurring the governor's wrath, the question of whether easy access to casinos causes more gambling-related problems is not that simple.
For this, we rely on two people who were probably never called "simpletons": Harvard psychiatry professors Debi A. LaPlante and Howard J. Shaffer. Shaffer is director and LaPlante the associate director of the Division on Addictions at The Cambridge Health Alliance, a Harvard Medical School teaching affiliate. Both collaborated on a paper called "Understanding the Influence of Gambling Opportunities: Expanding Exposure Models to Include Adaptation." They reviewed empirical research on gambling exposure — including "geographical exposure" — and found that "evidence suggests" that easy access to casinos plays a role in "gambling-related problems," although over time people can adapt and become less vulnerable to the influences of gambling. (Directions on how to access the article can be found on the division's website.)
LaPlante and Shaffer: Research on the geographic exposure to gambling opportunities is more consistent and suggests that when gambling opportunities are close at hand, gambling-related problems are evident as well.
The report cited the National Gambling Impact Study Commission, which found in 1999 that "a casino within 50 miles (vs. 50-250 miles) of a person's home is associated with nearly doubled levels of gambling-related problems and pathological gambling." A different study done in 2004 "found that, among a range of distances, a 10-mile limit provided the best predictive power for the prototypical exposure effect; that is, more so than individuals who lived at greater distances, individuals who reported a casino within 10 miles of their home were more like(ly) to have gambling-related problems."
But the professors warned that there are limits to such studies, such as whether casinos caused the problems or whether people with gambling problems were attracted to live closer to casinos. They also found that people who live close to casinos can become resistant to the influences of gambling. They cited Nevada as an example where people have adapted to living with casinos.
In the end, they say more research needs to be done — including to determine how long it takes people to adapt to gambling's influences in areas where new casinos are introduced. They warn policymakers — listen up, governor — that "gambling-related harms resulting from exposure is nascent and is open to multiple interpretations."
LaPlante and Shaffer: In isolation, the exposure and adaptation effects have the power to misdirect public policy. Focusing too heavily on the adaptation effect could cause policymakers to underestimate the influence and importance of early increases in gambling-related problems. Alternatively, focusing only on exposure could cause a public policy overreaction to the availability of new opportunities.
They conclude by saying "the available evidence suggests that exposure does play a role in the development of gambling behavior," and suggesting that something needs to be done since more and more opportunities to gamble, such as Internet gambling, are emerging all the time. "In light of this reality and to minimize any harm that might accrue as a result of gambling exposure, researchers, gambling industry representatives, and public health officials need to work together to facilitate the process of early and positive adaptation," they write.