Gambling on the health of the public: A health impact assessment for an urban casino

State and local governments are increasingly looking towards casinos to compensate for budget deficits. The locations of these establishments are often determined by the path of least resistance and are thus frequently built in low-income/high-minority communities. While a breadth of research has examined proximal associations between casinos and health, such as the effects of secondhand smoke exposure among casino employees, few systematic analyses have employed a population-health perspective to explore the health impacts of casinos via more distal social determinants of health. The health impact assessment (HIA) provides a procedural framework to elucidate these potential casual pathways, both positive and negative, to inform the policy process, promote the equitable distribution of health risks, and maximize opportunities for health promotion.

This poster will present the findings from a rapid HIA for a slot casino that is under construction in a residential area of Philadelphia. A systematic review of literature and demographic/heath data was conducted to identify potential proximal and distal health impacts with a focus on racial/ethnic minorities. The rapid HIA has indentified six major pathways through which the casino could impact health—employment, traffic congestion, physical activity, social capital, problem gambling, and public health services. However, robust data are needed to measure the magnitude and direction of these pathways over time. This rapid HIA explores the amenability of HIA methods with casino projects and provides a framework to assess the local health impacts of casinos to inform the policy process and highlight potential disparities in outcomes among racial/ethnic sub-populations.