Plan to Mitigate the Harms Associated with Gambling in Massachusetts: Operationalizing a Statewide Policy to Improve Community Health

In 2011 Massachusetts passed an Expanded Gaming Act that allows the establishment of up to three destination resort casinos and a slot machine parlor. Unlike many laws that influence the public health landscape, the expanded gaming legislation mandates the establishment of a Public Health Trust Fund that can be used “to assist social service and public health programs dedicated to addressing problems associated with compulsive gambling…and any studies and evaluations necessary… to ensure the proper and most effective strategies.” This unique policy decision opened the door for data collected through legislated research to be used to inform a prevention plan that will guide expenditures from the Public Health Trust Fund.

The Massachusetts Gaming Commission, the Massachusetts Department of Public Health and the Executive Committee of the Public Health Trust Fund worked with Education Development Center (EDC) to develop a statewide Strategic Plan for Services to Mitigate the Harms Associated with Gambling in Massachusetts. The plan was developed in direct response to baseline findings from the SEIGMA study, a comprehensive, multi-year research project funded by the Public Health Trust Fund that measures the impacts of gambling expansion and includes a general population survey examining gambling behavior, attitudes, awareness of services, and problem gambling prevalence. The plan was also informed by a brief literature review, a survey of prevention practitioners, stakeholder interviews, an analysis of five years’ worth of statewide gambling helpline data and findings from an online focus group conducted with clinicians who treat people experiencing gambling disorders.

The plan includes programmatic, community-level and institutional recommendations for actions across the prevention continuum from primary prevention through recovery support, as well as recommendations for capacity building and ongoing data collection. If successful, the plan will mitigate health-related harms associated with gambling and maintain or improve overall community health. Comprehensive process and outcome evaluation plans within the strategic plan are designed to allow the results of ongoing monitoring and evaluation to inform bi-yearly updates.

While measuring the impact of prevention is never straightforward, the Commonwealth’s unique combination of legislated funding for multi-year research, a research agenda that includes the collection of data through population surveys, analysis of crime data and analysis of community-level social and economic impacts using control communities, with a prevention plan that is in place before the casinos open should allow for strong evaluation of the individual and community-level impacts of expanded gambling and prevention initiatives.