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The UCLA Gambling Studies Program along with the Asian Pacific Policy and Planning Council (A3PCON) are collaborating to document the impact of gambling on Asian communities in Los Angeles. The specific objectives are to determine the impact of gambling on Asian communities in Los Angeles with an emphasis on documenting its effect, characterize differences in gambling patterns which will identify Asian communities who are at-risk, and to raise awareness about problem gambling within Los Angeles Asian communities. Dr. Timothy Fong, Program Director of UCLA’s Gambling Studies Program, explains how the project is going so far.
What led to your interest in studying gambling?
My background is that I did my adult psychiatry residency [at UCLA] from 1998 to 2002. I was headed toward a career in substance abuse and addiction research as well as treating patients. During that time, I saw an incredible increase in gambling here in the state of CA. That was mainly the expansion of gambling on Indian casinos, the rise of televised poker, the ascension of Las Vegas casinos.
It really struck me how there was no one studying the impact of gambling on society. Not only just a pathological gambling but the impact on our overall quality of life here in America by having so much gambling around. I was also struck how there was no state or federal funded treatment for pathological gamblers at all, even though governments were sponsoring the gambling.
I notice that in every casino in America that I go to, I would see a disproportionate number of Asians compared to the general population. No matter where I went, whether it was California, Las Vegas, New Orleans, Connecticut, Chicago, it was the same across the nation. I really wondered one, do Asians gamble more than other ethnicities, and two, is problem gambling a larger issue in Asian communities or a hidden issue not being talked about.
How did your partnership with the Asian Pacific Policy and Planning Council (A3PCON) come about?
There was a call for proposals by the UCLA in LA [Center for Community Partnerships] that was looking for partnerships in the community. It said, basically, take your science from your ivory towers and take it down to the community level.
Parallel to that, I was starting to work at the community level anyway with some very interested community mental health and substance abuse providers, primarily Asian. They were starting to see more and more gamblers present at their treatment centers.
They said we don’t know what to do because there are no FDA approved medicines, practice guidelines. This is an addiction, but it’s not quite an addiction because there are no drugs.
There’s very little data out there to show what’s the extent of the problem in the Asian community, which Asians are most vulnerable and how do you get Asians who are at risk into treatment. So when the announcement came out it was a natural fit.
How did the support from UCLA in LA help you further this partnership?
Very clearly, without the UCLA in LA award we would not have pursued this partnership further. We had been talking, but we didn’t have the time and the resources to donate to them. They certainly didn’t have anybody that they could send to us to do any research projects.
So the UCLA in LA proposal really gave us the resources and funding to go into the community and conduct very meaningful research that we would not have done. It also gave us an opportunity to further establish a relationship with [Asian Pacific Policy and Planning Council (A3PCON)]. Now we have a reason to sit down at the same table. Whereas, before a lot of it was just common courtesy. It was just table talk.
How did you set out to document the problem?
We set out to [look at] what is the level of problem of gambling within the Asian communities here in LA and look at the existing [addiction] treatment programs that are treating Asians and say how many of those patients have gambling problems, because it’s not standard protocol for them to screen for gambling problems. It was a pretty big daunting task.
The first thing we wanted to do was do a general survey of Asians who live in LA. Get a sense of what do they think, feel and know about gambling - a man on the street kind of survey.
The second thing we did was a qualitative focus group. To actually have Asians tell us these are the issues that are in our community, these are the things that we see gambling doing, this is how we feel about gambling. The focus groups were done in Korean, Cambodian and Vietnamese communities.
What did the survey reveal?
From our general population survey we wanted to compare Asian versus non-Asian. Surprisingly, there were really no differences between the groups. About half of both groups said that they recognized gambling as a disease, an actual brain disease, which sounds nice and all but it also means that the other half still see it as an issue of morality, and issue of greed, or will. Kind of like where drug addiction was about 15 or 20 years ago where people associated it with self-control.
What did the focus groups reveal?
Number one, gambling was a common thing that a lot of community members did. Number two, it was very socially acceptable. And number three, almost everyone knew one or two people that they knew had a gambling problem. It was a very common thread that they also didn’t know what to do about that person; where to send them, what to say to them, what to do about it.
What was also very interesting was that the casinos were very aggressive in marketing toward Asian communities. But they didn’t blame them for that. They didn’t say that that was a bad practice. This is just a reality. We learn about a lot of bus tours that were marketed for Asian communities. Fliers that were marketed toward that community.
What were the next steps?
The second set of surveys we actually went into the Asian drug and alcohol treatment programs. It turned out that 10 to 12 percent of all these patients met criteria for gambling problems. Compare that to the general population rate of around 1 to 2 percent. It’s about 5 times higher than you would expect.
It’s important because these are folks who are coming in with drug and alcohol problems. Often times the drug and alcohol programs are go hand in hand with gambling problems.
If treatment providers don’t screen for problem gambling they are not addressing the full needs of patients with substance abuse problems. Both of those surveys are done and we are getting ready to publish them.
Tell us about your research inside the casinos.
Then we went to the Commerce Casino. We wanted to say what percentage of folks here inside the casino are problem gamblers. Kind of like going to a bar and seeing how many people are alcoholics.
We surveyed over a four day period [over a 24 hour period] and found 35 percent of all patrons had a gambling problem, concerning enough that they would want to go do a full clinical evaluation. Again, general population rate is around 1 to 2 percent. It should be said that we don’t know how many of that 35 percent that meet criteria, need treatment today.
You would expect that. That’s where they go. What’s surprising is we didn’t find a higher rate between Asians and non-Asians. But what we did find was that about half of the actual casino patrons were Asian.
Fifty percent of the patrons were Asian in a state where only 12 percent are Asian. It does highlight that there are some cultural issues there.
How do you plan to use this data?
From that data, we said that we needed to develop an Asian-specific intervention for problem gambling. So that’s what we are trying to do right now, a five session treatment module.
Right now we had meeting last week where we talked about what should the content of the intervention be like. We are hoping to have this ready to go by May to start providing services. How do we start intervening much earlier? That’s the purpose of this model.
Is there anything that you can identify that would explain this disproportionate percent of Asian gamblers?
I think there is a blend of biological, psychological and social factors. In these Asian communities, gambling is very accepted for entertainment. So you have higher participation rates, a higher approval rate.
I think there’s a huge social component where the majority of social activities are spent at the casino you’re going to do that. If all your friends go to the casino, you’re going to go to the casino.
There’s an immigrant mentality as well, where folks who come here to take a chance and come to America are more likely to gamble because immigrating to America from your homeland is a huge gamble in and of itself. We can’t prove this but most likely they have some kind of biological predisposition to gambling in general, in life. It makes it very easy for them to go to the casino when they get here even though they may be very poor.
There are all sorts of other factors too. Maybe the recruiting, the advertising by the casino probably has an impact. I think it’s all those things. There is no real backlash against gambling in Asian communities. It’s not like the churches are saying don’t do this; or advocacy groups or intervention groups. It’s an activity that’s not frowned upon.
At this point are you focused on identifying what the actual cause might be from a scientific standpoint?
No. We are still doing some more work to try to find out the specific cultural factors that might contribute to differentiate regular gambling behavior versus problem gambling behavior.
When we do this intervention we want to find out the predictors of who will respond to it and who won’t. We want to know which factors contribute to the disease state of pathological gambling, not just the ones that contribute to regular gambling behavior.