Gambling and Problem Gambling among Older Minnesota Adults Randy Stinchfield, Ph.D. Department of Psychiatry University of Minnesota Medical School

Acknowledgements This report was written with funds from the State of Minnesota to the Northstar Problem Gambling Alliance, Roseville, Minnesota. This report is part of the mission of Northstar Problem Gambling Alliance to provide current information about gambling and problem gambling in the State of Minnesota Minnesota older adult gambling participation data was provided by the Minnesota State Lottery Thank you to Cathie Perrault, executive director, and the board of directors of the Northstar Problem Gambling Alliance for their helpful reviews

Casino in the middle of the day

Why are older adults at the casino? They have the time They have disposable income to spend on entertainment They enjoy gambling and the excitement; gambling is fun They are offered free transportation, inexpensive meals, free tokens It is a break from their routine; they may be bored They enjoy the social interaction and they may be lonely They have raised their family and their children may have moved away and they may be lonely They may have lost their spouse and friends and are lonely Other reasons?

Commercial Gambling in Minnesota More than 3,000 lottery retail outlets More than 3,000 charitable gambling sites 18 tribal casinos Two racetracks with card rooms Advertising on television, radio, newspaper, billboards, and at sporting events

Research Questions How many older Minnesota adults gamble and how many gamble often? What forms of gambling do older Minnesota adults play and which do they play often? Is gambling among older Minnesota adults on the rise? How does gambling among older Minnesotans compare to younger adult Minnesotans? Why do older Minnesotans gamble? What are the risks/costs and benefits of gambling for older Minnesota adults? How many older Minnesota adults are considered problem gamblers, that is, how big of an issue is problem gambling among older Minnesota adults?

To answer the first four Questions: MN State Lottery annual survey The first methodological issue is defining who is old Don Feeney and Todd Maki have used generations in their reports People in each generation have a shared experience that influences their attitudes and behavior, including gambling attitudes and behavior There are three older adult generations: “Greatest Generation” or “GI Generation” born between 1901 and 1924 and are over 90 years old in 2015 “Builders Generation” or “Silent Generation” born between 1925 and 1945 and are ages 70 to 90 in 2015 “Baby Boomers” born between 1946 and 1964 and are ages 51 to 69 in 2015

MN State Lottery Samples from 2014 to 2005 Year Younger N (%) Boomers Builders Greatest/GI 2014 990 (56.7) 528 (30.2) 213 (12.2) 15 (0.9) 2013 1,031 (52.9) 633 (32.5) 269 (13.8) 14 (0.7) 2012 937 (51.0) 619 (33.7) 265 (14.4) 18 (1.0) 2011 924 (49.4) 647 (34.6) 273 (14.6) 27 (1.5) 2010 1,031 (52.1) 611 (30.9) 306 (15.4) 32 (1.6) 2009 948 (48.6) 656 (33.6) 311 (16.0) 34 (1.8) 2008 874 (46.8) 654 (35.0) 302 (16.2) 37 (2.0) 2007 902 (46.4) 663 (34.1) 321 (16.5) 57 (2.9) 2006 843 (44.2) 673 (35.3) 329 (17.2) 63 (3.3) 2005 827 (43.9) 651 (34.6) 349 (18.5) 56 (2.8)

MN State Lottery Samples from 2004 to 1997 Year Younger N (%) Boomers Builders Greatest/GI 2004 790 (40.6) 722 (37.1) 345 (17.7) 88 (4.5) 2003 769 (40.2) 699 (36.6) 355 (18.5) 90 (4.7) 2002 751 (38.1) 721 (36.6) 384 (19.5) 113 (5.8) 2001 719 (36.5) 744 (37.7) 375 (19.0) 134 (6.8) 2000 Not Available 1999 637 (27.5) 899 (38.8) 572 (24.7) 210 (9.1) 1998 612 (26.0) 941 (40.1) 593 (25.2) 204 (8.7) 1997 556 (23.8) 1,016 (43.5) 566 (24.2) 200 (8.5)

MN State Lottery Survey Gambling Items During the last 12 months, how often have you done these activities? bet on a horse race? played a slot machine? bet on a sports event? played bingo for money? purchased a raffle ticket from a charity or non-profit organization? played dice for money? played card games for money? played card games at the card club at a Minnesota race track? played card games for money at a casino? played cards for money on the Internet? played cards for money in a tournament at a bar or restaurant? played cards for money somewhere else, like at home with friends? visited any kind of casino for gambling or any other reason?

MN State Lottery Survey Gambling Items continued played a slot machine or video game at a casino in Minnesota or surrounding states? played blackjack at a casino in Minnesota or surrounding states? played poker at a casino in Minnesota or surrounding states? played pulltabs? played bingo for money? played card games for money? purchased a Minnesota lottery ticket?

MN State Lottery Gambling Frequency Items Lottery (2005 to 2014) Casino (2005 to 2014) Pull tabs (2005 to 2011) Response options: (1) not in past year (2) once a year or more (3) once a month or more (4) once a week or more (5) daily

How many older adults gamble How many older adults gamble? (any game) Is gambling among older adults on the rise? (any game) How do older adults compare to younger adults?

How many forms of gambling do older adults play How many forms of gambling do older adults play? How do older adults compare to younger adults?

What games do older adults play What games do older adults play? How do older adults compare to younger adults?

How many older adults gamble often. What games do they play often How many older adults gamble often? What games do they play often? How do older adults compare to younger adults?

Is older adult frequent gambling on the rise Is older adult frequent gambling on the rise? (lottery) How do older adults compare to younger adults?

Is older adult frequent gambling on the rise Is older adult frequent gambling on the rise? (casino) How do older adults compare to younger adults?

Is older adult frequent gambling on the rise Is older adult frequent gambling on the rise? (pull tabs) How do older adults compare to younger adults?

What games do older adults play often What games do older adults play often? (Baby Boomers) Is older adult gambling on the rise? (Baby Boomers)

What games do older adults play often What games do older adults play often? (Builder/Greatest) Is older adult gambling on the rise? (Builder/Greatest)

Research Questions Revisited with Answers How many older Minnesota adults gamble and how many gamble often? Answer: In 2014, 77% of Boomers and 60% of Builders/Greatest/GI had gambled in the past year; 11.4% of Boomers and 9.4% of Builders/Greatest/GI had gambled once a week or more on the Lottery What forms of gambling do older Minnesota adults play and which do they play often? Answer: Older adults play all forms of gambling and lottery and casino are the most popular and the lottery is played most often Is gambling among older Minnesota adults on the rise? Answer: No, gambling by older adults is not on the rise and appears to be relatively stable

Research Questions Revisited with Answers How does gambling among older Minnesotans compare to younger adult Minnesotans? Answer: Older adults participate in fewer forms of gambling than younger adults; Baby Boomers (77%) and Younger (75%) adults had similar proportions who have gambled in the past year in 2014, whereas Builders/Greatest/GI had a lower rate (60%) who gambled in the past year; more older adults engage in weekly or more frequent lottery, casino, and pull tab gambling than younger adults Why do older Minnesotans gamble? Answer: They have the time; disposable income to spend on entertainment; they enjoy gambling and the excitement; gambling is fun; they like the free transportation, inexpensive meals, free tokens; gambling is a break from their routine; they may be bored; they enjoy the social interaction and they may be lonely; they have raised their family and they may have moved away and are lonely; they may have lost their spouse and friends and are lonely

Questions about Older Minnesota Adult Gambling What are the risks/costs and benefits of gambling for older Minnesota adults? How many older Minnesota adults are considered problem gamblers, that is, how big of an issue is problem gambling among older Minnesota adults?

Gambling Risks/Costs for Older Adults Financial Risks, particularly for older adults who may be on a fixed income and who, at their advanced age, would not be able to earn back money lost gambling Spending more money than intended and/or spending money gambling that is earmarked for other purposes Spending excessive amounts of time to the detriment of social relations Risk of becoming addicted to gambling Other risks/costs?

Gambling Benefits for Older Adults Social interaction Low-cost nutritious meals at casinos Gambling is a way to pass the time for older adults Break from their routine and a change of scenery from their senior living residence Intellection stimulation; some forms of gambling involve mental computations of odds; some forms of gambling involve memory and the use of systems that require cognitive activity, all of which keep the mind functioning and stimulated; use it or lose it Hope and Havir (2002) studied MN older adults and found social benefits of trips to the casino, including socializing with friends, eating meals with friends, curiosity was stimulated, and a fun way to pass the time

How many older Minnesota adults are problem gamblers? Laundergan et al did a survey of MN adults in 1990 and 0.9% of adults scored five or more on the SOGS Laundergan et al did a second survey in 1994 and 1.2% of adults scored five or more on the SOGS Laundergan compared older adults (55+) to younger adults (18-24) and found that older adults had a lower rate of “increasing consequences/probable pathological gambling” as indicated by a score of three or more on the SOGS than young adults: 14.3% for older adults vs. 20% for 18-24 year olds They also found that age was negatively correlated with level of problem gambling, that is, older adults were less likely to experience/report gambling problems

How many older Minnesota adults are problem gamblers? Since we do not have studies of older Minnesota adult rates of problem gambling we must look to other studies National Gambling Impact and Behavior Study (1999) reported that adults aged 65 and older had the lowest rate of problem and pathological gambling, less than 1% In a systematic review of older adult gambling, Tse, et al (2012) found a range of 0.3% to 2.7% in community samples, to 3.8% in senior centers, and 11% for older adults sampled at gambling venues In another systematic review, Subramaniam et al (2015), found a range in population-based prevalence rates of current PG from 0% (Welte et al 2001) to 1.2% (Wiebe & Cox, 2005) Much of the range in estimates is due to different methodologies, namely sampling, definition of older adult, and diagnostic tools

How many older Minnesota adults are problem gamblers? Another source of data to answer this question is gambling treatment studies. There have been two gambling treatment outcome studies in Minnesota. The first one was from 1992 to 1995 and recruited 1,249 adults from six state-supported treatment programs The second was from 2006 to 2007 and recruited 444 adults from eleven state-supported treatment providers These studies cannot be considered to be comprehensive numbers of MN older adults in gambling treatment because there are other treatment resources besides the state-supported providers

How many older Minnesota adults are problem gamblers How many older Minnesota adults are problem gamblers? Older adults in MN State-supported gambling treatment 1992-1995; 2006-2007 Year Younger N (%) Boomers Builders Greatest/GI Minnesota Gambling Treatment Study, 1992-1995 1992 (n=175) 28 (16%) 102 (58%) 44 (25%) 1 (1%) 1993 (n=270) 43 (16%) 176 (65%) 50 (18%) 1 (0.4%) 1994 (n=427) 83 (19%) 272 (64%) 71 (17%) 1 (0.2%) 1995 (n=377) 82 (22%) 236 (63%) 57 (15%) 2 (0.5%) Minnesota Gambling Treatment Study, 2006-2007 2006 (n=274) 124 (45%) 132 (48%) 18 (7%) 2007 (n=170) 64 (38%) 97 (57%) 9 (5%)

How many older Minnesota adults are problem gamblers How many older Minnesota adults are problem gamblers? Older adults in MN State-supported gambling treatment 1992-1995; 2006-2007

Research Questions Revisited with Answers What are the risks/costs and benefits of gambling for older Minnesota adults? Answer: Financial Risks, particularly for older adults who may be on a fixed income and who, at their advanced age, would not be able to earn back money lost gambling; spending more money than intended and/or spending money gambling that is earmarked for other purposes; spending excessive amounts of time to the detriment of social relations; becoming addicted to gambling; Benefits include: Social interaction; low-cost nutritious meals at casinos; gambling is a way to pass the time for older adults; a break from their routine and a change of scenery from their senior living residence; intellection stimulation How many older Minnesota adults are considered problem gamblers, that is, how big of an issue is problem gambling among older Minnesota adults? Answer: Less than 1%, however, older MN adults make up a larger proportion of people in treatment for Gambling Disorder.

Future Research Directions How much time and money do older adults spend on gambling? Do existing diagnostic instruments work for older adults? Do current gambling treatment models work for older adults? What variables serve as risk and protective factors for older adults that could have implications for public awareness and prevention? Conduct regular surveys of gambling and problem gambling rates among older adults and include assessment of time and money spent gambling

Concerns Identified in this Study First, there is a small segment of the older adult population that are frequent gamblers and these rates are higher than younger adults Second, given that most older adults are on fixed incomes, consider safeguards and policies to protect older adults from potential financial risks of gambling, particularly older adults who may be experiencing cognitive decline and poor decision making

Recommendations Teach older adults that if they choose to gamble, they need to follow guidelines about time and money in order to avoid negative consequences of gambling Teach older adults about the warning signs of problem gambling Develop and evaluate older adult gambling awareness and prevention programs

Final Thoughts For most older adults, gambling is a harmless pastime, however, the risk exists that gambling may develop into problem gambling, and therefore, they require information about the inherent risks of gambling The goal is that within the context of easy access to gambling, we will provide resources to older adults to assist them in making healthy and informed decisions about their gambling

For more information Contact Randy Stinchfield, Ph.D.: stinc001@umn.edu References: Emerson, M. O., and Laundergan, J. C. (1996). Gambling and problem gambling among adult Minnesotans: Changes 1990 to 1994. Journal of Gambling Studies, 12(3), 291-304. Emerson, M. O., Laundergan, J. C., and Schaefer, J. M. (1994). Adult survey of Minnesota problem gambling behavior: A needs assessment: Changes 1990 to 1994. Duluth, MN: Center for Addiction Studies, University of Minnesota, Duluth. Feeney, D., & Maki, T. (1997). Age, generational membership and their effect on gambling behavior and attitudes. Roseville, MN: Minnesota State Lottery. Laundergan, J. C., Schaeffer, J. M., Eckhoff, K. F., and Pirie, P. L. (1990). Adult survey of Minnesota gambling behavior: A benchmark 1990. Duluth, MN: Center for Addiction Studies, University of Minnesota, Duluth. Minnesota State Lottery (1994). Gambling behavior and attitudes. Roseville, MN: Minnesota State Lottery.

How do older adults compare to younger adults? (lottery)

How do older adults compare to younger adults? (casino)