Linn County needs a plan to deal with the public health costs of gambling

Note: This is an updated version of a column published in 2013.

So, we’re voting once again to establish a casino in Linn County.

My aim in this article is neither to support nor oppose a casino. My aim is to draw your attention to the facts on public health concerns and how to address them if we do get a casino.

This is an important community issue that warrants careful analysis and attention. Everyone in our community — from government organizations to private businesses to nonprofit organizations — has a role to play: To be prepared, to have a plan.

Gambling is one of the fastest-growing industries in this country. Most states have legalized it. One in three Americans visited a casino in 2009.

Iowa Racing and Gaming Commission records show that in Fiscal Year 2021 admissions to casino riverboats/gambling structures totaled nearly16.4 million. Iowa casino adjusted gross revenue totaled more than $1.5 billion in Fiscal Year 2021, when net sports wagering receipts also hit $90 million.

Some of the reasons given for wanting a casino in Cedar Rapids are to identify new sources of revenue without increasing taxes, a new avenue for entertainment and several hundred new jobs. We welcome the potential benefits.

However, gambling is more than an economic issue. It is also a public health issue.

Addictive gambling is considered a psychiatric disorder. According to the National Council on Problem Gambling, about 2 million American adults are pathological gamblers. Another 4 million to 8 million others have less serious but still significant gambling problems.

Most compulsive gamblers are men, according to a study by Harvard University, but it is increasing among women. The rate of compulsive gambling is higher among blacks than whites, and people living within a 50-mile radius of a casino are twice as likely to become compulsive gamblers.

Folks at the bottom of socioeconomic ladder are most vulnerable. Further, the gambling population has high rates of depression, mania, alcohol and drug abuse and some personality disorders. About 22 percent of gamblers report panic attacks, 72 percent report an episode of major depression and 52 percent say they abuse alcohol.

The Iowa Department of Public Health recently reported that 22 percent of adult Iowans said they had been negatively affected by a gambler (family, friend or someone they knew).

With these statistics in mind, we have an opportunity to develop a thoughtful, robust plan before any final state approval of a casino in Cedar Rapids. We need to build a coalition and develop partnerships with our stakeholders (investors, elected officials, customers, etc.). Our health and health care partners in the community need to be aware of the impact of gambling, outline the public health impact (smoking, addictive behaviors, human ecology, etc.), and develop an action-oriented agenda for prevention and treatment.

Our main job here at Linn County Public Health is to improve the public's health, so we are always eager to be a partner in these discussions and to advise a coalition tasked with studying and preparing our community for a potential casino.

The decision to allow casino gambling in Linn County is certainly a community issue. Now we must use the opportunity to help shape and guide our public health and social policies as they relate to gambling while we have the time to do so.

Pramod Dwivedi is health director, Linn County Public Health. Comments: pramod.dwivedi@linncounty.org