Problem Gambling Among Asian Pacific Islanders

1
Problem Gambling Among Asian Pacific Islanders

• Timothy W. Fong MD
• Hye-Young Kwon BA, MA
• UCLA Gambling Studies Program
• 20th Annual National Council on Problem Gambling
  Meeting
• St. Paul, MN
• June 24, 2006

2
Overview

• Impact of Gambling on Asian Pacific
• Islanders in Los Angeles
• Focus Groups
• Population Surveys
• Prevalence Surveys
• Cultural Factors
• Treatment Strategies

3
Asians in California

• 4 of the US are APIs
• 14 million
• 12 of California are APIs
• 5 million
• Highest rate of growth
• 1.2 millon Los Angeles County
• (2000 Census)

4
Asians in California

• Largest Asian Groups
• Filipino
• Chinese
• Vietnamese
• Korean
• Asian Indian
• Japanese
• Fastest growing
• Asian Indian, Vietnamese, Hmong

5
Asian Communities

• Monterey Park (64)
• Cerritos (61)
• Rowland Heights (52)
• San Gabriel (51)
• San Marino (50)
• Alhambra (48)

6
Asians and Gambling(Los Angeles)

• 60-70 of casino clientele are APIs
• Casinos market toward APIs
• Significant percentage of casino revenue comes
  from local API residents

7
Background Data

• NICOS (SF)
• 1999 70 identified gambling as number one social
  concern
• 15 problem gamblers
• 21 pathological gamblers

8
Consequences of PG on APIs

• 20 of child neglect cases
• (Santa Clara)
• 30 of API DV cases (SF Chinatown)
• Numerous bankruptcy reports from Monterey Park
• Recent cases of family violence
• (April 2006)

9
Impact of Gambling on Los Angeles Asian
Communities

• To understand the impact of problem gambling on
  APIs.
• To understand cultural influences which will
  inform prevention and treatment
• (Funded by UCLA in LA)

10
Surveys

• Prevalence
• a. Casino setting
• b. Treatment provider setting
• 2. General population
• APIs vs. Non-APIs
• (knowledge/attitudes/beliefs)

11
Surveys
12
General Population Survey

• Tofu and Lotus Festival
• 300 collected
• (Summer and Fall 2005)
• Convenience sample
• Randomly selected
• Reimbursed water

13
General Population Survey

• Compare knowledge, attitudes and beliefs about
  problem gambling between Asians vs. Non-Asians
• Why?
• To provide basis of where to focus prevention,
  education, treatment

14
Results
15
Results
16
Results

• No difference Asians vs. Non-Asians
• PG is a medical illness (54)
• Know someone with gambling problem (45)
• Shame about PG (54)
• PG as an important issue (50)
• Impacts the community (34)
• Feel helpless with PG (70)

17
Conclusions

• Need more education about PG
• Need to increase awareness about treatment and
  services
• De-stigmatization campaign
• Surprisingly, little difference across cultures

18
Prevalence Surveys
19
Prevalence Survey

• 379 surveys collected over 3 days at Commerce
  Casino (March 2006)
• SOGS
• NODS
• UCLA Gambling Survey
• Convenience Sampling
• 5 Starbucks reimbursement

20
Prevalence Survey

• Objectives
• What is the rate of PG among casino patrons?
• What is the rate of PG of APIs vs. Non-APIs?

21
Results
22
Results
23
Results
24
Conclusions

• High rates of PG inside a casino
• How many require treatment?
• No obvious ethnic differences BUT APIs will have
  more PGs
• Replication needed
• Secondary analysis underway (gender, time, health
  status)

25
Community Discussion Groups
26

• The Impact of gambling on Los Angeles Asian
  American communities (focus groups)

27
Organization of the presentation

• Qualitative research
• Why isnt quantitative research (i.e. survey)
  insufficient to capture Asian American experience
  and perspective on gambling?
• Method
• co-ethnic approach
• Asian Americans as homogenous model minorities?
• Diverse experience depending on place of origin,
  socioeconomic and immigration status
• Finding/ emergent themes and ideas and
  representative quotes from the participants

28
Voice from Asian American Communities

• Qualitative research( Discourse analysis)
• Going beyond the standardized survey method to
  unravel a deeper understanding or more essential
  reality
• Narration of gambling phenomenon within
  different Asian American communities

29
Method

• Three different focus groups
• 15Vietnamese, 17Cambodians, 8 Korean participants
  were divided into different focus group sessions
• The focus group lasted for approximately 45
  minutes
• Participants answers were translated and
  transcribed
• The comment themes were coded
• Participants/ Recruitment process
• AADAP and Indochinese youth community center
• Social workers, members from community
  organizations (i.e. church), Asian problem
  gamblers, and friends and families of problem
  gamblers

30
Cultural factors that promote gambling

• Acceptance
• Emphasis on material possessions
• Belief in luck self-worth
• Marketing forces
• Immigration Factors
• Peer behaviors
• Genetic predisposition (refugee, stowaways)

31
Co-ethnic Approach

• Asian Americans as homogenous model minority?
• Historical root of the model minority myth
• Consequences of the model image
• The widespread model minority myth which serves
  as a reflection of successful Asian Americans
  actually becomes an obstacle to addressing the
  critical need of many Asian American population
• how does the myth impact research on the
  community perspective on gambling?

32
Major findings

• Common theme
• knowing problem gamblers
• Recognizing warning signs
• Inability to help or give advice
• Greater denial/not seeking help until they are in
  desperate situations
• Gambling related problem leading to family
  conflict

33
Major findings continue

• Cultural approval of gambling but legalized
  gambling venues in the U.S. proliferates
• Gambling advertisement targeting Asian Americans

34
Differences

• Vietnamese participants
• Language barriers, culture shock, immigration and
  socioeconomic status were the major obstacle for
  overcoming problem gambling
• Cambodian participant
• More gambling opportunities are available within
  the community
• Lower educational level was coded
• Korean participants
• More internet gambling
• Using church as an outreach site

35
Conclusion

• For every one billboard for Pala Casino, we
  need to have something that counters it and say,
  look, these are the effects of it. But I dont
  see it, cause whos gonna pay for it, right?

36
Treatment Issues
37
Existing Treatment for APIs

• Gamblers Anonymous
• (Korean, Chinese)
• NICOS (SF)
• API mental health providers
• API substance abuse providers
• Churches
• Families

38
API treatment issues

• Guilt and shame
• - family secrecy,enabling
• Language barriers
• Acculturation status
• Peer influences
• Immigration status
• Access to care

39
Future Plans

• Clinical toolkit
• Focus on family interventions
• Assess impact of education
• Work with casinos
• Work with other agencies (I.e. DV counselors)
• Improve screening
• Increase treatment workforce capacity
• Asian-specific treatments?

40
Acknowledgements

• Richard Rosenthal
• Sam Joo, Mariko Khan, Sunnyo Pak
• Asian Pacific Islander Problem Gambling Taskforce
• Angelina Chan
• Adrienne Marco
• Alice Davis

41
Contact Information Timothy Fong MD Hye-Young
Kwon 310-825-4845tfong_at_mednet.ucla.eduwww.uclaga
mblingprogram.org