Nearly half a million Californians reported symptoms of problem gambling

Data from the newest California Health Interview Survey show associations between gambling and a risk of poor health outcomes as well as mental health problems.

About 1 in 4 California adults (7.2 million) said they gambled in the past year. Of those, about 488,000 (6.7%) reported they had symptoms of problem gambling, which is often marked by an uncontrollable urge to gamble, negative effects on a person’s finances, deteriorating relationships, and/or mental health problems.

The California Health Interview Survey (CHIS) — the nation’s largest state-based health survey — added questions about gambling in 2023 to examine the issue through a public health lens.

“The widespread reach of CHIS allowed us to examine the associations between gambling and health outcomes,” said Ninez A. Ponce, PhD, MPP, director of the UCLA Center for Health Policy Research and lead investigator of the California Health Interview Survey, or CHIS. “The data can help policymakers, advocates, and the public better understand gambling as more than an economic and financial issue.”

In California, legal forms of gambling include tribal casinos, card rooms, lotteries, betting on horse racing, and charitable gaming. State propositions to legalize online and sports betting failed in 2022 and 2024. Since 2018, 38 states, plus the District of Columbia and Puerto Rico, have legalized at least one form of sports betting.

While most people who gamble do not experience any health or financial problems, the increasing opportunities for gambling has made studying its effects so important, Ponce said.

The CHIS data showed that adults who reported gambling in the past year were more likely to report behaviors associated with increased risk of poor health outcomes, such as:

• 2% were current smokers, compared with 4.4% of adults who did not report gambling.
• 4% were current e-cigarette users, compared with 4.5% who did not report gambling.
• 4% reported binge drinking in the past month, compared with 15.7% who did not report gambling.
• 4% used substances like methamphetamine, heroin, or non–physician directed prescription drugs, compared with 1.2% who did not report gambling.

The data also provided insights into how the consequences of gambling ripple outward. Among California adults who had gambled in the past 12 months, 1.6% (112,000) reported that they needed help with living expenses from friends, family members, or public assistance programs because of gambling. And 3.8% (274,000) reported that they had kept their friends or family from knowing how much they gambled.

Further study of the data demonstrated a possible need for public health interventions, Ponce said. A quarter of adults with any symptoms of problem gambling reported experiencing serious psychological distress in the past year, compared to 13.5% of gambling adults without symptoms of problem gambling.

“Our survey data show these problems are going untreated,” said Ponce, who holds the Fred W. and Pamela K. Wasserman Chair in Health Policy and Management at the UCLA Fielding School of Public Health. “Only 28.2% of adults who gambled in the past year and showed any symptoms of problem gambling said that they saw a health care provider to discuss their mental health or alcohol or drug use in the past year.”  

Who is more likely to gamble?

While gamblers could be found among all demographic groups, more men, older adults, American Indians and Alaska Natives reported gambling.

• Men were more likely than women to have gambled in the past year (28.1% vs. 21.7%).
• Older adults were also more likely than young adults to have done so: 29.1% of adults ages 50– 64 and 24.8% of those 65 and older reported gambling in the past year, compared with 17.6% of young adults ages 18–24.
• Measuring who gambled in the past year by racial or ethnic groups, 40.4% of American Indian and Alaska Native adults gambled, 34% of Black or African American adults, 32.2% of multi-racial adults, 25.1% of Latinx adults, 24.8% of white adults, and 19.9% of Asian adults. For the overall population, 24.8% of adults gambled in the past year.
• Veterans were more likely than non-veterans to report gambling in the past year (32.0% vs. 24.4%).