1. Michael Campos, Ph.D. UCLA Gambling Studies Program Phone: 310.825.6427 E-mail: mdcampos@mednet.ucla.edu

2. 2010 Census Data (Ennis et al., 2011) 2006 California Problem Gambling Prevalence Survey Data (Volberg et al., 2006) Acculturation

3. Acknowledgements Richard J. Rosenthal, M.D. Office of Problem Gambling (OPG) UCLA Gambling Studies Program (UGSP) Rachel Volberg, Ph.D.

4. Definition of Hispanic 2010 Census: “Hispanic or Latino” refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

5. Diversity of the Hispanic Population Country of origin Racial background Reasons for immigration Length of time in U.S. Acculturation

6. U.S. Demographic Trends 308.7 million people resided in the U.S. in 2010. 50.5 million (16%) were of Hispanic origin. Increase from 35.3 million (13%) in 2000 Represents the majority of growth in the total population. Between 2000 and 2010 the Hispanic population grew by 43% which was 4 times the national growth rate.

7. U.S. Demographic Trends Three quarters of Hispanics reported being of Mexican, Puerto Rican, or Cuban origin. Mexican origin = 63% Puerto Rican = 9% Cuban = 4%

8. U.S. Demographic Trends Population Increases among other Hispanic groups: Salvadoran = 152% Guatemalan = 180% South Americans = 105% Dominicans = 85%

9. California Demographics CA population = 37,253,956 CA Hispanic population = 14,013,719 37.6% of CA residents were Hispanic Majority (81%) were Mexican origin or heritage CA ranks first in population for 4 of 7 Hispanic groups

10. Key Points Hispanics are a large and growing segment of the population. The majority of Hispanics in the US are of Mexican origin or heritage, but trends show increasing diversity within the Hispanic population. In California, Hispanics comprise over 1/3 of the total population, with the large majority being of Mexican origin or heritage.

11. Culture and Mental Health A patient’s cultural background may influence Description of symptoms Meaning imparted to illness Causation and prevalence for some disorders, but not others Coping styles Treatment seeking Stigma A clinician’s cultural background may influence Communication Diagnosis Conceptions of Mental Illness Assumptions about what a clinician is (and is not) supposed to do Source: Mental Health: Culture, Race, and Ethnicity, SAMHSA, 2001

12. Gambling Among U.S. Hispanics Few nationally representative samples Others sampled from Texas, New Mexico, Florida, Minnesota All cross-sectional surveys or interviews General areas of studies: Epidemiology Help Line Usage Co-morbidities

13. Prevalence of Gambling Problems Studies show elevated prevalence rates for problem or pathological gambling among Hispanics relative to Non-Hispanic Caucasians (Stinchfield, 1997; Welte et al., 2001; Westermeyer et al., 2005)

14. Help Seeking for Gambling Problems Source: Caudrado, 1999

15. Key Points Few studies have examined gambling among Hispanics and for the most part they have focused on epidemiology. Most studies show increased prevalence of gambling problems among Hispanics relative to Non-Hispanic Caucasians. Help seeking for gambling problems among Hispanics is lower than that of Non-Hispanic Caucasians.

16. CA Prevalence Survey Data

17. Gambling Problem Grouping Assessed using the NODS (Gerstein et al., 1999). Used the same four groups as in the CA Problem Gambling Prevalence Survey Final Report: Non-Gambler/Non-Problem Gambler At-Risk (1 to 2 NODS items endorsed) Problem (3 to 4 NODS items endorsed) Pathological Gambler (5 or more NODS items endorsed)

18. Prevalence of Gambling Problems ** p < 0.01

19. Prevalence of Gambling Problems by Gender Note: Percentages with different superscripts are significantly different at p < 0.05 or less.

20. Preferred Games for Past Year Gamblers * p < 0.05; ** p < 0.01 ** *

21. Preferred Games for Past Year Male Gamblers ** * * p < 0.05; ** p < 0.01

22. Preferred Games for Past Year Female Gamblers ** * p < 0.05; ** p < 0.01

23. Key Points Problem, but not pathological gambling, is higher among Hispanics relative to Non-Hispanics, particularly among males. Past year gambling is lower among Hispanic females relative to Non- Hispanic females. Counter to expectations, we did not see a preference for action oriented games among Hispanic males.

24. U.S. Acculturation and Gambling Among Hispanics

25. Acculturation The construct arose from the anthropology literature and was originally conceptualized as a group-level process. Psychologists have conceptualized it as an individual- level process. Involves changes in behavior, cognition, values and is influenced by context. Often researched using proxy measures.

26. Acculturation Proxy Measure Used a method described in Cruz et al., 2008. Items: Language used for interview Language spoken at home Nativity Time spent in the U.S. Limitations to this method

27. Prevalence of Gambling Problems by US Acculturation Note: Percentages with different superscripts are significantly different at p < 0.05 or less.

28. Prevalence of Gambling Problems Among Males

29. Prevalence of Gambling Problems Among Females

30. Preferred Games for Past Year Gamblers a bb a b b a b b a b c a a b

31. Preferred Games for Past Year Male Gamblers a a b b b a a,b bb b a a b b

32. Preferred Games for Past Year Female Gamblers b a b a c

33. Key Points When acculturation was taken into account it was the high-acculturated Hispanics were more likely to play action oriented games. Low-acculturated were more likely to play lottery or slot machines. Counter to expectations, the data did not support the preference for action oriented games among low- acculturated, male Hispanic gamblers.

34. Conclusions Studies show elevated prevalence rates for pathological gambling; our data show more problem gambling, particularly among males, but similar prevalence for pathological gambling. Hispanics may be less likely to seek help for gambling problems. Preferred types of games among Hispanics similar to those for all other groups surveyed. Our data did not support the idea that Hispanics play more ‘culture bound’ games.