Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
BMC Public Health. 2012 May 25;12:377. doi: 10.1186/1471-2458-12-377.
Recent government reports have identified gambling, along with alcohol abuse, drug abuse and pornography, as contributing to child neglect and abuse in Indigenous communities in the Northern Territory (NT). These reports also identify gaps in empirical evidence upon which to base sound policy. To address this shortfall, data from ten remote Indigenous communities was analysed to determine the relationship between gambling problems, housing conditions, community contexts and child health in indigenous communities.
Logistic regression was used to assess associations between gambling problems, community contexts, housing conditions and child health. Separate multivariable models were developed for carer reported gambling problems in houses and six child health outcomes.
Carer reported gambling problems in households across the ten communities ranged from 10% to 74%. Inland tropical communities had the highest level of reported gambling problems. Less access to a doctor in the community showed evidence of a multivariable adjusted association with gambling problems in houses. No housing variables showed evidence for a multivariable association with reported gambling problems. There was evidence for gambling problems having a multivariable adjusted association with carer report of scabies and ear infection in children.
The analyses provide evidence that gambling is a significant problem in Indigenous communities and that gambling problems in households is related to poor child health outcomes. A comprehensive (prevention, treatment, regulation and education) public health approach to harm minimisation associated with gambling amongst the Indigenous population is required that builds on current normative community regulation of gambling.
最近的政府报告指出，赌博与酗酒、吸毒和色情制品一样，是导致北领地（NT）原住民社区儿童忽视和虐待的原因之一。这些报告还指出，缺乏实证证据来支持合理的政策。为了解决这一不足，对来自十个偏远原住民社区的数据进行了分析，以确定赌博问题、住房条件、社区环境与原住民社区儿童健康之间的关系。
使用逻辑回归来评估赌博问题、社区环境、住房条件和儿童健康之间的关联。针对家庭照顾者报告的赌博问题和六个儿童健康结果，分别开发了多变量模型。
十个社区中家庭照顾者报告的赌博问题比例从 10%到 74%不等。内陆热带社区报告的赌博问题比例最高。社区中较少的医生可及性显示出与家庭赌博问题存在多变量调整关联的证据。没有住房变量显示出与报告的赌博问题存在多变量关联的证据。赌博问题与照顾者报告的儿童疥疮和耳部感染存在多变量调整关联的证据。
分析结果表明，赌博是原住民社区的一个严重问题，家庭中的赌博问题与儿童健康结果不佳有关。需要采取一种全面的（预防、治疗、监管和教育）公共卫生方法来减少与原住民人口相关的赌博危害，该方法建立在当前对赌博的规范性社区监管之上。
