Hispanic Gamblers and the
CPGTSP Outpatient Program
Michael Campos, Ph.D.
UCLA Gambling Studies Program
Phone: 310.825.6427
E-mail: mdcampos@mednet.ucla.edu

 2010 Census Data (Ennis et al., 2011)
 2006 California Problem Gambling Prevalence
Survey Data (Volberg et al., 2006)
 2012 Outpatient CPGTSP Program Demographic and Utilization Data (UGSP 2013)

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.

Diversity of the Hispanic Population
 Country of origin
 Racial background
 Reasons for immigration
 Length of time in U.S.
 Generational Status
 Language Preference
 Acculturation

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.

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%

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

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

Hispanic Population by County

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.

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

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

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)

Help Seeking for Gambling
Problems
Source: Caudrado, 1999

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.

CA Prevalence Survey Data

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)

Prevalence of Gambling
Problems
** p < 0.01

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

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.

Spanish Speaking Gambling
Treatment Providers

Gambling Problem Prevalence by
CA Region




Red = 4.5%
Yellow = 4.3% to 4.5%
Green = 3.7% to 4.3%
Blue = 2.0% to 3.7%

Spanish Speaking CPGTSP
Providers

CPGTSP Outpatient Data

Sample Used
 The sample was limited to
English Speaking, US Born,
Non-Hispanic Caucasians and Hispanics
 62.1% of Hispanics spoke a language other than English at home and 39.8% of
Hispanics were born outside the US
 All data comes from Intake and In Treatment Forms
Non-Hispanic Caucasian Hispanic
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
53.5%
15.3%
Ethnicity

Top Referral Sources
Non-Hispanic
Caucasian
220 (39.1) Helpline (1-800-
GAMBLER)
GA or Gam-Anon
California Council on
Problem Gambling
Family/Friend
Healthcare Professional
Former Client
69 (12.3)
40 (7.1)
48 (8.5)
49 (8.7)
39 (6.9)
Hispanic
102 (63.4)
8 (5.0)
14 (8.7)
7 (4.3)
5 (3.1)
6 (3.7)

Demographics

Key Points
 Relative to Non-Hispanic Caucasians, Hispanics were
 Younger
 More likely to be male
 Less educated
 Trended towards being more likely to be married
 No statistical differences for income or employment.

Age, Gender, Marital Status t-value or X 2 Non-Hispanic
Caucasian
Hispanic p-value
49.5 (13.3)
341 (56.6)
44.5 (13.4)
105 (65.2)
4.17
3.84
0.000
0.050
Mean (SD) Age
N (%) Male
N (%) Marital
Status
Divorced
Separated
Widowed
Cohabitation
Now Married
Single/Never
Married
150 (24.9)
38 (6.3)
28 (4.7)
33 (5.5)
207 (34.4)
146 (24.3)
23 (14.3)
15 (9.3)
7 (4.3)
8 (5.0)
66 (41.0)
42 (26.1)
9.79
0.081

Education
< High School
High School
Some College
Bachelor’s
Degree
Grad/Prof
Degree
Non-Hispanic
Caucasian
48 (8.0)
77 (12.8)
288 (47.8)
127 (21.1)
62 (10.3)
Hispanic
36 (22.4)
39 (24.2)
63 (39.1)
16 (9.9)
7 (4.3)
X 2
44.60
p-value
0.000

Employment
Full Time
Part Time
Unemployed
(SW)
Unemployed
(NSW)
Non-Hispanic
Caucasian
295 (49.0)
87 (14.5)
83 (13.8)
137 (22.8)
Hispanic
96 (59.6)
18 (11.2)
20 (12.4)
27 (16.8)
X 2
6.08
p-value
0.108

Income
< $9,999
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 and Above
Non-Hispanic
Caucasian
50 (8.3)
37 (6.2)
75 (12.5)
74 (12.4)
74 (12.4)
132 (22.0)
56 (9.3)
64 (10.7)
17 (2.8)
20 (3.3)
Hispanic
13 (8.1)
14 (8.7)
15 (9.3)
24 (14.9)
29 (18.0)
36 (22.4)
17 (10.6)
10 (6.2)
1 (0.6)
2 (1.2)
X 2
2.41
p-value
0.121

Gambling Behavior

Gambling Activities
Non-Hispanic White Hispanic
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
Poker Black
Jack*
Video
Poker**
Craps Slots Roulette Other

Gambling Locations
 Most frequently cited location for gambling was at a casino.
 Relative to Non-Hispanic Caucasians, Hispanics
 Were more likely to gamble at a casino
 Equally likely to report gambling at other locations (e.g., track, OTB, Friend’s/Family Home, Internet, etc.)

Gambling Problem Severity

Key Points
 Relative to Non-Hispanic Caucasians, Hispanics
 Trended towards slightly higher NODS scores



Experienced problems sooner after starting to gamble
Entered treatment sooner after experiencing a problem
Trended towards being more likely to owe money to family or friends
 Multivariate analysis indicated that ethnicity was not associated with problem severity, rather, current age, age of first gambling experience, time to first problem after initiating gambling, and having an Axis I disorder were.

Duration and NODS scores
Mean (SD)
Age First
Gambled
Years to First
Problems
Years to
Treatment
Mean NODS score
Non-Hispanic
Caucasian
25.8 (12.3)
17.3 (13.8)
12.9 (13.5)
8.08 (1.8)
Hispanic
27.1 (12.2)
13.6 (12.2)
9.5 (11.6)
8.38 (1.7) t-value
-1.13
3.01
3.11
-1.87
p-value
0.257
0.003
0.002
0.062

Legal Problems Due to Gambling
Non-Hispanic Caucasian Hispanic
12
10
8
6
4
2
0
7.3
11.8
% with Legal Problems

Gambling Debt
Hispanic Non-Hispanic
Caucasian
9.29 (1.9) Mean (SD)
Log of Total
Debt
Any Casino
Debt
Any Credit
Card Debt
Any
Family/Friend
Debt
Any Other
Debt
62 (10.3)
186 (30.9)
156 (25.9)
112 (18.6)
9.02 (1.5)
15 (9.3)
56 (34.8)
54 (33.5)
39 (24.2) t-value or X 2
1.46
0.13
0.89
3.70
2.53
p-value
0.104
0.713
0.347
0.054
0.112

Substance Use
Non-Hispanic Caucasian Hispanic
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
Smoking* Alcohol*
Non-Hispanic Caucasian Hispanic
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%

Psychiatric Comorbidity
Mood
Anxiety
ADHD
Psychotic
Personality
Any Axis I
Disorder
Non-Hispanic
Caucasian
181 (33.5)
105 (19.4)
20 (3.7)
18 (3.3)
6 (1.1)
233 (43.0)
Hispanic
30 (18.6)
19 (11.8)
1 (0.6)
1 (0.6)
2 (1.2)
41 (25.5)
X 2
12.97
4.94
4.05
3.45
0.02
16.03
p-value
0.000
0.026
0.044
0.063
0.889
0.000

Significant Predictors of Problem
Severity
Variable
Age
Age First
Gambled
Time to First
Problem
Any Axis I
Disorder
Beta
0.21
-0.36
-0.12
0.131
F
[16, 540]
= 16.75, p < 0.000; R 2 = 0.16
t-value
3.10
-4.79
-2.11
3.08
p-value
0.000
0.000
0.036
0.002

Treatment

Key Points
 Relative to Non-Hispanic Caucasians, Hispanics
 Are more often entering treatment for the first time
 Waited about the same time to enter treatment
 Spent a bit more time in treatment, but had slightly fewer sessions
 Multivariate analysis suggested that ethnicity was not related to number of visits, rather, age and intake
NODS scores were.

Prior Treatment Experience
Non-Hispanic Caucasian Hispanic
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
None One Prior Therapist 2 or More Prior
Therapists
Chi-Square = 12.21, p < 0.01

Wait for Treatment
Non-Hispanic Caucasian Hispanic
12
10
8
6
4
2
0
11.1
8.7
Days from First Contact to Intake

Time in Treatment and Number of
Sessions
Non-Hispanic Caucasian Hispanic Non-Hispanic Caucasian Hispanic
90
80
40
30
20
10
0
70
60
50
72.9
84.2*
Days from Intake to Discharge
6
5
4
3
2
1
0
5.5*
5.1
Total Number of Visits

Predictors of Number of Visits
Age
Variable
Intake NODS
Score
Beta
0.14
0.11
F
[16, 668]
= 9.12, p < 0.013; R 2 = 0.045
t-value
2.54
2.60
p-value
0.011
0.010