A Mixed Methods Analysis of Gambling Harm for Women in New ...
A Mixed methods Analysis of gambling harm for women in New ZealandFinal Report31 July 2019Prepared for Ministry of Health by:Katie Palmer du Preez, Laura Mauchline, Anna-Marie Paavonen, Rebecca Thurlow, Nick Garrett, Maria E. Bellringer, Jason Landon and Max Abbott.Auckland University of Technology (AUT)Gambling and Addictions Research Centre (GARC).AknowledgementsThe authors thank Professor Rebecca Cassidy and Associate Professor Nicki Dowling who peer reviewed this report and provided useful, critical feedback. DisclaimerThis report was prepared under contract (Number 359417-01) to the New Zealand Ministry of Health. The copyright in this article is owned by the Crown and administered by the Ministry. The views of the authors do not necessarily represent the views or policy of the New Zealand Ministry of Health. The Ministry makes no warranty, express or implied, nor assumes any liability or responsibility for use of, or reliance on, the contents of this report.Suggested citationPalmer du Preez, K., Mauchline, L., Paavonen, A., Thurlow, R., Garrett, N., Bellringer, M.E., Landon, J., & Abbott, M. (2019). A mixed methods analysis of gambling harm for women in New Zealand. Auckland: Auckland University of Technology, Gambling and Addictions Research Centre.ABSTRACTThe World Health Organization (WHO) supports multiple layers of gender analysis in health research and policy, accounting for personal and community-level impacts of gender, and investigation of the interactions between sex and gender and their dual impact on health. Gender informed analyses have rarely been conducted in gambling studies, where insufficient attention has been given to gender as an analytical category and/or theoretical construct. Gambling studies have looked at the impacts of gambling on women, however little research has explored gambling harm in New Zealand as a gendered, multifaceted phenomenon involving the interplay of environmental, social and individual level factors. Mixed methods studies are useful for studying dynamic and complex inter-relationships, and understanding multi-layered issues, yet are used relatively rarely in gambling research. Accordingly, gaps in our current understanding of how women are affected by gambling, as both gamblers and as affected others, are likely to constrain harm prevention reduction efforts. Two overarching research questions were posed: How do gender related issues, notions and practices influence women’s gambling related harm in New Zealand? What are the implications for women’s gambling harm reduction?A mixed methods approach was selected to enable a multifaceted exploration of the context, issues and factors influencing women’s gambling related harm in New Zealand, and suggest pathways for harm reduction. Three different methods of data analysis were employed across four datasets, to produce a polyvalent understanding. The three methods were: discourse analysis, thematic analysis and factor analysis with multivariate modelling. The research design comprised four components: poststructural analysis of literature positioning women in relation to gambling practices and harm, analysis of women’s experiences of gambling harm in New Zealand, gender analysis of population data related to gambling behaviour and gambling problems in New Zealand and finally, synthesis of findings in relation to harm prevention and reduction.This research demonstrated that women’s gambling and harm in New Zealand are multi-faceted phenomena. Gambling studies have shaped and arguably constrained responses to preventing and minimising women’s gambling harm: tending to focus attention narrowly on individual women’s psychological wellbeing. Gender issues and ideology infuse gambling practices and experiences of harm. Women’s socio-cultural positioning as primary caregivers for families contributes to gambling harm by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing, and access rest, relaxation and support. Gambling venues in local communities appear to offer women respite, distraction, comfort, time-out and/or connection – while placing them at heightened risk of experiencing problems and harm. Promising avenues for addressing gambling harm for women in New Zealand include reducing EGM gambling opportunities in community settings, promoting gender equality and women’s community connectedness in gambling harm prevention and reduction activities, and explicit and ongoing commitment to gender-aware gambling harm reduction research, policy and practice.CONTENTS TOC \o "1-3" \h \z \u EXECUTIVE SUMMARY PAGEREF _Toc15478248 \h 1BACKGROUND PAGEREF _Toc15478249 \h 9METHODOLOGY PAGEREF _Toc15478250 \h 10WOMEN IN GAMBLING STUDIES: A POSTSTRUCTURAL ANALYSIS PAGEREF _Toc15478251 \h 13Poststructural feminism PAGEREF _Toc15478252 \h 13Critical gambling studies PAGEREF _Toc15478253 \h 15Key research questions PAGEREF _Toc15478254 \h 16Data selection, collection and analysis PAGEREF _Toc15478255 \h 16Results PAGEREF _Toc15478256 \h 18Women as ‘needy enablers’ PAGEREF _Toc15478257 \h 19Women as ‘intervention allies’ PAGEREF _Toc15478258 \h 22Women under strain PAGEREF _Toc15478259 \h 24Women gamblers are ‘risky gamblers’ PAGEREF _Toc15478260 \h 27‘Vulnerable women gamblers’ PAGEREF _Toc15478261 \h 30Women’s gambling and harm as a socio-cultural phenomenon PAGEREF _Toc15478262 \h 32Discussion PAGEREF _Toc15478263 \h 35Gambling studies lacking gender sensitivity may contribute to harm PAGEREF _Toc15478264 \h 36Psychological understandings of women harmed by gambling constrain intervention practice PAGEREF _Toc15478265 \h 37Rethinking gambling studies and intervention to reduce women’s gambling harm. PAGEREF _Toc15478266 \h 39Conclusion PAGEREF _Toc15478267 \h 40GENDER ANALYSIS OF EXPERIENCES OF GAMBLING HARM PAGEREF _Toc15478268 \h 41Gambling harm affects men and women relatively equally PAGEREF _Toc15478269 \h 41A gender perspective on the social determinants of gambling harm PAGEREF _Toc15478270 \h 42Methodology and methods PAGEREF _Toc15478271 \h 43Gambling Harms dataset PAGEREF _Toc15478272 \h 44Pacific Impacts dataset PAGEREF _Toc15478273 \h 45Key research questions PAGEREF _Toc15478274 \h 45Data analysis PAGEREF _Toc15478275 \h 45Results PAGEREF _Toc15478276 \h 47Women’s responsibility for domestic and emotional labour PAGEREF _Toc15478277 \h 48‘Negligent mothers’: When children are harmed by gambling PAGEREF _Toc15478278 \h 53“Balls of steel”: Masculinities and gambling practices PAGEREF _Toc15478279 \h 57Gambling and violence against women PAGEREF _Toc15478280 \h 59Discussion PAGEREF _Toc15478281 \h 62Addressing issues of gender, power and privilege played out in families and communities PAGEREF _Toc15478282 \h 62Improving support and recreational opportunities available for women in their communities PAGEREF _Toc15478283 \h 64Conclusion PAGEREF _Toc15478284 \h 65GENDER ANALYSIS OF NEW ZEALAND POPULATION DATA PAGEREF _Toc15478285 \h 66Introduction PAGEREF _Toc15478286 \h 66Methods PAGEREF _Toc15478287 \h 68Recruitment and sampling PAGEREF _Toc15478288 \h 68Measures PAGEREF _Toc15478289 \h 68Analyses PAGEREF _Toc15478290 \h 72Results PAGEREF _Toc15478291 \h 75Descriptive statistics PAGEREF _Toc15478292 \h 75Gender analysis of gambling and leisure engagement categories PAGEREF _Toc15478293 \h 83Modelling of factors predicting at-risk gambling by gender PAGEREF _Toc15478294 \h 89Discussion PAGEREF _Toc15478295 \h 92Gambling engagement in New Zealand appears gendered, particularly for men PAGEREF _Toc15478296 \h 92Heightened risk for women, especially in non-casino EGM contexts PAGEREF _Toc15478297 \h 94Gambling on card games or poker in private settings may be as risky for women as for men PAGEREF _Toc15478298 \h 95Conclusion PAGEREF _Toc15478299 \h 96ADDRESSING GAMBLING HARM FOR WOMEN IN NEW ZEALAND PAGEREF _Toc15478300 \h 97Reducing EGM gambling opportunities in community settings PAGEREF _Toc15478301 \h 97Promoting gender equality for women’s gambling harm prevention and reduction PAGEREF _Toc15478302 \h 100Gender-aware gambling harm reduction research, policy and practice PAGEREF _Toc15478303 \h 103Limitations PAGEREF _Toc15478304 \h 107Conclusion PAGEREF _Toc15478305 \h 107REFERENCES PAGEREF _Toc15478306 \h 109List of tables TOC \h \z \c "Table" Table 1: Overview of participants and perspectives included in the combined qualitative dataset PAGEREF _Toc15478307 \h 46Table 2: Social demographics by gender PAGEREF _Toc15478308 \h 75Table 3: Socioeconomic status by gender PAGEREF _Toc15478309 \h 76Table 4: Life events, quality of life, mental health, and tobacco and drug use by gender PAGEREF _Toc15478310 \h 77Table 5: Total participation in gambling activities in the past 12 months by gender PAGEREF _Toc15478311 \h 78Table 6: Total at least monthly participation in gambling activities by gender. PAGEREF _Toc15478312 \h 79Table 7: Typical monthly expenditure on different gambling activities by gender PAGEREF _Toc15478313 \h 81Table 8: Problem Gambling Severity Index (PGSI) scores by gender PAGEREF _Toc15478314 \h 82Table 9: Participation in leisure activities by gender PAGEREF _Toc15478315 \h 82Table 10: Results of factor analysis of gambling activities PAGEREF _Toc15478316 \h 85Table 11: Factor analysis of leisure activities PAGEREF _Toc15478317 \h 87Table 12: Logistic regression for associations with gender vs. gambling participation categories PAGEREF _Toc15478318 \h 88Table 13: Composite scores by gender for the participation categories. PAGEREF _Toc15478319 \h 89Table 14: Examination of at-risk gambling behaviour by gender PAGEREF _Toc15478320 \h 90Table 15: Examination of at-risk gambling behaviour for women PAGEREF _Toc15478321 \h 91Table 16: Examination of at-risk gambling behaviour for males PAGEREF _Toc15478322 \h 92List of figures TOC \h \z \c "Figure" Figure 1: NGS survey instrument measures for gambling participation reproduced from Abbott et al (2017). PAGEREF _Toc15478323 \h 69Figure 2: NGS survey instrument measures for leisure participation reproduced from Abbott et al (2017) PAGEREF _Toc15478324 \h 70Figure 3: NGS survey instrument measures for tobacco use, reproduced from Abbott et al (2017). PAGEREF _Toc15478325 \h 71Figure 4: NGS survey instrument measures for other drug use, reproduced from Abbott et al (2017). PAGEREF _Toc15478326 \h 72Figure 5. Health promotion imagery reproduced from HPA website (HPA, 2018) PAGEREF _Toc15478327 \h 102EXECUTIVE SUMMARYBackgroundThere are gaps in our current understanding of how women are affected by gambling as both gamblers across the spectrum (low-risk to problem gambler), and as affected others. This has important implications for harm minimisation and treatment efforts. In-depth examination of how New Zealand women are affected by gambling, has the potential to suggest how harm prevention, minimisation and treatment efforts might be improved or better tailored to address issues for women. In 2018, the Ministry of Health contracted the Auckland University of Technology (AUT) Gambling and Addictions Research Centre (GARC) to explore the context, experiences and factors influencing gambling harm for women in New Zealand, and to identify opportunities for harm prevention and reduction.MethodologyA mixed methods approach was selected to enable a multifaceted exploration of the context, issues and factors influencing women’s gambling related harm in New Zealand, and suggest pathways for harm reduction. In this study, three different methods of data analysis were employed across four datasets, to produce a polyvalent understanding of some of the issues surrounding women and gambling harm in New Zealand. The three methods were: discourse analysis, thematic analysis and factor analysis with multivariate modelling. The overarching research questions were: How do gender related issues, notions and practices influence women’s gambling related harm in New Zealand? What are the implications for women’s gambling harm reduction? Understanding of gender: The term ‘gender’ usually refers to cultural, social, and historical understandings and interpretations of the biological concept of sex. In this study, gender was understood as constituted through sociocultural processes which shape men and women and what can be regarded as ‘feminine’ or ‘masculine’ attributes, practices, spaces and/or implied values (Becker et al., 2016). Gender was acknowledged as having material effects in people’s lives. As Holdsworth et al (2012, p. 209) state, “gender is more than a source of personal and social identity; it is a key determinant in the social stratification system and for the distribution of resources within society”.The research design comprised the following components and supplementary research questions:Poststructural analysis of literature positioning women in relation to gambling practices and harm. Research questions: What are the subject positions and discourses in play in relation to women and gambling harm in gambling studies literature? What are the implications for women’s experiences of gambling harm? What are the possibilities and constraints for women’s gambling harm reduction?Analysis of women’s experiences of gambling harm in New Zealand. Research questions:What gender or gender-related issues, notions or practices were discussed in relation to gambling harm? What are the implications of gender-related issues, notions or practices for women’s experiences of gambling harm? How/when is the gendered nature of gambling harm different for Māori and Pacific women?Gender analysis of population data related to gambling behaviour and gambling problems in New Zealand. Research questions:To what extent and how is gambling participation in New Zealand gendered? What are the relationships between gendered gambling participation and age, ethnicity and gambling problems? How do factors associated with problematic gambling interact with gender?Synthesis of findings in relation to harm prevention and reduction.Women in gambling studies: A poststructural analysisThis first component of this study involved poststructural analysis of literature positioning women in relation to gambling harm. This analysis drew on poststructural feminism ADDIN EN.CITE <EndNote><Cite><Author>Allen</Author><Year>2008</Year><RecNum>238</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Allen, 2008)</DisplayText><record><rec-number>238</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543969789">238</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Allen, Amy</author></authors></contributors><titles><title>The politics of our selves: Power, autonomy, and gender in contemporary critical theory</title></titles><dates><year>2008</year></dates><pub-location>New York</pub-location><publisher>Columbia University Press</publisher><isbn>0231136234</isbn><urls></urls></record></Cite></EndNote>(e.g. Allen, 2008), and was also informed by critical gambling studies. From this perspective, a range of gambling studies literature was treated as texts - providing us with a view of how women can be positioned in relation to gambling harm, and with what effects and implications for harm reduction. Three subject positions were identified in relation to women affected others: women as ‘needy enablers’, women as ‘gamblers’ caregivers’ and women ‘under strain’. A further three subject positions were identified in relation to women gamblers: women as ‘risky gamblers’, ‘vulnerable women gamblers’, and women’s gambling as a ‘socio-cultural phenomenon’.Gambling studies have associated problem gambling with menAcross gambling studies, there has been a lack of sensitivity to the particular issues women face, which form the cultural backdrop to their experiences of gambling and gambling harm (McCarthy et al., 2019). Gambling studies have associated problem gambling with men (Volberg, 2003), and continue to identify male gender as a ‘risk factor’ for gambling problems (Abbott, 2017a). Women affected others (predominantly as partners and mothers) have been positioned as adjunct to the psychological treatment and support needs of gambling men. More recently, women have been seen as under strain caused by the gambling of others (Kourgiantakis, Saint-Jacques, & Tremblay, 2013), and in need of psychological support in their own right. Since the 1990s, women who gamble have been constructed through population data gathering techniques, mapping the characteristics of problem gamblers and those affected, and the sociodemographic patterns of risk and vulnerability that crosscut the population. A far smaller body of research has constructed women who gamble as subject to social and cultural determinants of gambling and gambling harm, including: women’s experiences of poverty, violence and socially prescribed responsibility for domestic and emotional labour in families. Gambling studies lacking gender sensitivity may contribute to gambling harmGambling studies lacking gender sensitivity may contribute to gambling harm by presenting gambling as inconsistent with ‘proper domestic family life’, and participating in policing the boundaries of ‘acceptable femininities’ which further entrench women’s responsibility for others’ wellbeing. Gender disaggregated data, while necessary to identify disparities, are insufficient for understanding the underlying issues without coherent analysis of gender as a social determinant of health and wellbeing.Psychological understandings of women harmed by gambling may constrain intervention Dominant psychological understandings of health and wellbeing emphasised the personal facets of health that were located within women themselves: e.g. coping skills and emotion regulation, confidence and self-efficacy, knowledge and understanding of gambling issues. These psychological discourses tended to make women’s gambling behaviours, responses to gambling behaviours, thoughts and emotions problematic, framing them as issues to be dealt with or managed. This obscured considerations of broader societal issues, gendered demands and expectations, poverty, victimisation and violence, leaving these issues comparatively unchallenged in relation to women’s gambling practices and harm.Elucidating and intervening in the social determinants of gambling consumption and harmIt is argued that research and intervention with the aim of reducing gambling related harm for women necessitates discussion of the broader conditions under which women live. Psychological perspectives on women’s gambling harm and intervention should be explicitly balanced with a greater level of understanding and intervention across broader socio-cultural domains. Positioning gambling harm as a socio-cultural phenomenon, will create space for researchers and practitioners to recognise and reflect on how knowledge and practice systems may often have unanticipated effects (e.g. supporting gender narratives that disadvantage women). Opportunities for orienting gambling services towards the social determinants of women’s gambling harm may be found in critical psychology, and/or approaches which emphasise collaborative collective action, community development and client-led practice. Gender analysis of experiences of harmThis component involved secondary analysis of two large existing qualitative datasets documenting New Zealanders’ experiences of gambling and harm (Gambling Harms Study, and Pacific Impacts Study). These studies involved a mix of interviews and focus groups conducted with 165 New Zealanders (gamblers, affected others, community and gambling specific services, academics and policy makers). Secondary thematic analysis of these datasets was conducted to identify some of the gendered aspects of gambling harm and implications for New Zealand women who gamble and/or are affected by others’ gambling. Women’s socially prescribed responsibilities for familial and child wellbeing Women’s socially prescribed responsibilities for familial and child wellbeing, were factors that shaped some New Zealand women’s gambling practices (particularly EGM gambling in community settings), and experiences of gambling harm (through shame and the adoption of personal responsibility). These findings support the argument that women’s socio-cultural positioning as primary caregivers contributes to gambling harm: by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing and access support (J?rvinen-Tassopoulos, 2016; Morrison & Wilson, 2015; Schull, 2002). Of particular concern was the finding that women’s gambling in New Zealand community settings may be normalised, or seen as a less harmful way of coping with familial distress, than alcohol or smoking. A particular gendered cultural meaning of community based EGM gambling may be in operation – one that recalls the historical positioning of certain prescription drugs and forms of alcohol as “Mother’s little helper” (Chandler et al., 2014). This social meaning and practice should be explored further in targeted research, and health promotion/harm reduction work.Addressing issues of gender, power and privilege played out in families and communitiesFamily and community interventions should recognise that ‘the family’ can be a problematic space for women in regards to health and wellbeing, and explicitly address issues of gender inequality, power and privilege played out in families and communities. Challenging patriarchal family structures and practices, in ways that are effective, culturally nuanced and appropriate, remains an ongoing challenge.Improving support and recreational opportunities available for women in their communitiesCommunity gambling venues (pubs and clubs) clearly provided some women with easily accessible, convenient and safe spaces, in the context of an often palpable lack of social support in their lives. Providing women with accessible alternative spaces to relax, be alone and/or to connect with others in their communities, remains an appropriate response to women’s gambling harm. Gambling support services should position themselves to identify, meet and advocate for the needs of women in this area specifically. Gender analysis of New Zealand population dataThe third component of this study comprised new gender analyses of existing nationally representative New Zealand National Gambling Study (NGS) data on New Zealanders’ gambling and leisure activity participation, problem gambling, as well as a wide range of measures of health and well-being. New analyses were conducted of baseline data (N=6,251) collected in 2012 (Wave 1) via face-to-face household recruitment and computer-assisted personal interviews (CAPI) with adults aged 18+ years.Construction of gambling and leisure behaviour categories Gambling and leisure behaviour engagement categories were constructed by reducing a multitude of engagement variables (e.g. game or activity type, frequency, expenditure) using exploratory factor analysis. Eleven underlying categories for gambling engagement were identified including: horse/dog race betting, cards not in a casino, non-casino EGMs, casino, betting with friends/sports betting, Lotto shop, housie/bingo, online lotto, overseas casino, Instant Kiwi, and New Zealand raffles. Six underlying leisure engagement categories included: Online leisure, home/recreation, going out, music/religion, TV/shopping, and pubs or gambling. Modelling of factors for at risk gambling by genderA multiple variable logistic regression was undertaken to examine the impact of gambling and leisure behaviour categorisation on at-risk gambling by gender. The final step of modelling, starting with confounding factors, examined the impact of the gambling and leisure behaviour categories, including interactions with gender. When New Zealand women gambled, they gambled to a similar extent to men In the current study, when New Zealand women gambled, they gambled to a similar extent (composite scores for frequency and level of expenditure) to men. Men were shown to have a higher gambling magnitude than women in three categories only: Casino gambling (table and EGM), Horse/dog race betting, and Betting with Friends/Sports Betting. These findings are in line with some international trends, e.g. in the UK. It is possible that women gambled a greater proportion of their available resources than men. This could render gender differences in gambling engagement negligible in relation to potential impacts on wellbeing, or even point to greater proportional investment of time and money in gambling by women. Future research should explore gendered gambling engagement (time and money spent) in relation to leisure time and disposable income available to men and women. Heightened risk for women, particularly in community-based gambling contextsWhile New Zealand women and men engaged in non-casino EGM gambling to a similar extent, the gambling risk associated with this practice was heightened for women – over and above the effects of many other factors usually related to gambling risk (e.g. age, ethnicity, socio-economic deprivation and psychological distress and other coexisting issues). The present study suggested that it may be somewhat ‘riskier’ for women to gamble on many gambling forms, than it is for men – with implications for health promotion for women as a population group. Gambling risk for women was associated with six gambling engagement categories in order of risk magnitude: non-casino EGMs, cards not in a casino, housie/bingo, casino gambling, horse/dog race betting and Instant Kiwi. Risky gambling for men was associated with only four gambling categories: cards not in a casino, non-casino EGMs, casino gambling and buying lottery tickets from a shop. This finding supports the exploration of the contextual factors for risky gambling for women across each of the different gambling forms, and the development of gender-aware public health strategies and interventions. Addressing gambling harm for women in New ZealandThe current study considered women’s gambling harm as a multi-faceted phenomenon highlighting the benefits and opportunities of data triangulation and mixed methods design seldom carried out in gambling studies ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(Cassidy, 2018; Cassidy, Pisac, & Loussouarn, 2013)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite><Cite><Author>Cassidy</Author><Year>2013</Year><RecNum>345</RecNum><record><rec-number>345</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563924196">345</key></foreign-keys><ref-type name="Edited Book">28</ref-type><contributors><authors><author>Cassidy, Rebecca</author><author>Pisac, Andrea</author><author>Loussouarn, Claire</author></authors></contributors><titles><title>Qualitative research in gambling: Exploring the production and consumption of risk</title></titles><dates><year>2013</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><isbn>1134445857</isbn><urls></urls></record></Cite></EndNote>(Cassidy, 2018; Cassidy, Pisac, & Loussouarn, 2013). This study highlights some key tensions between positioning women’s gambling harm as an individual issue (to be ‘treated’), and a public health approach which necessitates attending to the social contexts and environments in which gambling and harm for women is produced and experienced. Analysis of opportunities to address gambling harm for women in New Zealand identified the following as promising avenues for women’s gambling harm reduction. Reducing EGM gambling opportunities in community settingsThis study suggests that in the context of broader societal constructions of gender and gender roles, community-based EGMs constitute a serious health-risk for women (and men). Community EGM venue operators have a legal responsibility to look after their gambling patrons, akin to the care and consideration required when serving alcohol ADDIN EN.CITE <EndNote><Cite><Author>DIA</Author><Year>2014</Year><RecNum>307</RecNum><DisplayText>(DIA, 2014)</DisplayText><record><rec-number>307</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561595297">307</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Mystery shopper information summary: Class 4 venues</title></titles><dates><year>2014</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(DIA, 2014), however monitoring conducted by the regulator shows that host responsibility practices are inconsistently and inadequately carried out in these venues ADDIN EN.CITE <EndNote><Cite><Author>DIA</Author><Year>2014</Year><RecNum>307</RecNum><DisplayText>(DIA, 2014, 2017b)</DisplayText><record><rec-number>307</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561595297">307</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Mystery shopper information summary: Class 4 venues</title></titles><dates><year>2014</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite><Cite><Author>DIA</Author><Year>2017</Year><RecNum>306</RecNum><record><rec-number>306</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561591270">306</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Sector report: Gaming machine mystery shopper exercise results</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(DIA, 2014, 2017b). Bold policy action is called for to prevent gambling harm that is clearly associated with the availability of particular products in particular settings, in the absence of appropriate host responsibility ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2019</Year><RecNum>293</RecNum><DisplayText>(Wardle, Reith, Langham, & Rogers, 2019)</DisplayText><record><rec-number>293</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560223569">293</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wardle, Heather</author><author>Reith, Gerda</author><author>Langham, Erika</author><author>Rogers, Robert D</author></authors></contributors><titles><title>Gambling and public health: we need policy action to prevent harm</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>l1807</pages><volume>365</volume><dates><year>2019</year></dates><isbn>0959-8138</isbn><urls></urls></record></Cite></EndNote>(Wardle, Reith, Langham, & Rogers, 2019). This study supports research suggesting that the removal of EGMs from all community venues is likely to have a positive effect on gambling harm for women and other groups, in combination with facilitating gender equality and community connectedness ADDIN EN.CITE <EndNote><Cite><Author>Pearce</Author><Year>2008</Year><RecNum>312</RecNum><DisplayText>(Nuske, Holdsworth, & Breen, 2016; Pearce, Mason, Hiscock, & Day, 2008)</DisplayText><record><rec-number>312</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561672680">312</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pearce, Jamie</author><author>Mason, K</author><author>Hiscock, Rosemary</author><author>Day, Peter</author></authors></contributors><titles><title>A national study of neighbourhood access to gambling opportunities and individual gambling behaviour</title><secondary-title>Journal of Epidemiology & Community Health</secondary-title></titles><periodical><full-title>Journal of Epidemiology & Community Health</full-title></periodical><pages>862-868</pages><volume>62</volume><number>10</number><dates><year>2008</year></dates><isbn>0143-005X</isbn><urls></urls></record></Cite><Cite><Author>Nuske</Author><Year>2016</Year><RecNum>213</RecNum><record><rec-number>213</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540777668">213</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nuske, Elaine Mary</author><author>Holdsworth, Louise</author><author>Breen, Helen</author></authors></contributors><titles><title>Significant life events and social connectedness in Australian women's gambling experiences</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>7-26</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(Nuske, Holdsworth, & Breen, 2016; Pearce, Mason, Hiscock, & Day, 2008).Promoting gender equality for women’s gambling harm prevention and reductionA public health approach necessitates attending to the understandings and views that influence patterns of consumption and harm. This research has suggested that gender inequalities in the home and broader society are involved in shaping gambling practises, producing and exacerbating harm. There is little evidence of supporting gender equality in women’s gambling harm prevention and reduction practice at present. Some current health promotion messaging and imagery targeting women encourages them to ‘put time into family/whānau not pokies’ ADDIN EN.CITE <EndNote><Cite><Author>HPA</Author><Year>2018</Year><RecNum>305</RecNum><DisplayText>(HPA, 2018)</DisplayText><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560823140">305</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>HPA,</author></authors></contributors><titles><title>What does HPA do?</title></titles><volume>2019</volume><number>18 June</number><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Health Promotion Agency</publisher><urls><related-urls><url>;(HPA, 2018). This messaging is concerning in the context of the findings of this study, where gendered responsibility for family (and child) wellbeing, were found to be contextual factors for women’s problematic gambling and harm. The current study supports finding new and creative ways to support gender equality in New Zealand families, and question women’s socially prescribed responsibility for family wellbeing. Supported opportunities for women and whānau to influence policy and practice should be created and funded. Partnerships with New Zealand women’s health and gender equality organisations, in combination with gender-sensitive research, may support and increase the quality of health promotion initiatives to reduce gambling harm for women.Gender-aware gambling harm reduction research, policy and practiceThis study has also offered glimpses and suggestions of what gambling harm reduction research, policy and practice could look like – if women and gender issues were carefully considered in research, policy and intervention design and practice.Gambling studies should work consciously to balance a historical focus on the ‘individual woman in therapy’, with research elucidating the social determinants of women’s gambling harm. Multiple avenues are suggested by this study, including: The gendered cultural meanings of community based EGM gambling e.g. ethnographic in-venue studies of social interactions, behaviours, and perceptions that occur within community gambling venues.Environmental and industry factors contributing to gambling harm for women e.g. critical analysis of gambling venue marketing strategies and their impact on behaviour, analysis of available recreational opportunities particularly in community contexts.Exploration of the contextual factors for gambling and harm for women across each of the different gambling forms e.g. Multi-faceted exploration of gambling on card games or poker in private settings.High quality actionable research produced together with those who are experiencing or working to address gambling harm is rare in the gambling studies field. Transformative, action and critical research traditions therefore hold great promise for reducing harm for women in New Zealand. Mixed methods research, and/or approaches that incorporate nuance and complexity are less likely to contribute to unintended consequences, e.g. reinforce gender stereotypes or individualise gambling harm in ways that run counter to public health harm prevention and reduction work.Suggestions for gender-aware policy supported by this study include making participation in gambling harm prevention and reduction research a condition of the licensing of all entities providing gambling opportunities in New Zealand. This would support the naturalistic and real-world research that is necessary to explore the conditions in which women’s gambling harm is produced and efforts to prevent and reduce harm are undertaken – particularly in community EGM settings. The findings of this research support recently announced Ministry initiatives including the establishment of a gambling consumer network and peer support, along with a focus on co-design and including the voices of people with lived experiences of gambling harm in the development, delivery and evaluation of services and programmes (Ministry of Health, 2019). In addition, policy makers and funders should insist that gender equality is a priority in all service provision and evaluation. To avoid stereotypical labelling and victim blaming, women’s experiences of gambling harm should be centralised. Gender analysis and meaningful involvement of people with lived experiences of gambling harm should therefore be made a prerequisite for all Ministry funded research.This study supports gambling harm prevention and reduction practice explicitly maintaining a focus on gender equality. These kinds of individual-social interventions have been developed in the women’s health field. Ussher and colleagues (2002) designed a material-discursive-intrapsychic model of a women’s health issue. A women-centred intervention based on this model included critical discussion of the social expectations placed upon women, in particular that of caring for others before caring for self, and the implications of multiple and often conflicting roles. Women were supported to explore and collectively advocate for alternative framings and support systems that might lead to better outcomes for them in their lives. Reconsideration of the New Zealand Health Promotion Agency approach to women’s gambling harm prevention and reduction should be conducted involving in-depth engagement with women’s experiences of harm and consultation with key stakeholders. The current study suggests the following avenues hold promise in orienting the practices of gambling support towards the needs of women in New Zealand:Co-design of community-based service environments and practices with women, women’s groups and women’s health organisations (including Māori and Pacific women’s groups).Holistic support services drawing on multiple existing models for improved Māori and Pacific health. This will reduce the need for women to identify themselves and/or families as ‘problem gambling’ or ‘not coping’ to access information and support, countering the impact of shame and a sense of ‘failure to care’. Gender equality as a core consideration of service environments, design and delivery, e.g. through the availability of childcare facilities and supportive communal spaces, and by working with women and their communities to identify barriers and promote shared caring responsibilities in families and broader society. ConclusionWomen’s gambling harm in New Zealand is a multi-faceted phenomenon. Gambling studies have shaped and arguably constrained responses to preventing and minimising women’s gambling harm: tending to focus attention narrowly on individual women’s psychological wellbeing. Gender issues and ideology infuse and shape both gambling practices and harm. Women’s socio-cultural positioning as primary caregivers for families contributes to gambling harm by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing, and access rest, relaxation and support. Gambling venues in local communities appear to offer women respite, distraction, comfort, time-out and/or connection – while placing them at risk of experiencing problems and harm. Promising avenues for addressing gambling harm for women in New Zealand include reducing EGM gambling opportunities in community settings, promoting gender equality and women’s community connectedness in gambling harm prevention and reduction activities, and commitment to gender-aware gambling harm reduction research, policy and practice.BACKGROUNDStudies of gender and gambling issues have traditionally focussed on demographics, gambling behaviour and gambling motivations. Current knowledge of women’s gambling is largely derived from population surveys. Reviews of this research have consistently identified an overrepresentation of young males (18–30 years) amongst problem gamblers, and also people who belong to ethnic minority groups, are experiencing unemployment, low income, low education, reliance on social welfare, or are either divorced or single PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Kb2hhbnNzb248L0F1dGhvcj48WWVhcj4yMDA5PC9ZZWFy
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ADDIN EN.CITE.DATA (Abbott, 2017a; Johansson, Grant, Kim, Odlaug, & G?testam, 2009; Williams, West, & Simpson, 2012). Research specifically examining female gambling behaviours, motivations and impacts remains relatively rare (e.g., Bunkle, 2009; Corney & Davis, 2010, Holdsworth, Hing, & Breen, 2012; Nixon, Evans, Kalischuk, Solowoniuk, McCallum & Hagen, 2013). Other research has described gender differences in clinical samples of problem gamblers (e.g., Crisp et al., 2000; 2004; Potenza, Steinberg, McLaughlin, Wu, Rounsaville, & O’Malley, 2001). The need to better understand problem gambling risk and protective factors has long been recognised (Shaffer, LaBrie, LaPlante, Nelson & Stanton, 2004) and has often been the focus of the research on women’s gambling harm (e.g., Corney & Davis, 2010; Nixon et al., 2013; Trevorrow & Moore, 1998), however it remains that it is a small and limited evidence base. This is particularly true with respect to women’s gambling in New Zealand.Gender differences have been explored around gambling behaviour and motivation. It is held that men tend to gamble for the excitement, while women gamble mostly to escape (Lesieur, & Blume, 1991), and that women tend to favour more private chance-based gambling (e.g., Svensson & Romild, 2014). This combination of more private escape-oriented gambling on gambling forms with minimal face-to-face contact may confer additional risk on women because it is out of sight of family members and friends, and on those forms of gambling which tend to be ‘continuous’ permitting rapid re-engagement across a short period (see e.g., Dickerson, 1993; Griffiths, 1999). Researchers have suggested women are more likely to gamble for/because of escape, avoidance, boredom, loneliness, social isolation, and depression (e.g., Crisp et al, 2000; 2004; Lesieur & Blume, 1993). However, the research is not equivocal (e.g., Trevorrow & Moore, 1998), often drawn from clinical samples (Crisp et al., 2000; 2004), and thus sometimes neglects to consider that people’s motivations for gambling are different in different contexts/times (Clarke, Tse, Abbott, Townsend, Kingi, & Manaia, 2006). There are significant gaps in our current understanding of how women are affected by gambling as both gamblers across the spectrum (low-risk to problem gambler), and as affected others PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IaW5nPC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA (Hing & Breen, 2001; Holdsworth, Hing, & Breen, 2012; Holdsworth, Nuske, & Breen, 2013; Holdsworth, Nuske, Tiyce, & Hing, 2013). This has important implications for harm minimisation and treatment efforts. Existing research has tended to either ignore women, or analyse their practices and preferences without reference to gender dynamics ADDIN EN.CITE <EndNote><Cite><Author>Romild</Author><Year>2016</Year><RecNum>43</RecNum><DisplayText>(Romild, Svensson, & Volberg, 2016; Volberg, 2003)</DisplayText><record><rec-number>43</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386899">43</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Romild, Ulla</author><author>Svensson, Jessika</author><author>Volberg, Rachel</author></authors></contributors><titles><title>A gender perspective on gambling clusters in Sweden using longitudinal data</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>43-60</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite><Cite><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Romild, Svensson, & Volberg, 2016; Volberg, 2003). Gender informed analyses have rarely been conducted, and gambling studies have given insufficient attention to gender as an analytical category and/or theoretical construct PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib2xkc3dvcnRoPC9BdXRob3I+PFllYXI+MjAxMjwvWWVh
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ADDIN EN.CITE.DATA (Holdsworth et al., 2012; Kairouz, Monson, & Robillard, 2017; Merkouris et al., 2016). Important gender differences may have been missed and/or unhelpful gender stereotypes reinforced ADDIN EN.CITE <EndNote><Cite><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><DisplayText>(Romild et al., 2016; Volberg, 2003)</DisplayText><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite><Cite><Author>Romild</Author><Year>2016</Year><RecNum>43</RecNum><record><rec-number>43</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386899">43</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Romild, Ulla</author><author>Svensson, Jessika</author><author>Volberg, Rachel</author></authors></contributors><titles><title>A gender perspective on gambling clusters in Sweden using longitudinal data</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>43-60</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(Romild et al., 2016; Volberg, 2003). Several journals have published special issues in recent years, exploring the scientific, methodological, and ethical rationales for analysing both sex and gender in health research PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Db3VydGVuYXk8L0F1dGhvcj48WWVhcj4yMDAwPC9ZZWFy
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ADDIN EN.CITE.DATA (e.g. Courtenay, 2000; Johnson, Greaves, & Repta, 2009; Lawrence & Rieder, 2007). Sex has an enormous impact on human health. For example research has demonstrated that male and female bodies have innate physiological and hormonal differences that result in different responses to alcohol, drugs, and treatment ADDIN EN.CITE <EndNote><Cite><Author>Ettorre</Author><Year>2004</Year><RecNum>354</RecNum><DisplayText>(Ettorre, 2004)</DisplayText><record><rec-number>354</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1564520431">354</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ettorre, Elizabeth</author></authors></contributors><titles><title>Revisioning women and drug use: gender sensitivity, embodiment and reducing harm</title><secondary-title>International Journal of Drug Policy</secondary-title></titles><periodical><full-title>International Journal of Drug Policy</full-title></periodical><pages>327-335</pages><volume>15</volume><number>5-6</number><dates><year>2004</year></dates><isbn>0955-3959</isbn><urls></urls></record></Cite></EndNote>(Ettorre, 2004). Unfortunately, gender is often conflated or confused with sex, constraining discussion to biological categories of influences on health and wellbeing. Gender is a multidimensional social construct that is culturally based, historically specific, and constantly changing. The concept of gender refers to the socially prescribed and experienced dimensions of "femaleness" or "maleness" in a society. The relationships between gender, health and wellbeing are always linked to social and political contexts. For example, gender has been connected to social and economic status, particularly in systems and spaces where maleness is preferred over femaleness ADDIN EN.CITE <EndNote><Cite><Author>Johnson</Author><Year>2009</Year><RecNum>83</RecNum><DisplayText>(Johnson et al., 2009)</DisplayText><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525137660">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Johnson, Joy L</author><author>Greaves, Lorraine</author><author>Repta, Robin</author></authors></contributors><titles><title>Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research</title><secondary-title>International Journal for Equity in Health</secondary-title></titles><periodical><full-title>International Journal for Equity in Health</full-title></periodical><pages>14</pages><volume>8</volume><number>1</number><dates><year>2009</year></dates><isbn>1475-9276</isbn><urls></urls></record></Cite></EndNote>(Johnson et al., 2009). Techniques for identifying and addressing the effects of gender on health are therefore crucial. Accordingly, the World Health Organization (WHO) provides a review of various gender tools, policies and guidelines designed to help measure the impact of gender on human health around the world ADDIN EN.CITE <EndNote><Cite><Author>World Health Organisation</Author><Year>2003</Year><RecNum>350</RecNum><DisplayText>(World Health Organisation, 2003)</DisplayText><record><rec-number>350</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1564088675">350</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>World Health Organisation,</author></authors></contributors><titles><title>Gender analysis in health: A review of selected tools</title></titles><dates><year>2003</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite></EndNote>(World Health Organisation, 2003). The WHO supports multiple layers of gender analysis in health research and policy, accounting for personal and community-level impacts of gender, and investigation of the interactions between sex and gender and their dual impact on health.Gambling studies have looked at the impacts of gambling on women, however little research has explored gambling harm in New Zealand as a gendered, multifaceted phenomenon involving the interplay of environmental, social and individual level factors. There is therefore a need to bring a socio-political lens to understanding women’s gambling experiences, practices, motivations and impacts ADDIN EN.CITE <EndNote><Cite><Author>Holdsworth</Author><Year>2012</Year><RecNum>4</RecNum><DisplayText>(Holdsworth et al., 2012; McCarthy, Thomas, Bellringer, & Cassidy, 2019)</DisplayText><record><rec-number>4</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1488855594">4</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holdsworth, Louise</author><author>Hing, Nerilee</author><author>Breen, Helen</author></authors></contributors><titles><title>Exploring women's problem gambling: A review of the literature</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>199-213</pages><volume>12</volume><number>2</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>McCarthy</Author><Year>2019</Year><RecNum>265</RecNum><record><rec-number>265</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081760">265</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCarthy, Simone</author><author>Thomas, Samantha L</author><author>Bellringer, Maria E</author><author>Cassidy, Rebecca</author></authors></contributors><titles><title>Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice</title><secondary-title>Harm reduction journal</secondary-title></titles><periodical><full-title>Harm reduction journal</full-title></periodical><pages>18</pages><volume>16</volume><number>1</number><dates><year>2019</year></dates><isbn>1477-7517</isbn><urls></urls></record></Cite></EndNote>(Holdsworth et al., 2012; McCarthy, Thomas, Bellringer, & Cassidy, 2019). In-depth examination of how New Zealand women are affected by gambling, has the potential to suggest how harm prevention, minimisation and treatment efforts might be improved or better tailored to address issues for women. In 2018, the Ministry of Health contracted the Auckland University of Technology (AUT) Gambling and Addictions Research Centre (GARC) to explore the context, experiences and factors influencing gambling harm for women in New Zealand, and to identify opportunities for harm reduction. The overarching research questions were: How do gender related issues, notions and practices influence women’s gambling related harm in New Zealand? What are the implications for women’s gambling harm reduction?METHODOLOGYA mixed methods approach was selected to enable a multifaceted exploration of the context, issues and factors influencing women’s gambling related harm in New Zealand, and suggest pathways for harm reduction. The project drew on the work of Greene ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Greene</Author><Year>2007</Year><RecNum>11</RecNum><DisplayText>(2007)</DisplayText><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816832">11</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Greene, Jennifer C</author></authors></contributors><titles><title>Mixed methods in social inquiry</title></titles><dates><year>2007</year></dates><pub-location>San Francisco, CA</pub-location><publisher>John Wiley & Sons</publisher><isbn>0787983829</isbn><urls></urls></record></Cite></EndNote>(2007), and the notion of complementarity. Complementarity is brought into play when different methods are used to explore different features of the same phenomenon ADDIN EN.CITE <EndNote><Cite><Author>Greene</Author><Year>1989</Year><RecNum>12</RecNum><DisplayText>(Greene, Caracelli, & Graham, 1989)</DisplayText><record><rec-number>12</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816977">12</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Greene, Jennifer C</author><author>Caracelli, Valerie J</author><author>Graham, Wendy F</author></authors></contributors><titles><title>Toward a conceptual framework for mixed-method evaluation designs</title><secondary-title>Educational evaluation and policy analysis</secondary-title></titles><periodical><full-title>Educational evaluation and policy analysis</full-title></periodical><pages>255-274</pages><volume>11</volume><number>3</number><dates><year>1989</year></dates><isbn>0162-3737</isbn><urls></urls></record></Cite></EndNote>(Greene, Caracelli, & Graham, 1989). Mixed methods studies with a complementarity purpose are useful for studying dynamic and complex inter-relationships, and understanding multi-layered issues. Despite their potential, they are used relatively rarely in gambling research ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(Cassidy, 2018; Cassidy et al., 2013)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite><Cite><Author>Cassidy</Author><Year>2013</Year><RecNum>345</RecNum><record><rec-number>345</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563924196">345</key></foreign-keys><ref-type name="Edited Book">28</ref-type><contributors><authors><author>Cassidy, Rebecca</author><author>Pisac, Andrea</author><author>Loussouarn, Claire</author></authors></contributors><titles><title>Qualitative research in gambling: Exploring the production and consumption of risk</title></titles><dates><year>2013</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><isbn>1134445857</isbn><urls></urls></record></Cite></EndNote>(Cassidy, 2018; Cassidy et al., 2013). A component design was adopted, where methods remained discrete and independent throughout the study, and the findings were interpreted together in the final phase ADDIN EN.CITE <EndNote><Cite><Author>Greene</Author><Year>2007</Year><RecNum>11</RecNum><DisplayText>(Greene, 2007)</DisplayText><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816832">11</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Greene, Jennifer C</author></authors></contributors><titles><title>Mixed methods in social inquiry</title></titles><dates><year>2007</year></dates><pub-location>San Francisco, CA</pub-location><publisher>John Wiley & Sons</publisher><isbn>0787983829</isbn><urls></urls></record></Cite></EndNote>(Greene, 2007). The main purpose of the component design was to highlight a range of different facets of women’s gambling harm. The mixed methods approach comprised three analytical components and a discussion of the combined implications of the findings for women’s gambling harm reduction. Each analytical component was designed to select, pose questions of, and interpret data relating to women’s gambling harm at three different levels: The broader socio-political context for women’s gambling practices and harm, women’s experiences of gambling harm, and the gendered nature of gambling behaviour and factors associated with experiencing problems. This approach made use of some existing data sets produced by GARC and co-owned by the Ministry of Health. Secondary analyses of existing qualitative and quantitative data are recognised as a valid, efficient and cost effective way to begin to explore under-researched health issues ADDIN EN.CITE <EndNote><Cite><Author>Hinds</Author><Year>1997</Year><RecNum>57</RecNum><DisplayText>(Hinds, Vogel, & Clarke-Steffen, 1997; Jacobson, Hamilton, & Galloway, 1993)</DisplayText><record><rec-number>57</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541100">57</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hinds, Pamela S</author><author>Vogel, Ralph J</author><author>Clarke-Steffen, Laura</author></authors></contributors><titles><title>The possibilities and pitfalls of doing a secondary analysis of a qualitative data set</title><secondary-title>Qualitative health research</secondary-title></titles><periodical><full-title>Qualitative health research</full-title></periodical><pages>408-424</pages><volume>7</volume><number>3</number><dates><year>1997</year></dates><isbn>1049-7323</isbn><urls></urls></record></Cite><Cite><Author>Jacobson</Author><Year>1993</Year><RecNum>58</RecNum><record><rec-number>58</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541234">58</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Jacobson, Ann F</author><author>Hamilton, Patti</author><author>Galloway, James</author></authors></contributors><titles><title>Obtaining and evaluating data sets for secondary analysis in nursing research</title><secondary-title>Western journal of nursing research</secondary-title></titles><periodical><full-title>Western journal of nursing research</full-title></periodical><pages>483-494</pages><volume>15</volume><number>4</number><dates><year>1993</year></dates><isbn>0193-9459</isbn><urls></urls></record></Cite></EndNote>(Hinds, Vogel, & Clarke-Steffen, 1997; Jacobson, Hamilton, & Galloway, 1993).In this study, three different methods of data analysis were employed across four datasets, to produce a polyvalent understanding of some of the issues surrounding women and gambling harm in New Zealand. The three methods were: discourse analysis, thematic analysis and factor analysis with multivariate modelling. The specific details and rationale relating to the data selected and methods adopted in each component are discussed in the following sections of this report. The research design comprised the following four components and supplementary research questions:Poststructural analysis of literature positioning women in relation to gambling practices and harm. Research questions: What are the subject positions and discourses in play in relation to women and gambling harm in gambling studies literature? What are the implications for women’s experiences of gambling harm? What are the possibilities and constraints for women’s gambling harm reduction?Analysis of women’s experiences of gambling harm in New Zealand. Research questions: What gender or gender-related issues, notions or practices were discussed in relation to gambling harm? What are the implications of gender-related issues, notions or practices for women’s experiences of gambling harm? How/when is the gendered nature of gambling harm different for Māori and Pacific women?Gender analysis of population data related to gambling behaviour and gambling problems in New Zealand. Research questions: To what extent and how is gambling participation in New Zealand gendered? What are the relationships between gendered gambling participation and age, ethnicity and gambling problems? How do factors associated with problematic gambling interact with gender?Synthesis of findings in relation to harm prevention and reduction.It is acknowledged from the outset that the broader socio-political context for gambling and harm, experiences, and factors associated with experiencing problems explored in this project are likely to also be relevant to men, and to other population groups. The focus of this analysis was on the implications for women’s health and wellbeing. Understanding of gender: The term ‘gender’ usually refers to cultural, social, and historical understandings and interpretations of the biological concept of sex. In this study, gender was understood as constituted through sociocultural processes which shape men and women and what can be regarded as ‘feminine’ or ‘masculine’ attributes, practices, spaces and/or implied values (Becker et al., 2016). Gender was acknowledged as having material effects in people’s lives. As Holdsworth et al (2012, p. 209) state, “gender is more than a source of personal and social identity; it is a key determinant in the social stratification system and for the distribution of resources within society”. WOMEN IN GAMBLING STUDIES: A POSTSTRUCTURAL ANALYSISThe first component of this study involved analysis of literature positioning women in relation to gambling harm. 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ADDIN EN.CITE.DATA (e.g. J. Butler, 1990; Gavey, 2011; Weedon, 1987). While humanist or liberal feminist positions may seek agreement and unity from women to conduct feminist projects in the best interests of ‘all women’, from a poststructural feminist position identity categories are porous, essentially incomplete “permanently available site[s] of contested meanings” ADDIN EN.CITE <EndNote><Cite><Author>Butler</Author><Year>1990</Year><RecNum>321</RecNum><Pages>21</Pages><DisplayText>(J. Butler, 1990, p. 21)</DisplayText><record><rec-number>321</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563232464">321</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Butler, Judith</author></authors></contributors><titles><title>Gender trouble: Feminism and the subversion of identity</title></titles><dates><year>1990</year></dates><pub-location>US</pub-location><publisher>Routledge</publisher><isbn>1135959935</isbn><urls></urls></record></Cite></EndNote>(J. Butler, 1990, p. 21). Within such a perspective, partiality and intersectionality are promoted in place of any totalising claims to knowledge or the truth about gender, race or class in relation to gambling and harm. GenderFeminists have made a distinction between biological sex (i.e., what genitals one is born with that distinguishes them as girl/boy), and the (gendered) socialisation or moulding of people into feminine or masculine individuals ADDIN EN.CITE <EndNote><Cite><Author>De Beauvoir</Author><Year>1953</Year><RecNum>317</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. de Beauvoir, 1953; Millett, 1970; Oakley, 1972)</DisplayText><record><rec-number>317</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563231601">317</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>de Beauvoir, Simone</author></authors></contributors><titles><title>The second sex, trans. and ed. HM Parshley</title><secondary-title>New York: Knopf</secondary-title></titles><periodical><full-title>New York: Knopf</full-title></periodical><pages>44-73</pages><volume>1993</volume><dates><year>1953</year></dates><urls></urls></record></Cite><Cite><Author>Kate</Author><Year>1970</Year><RecNum>318</RecNum><record><rec-number>318</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563231672">318</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Millett, Kate</author></authors></contributors><titles><title>Sexual politics</title><secondary-title>New York: Doubleday</secondary-title></titles><periodical><full-title>New York: Doubleday</full-title></periodical><dates><year>1970</year></dates><urls></urls></record></Cite><Cite><Author>Oakley</Author><Year>1972</Year><RecNum>319</RecNum><record><rec-number>319</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563231806">319</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Oakley, Ann</author></authors></contributors><titles><title>Sex, Gender and Society. Revised Edition</title></titles><dates><year>1972</year></dates><pub-location>Hampshire</pub-location><publisher>Arena Gower Publishing</publisher><urls></urls></record></Cite></EndNote>(e.g. de Beauvoir, 1953; Millett, 1970; Oakley, 1972). Poststructural notions of gender challenge taken for granted truths that may have become so ingrained so as to be barely perceptible, let along subject to critique. For example, poststructural feminist writing draws on Foucault’s studies of the history of sexuality to posit that a powerful discursive framework is involved in regulating the seemingly self-evident links between sex, gender and sexuality. Cultural systems of knowledge and practice establish causal or expressive links, from biological sex to cultural gender and the expression or effect of both of these in sexual desire and behaviour. They construct a “heterosexual matrix” – comprised of stabilising concepts of binary gender through which we become “culturally intelligible” as people (Butler, 1990 p.17). Gender categories are seen as the effects of “dominant cultural discourses and their underlying master narratives – be they biological, medical, legal, philosophical or literary” ADDIN EN.CITE <EndNote><Cite><Author>De Lauretis</Author><Year>1987</Year><RecNum>322</RecNum><Pages>1</Pages><DisplayText>(de Lauretis, 1987, p. 1)</DisplayText><record><rec-number>322</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563311284">322</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>de Lauretis, Teresa</author></authors></contributors><titles><title>Technologies of gender: Essays on theory, film, and fiction</title></titles><dates><year>1987</year></dates><publisher>Indiana University Press</publisher><isbn>0253017920</isbn><urls></urls></record></Cite></EndNote>(de Lauretis, 1987, p. 1). Gavey ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Gavey</Author><Year>2005</Year><RecNum>219</RecNum><Pages>86</Pages><DisplayText>(2005, p. 86)</DisplayText><record><rec-number>219</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="0">219</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Gavey, Nicola</author></authors></contributors><titles><title>Just sex: The cultural scaffolding of rape</title></titles><dates><year>2005</year></dates><publisher>New York: Routledge.</publisher><urls></urls></record></Cite></EndNote>(2005, p. 86) describes how poststructuralism provides a way of understanding how particular practices and knowledge systems “which are highly gender-specific – make possible different kinds of desires, and way of being, to women and men.” This perspective draws attention to the social landscapes that both produce and shape gender. Gender is understood as both socially constructed and performed in relation to norms ADDIN EN.CITE <EndNote><Cite><Author>Butler</Author><Year>1990</Year><RecNum>321</RecNum><DisplayText>(J. Butler, 1990)</DisplayText><record><rec-number>321</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563232464">321</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Butler, Judith</author></authors></contributors><titles><title>Gender trouble: Feminism and the subversion of identity</title></titles><dates><year>1990</year></dates><pub-location>US</pub-location><publisher>Routledge</publisher><isbn>1135959935</isbn><urls></urls></record></Cite></EndNote>(J. Butler, 1990). The approach taken for this analysis also drew on key concepts developed by the philosopher Michel Foucault: discourse, subjectivity, power/knowledge ADDIN EN.CITE <EndNote><Cite><Author>Foucault</Author><Year>1972</Year><RecNum>191</RecNum><DisplayText>(Foucault, 1972)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="0">191</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Foucault, M</author></authors><subsidiary-authors><author>Sheridan, A.</author></subsidiary-authors></contributors><titles><title>The archaeology of knowledge</title></titles><edition>2002 Routledge Classics</edition><dates><year>1972</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite></EndNote>(Foucault, 1972).DiscourseFoucault defined discourse as “practices that systematically form the objects of which they speak” ADDIN EN.CITE <EndNote><Cite><Author>Foucault</Author><Year>1972</Year><RecNum>191</RecNum><Pages>49</Pages><DisplayText>(Foucault, 1972, p. 49)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="0">191</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Foucault, M</author></authors><subsidiary-authors><author>Sheridan, A.</author></subsidiary-authors></contributors><titles><title>The archaeology of knowledge</title></titles><edition>2002 Routledge Classics</edition><dates><year>1972</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite></EndNote>(Foucault, 1972, p. 49). This refers to the way in which practices people engage in both contribute to and are produced by knowledge systems ADDIN EN.CITE <EndNote><Cite><Author>Norman</Author><Year>1992</Year><RecNum>301</RecNum><DisplayText>(Fairclough, 1992)</DisplayText><record><rec-number>301</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1382650997">301</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Fairclough, Norman</author></authors></contributors><titles><title>Discourse and social change</title></titles><dates><year>1992</year></dates><publisher>Cambridge: Polity</publisher><urls></urls></record></Cite></EndNote>(Fairclough, 1992). Discourses are composed of: ideas, attitudes, beliefs, courses of action and practices ADDIN EN.CITE <EndNote><Cite><Author>Fadyl</Author><Year>2013</Year><RecNum>13</RecNum><DisplayText>(Fadyl, Nicholls, & McPherson, 2013)</DisplayText><record><rec-number>13</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511822772">13</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fadyl, Joanna K</author><author>Nicholls, David A</author><author>McPherson, Kathryn M</author></authors></contributors><titles><title>Interrogating discourse: The application of Foucault’s methodological discussion to specific inquiry</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>478-494</pages><volume>17</volume><number>5</number><dates><year>2013</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(Fadyl, Nicholls, & McPherson, 2013). Foucault discussed discourses as enabling objects, entities or phenomena to be conceived of, discussed, enacted in the world at a particular point in time ADDIN EN.CITE <EndNote><Cite><Author>Foucault</Author><Year>1972</Year><RecNum>191</RecNum><DisplayText>(Foucault, 1972)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="0">191</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Foucault, M</author></authors><subsidiary-authors><author>Sheridan, A.</author></subsidiary-authors></contributors><titles><title>The archaeology of knowledge</title></titles><edition>2002 Routledge Classics</edition><dates><year>1972</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite></EndNote>(Foucault, 1972). There are always multiple discourses in operation, which produce different possibilities and constraints for action. For example, ‘gambling’ can be constructed within public health discourses as a potentially dangerous practice (a harmful activity), and within economic discourses as an ordinary consumer activity (a contemporary form of consumer culture) ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2017</Year><RecNum>90</RecNum><DisplayText>(Wardle, 2017)</DisplayText><record><rec-number>90</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530063872">90</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wardle, Heather</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>The 'refeminisation' of gambling: Social, cultural and historical insights into female gambling behaviour in Great Britain</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Wardle, 2017). Psychological, biomedical and public health discourses have offered different configurations of problem and/or pathological gambling as: “a mental disorder, a physiological syndrome, or sometimes a (calculable) combination of all of these things, expressed as factors of risk” ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><Pages>38</Pages><DisplayText>(Reith, 2007, p. 38)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(Reith, 2007, p. 38). All of these constructions have made various activities/actions in relation to gambling possible, e.g. specialist gambling counselling, the building of casinos, and public health promotion activities. From a poststructural perspective, we can consider ‘gambling’, ‘problem gambling’ and ‘gambling harm’ to be objects of knowledge that are continually being constituted and transformed in discourse. Poststructural analysis, and particularly Foucauldian approaches to discourse analysis are now well established in fields as diverse as architecture, disability studies, drama, feminism, health care, history, management, politics, social policy, and sport ADDIN EN.CITE <EndNote><Cite><Author>Fontana-Giusti</Author><Year>2013</Year><RecNum>324</RecNum><DisplayText>(Fontana-Giusti, 2013; Lewis, Gewirtz, & Clarke, 2000; Tremain, 2006)</DisplayText><record><rec-number>324</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563312251">324</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Fontana-Giusti, Gordana</author></authors></contributors><titles><title>Foucault for architects</title></titles><dates><year>2013</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><isbn>1135010099</isbn><urls></urls></record></Cite><Cite><Author>Tremain</Author><Year>2006</Year><RecNum>325</RecNum><record><rec-number>325</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563312336">325</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Tremain, Shelley</author></authors></contributors><titles><title>Foucault and the Government of Disability</title></titles><dates><year>2006</year></dates><publisher>Taylor & Francis</publisher><isbn>1501-7419</isbn><urls></urls></record></Cite><Cite><Author>Lewis</Author><Year>2000</Year><RecNum>326</RecNum><record><rec-number>326</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563312387">326</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Lewis, Gail</author><author>Gewirtz, Sharon</author><author>Clarke, John</author></authors></contributors><titles><title>Rethinking social policy</title></titles><dates><year>2000</year></dates><publisher>Sage</publisher><isbn>1412932742</isbn><urls></urls></record></Cite></EndNote>(Fontana-Giusti, 2013; Lewis, Gewirtz, & Clarke, 2000; Tremain, 2006). 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ADDIN EN.CITE.DATA (Cheek, 1999; Lupton, 2003; Nicholls, 2012; Rose, 1985a). Foucault's work, and particularly the idea of 'discourse' has been used successfully by social scientists to identify and understand inequalities thereby contributing to improving health outcomes. For example, Payne and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Payne</Author><Year>2010</Year><RecNum>330</RecNum><DisplayText>(2010)</DisplayText><record><rec-number>330</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563313209">330</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Payne, Deborah</author><author>Nicholls, David A</author></authors></contributors><titles><title>Managing breastfeeding and work: a Foucauldian secondary analysis</title><secondary-title>Journal of Advanced Nursing</secondary-title></titles><periodical><full-title>Journal of Advanced Nursing</full-title></periodical><pages>1810-1818</pages><volume>66</volume><number>8</number><dates><year>2010</year></dates><isbn>0309-2402</isbn><urls></urls></record></Cite></EndNote>(2010) identified powerful tensions between medical discourses constructing ‘successful breastfeeding’ in terms of infant growth and absence of infections and diseases, and economic discourses constructing ‘good workers’ as available, efficient and productive. These authors showed how the interaction of these discourses placed considerable strain on breastfeeding workers and contributed to gender inequality in the workplace. Implications for practice and policy included the provision of appropriate spaces where breastfeeding workers may feed their babies or express breastmilk, and the provision of paid work breaks for breastfeeding workers.SubjectivityFoucault ascribed to discourses a key role in subjectivation: the ways particular discourses about people came into being and the effects they have on people’s lives ADDIN EN.CITE <EndNote><Cite><Author>Mills</Author><Year>1997</Year><RecNum>330</RecNum><DisplayText>(Mills, 1997)</DisplayText><record><rec-number>330</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1393529843">330</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mills, Sara</author></authors></contributors><titles><title>Discourse: The new critical idiom</title><secondary-title>London and New York: Routledge</secondary-title></titles><periodical><full-title>London and New York: Routledge</full-title></periodical><dates><year>1997</year></dates><urls></urls></record></Cite></EndNote>(Mills, 1997). The poststructural notion of subjectivity involves inquiring about the kinds of selves that we are able to be, and to possibly become ADDIN EN.CITE <EndNote><Cite><Author>Allen</Author><Year>2008</Year><RecNum>238</RecNum><DisplayText>(Allen, 2008)</DisplayText><record><rec-number>238</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543969789">238</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Allen, Amy</author></authors></contributors><titles><title>The politics of our selves: Power, autonomy, and gender in contemporary critical theory</title></titles><dates><year>2008</year></dates><pub-location>New York</pub-location><publisher>Columbia University Press</publisher><isbn>0231136234</isbn><urls></urls></record></Cite></EndNote>(Allen, 2008). Discourses make particular realities, subjectivities and experiences possible for people to take up or have imposed on them ADDIN EN.CITE <EndNote><Cite><Author>Foucault</Author><Year>1972</Year><RecNum>191</RecNum><DisplayText>(Allen, 2008; Foucault, 1972)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="0">191</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Foucault, M</author></authors><subsidiary-authors><author>Sheridan, A.</author></subsidiary-authors></contributors><titles><title>The archaeology of knowledge</title></titles><edition>2002 Routledge Classics</edition><dates><year>1972</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite><Cite><Author>Allen</Author><Year>2008</Year><RecNum>238</RecNum><record><rec-number>238</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543969789">238</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Allen, Amy</author></authors></contributors><titles><title>The politics of our selves: Power, autonomy, and gender in contemporary critical theory</title></titles><dates><year>2008</year></dates><pub-location>New York</pub-location><publisher>Columbia University Press</publisher><isbn>0231136234</isbn><urls></urls></record></Cite></EndNote>(Allen, 2008; Foucault, 1972). Our ‘selves’ are therefore made up of various subject positions available in discourse at particular historical moments ADDIN EN.CITE <EndNote><Cite><Author>Allen</Author><Year>2008</Year><RecNum>238</RecNum><DisplayText>(Allen, 2008)</DisplayText><record><rec-number>238</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543969789">238</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Allen, Amy</author></authors></contributors><titles><title>The politics of our selves: Power, autonomy, and gender in contemporary critical theory</title></titles><dates><year>2008</year></dates><pub-location>New York</pub-location><publisher>Columbia University Press</publisher><isbn>0231136234</isbn><urls></urls></record></Cite></EndNote>(Allen, 2008). For example, Reith ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><Pages>38</Pages><DisplayText>(2007, p. 38)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(2007, p. 38) described how the ‘problem gambler’ was produced by biomedical and psychological discourses which created “a system of classification and nomenclature… with a checklist of symptoms that could be measured and compared against a norm”. The observation and classification of various types of problem gambling behaviour has provided the conceptual tools for thinking about people in new ways, “creating a language with which to describe and discuss them, so rendering them increasingly visible to social inquiry and also increasingly ‘real’” ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><Pages>38</Pages><DisplayText>(Reith, 2007, p. 38)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(Reith, 2007, p. 38). Miller and colleagues have analysed how ‘responsible gambling’ discourses which emphasise self-monitoring and self-control, enable ‘problem gamblers’ to be positioned as “lazy”, “stupid” and “greedy”, stigmatising individuals and constraining broader public health activities ADDIN EN.CITE <EndNote><Cite><Author>Miller</Author><Year>2018</Year><RecNum>61</RecNum><DisplayText>(H. Miller & Thomas, 2018; H. Miller, Thomas, Smith, & Robinson, 2016)</DisplayText><record><rec-number>61</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520543265">61</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Miller, Helen</author><author>Thomas, Samantha</author></authors></contributors><titles><title>The problem with ‘responsible gambling’: Impact of government and industry discourses on feelings of felt and enacted stigma in people who experience problems with gambling</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>85-94</pages><volume>26</volume><number>2</number><dates><year>2018</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite><Cite><Author>Miller</Author><Year>2016</Year><RecNum>63</RecNum><record><rec-number>63</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520543416">63</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Miller, Helen</author><author>Thomas, Samantha L</author><author>Smith, Kylie M</author><author>Robinson, Priscilla</author></authors></contributors><titles><title>Surveillance, responsibility and control: An analysis of government and industry discourses about “problem” and “responsible” gambling</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>163-176</pages><volume>24</volume><number>2</number><dates><year>2016</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(H. Miller & Thomas, 2018; H. Miller, Thomas, Smith, & Robinson, 2016). Gavey (1989) and Weedon (1987) state there are always multiple subject positions available to us to take up or have imposed on us at particular times, but relationships of power influence which ones we are able or encouraged to take up, and when.Power/knowledgeFrom a poststructural perspective, power and knowledge are linked. Foucault (1972) described how power makes actions possible. He wrote of a knowledge-power nexus (pouvior-savior), meaning that the ways in which we are able to make sense of something discursively, influence how we are able to act. Weedon (1987) explains poststructural understandings of power as productive, a force that makes things happen and keeps things going. Power relations infuse the way discourse works, to produce certain subject positions for women, and discourage or constrain others. For example, Aston ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Aston</Author><Year>2009</Year><RecNum>146</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>146</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537307879">146</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Aston, Shaughney</author></authors></contributors><titles><title>Identities under construction: Women hailed as addicts</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>611-628</pages><volume>13</volume><number>6</number><dates><year>2009</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(2009) explored the ways in which women struggled against dominant addiction treatment ideologies which required them to identify as ‘addicts’ in order to access support. Exploring the ways that power operates to open up and close down particular subjectivities for women through discourse, is an important step in understanding how we might create positive change.Critical gambling studiesCritical addictions studies hold that “alongside whatever progress has been achieved, each model of addiction reflects the taken-for-granted premises, prejudices, and politics of the institutions, the epoch, and the culture in which it was born” ADDIN EN.CITE <EndNote><Cite><Author>Granfield</Author><Year>2014</Year><RecNum>149</RecNum><Pages>16</Pages><DisplayText>(Granfield & Reinarman, 2014, p. 16)</DisplayText><record><rec-number>149</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537313129">149</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Granfield, Robert</author><author>Reinarman, Craig</author></authors><secondary-authors><author>Granfield, Robert</author><author>Reinarman, Craig</author></secondary-authors></contributors><titles><title>Addiction is not just a brain disease: Critical studies of addiction</title></titles><pages>1-21</pages><dates><year>2014</year></dates><publisher>Routledge</publisher><isbn>1135015988</isbn><urls></urls></record></Cite></EndNote>(Granfield & Reinarman, 2014, p. 16). For example, critical scholars argued that addiction is not just a brain disease as framed in dominant biological models of addictions ADDIN EN.CITE <EndNote><Cite><Author>Granfield</Author><Year>2014</Year><RecNum>149</RecNum><DisplayText>(Granfield & Reinarman, 2014)</DisplayText><record><rec-number>149</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537313129">149</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Granfield, Robert</author><author>Reinarman, Craig</author></authors><secondary-authors><author>Granfield, Robert</author><author>Reinarman, Craig</author></secondary-authors></contributors><titles><title>Addiction is not just a brain disease: Critical studies of addiction</title></titles><pages>1-21</pages><dates><year>2014</year></dates><publisher>Routledge</publisher><isbn>1135015988</isbn><urls></urls></record></Cite></EndNote>(Granfield & Reinarman, 2014). As early as the 1940s, critical research in addictions studies has shown that ‘addicts’ are also human actors embedded in a web of context-dependent social relations that influence possible decisions, behaviours and thus experiences that shape ‘the brain’. Critical analysis of addictions begins with the principle that ‘addiction’ is a complex phenomenon, best understood within a broader social, political, economic, and historical context. Aligned with this thinking, critical gambling studies interrogate how dominant accounts of gambling operate ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(Cassidy, 2018)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite></EndNote>(Cassidy, 2018). For example, recent work has focussed on what the notion of ‘responsible gambling’ makes possible in terms of prioritising governmental and industry interests, and what is constrained e.g. a sense of social rather than individual responsibility for gambling harm ADDIN EN.CITE <EndNote><Cite><Author>Hancock</Author><Year>2017</Year><RecNum>141</RecNum><DisplayText>(P. J. Adams & Rossen, 2012; L. Hancock & Smith, 2017)</DisplayText><record><rec-number>141</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194353">141</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hancock, Linda</author><author>Smith, Garry</author></authors></contributors><titles><title>Critiquing the Reno model I-IV international influence on regulators and governments (2004–2015)—the distorted reality of “responsible gambling”</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>1151-1176</pages><volume>15</volume><number>6</number><dates><year>2017</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams & Rossen, 2012; L. Hancock & Smith, 2017). Critical studies aim to identify and critique how structural differences including class, gender and ethnicity influence the gambling experience and distribution of the costs and benefits of gambling PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2jDvGxsPC9BdXRob3I+PFllYXI+MjAxMjwvWWVhcj48
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ADDIN EN.CITE.DATA (e.g. P. J. Adams, 2016; P. J. Adams & Livingstone, 2015; Schüll, 2012). Critical gambling researchers share a broad commitment to documentation, prevention and alleviation of social inequalities exacerbated by the problematic provision and governance of gambling. Structural determinants of gambling harm include that many groups of individuals considered at high risk for gambling related harm in New Zealand, live in deprived neighbourhoods containing high concentrations of gambling venues and outlets PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYmJvdHQ8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Abbott, 2017a; Pearce et al., 2008; Young, Markham, & Doran, 2012). From a critical perspective, research does not just describe or explain, but is also part of the ongoing, reiterative process of conceptualising problems and their solutions. Practitioners and researchers in a given context such as gambling studies, usually share some assumptions about social reality and the underlying nature of social problems and solutions. These assumptions feed in to the research process via theories about problems and change, the research questions asked and methods used. These assumptions also change over time. For example, population based gambling research has shaped the notion of gambling harm as ‘proliferating’, in the sense of being multifarious, and spreading - not restricted to problem gambling subjects alone. This has created some of the conditions of possibility for a public health approach to addressing harm PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYmJvdHQ8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Abbott, 2001b; Browne, Bellringer, et al., 2017; Langham et al., 2015). What this suggests is that research texts are valid data for studying how problems emerge and change over time, and what might be the implications for efforts to intervene ADDIN EN.CITE <EndNote><Cite><Author>Ahl</Author><Year>2007</Year><RecNum>9</RecNum><DisplayText>(Ahl, 2007; Fadyl et al., 2013)</DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816449">9</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Ahl, Helene</author></authors><secondary-authors><author>Neergaard, H</author><author>Parm Ulhoi, J</author></secondary-authors></contributors><titles><title>A Foucauldian framework for discourse analysis</title><secondary-title>Handbook of qualitative research methods in entrepreneurship</secondary-title></titles><periodical><full-title>Handbook of qualitative research methods in entrepreneurship</full-title></periodical><pages>216-250</pages><dates><year>2007</year></dates><pub-location>USA</pub-location><publisher>Edward Elgar Publishing Limited</publisher><urls></urls></record></Cite><Cite><Author>Fadyl</Author><Year>2013</Year><RecNum>13</RecNum><record><rec-number>13</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511822772">13</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fadyl, Joanna K</author><author>Nicholls, David A</author><author>McPherson, Kathryn M</author></authors></contributors><titles><title>Interrogating discourse: The application of Foucault’s methodological discussion to specific inquiry</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>478-494</pages><volume>17</volume><number>5</number><dates><year>2013</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(Ahl, 2007; Fadyl et al., 2013). A key aspect of critical gambling studies includes exploration of what gambling does to personhood: How is gambling embedded in specific understandings of subjectivity? How does gambling configure and reconfigure social identities? What kind of subjective states and experiences are unique to gambling? From this perspective, gambling studies as texts can provide us with a view of how subject positions are made and unmade for women (and men) who are affected by gambling. Gambling studies can also offer us glimpses of what life is like for women affected by gambling, from a post-structural feminist perspective. Key research questions What are the subject positions and discourses in play in relation to women and gambling harm in gambling studies literature? What are the implications for women’s experiences of gambling harm? What are the possibilities and constraints for women’s gambling harm reduction?Data selection, collection and analysisGambling was a male dominated activity in New Zealand prior to the introduction of EGMs and casinos, and corresponding increase in women’s gambling participation and problems ADDIN EN.CITE <EndNote><Cite><Author>Bunkle</Author><Year>2009</Year><RecNum>14</RecNum><DisplayText>(Abbott, 2001b; Bunkle, 2009)</DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511823898">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bunkle, Phillida</author></authors></contributors><titles><title>Women and Gambling: What can be learned from the New Zealand experience? A Women's Studies Approach</title><secondary-title>Women's Studies Journal</secondary-title></titles><periodical><full-title>Women's Studies Journal</full-title></periodical><pages>36</pages><volume>23</volume><number>1</number><dates><year>2009</year></dates><isbn>0112-4099</isbn><urls></urls></record></Cite><Cite><Author>Abbott</Author><Year>2001</Year><RecNum>109</RecNum><record><rec-number>109</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531711264">109</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>What do we know about gambling and problem gambling in New Zealand? Report number seven of the New Zealand gaming survey</title></titles><dates><year>2001</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2001b; Bunkle, 2009). In the 1990s there was a sharp increase in women gambling regularly in New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2001</Year><RecNum>16</RecNum><DisplayText>(Abbott, 2001a)</DisplayText><record><rec-number>16</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824772">16</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>Problem gamblers and non-problem gamblers in New Zealand: A report on Phase Two of the 1999 Prevalence Survey. Report No 6 of the New Zealand Gambling Survey</title></titles><dates><year>2001</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2001a). To correspond with the emergence of women’s gambling as a phenomenon and topic of inquiry, gambling studies literature published in New Zealand and internationally since 1990 were accessed. Literature addressing gender issues, and particularly issues for women, were selected for analysis. Data were selected to enable a range of historically emerging framings of women’s gambling practices and harm to be brought to light. The aim of data selection was not to produce a comprehensive dataset of all literature about women and gambling harm, but rather to access ‘glimmers’ ADDIN EN.CITE <EndNote><Cite><Author>Parker</Author><Year>1992</Year><RecNum>56</RecNum><DisplayText>(Parker, 1992)</DisplayText><record><rec-number>56</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520463623">56</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Parker, I</author></authors></contributors><titles><title>Discourse dynamics</title></titles><dates><year>1992</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite></EndNote>(Parker, 1992) of the discursive situation of women in relation to gambling harm in literature that could be accessed by or applied to New Zealand women. This facilitated inquiry into how our understandings of women harmed by gambling have changed over time, with particular implications for women’s experiences of gambling harm and efforts to reduce harm. Key gambling studies literature was identified by entering the search terms ‘women’, ‘female’, ‘gender’ and ‘gambling’ in various combinations into the search engines Medline, Psychinfo, EBSCO Health and Academic Premier. Literature was also found through alternative channels for health knowledge in New Zealand, such as the Ministry of Health website, health related reports and newsletters and other grey literature repositories. Policy documents and statements were not included in this review. Targeted searches of journals where gambling studies are routinely published (e.g. Addiction, International Journal of Mental Health and Addiction, Journal of Gambling Studies, International Gambling Studies, Journal of Gambling Issues) were also performed.Discourse analysisDiscourse analysis makes it possible to articulate a range of assumptions which underpin the multiple ways that issues or phenomena are conceptualised and dealt with in a particular field. Identifying some of the assumptions underpinning the way that particular issues are talked about and acted upon in a field is not about saying that one view is inherently ‘good’ and another ‘bad’. Exploring the range of ideas that guide our practices aimed at producing ‘health’ in individuals and populations can reveal some current constraints, as well as open up opportunities for viewing problems and their solutions differently. It can also point out situations where one particular view has held sway, to the exclusion of other perspectives. Exploring the discourses evident in our knowledge and practices in relation to women’s gambling and harm has the potential to reveal new and/or different avenues to pursue for harm reduction.Discourse analysis involved careful reading of the literature with a view to articulating how women harmed by gambling are constructed ADDIN EN.CITE <EndNote><Cite><Author>Ahl</Author><Year>2007</Year><RecNum>9</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Ahl, 2007)</DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816449">9</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Ahl, Helene</author></authors><secondary-authors><author>Neergaard, H</author><author>Parm Ulhoi, J</author></secondary-authors></contributors><titles><title>A Foucauldian framework for discourse analysis</title><secondary-title>Handbook of qualitative research methods in entrepreneurship</secondary-title></titles><periodical><full-title>Handbook of qualitative research methods in entrepreneurship</full-title></periodical><pages>216-250</pages><dates><year>2007</year></dates><pub-location>USA</pub-location><publisher>Edward Elgar Publishing Limited</publisher><urls></urls></record></Cite></EndNote>(e.g. Ahl, 2007). Analytical steps were to identify and examine the terms and concepts that were routinely used to differentiate, describe, and seek to impact on women’s gambling practices and gambling harm. The subject positions and spaces created by various discourses for women harmed by gambling were defined and explored. Key analytic questions continually posed during the data analysis process helped maintain methodological congruence with the poststructural concepts described above. Key analytic questions included:How are women framed in relation to gambling and harm in these documents? Who is speaking about women’s gambling issues (e.g. academics, clinicians, women’s groups)? What are the roles and responsibilities (e.g. of the helping professions, gambling industry, families, communities and women) for addressing women’s gambling harm as evidenced in the documents?What are the implications for women’s experiences of gambling harm?Where are some possibilities and constraints for women’s gambling harm reduction? ResultsEmerging consumer culture, coupled with reduced state involvement in social life ADDIN EN.CITE <EndNote><Cite><Author>Kelsey</Author><Year>1996</Year><RecNum>139</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Kelsey, 1996)</DisplayText><record><rec-number>139</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536183766">139</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Kelsey, Jane</author></authors></contributors><titles><title>The New Zealand Experiment: A World Model for Structural Adjustment?</title></titles><dates><year>1996</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University Press with Bridget Williams Books</publisher><urls></urls></record></Cite></EndNote>(e.g. Kelsey, 1996), has created some of the conditions for gambling to be positioned as a legitimate entertainment industry and practice ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><DisplayText>(Reith, 2007)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(Reith, 2007). For example, in New Zealand parliamentary debate around introducing casinos via the Casino Control Act (1990), the notion that expansion of gambling opportunities would bring capital investment with ‘no-net-risk’ was largely uncontested ADDIN EN.CITE <EndNote><Cite><Author>Bunkle</Author><Year>2009</Year><RecNum>14</RecNum><DisplayText>(Bunkle, 2009)</DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511823898">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bunkle, Phillida</author></authors></contributors><titles><title>Women and Gambling: What can be learned from the New Zealand experience? A Women's Studies Approach</title><secondary-title>Women's Studies Journal</secondary-title></titles><periodical><full-title>Women's Studies Journal</full-title></periodical><pages>36</pages><volume>23</volume><number>1</number><dates><year>2009</year></dates><isbn>0112-4099</isbn><urls></urls></record></Cite></EndNote>(Bunkle, 2009). Economic discourses have constructed a role for gambling in promoting national wellbeing. Gambling studies can be conceptualised as emerging to address tension between competing framings of gambling: as a potentially dangerous practice, and as an ordinary consumer activity ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2017</Year><RecNum>90</RecNum><DisplayText>(Wardle, 2017)</DisplayText><record><rec-number>90</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530063872">90</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wardle, Heather</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>The 'refeminisation' of gambling: Social, cultural and historical insights into female gambling behaviour in Great Britain</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Wardle, 2017). Reith ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><DisplayText>(2007)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(2007) argued that a key function of gambling studies has been the production of ‘problem gambling’ as a mental health concern, and the ‘problem gambler’ as suffering from treatable psychological issues such as impulsivity and irrationality. Excessive gambling constructed as mental illness (as opposed to moral degeneracy), has made the notions of ‘problem gambling’ and ‘gambling treatment’ possible: With the recognition of pathological gambling as a psychiatric disorder came a proliferation of interest in the subject, with the establishment of a range of medical, legal, academic, and treatment professionals as well as lay groups and formal organizations, all with their own conception of and interest in the problem. ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><Pages>38</Pages><DisplayText>(Reith, 2007, p. 38)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(Reith, 2007, p. 38)Gambling studies have associated problem gambling with men ADDIN EN.CITE <EndNote><Cite><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><DisplayText>(Volberg, 2003)</DisplayText><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Volberg, 2003), and continue to identify male gender as a ‘risk factor’ for gambling problems ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>6</RecNum><DisplayText>(Abbott, 2017a; Abbott, Binde, et al., 2018)</DisplayText><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502937388">6</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>The epidemiology and impact of gambling disorder and other gambling-related harm</title><secondary-title>2017 WHO Forum on alcohol, drugs and addictive behaviours</secondary-title></titles><dates><year>2017</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>245</RecNum><record><rec-number>245</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554758831">245</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Binde, Per</author><author>Clark, Luke</author><author>Hodgins, David</author><author>Johnson, Mark</author><author>Manitowabi, Darrel</author><author>Quilty, Lena</author><author>Sp?ngberg, Jessika</author><author>Volberg, Rachel</author><author>Walker, Douglas</author><author>Williams, Robert</author></authors></contributors><titles><title>Conceptual Framework of Harmful Gambling: An International Collaboration (Third Edition)</title></titles><dates><year>2018</year></dates><pub-location>Guelph, Ontario, Canada.</pub-location><publisher>Gambling Research Exchange Ontario (GREO)</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2017a; Abbott, Binde, et al., 2018). Women affected others (predominantly as partners and mothers) have been positioned as adjunct to the psychological treatment and support needs of gambling men. More recently, women have been seen as under strain caused by the gambling of others ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2013</Year><RecNum>190</RecNum><DisplayText>(Kourgiantakis, Saint-Jacques, & Tremblay, 2013)</DisplayText><record><rec-number>190</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539558737">190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Problem gambling and families: A systematic review</title><secondary-title>Journal of Social Work Practice in the Addictions</secondary-title></titles><periodical><full-title>Journal of Social Work Practice in the Addictions</full-title></periodical><pages>353-372</pages><volume>13</volume><number>4</number><dates><year>2013</year></dates><isbn>1533-256X</isbn><urls></urls></record></Cite></EndNote>(Kourgiantakis, Saint-Jacques, & Tremblay, 2013), and in need of psychological support in their own right.Gambling studies have played a key role in the construction of ‘problem gambling’ and ‘gambling harm’ as manageable phenomena at the population level. It is no accident that rapid growth in the availability of legal gambling opportunities has invoked techniques for the measurement and management of impacts on the wellbeing of populations. The two processes are interconnected and mutually reinforcing ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2007</Year><RecNum>150</RecNum><DisplayText>(P. J. Adams, 2007)</DisplayText><record><rec-number>150</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537402593">150</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Gambling, freedom and democracy</title></titles><dates><year>2007</year></dates><publisher>Routledge</publisher><isbn>1135907293</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams, 2007). Since the 17th century, systems of knowledge about the health of populations have become intricately linked to styles of power, and procedures of modern Western states ADDIN EN.CITE <EndNote><Cite><Author>Lupton</Author><Year>1995</Year><RecNum>293</RecNum><DisplayText>(Lupton, 1995; Lupton & Chapman, 1995)</DisplayText><record><rec-number>293</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1376343580">293</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Lupton, Deborah</author></authors></contributors><titles><title>The imperative of health: Public health and the regulated body</title></titles><dates><year>1995</year></dates><pub-location>London</pub-location><publisher>Sage Publications</publisher><urls></urls></record></Cite><Cite><Author>Lupton</Author><Year>1995</Year><RecNum>439</RecNum><record><rec-number>439</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1454530502">439</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lupton, Deborah</author><author>Chapman, Simon</author></authors></contributors><titles><title>‘A healthy lifestyle might be the death of you’: discourses on diet, cholesterol control and heart disease in the press and among the lay public</title><secondary-title>Sociology of Health & Illness</secondary-title></titles><periodical><full-title>Sociology of Health & Illness</full-title></periodical><pages>477-494</pages><volume>17</volume><number>4</number><dates><year>1995</year></dates><publisher>Blackwell Publishing Ltd</publisher><urls><related-urls><url>;(Lupton, 1995; Lupton & Chapman, 1995). Scientific technologies, e.g. statistical thinking and tools of measurement, have come to define ‘best practice’ in seeking to improve collective human wellbeing ADDIN EN.CITE <EndNote><Cite><Author>Hacking</Author><Year>1991</Year><RecNum>625</RecNum><DisplayText>(Hacking, 1991)</DisplayText><record><rec-number>625</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1476753151">625</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Hacking, Ian</author></authors><secondary-authors><author>Burchell, Graham</author><author>Gordon, Colin</author><author>Miller, Peter</author></secondary-authors></contributors><titles><title>How should we do the history of statistics?</title><secondary-title>The Foucault effect: Studies in governmentality</secondary-title></titles><periodical><full-title>The Foucault effect: studies in governmentality</full-title></periodical><pages>181-196</pages><dates><year>1991</year></dates><pub-location>Chicago</pub-location><publisher>The University of Chicago Press</publisher><urls></urls></record></Cite></EndNote>(Hacking, 1991). In New Zealand, the first national survey of gambling and problem gambling coincided with the introduction of casinos as well as specialist support services for problem gambling in 1992. Population surveys continue to be conducted “to investigate… risk and resiliency factors associated with gambling participation” ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>135</RecNum><Pages>13</Pages><DisplayText>(Abbott, Bellringer, & Garret, 2018, p. 13)</DisplayText><record><rec-number>135</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1534887305">135</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garret, N</author></authors></contributors><titles><title>New Zealand National Gambling Study: Wave 4 2015, Report number 6</title></titles><dates><year>2018</year></dates><pub-location>Auckland</pub-location><publisher>Gamblign and Addictions Research Centre, AUT University</publisher><urls></urls></record></Cite></EndNote>(Abbott, Bellringer, & Garret, 2018, p. 13). Women who gamble have been constructed through such population data gathering techniques, mapping the characteristics of problem gamblers and those affected, and the sociodemographic patterns of risk and vulnerability that crosscut the population. A far smaller body of research has constructed women who gamble as subject to social and cultural determinants of gambling and gambling harm. In the gambling studies literature accessed for this project, women were visible as affected by others’ gambling, and as gamblers themselves. Three subject positions were identified in relation to women affected others: women as needy enablers, women as gamblers’ caregivers and women under strain. A further three subject positions were identified in relation to women gamblers: women as risky gamblers, vulnerable women gamblers, and women’s gambling as a socio-cultural phenomenon. All six subject positions are outlined below, with a focus on what each position constrains and makes possible for services and practices oriented towards women’s gambling harm reduction.Women as ‘needy enablers’ As early as the 1950s, Jackson outlined a dominant construction of women married to alcoholic husbands, as pathologically motivated to choose and remain with these men, as well as acting to prolong the disorder ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>2014</Year><RecNum>164</RecNum><Prefix>Jackson`, 1954`, cited by </Prefix><DisplayText>(Jackson, 1954, cited by Orford, 2014)</DisplayText><record><rec-number>164</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538093362">164</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>A response to Calderwood and Rajesparam's ideas on codependence</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-4</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Jackson, 1954, cited by Orford, 2014). Studies of the relationship between being a ‘gambler’s wife’, social adjustment and personality issues have similarly produced the notion that if a partner is negatively affected by gambling, then she must have problems of her own. For example:Wives of pathological gamblers tend to endure long marriages despite financial and emotional burden. Difficulties in social adjustment, personality psychopathology, and comorbidity with psychiatric disorders are pointed to as reasons for remaining in such overwhelming relationships. ADDIN EN.CITE <EndNote><Cite><Author>Mazzoleni</Author><Year>2009</Year><RecNum>165</RecNum><DisplayText>(Mazzoleni, Gorenstein, Fuentes, & Tavares, 2009)</DisplayText><record><rec-number>165</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538094046">165</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mazzoleni, Maria Helena B</author><author>Gorenstein, Clarice</author><author>Fuentes, Daniel</author><author>Tavares, Hermano</author></authors></contributors><titles><title>Wives of pathological gamblers: personality traits, depressive symptoms and social adjustment</title><secondary-title>Revista Brasileira de Psiquiatria</secondary-title></titles><periodical><full-title>Revista Brasileira de Psiquiatria</full-title></periodical><pages>332-337</pages><volume>31</volume><number>4</number><dates><year>2009</year></dates><isbn>1516-4446</isbn><urls></urls></record></Cite></EndNote>(Mazzoleni, Gorenstein, Fuentes, & Tavares, 2009)The enabling wife or partner can be implicated in producing and/or maintaining problematic gambling, through her excessive need for control and intimacy in relationships, e.g.: …the gambler's partner… frequently has a history, stemming from her family of origin, of not having successfully achieved [intimacy]… As an adult, she may crave intimacy without knowing how to create it... This heightens the gambler's fear of being smothered and his pursuit of gambling as a substitute for love. ADDIN EN.CITE <EndNote><Cite><Author>Steinberg</Author><Year>1993</Year><RecNum>177</RecNum><Pages>164</Pages><DisplayText>(Steinberg, 1993, p. 164)</DisplayText><record><rec-number>177</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040947">177</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Steinberg, Marvin A</author></authors></contributors><titles><title>Couples treatment issues for recovering male compulsive gamblers and their partners</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>153-167</pages><volume>9</volume><number>2</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Steinberg, 1993, p. 164)A vicious circle often becomes entrenched… with gamblers feeling an increased need to gamble in reaction to the controlling behaviors of their significant others, who in turn try to exert even greater control ADDIN EN.CITE <EndNote><Cite><Author>Bertrand</Author><Year>2008</Year><RecNum>176</RecNum><Pages>397</Pages><DisplayText>(Bertrand, Dufour, Wright, & Lasnier, 2008, p. 397)</DisplayText><record><rec-number>176</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040591">176</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bertrand, Karine</author><author>Dufour, Magali</author><author>Wright, John</author><author>Lasnier, Beno?t</author></authors></contributors><titles><title>Adapted couple therapy (ACT) for pathological gamblers: A promising avenue</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>393</pages><volume>24</volume><number>3</number><dates><year>2008</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Bertrand, Dufour, Wright, & Lasnier, 2008, p. 397)She could be positioned as ‘needing to be needed’, a ‘partner in crime’ facilitating gambling so that she could play the part of the ‘rescuer’ or ‘martyr’ and receive sympathy and attention from others: “…the spouse can feel like a ‘‘victim’’ caused by the gambler’s irresponsibility, thus evoking, or even exaggerating, family and marital difficulties more easily—itself an instance of the disillusion/retaliation effect.” ADDIN EN.CITE <EndNote><Cite><Author>Cunha</Author><Year>2015</Year><RecNum>179</RecNum><Pages>130</Pages><DisplayText>(Cunha, Sotero, & Relvas, 2015, p. 130)</DisplayText><record><rec-number>179</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539044813">179</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cunha, Diana</author><author>Sotero, Luciana</author><author>Relvas, Ana Paula</author></authors></contributors><titles><title>The pathological gambler and his spouse: How do their narratives match?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>112-141</pages><number>31</number><dates><year>2015</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Cunha, Sotero, & Relvas, 2015, p. 130). Women could be positioned as enablers by their actions, e.g. seeking to control the gambler/gambling, or inaction e.g. tolerating the gambling, or being ‘in denial’: After many vows and disappointments, relatives may give up efforts to solve the problem, and by their passivity they actually maintain the gambler and themselves in addiction. ADDIN EN.CITE <EndNote><Cite><Author>Slezáková</Author><Year>2018</Year><RecNum>163</RecNum><DisplayText>(Slezáková, 2018)</DisplayText><record><rec-number>163</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538091553">163</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Slezáková, Silvia</author></authors></contributors><titles><title>Pathological Gambling and Co-dependence</title><secondary-title>Acta Ludologica</secondary-title></titles><periodical><full-title>Acta Ludologica</full-title></periodical><pages>40-51</pages><volume>1</volume><number>1</number><dates><year>2018</year></dates><isbn>2585-8599</isbn><urls></urls></record></Cite></EndNote>(Slezáková, 2018)Psychological concepts such as ‘conformism’ and ‘social desirability’ were drawn on to theorise why women may stay in unhappy relationships with gambling men, avoiding the problem, rather than seeking appropriate help and support ADDIN EN.CITE <EndNote><Cite><Author>Cunha</Author><Year>2015</Year><RecNum>179</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Cunha et al., 2015)</DisplayText><record><rec-number>179</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539044813">179</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cunha, Diana</author><author>Sotero, Luciana</author><author>Relvas, Ana Paula</author></authors></contributors><titles><title>The pathological gambler and his spouse: How do their narratives match?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>112-141</pages><number>31</number><dates><year>2015</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(e.g. Cunha et al., 2015). A key component of the construction of women partners as part of the gambling problem, has been the psychological concept of ‘co-dependence’. For example, Mazzoleni and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Mazzoleni</Author><Year>2009</Year><RecNum>165</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>165</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538094046">165</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mazzoleni, Maria Helena B</author><author>Gorenstein, Clarice</author><author>Fuentes, Daniel</author><author>Tavares, Hermano</author></authors></contributors><titles><title>Wives of pathological gamblers: personality traits, depressive symptoms and social adjustment</title><secondary-title>Revista Brasileira de Psiquiatria</secondary-title></titles><periodical><full-title>Revista Brasileira de Psiquiatria</full-title></periodical><pages>332-337</pages><volume>31</volume><number>4</number><dates><year>2009</year></dates><isbn>1516-4446</isbn><urls></urls></record></Cite></EndNote>(2009) reported on personality psychopathology in women married to problem gamblers that: “high reward dependence suggests a need for attachment and strong bonds… reported as traits related to dependent personality disorder” ADDIN EN.CITE <EndNote><Cite><Author>Mazzoleni</Author><Year>2009</Year><RecNum>165</RecNum><Pages>335</Pages><DisplayText>(Mazzoleni et al., 2009, p. 335)</DisplayText><record><rec-number>165</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538094046">165</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mazzoleni, Maria Helena B</author><author>Gorenstein, Clarice</author><author>Fuentes, Daniel</author><author>Tavares, Hermano</author></authors></contributors><titles><title>Wives of pathological gamblers: personality traits, depressive symptoms and social adjustment</title><secondary-title>Revista Brasileira de Psiquiatria</secondary-title></titles><periodical><full-title>Revista Brasileira de Psiquiatria</full-title></periodical><pages>332-337</pages><volume>31</volume><number>4</number><dates><year>2009</year></dates><isbn>1516-4446</isbn><urls></urls></record></Cite></EndNote>(Mazzoleni et al., 2009, p. 335). Borrowed from the substance abuse literature, key characteristics of co-dependence include the external focussing of one’s energy, self-sacrificing behaviour, attempts to control other people and suppressing one’s own emotions ADDIN EN.CITE <EndNote><Cite><Author>Dear</Author><Year>2005</Year><RecNum>171</RecNum><DisplayText>(Dear, Roberts, & Lange, 2005)</DisplayText><record><rec-number>171</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538439626">171</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dear, Greg E</author><author>Roberts, Clare M</author><author>Lange, Lois</author></authors></contributors><titles><title>Defining codependency: A thematic analysis of published definitions</title></titles><dates><year>2005</year></dates><urls></urls></record></Cite></EndNote>(Dear, Roberts, & Lange, 2005). Co-dependent women, overly focussed on taking care of others, are held to neglect key intra-personal psychological tasks, resulting in a “disturbance of identity development” ADDIN EN.CITE <EndNote><Cite><Author>Knudson</Author><Year>2012</Year><RecNum>166</RecNum><DisplayText>(Knudson & Terrell, 2012)</DisplayText><record><rec-number>166</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538096551">166</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Knudson, Theresa M</author><author>Terrell, Heather K</author></authors></contributors><titles><title>Codependency, perceived interparental conflict, and substance abuse in the family of origin</title><secondary-title>The American Journal of Family Therapy</secondary-title></titles><periodical><full-title>The American Journal of Family Therapy</full-title></periodical><pages>245-257</pages><volume>40</volume><number>3</number><dates><year>2012</year></dates><isbn>0192-6187</isbn><urls></urls></record></Cite></EndNote>(Knudson & Terrell, 2012). Co-dependency tends to define women as ‘relationship addicts’ ADDIN EN.CITE <EndNote><Cite><Author>Collins</Author><Year>1993</Year><RecNum>174</RecNum><DisplayText>(Collins, 1993)</DisplayText><record><rec-number>174</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538441344">174</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Collins, Barbara G</author></authors></contributors><titles><title>Reconstruing codependency using self-in-relation theory: A feminist perspective</title><secondary-title>Social Work</secondary-title></titles><periodical><full-title>Social Work</full-title></periodical><pages>470-476</pages><volume>38</volume><number>4</number><dates><year>1993</year></dates><isbn>1545-6846</isbn><urls></urls></record></Cite></EndNote>(Collins, 1993). For example:Co-dependent [partners of gamblers] often take on a martyr’s role and become “benefactors” to an individual in need. When the caretaking becomes compulsive, the co-dependent feels choiceless and helpless in the relationship, but is unable to break away from the cycle of behaviour that causes it. Co-dependents view themselves as victims, and are attracted to that same weakness in love and friendship relationships. ADDIN EN.CITE <EndNote><Cite><Author>Slezáková</Author><Year>2018</Year><RecNum>163</RecNum><Pages>49-50</Pages><DisplayText>(Slezáková, 2018, pp. 49-50)</DisplayText><record><rec-number>163</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538091553">163</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Slezáková, Silvia</author></authors></contributors><titles><title>Pathological Gambling and Co-dependence</title><secondary-title>Acta Ludologica</secondary-title></titles><periodical><full-title>Acta Ludologica</full-title></periodical><pages>40-51</pages><volume>1</volume><number>1</number><dates><year>2018</year></dates><isbn>2585-8599</isbn><urls></urls></record></Cite></EndNote>(Slezáková, 2018, pp. 49-50)The concept of ‘co-dependency’ is held to be commonly employed in gambling therapy ADDIN EN.CITE <EndNote><Cite><Author>Calderwood</Author><Year>2014</Year><RecNum>167</RecNum><DisplayText>(Calderwood & Rajesparam, 2014; Orford, 2014)</DisplayText><record><rec-number>167</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538096753">167</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Calderwood, Kimberly A</author><author>Rajesparam, Anne</author></authors></contributors><titles><title>Applying the codependency concept to concerned significant others of problem gamblers: Words of caution</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-16</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite><Cite><Author>Orford</Author><Year>2014</Year><RecNum>164</RecNum><record><rec-number>164</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538093362">164</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>A response to Calderwood and Rajesparam's ideas on codependence</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-4</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Calderwood & Rajesparam, 2014; Orford, 2014), particularly in the United States ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>1994</Year><RecNum>183</RecNum><DisplayText>(Orford, 1994)</DisplayText><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539291103">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>Empowering family and friends: a new approach to the secondary prevention of addiction</title><secondary-title>Drug and alcohol review</secondary-title></titles><periodical><full-title>Drug and alcohol review</full-title></periodical><pages>417-429</pages><volume>13</volume><number>4</number><dates><year>1994</year></dates><isbn>0959-5236</isbn><urls></urls></record></Cite></EndNote>(Orford, 1994), and the concept certainly remains present in popular culture and self-help literature ADDIN EN.CITE <EndNote><Cite><Author>Lancer</Author><Year>2015</Year><RecNum>168</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Lancer, 2015; Wegscheider-Cruse & Cruse, 2012; Weinhold & Weinhold, 2008)</DisplayText><record><rec-number>168</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538102926">168</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Lancer, Darlene</author></authors></contributors><titles><title>Codependency for Dummies</title></titles><dates><year>2015</year></dates><publisher>John Wiley & Sons</publisher><isbn>1118982096</isbn><urls></urls></record></Cite><Cite><Author>Weinhold</Author><Year>2008</Year><RecNum>169</RecNum><record><rec-number>169</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538103298">169</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Weinhold, Barry K</author><author>Weinhold, Janae B</author></authors></contributors><titles><title>Breaking free of the co-dependency trap</title></titles><dates><year>2008</year></dates><publisher>New World Library</publisher><isbn>1577316142</isbn><urls></urls></record></Cite><Cite><Author>Wegscheider-Cruse</Author><Year>2012</Year><RecNum>170</RecNum><record><rec-number>170</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538103350">170</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Wegscheider-Cruse, Sharon</author><author>Cruse, Joseph</author></authors></contributors><titles><title>Understanding codependency, updated and expanded: The science behind it and how to break the cycle</title></titles><dates><year>2012</year></dates><publisher>Health Communications, Inc.</publisher><isbn>0757316174</isbn><urls></urls></record></Cite></EndNote>(e.g. Lancer, 2015; Wegscheider-Cruse & Cruse, 2012; Weinhold & Weinhold, 2008). The goal of therapeutic approaches to address women as co-dependent enablers has been to facilitate self-reliance, and encourage women to ‘work on themselves’ in therapy: …the spouse is assisted in giving up the responsibility for causing the gambling and/or changing the gambler and instead focusing on the change within herself. ADDIN EN.CITE <EndNote><Cite><Author>Steinberg</Author><Year>1993</Year><RecNum>177</RecNum><Pages>154</Pages><DisplayText>(Steinberg, 1993, p. 154)</DisplayText><record><rec-number>177</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040947">177</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Steinberg, Marvin A</author></authors></contributors><titles><title>Couples treatment issues for recovering male compulsive gamblers and their partners</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>153-167</pages><volume>9</volume><number>2</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Steinberg, 1993, p. 154) The lead facilitator’s first question to the CSO [concerned significant other] was “What is your problem?”… the facilitator told the group that family members [affected by gambling] rarely come to more than one session because they will not admit that they have a problem. ADDIN EN.CITE <EndNote><Cite><Author>Calderwood</Author><Year>2014</Year><RecNum>167</RecNum><Pages>2</Pages><DisplayText>(Calderwood & Rajesparam, 2014, p. 2)</DisplayText><record><rec-number>167</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538096753">167</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Calderwood, Kimberly A</author><author>Rajesparam, Anne</author></authors></contributors><titles><title>Applying the codependency concept to concerned significant others of problem gamblers: Words of caution</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-16</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Calderwood & Rajesparam, 2014, p. 2) Patford ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Patford</Author><Year>2009</Year><RecNum>186</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>186</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539310722">186</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Patford, Janet</author></authors></contributors><titles><title>For worse, for poorer and in ill health: how women experience, understand and respond to a partner’s gambling problems</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>177-189</pages><volume>7</volume><number>1</number><dates><year>2009</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(2009) provided glimpses of how women affected others may implicate themselves in the problematic gambling using psychological terms:…two said their own behaviour had been alienating: ‘If I had met him with a happier face at home…’ A fourth confessed that she sometimes avoided confrontation… A fifth acknowledged her reliance on denial. ADDIN EN.CITE <EndNote><Cite><Author>Patford</Author><Year>2009</Year><RecNum>186</RecNum><Suffix> emphasis added</Suffix><Pages>183</Pages><DisplayText>(Patford, 2009, p. 183 emphasis added)</DisplayText><record><rec-number>186</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539310722">186</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Patford, Janet</author></authors></contributors><titles><title>For worse, for poorer and in ill health: how women experience, understand and respond to a partner’s gambling problems</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>177-189</pages><volume>7</volume><number>1</number><dates><year>2009</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Patford, 2009, p. 183 emphasis added)The notion of ‘co-dependency’ has been taken up by women to advocate for their own support and treatment needs within gambling treatment models that have centralised the gambler. Steinberg ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Steinberg</Author><Year>1993</Year><RecNum>177</RecNum><DisplayText>(1993)</DisplayText><record><rec-number>177</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040947">177</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Steinberg, Marvin A</author></authors></contributors><titles><title>Couples treatment issues for recovering male compulsive gamblers and their partners</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>153-167</pages><volume>9</volume><number>2</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(1993) argued that increased attention to the “co-dependent process” augmented a perception of couple and family interventions as purely ancillary to treatment for gamblers. The identification of women partners as psychological subjects in their own right has expanded the remit of psychological professionals to intervene on their behalf. Mazzoleni et al ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Mazzoleni</Author><Year>2009</Year><RecNum>165</RecNum><Pages>332</Pages><DisplayText>(2009, p. 332)</DisplayText><record><rec-number>165</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538094046">165</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mazzoleni, Maria Helena B</author><author>Gorenstein, Clarice</author><author>Fuentes, Daniel</author><author>Tavares, Hermano</author></authors></contributors><titles><title>Wives of pathological gamblers: personality traits, depressive symptoms and social adjustment</title><secondary-title>Revista Brasileira de Psiquiatria</secondary-title></titles><periodical><full-title>Revista Brasileira de Psiquiatria</full-title></periodical><pages>332-337</pages><volume>31</volume><number>4</number><dates><year>2009</year></dates><isbn>1516-4446</isbn><urls></urls></record></Cite></EndNote>(2009, p. 332) refer to the ‘double edged’ nature of co-dependency for women affected by gambling as “legitimising [their] problems, while stigmatizing them as inept and needy”. Women also positioned themselves as ‘needy enablers’, explicitly claiming co-dependency as a helpful way of understanding their own experience and needs ADDIN EN.CITE <EndNote><Cite><Author>Calderwood</Author><Year>2014</Year><RecNum>167</RecNum><DisplayText>(Calderwood & Rajesparam, 2014; Orford, 2014)</DisplayText><record><rec-number>167</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538096753">167</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Calderwood, Kimberly A</author><author>Rajesparam, Anne</author></authors></contributors><titles><title>Applying the codependency concept to concerned significant others of problem gamblers: Words of caution</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-16</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite><Cite><Author>Orford</Author><Year>2014</Year><RecNum>164</RecNum><record><rec-number>164</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538093362">164</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>A response to Calderwood and Rajesparam's ideas on codependence</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-4</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Calderwood & Rajesparam, 2014; Orford, 2014). A positioning as ‘part of the problem’ seems to have enabled both women and clinicians to emphasise and include family in addressing gambling problems, albeit in ways that can be seen and experienced as problematic for some women.Gambling studies have examined how positioning women as ‘co-dependent’ has operated to pathologise women PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DYWxkZXJ3b29kPC9BdXRob3I+PFllYXI+MjAxNDwvWWVh
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ADDIN EN.CITE.DATA (Calderwood & Rajesparam, 2014; Lee, 2014; Orford, 2014). Hollway ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Hollway</Author><Year>2006</Year><RecNum>178</RecNum><DisplayText>(2006)</DisplayText><record><rec-number>178</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539041979">178</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hollway, Wendy</author></authors></contributors><titles><title>Family figures in 20th-century British ‘psy’discourses</title><secondary-title>Theory & psychology</secondary-title></titles><periodical><full-title>Theory & psychology</full-title></periodical><pages>443-464</pages><volume>16</volume><number>4</number><dates><year>2006</year></dates><isbn>0959-3543</isbn><urls></urls></record></Cite></EndNote>(2006) emphasised the key role of psychological discourses in positioning mothers as either ‘not caring enough’, or ‘caring too much’. The ‘co-dependence’ concept can also be seen as infused with psychological and gender discourses, which construct some women as ‘monstrously feminine’ ADDIN EN.CITE <EndNote><Cite><Author>Kristeva</Author><Year>1982</Year><RecNum>172</RecNum><DisplayText>(Kristeva, 1982)</DisplayText><record><rec-number>172</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538439755">172</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Kristeva, Julia</author></authors></contributors><titles><title>Powers of horror: an essay on abjection</title></titles><dates><year>1982</year></dates><pub-location>New York</pub-location><publisher>Columbia University Press.</publisher><urls></urls></record></Cite></EndNote>(Kristeva, 1982) by caring to excess. Feminist critics have argued that most of the characteristics ascribed to co-dependency (caring for and in turn being dependent on others) are aspects of traditional female roles made more or less compulsory in situations of gender inequality PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CYWJjb2NrPC9BdXRob3I+PFllYXI+MTk5NTwvWWVhcj48
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ADDIN EN.CITE.DATA (Babcock & McKay, 1995; Collins, 1993; McKay, 1995). McKay ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>McKay</Author><Year>1995</Year><RecNum>175</RecNum><DisplayText>(1995)</DisplayText><record><rec-number>175</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538441375">175</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McKay, Christine</author></authors></contributors><titles><title>Codependency: The pathologizing of female oppression</title><secondary-title>Challenging codependency: Feminist critiques</secondary-title></titles><periodical><full-title>Challenging codependency: Feminist critiques</full-title></periodical><pages>219-240</pages><dates><year>1995</year></dates><urls></urls></record></Cite></EndNote>(1995) went so far as to identify co-dependency as the pathologising of female oppression. Assuming women to be “pathologically vulnerable or over-controlling” ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>2014</Year><RecNum>164</RecNum><Pages>1</Pages><DisplayText>(Orford, 2014, p. 1)</DisplayText><record><rec-number>164</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538093362">164</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>A response to Calderwood and Rajesparam's ideas on codependence</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-4</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Orford, 2014, p. 1), can marginalise them and discourage their gambling support service use ADDIN EN.CITE <EndNote><Cite><Author>Calderwood</Author><Year>2014</Year><RecNum>167</RecNum><DisplayText>(Calderwood & Rajesparam, 2014)</DisplayText><record><rec-number>167</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538096753">167</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Calderwood, Kimberly A</author><author>Rajesparam, Anne</author></authors></contributors><titles><title>Applying the codependency concept to concerned significant others of problem gamblers: Words of caution</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-16</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Calderwood & Rajesparam, 2014).Positioning women as ‘needy enablers’ also defined the goals of appropriate support practice narrowly (e.g. as about encouraging self-reliance). This may place limits around the ability of clinicians and support workers to be client-centred (i.e. to respond to the gambling related harm and needs as experienced and defined by women seeking assistance). Further, when women were positioned as ‘needy enablers’, the role of psychological processes was emphasised, obscuring the influence of political processes and gender dynamics on possible ways of being and relationship forms. Women who constructed their experience in these individual psychological terms, seemed much less able to “explicitly link their partner’s gambling to factors in the wider social environment” such as a pro-gambling work culture, government acceptance of gambling products and entities responsible for producing and promoting gambling machines and services ADDIN EN.CITE <EndNote><Cite><Author>Patford</Author><Year>2009</Year><RecNum>186</RecNum><Pages>183</Pages><DisplayText>(Patford, 2009, p. 183)</DisplayText><record><rec-number>186</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539310722">186</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Patford, Janet</author></authors></contributors><titles><title>For worse, for poorer and in ill health: how women experience, understand and respond to a partner’s gambling problems</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>177-189</pages><volume>7</volume><number>1</number><dates><year>2009</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Patford, 2009, p. 183). Women as ‘intervention allies’Gambling studies research also positioned women as concerned significant others (CSOs) who were active and integral participants in the gambler’s recovery: “If they are able to hinder the rehabilitation process, spouses of pathological gamblers are also able to foster change in their partners” ADDIN EN.CITE <EndNote><Cite><Author>Bertrand</Author><Year>2008</Year><RecNum>176</RecNum><Pages>397</Pages><DisplayText>(Bertrand et al., 2008, p. 397)</DisplayText><record><rec-number>176</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040591">176</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bertrand, Karine</author><author>Dufour, Magali</author><author>Wright, John</author><author>Lasnier, Beno?t</author></authors></contributors><titles><title>Adapted couple therapy (ACT) for pathological gamblers: A promising avenue</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>393</pages><volume>24</volume><number>3</number><dates><year>2008</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Bertrand et al., 2008, p. 397). Orford ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Orford</Author><Year>1994</Year><RecNum>183</RecNum><DisplayText>(1994)</DisplayText><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539291103">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>Empowering family and friends: a new approach to the secondary prevention of addiction</title><secondary-title>Drug and alcohol review</secondary-title></titles><periodical><full-title>Drug and alcohol review</full-title></periodical><pages>417-429</pages><volume>13</volume><number>4</number><dates><year>1994</year></dates><isbn>0959-5236</isbn><urls></urls></record></Cite></EndNote>(1994) described ‘empowering’ family and friends as a new more enlightened approach to addressing addiction. CSOs could become adjunct treatment professionals, responsible for extending the reach, influence and effectiveness of psychological therapies into the home:The inclusion of support people [in the CBT program] was primarily intended to aid participants in the implementation of the treatment plan, impose some accountability upon them, and reduce the likelihood of their interference with the program. ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Pages>235</Pages><DisplayText>(Dowling, 2014, p. 235)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Dowling, 2014, p. 235)Women partners and mothers have been produced as key intervention allies for gambling men, given their ‘natural’ supportive involvement in recovery processes as spouses or partners: As is typical of other addictions, it is the partner of the compulsive gambler who most often initiates therapeutic contact. Whether she arrives to treatment alone or with the gambler… ADDIN EN.CITE <EndNote><Cite><Author>Steinberg</Author><Year>1993</Year><RecNum>177</RecNum><Pages>155`, emphasis added</Pages><DisplayText>(Steinberg, 1993, pp. 155, emphasis added)</DisplayText><record><rec-number>177</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539040947">177</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Steinberg, Marvin A</author></authors></contributors><titles><title>Couples treatment issues for recovering male compulsive gamblers and their partners</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>153-167</pages><volume>9</volume><number>2</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Steinberg, 1993, pp. 155, emphasis added)Very few males (19%) were recruited to the project [evaluating support for CSOs]. This was not surprising since problem gamblers are predominantly male and CSOs are predominantly spouses or partners… it is possible that men may not be as negatively affected by being close to a problem gambler. ADDIN EN.CITE <EndNote><Cite><Author>Hodgins</Author><Year>2007</Year><RecNum>180</RecNum><Pages>227</Pages><DisplayText>(Hodgins, Toneatto, Makarchuk, Skinner, & Vincent, 2007, p. 227)</DisplayText><record><rec-number>180</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539049524">180</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hodgins, David C</author><author>Toneatto, Tony</author><author>Makarchuk, Karyn</author><author>Skinner, Wayne</author><author>Vincent, Susan</author></authors></contributors><titles><title>Minimal treatment approaches for concerned significant others of problem gamblers: a randomized controlled trial</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>215-230</pages><volume>23</volume><number>2</number><dates><year>2007</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Hodgins, Toneatto, Makarchuk, Skinner, & Vincent, 2007, p. 227) The assertion that CSOs tend to be women and ‘men may not be as negatively affected by being close to a problem gambler’ ascribed to women a greater interest or stake in addressing gambling harm in families. Dowling ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><DisplayText>(2014)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(2014) noted that male partners of problem gamblers were far less likely than female partners to agree to participate in the gambling treatment process. Studies of gambling CSOs were typically of women, or mostly women ADDIN EN.CITE <EndNote><Cite><Author>Hing</Author><Year>2013</Year><RecNum>181</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Hing, Tiyce, Holdsworth, & Nuske, 2013; Hodgins, Toneatto, et al., 2007)</DisplayText><record><rec-number>181</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539049624">181</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hing, Nerilee</author><author>Tiyce, Margaret</author><author>Holdsworth, Louise</author><author>Nuske, Elaine</author></authors></contributors><titles><title>All in the family: help-seeking by significant others of problem gamblers</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>396-408</pages><volume>11</volume><number>3</number><dates><year>2013</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Hodgins</Author><Year>2007</Year><RecNum>180</RecNum><record><rec-number>180</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539049524">180</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hodgins, David C</author><author>Toneatto, Tony</author><author>Makarchuk, Karyn</author><author>Skinner, Wayne</author><author>Vincent, Susan</author></authors></contributors><titles><title>Minimal treatment approaches for concerned significant others of problem gamblers: a randomized controlled trial</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>215-230</pages><volume>23</volume><number>2</number><dates><year>2007</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(e.g. Hing, Tiyce, Holdsworth, & Nuske, 2013; Hodgins, Toneatto, et al., 2007). New Zealand women (2.9%) were found to be more likely to identify their spouse/partner as having a gambling problem than men (1.5%) ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2014</Year><RecNum>36</RecNum><DisplayText>(Abbott, Bellringer, Garrett, & Mundy-McPherson, 2014)</DisplayText><record><rec-number>36</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520383203">36</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garrett, N</author><author>Mundy-McPherson, S </author></authors></contributors><titles><title>New Zealand 2012 National Gambling Study: Gambling harm and problem gambling (Report No. 2)</title></titles><dates><year>2014</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University of Technology, Gambling & Addictions Research Centre</publisher><urls></urls></record></Cite></EndNote>(Abbott, Bellringer, Garrett, & Mundy-McPherson, 2014). Clinical population research highlighted that in New Zealand and internationally, the majority of those seeking support in relation to a significant others’ problem gambling are women ADDIN EN.CITE <EndNote><Cite><Author>Hing</Author><Year>2013</Year><RecNum>181</RecNum><DisplayText>(Hing et al., 2013; Ministry of Health, 2018a)</DisplayText><record><rec-number>181</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539049624">181</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hing, Nerilee</author><author>Tiyce, Margaret</author><author>Holdsworth, Louise</author><author>Nuske, Elaine</author></authors></contributors><titles><title>All in the family: help-seeking by significant others of problem gamblers</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>396-408</pages><volume>11</volume><number>3</number><dates><year>2013</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Ministry of Health</Author><Year>2018</Year><RecNum>50</RecNum><record><rec-number>50</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520389574">50</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry of Health,</author></authors></contributors><titles><title>Intervention client data</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><urls><related-urls><url>;(Hing et al., 2013; Ministry of Health, 2018a). The identification of CSOs as key intervention allies for problem gamblers has led to recommendations and programmes for improving CSOs’ ability to support their gambler’s recovery, for example: [The self-help workbook] Helping the Problem Gambler, Helping Yourself…[involves] understanding problem gambling, becoming and staying motivated to help, changing the role you play, minimising your distress, engaging the gambler into treatment… numerous exercises are included in order to encourage the CSO to substitute new behaviours for earlier methods of dealing with the gambler. (Hodgins et al., 2007, p. 217)The goals of the modified [CRAFT] program are equivalent to those for CSOs of substance abusers: helping to persuade the gambler to enter treatment, helping to reduce gambling behaviour, and assisting CSOs with their own functioning. ADDIN EN.CITE <EndNote><Cite><Author>Makarchuk</Author><Year>2002</Year><RecNum>184</RecNum><Pages>127</Pages><DisplayText>(Makarchuk, Hodgins, & Peden, 2002, p. 127)</DisplayText><record><rec-number>184</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539292693">184</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Makarchuk, Karyn</author><author>Hodgins, David C</author><author>Peden, Nicole</author></authors></contributors><titles><title>Development of a brief intervention for concerned significant others of problem gamblers</title><secondary-title>Addictive Disorders & Their Treatment</secondary-title></titles><periodical><full-title>Addictive Disorders & Their Treatment</full-title></periodical><pages>126-134</pages><volume>1</volume><number>4</number><dates><year>2002</year></dates><isbn>1531-5754</isbn><urls></urls></record></Cite></EndNote>(Makarchuk, Hodgins, & Peden, 2002, p. 127)A positioning as intervention allies or caregivers opened up the possibility for women to be ‘empowered to care’ (as Orford, 1994 suggested). There were many reports in gambling studies literature of CSOs seeking advice and support from professionals (directly or through self-help guides), as they struggled to assist the gambler in their lives ADDIN EN.CITE <EndNote><Cite><Author>Rodda</Author><Year>2013</Year><RecNum>195</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Hing et al., 2013; Rodda, Lubman, Dowling, & McCann, 2013)</DisplayText><record><rec-number>195</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539653870">195</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rodda, Simone N</author><author>Lubman, Dan I</author><author>Dowling, Nicki A</author><author>McCann, Terence V</author></authors></contributors><titles><title>Reasons for using web-based counselling among family and friends impacted by problem gambling</title><secondary-title>Asian Journal of Gambling Issues and Public Health</secondary-title></titles><periodical><full-title>Asian Journal of Gambling Issues and Public Health</full-title></periodical><pages>12</pages><volume>3</volume><number>1</number><dates><year>2013</year></dates><isbn>2195-3007</isbn><urls></urls></record></Cite><Cite><Author>Hing</Author><Year>2013</Year><RecNum>181</RecNum><record><rec-number>181</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539049624">181</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hing, Nerilee</author><author>Tiyce, Margaret</author><author>Holdsworth, Louise</author><author>Nuske, Elaine</author></authors></contributors><titles><title>All in the family: help-seeking by significant others of problem gamblers</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>396-408</pages><volume>11</volume><number>3</number><dates><year>2013</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(e.g. Hing et al., 2013; Rodda, Lubman, Dowling, & McCann, 2013). In these cases, women could experience relief and a sense of validating authority through their alignment with the psychological profession, learning the ‘right’ things to say and do to promote recovery:Meeting with my therapist for me offered me the kind of support that I really needed… in terms of how I should be acting, what I should be saying, what I should not be saying… ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><Prefix>family member interviewed by </Prefix><Pages>301</Pages><DisplayText>(family member interviewed by Kourgiantakis, Saint-Jacques, & Tremblay, 2018, p. 301)</DisplayText><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(family member interviewed by Kourgiantakis, Saint-Jacques, & Tremblay, 2018, p. 301)Constructing their experience of gambling harm through the position of an intervention ally or caregiver enabled some women to feel useful, and to reduce their feelings of powerlessness. It offered them psychological techniques to manage their own emotional regulation, and pay great attention to their interactions with the gambler so that they do not inadvertently make the situation worse: I read articles, I read how to cope, I read how to help. So I feel like I’ve been active kind of behind the scenes here in helping him because I’ve done my own research and I’ve done my own things and I’ve applied them to him to try and make sure he stays on track… So, I haven’t been pushy. Just kind of supporting him and making it seem like I’m not telling him what to do. ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><Prefix>Family member interviewed by </Prefix><Pages>300</Pages><DisplayText>(Family member interviewed by Kourgiantakis et al., 2018, p. 300)</DisplayText><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Family member interviewed by Kourgiantakis et al., 2018, p. 300).‘Intervention allies’ were clearly psychological subjects invested with key modifiable indicators of psychological health and wellbeing (e.g. emotion regulation, motivation to care, communication techniques). In positioning women in this way, treatment approaches may inadvertently produce and reinforce women in stereotypical ways (e.g. as naturally caring), and as responsible for gamblers’ recovery. This tendency has been commented on in relation to Gamblers Anonymous (GA) where: “In short, loyal women have been integral to recovery” ADDIN EN.CITE <EndNote><Cite><Author>Ferentzy</Author><Year>2010</Year><RecNum>182</RecNum><Pages>488</Pages><DisplayText>(Ferentzy, Skinner, & Antze, 2010, p. 488)</DisplayText><record><rec-number>182</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539290793">182</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ferentzy, Peter</author><author>Skinner, Wayne</author><author>Antze, Paul</author></authors></contributors><titles><title>Changing spousal roles and their effect on recovery in gamblers anonymous: GamAnon, social support, wives and husbands</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>487-501</pages><volume>26</volume><number>3</number><dates><year>2010</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Ferentzy, Skinner, & Antze, 2010, p. 488). The ways in which being positioned as a loyal woman, intervention ally or caregiver can be experienced as harmful by women is shown in several accounts in gambling studies literature, for example:Is the family who lives with or leaves the gambler the problem too? Where does it end… this ‘problem’?... There was nothing I could do about my husband’s gambling. The problem gambling support services focussed on trying to get me to help my husband. It was soul destroying. Inside me there was a small voice trying to scream out that we needed help. Us. The family… It was me that was left to stop the rescuing and take the destructive abuse that followed… it was us that ended up leaving. ADDIN EN.CITE <EndNote><Cite><Author>Borrell</Author><Year>2008</Year><RecNum>185</RecNum><Prefix>'Anna' interviewed by </Prefix><Pages>231</Pages><DisplayText>('Anna' interviewed by Borrell, 2008b, p. 231)</DisplayText><record><rec-number>185</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539298311">185</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Borrell, Jennifer</author></authors></contributors><titles><title>Understanding problem gambling: The interaction of personal and structural processes</title></titles><dates><year>2008</year></dates><publisher>VDM Publishing</publisher><isbn>3639098056</isbn><urls></urls></record></Cite></EndNote>('Anna' interviewed by Borrell, 2008b, p. 231)I love him and I still do love him. But I can’t do it any more – I am not his mother. (Participant interviewed by Patford, 2009, p. 184).The caregiver position could also be taken up to denigrate and blame women who do not seem to ‘care enough’. For example, a participant described how just as a ‘good mother’ would not shirk her obligations to her children, a ‘good wife’ sticks by her gambling spouse: If you’ve got a child that’s a drug addict or a schizophrenic you cope with it. Or, if you’ve got a handicapped child, you cope with it. You don’t go, “Oh, woe is me! That is too hard – let’s bail out. (Participant interviewed by Patford, 2009, p. 186). These examples suggest how the practices of supporting a gambler’s recovery can be intertwined with traditional ideas about women and womanhood, motherhood and family responsibilities. Positioning women as ‘intervention allies’ tended to individualise women’s health and wellbeing, shutting down consideration of the ways in which gambling harm is beyond their personal control (i.e. exacerbated by gender dynamics and inequalities, linked to the practices of the gambler, as well as broader social and economic systems including the behaviours of the gambling industry). There are many important reasons why women may wish or need to extricate themselves from their relationships with people experiencing gambling problems, including situations of family violence and abuse ADDIN EN.CITE <EndNote><Cite><Author>Palmer du Preez</Author><Year>2018</Year><RecNum>196</RecNum><DisplayText>(NA Dowling et al., 2014; Palmer du Preez, Bellringer, et al., 2018)</DisplayText><record><rec-number>196</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539728252">196</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Palmer du Preez, K</author><author>Bellringer, Maria</author><author>Pearson, Janet</author><author>Dowling, Nicki</author><author>Suomi, Aino</author><author>Koziol-Mclain, Jane</author><author>Wilson, Denise</author><author>Jackson, Alun</author></authors></contributors><titles><title>Family violence in gambling help-seeking populations</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>1-18</pages><dates><year>2018</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>289</RecNum><record><rec-number>289</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559867411">289</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dowling, NA</author><author>Jackson, Alun C</author><author>Suomi, Aino</author><author>Lavis, Tiffany</author><author>Thomas, Shane A</author><author>Patford, Janet</author><author>Harvey, Peter</author><author>Battersby, Malcolm</author><author>Koziol-Mclain, Jane</author><author>Abbott, Max</author></authors></contributors><titles><title>Problem gambling and family violence: Prevalence and patterns in treatment-seekers</title><secondary-title>Addictive behaviors</secondary-title></titles><periodical><full-title>Addictive behaviors</full-title></periodical><pages>1713-1717</pages><volume>39</volume><number>12</number><dates><year>2014</year></dates><isbn>0306-4603</isbn><urls></urls></record></Cite></EndNote>(NA Dowling et al., 2014; Palmer du Preez, Bellringer, et al., 2018). Feeling ‘obliged to care’, is likely to complicate these processes. To the extent that psychological services foster the expectation that women can or should be ‘intervention allies’, they run the risk exacerbating gambling related harm for women. Women under strainA smaller body of literature positioned women as ‘under strain’. This literature draws on and interprets population, clinical and community based research identifying the multifaceted and complex nature of gambling harm experienced by CSOs ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2013</Year><RecNum>190</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Kourgiantakis et al., 2013; Riley, Harvey, Crisp, Battersby, & Lawn, 2018)</DisplayText><record><rec-number>190</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539558737">190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Problem gambling and families: A systematic review</title><secondary-title>Journal of Social Work Practice in the Addictions</secondary-title></titles><periodical><full-title>Journal of Social Work Practice in the Addictions</full-title></periodical><pages>353-372</pages><volume>13</volume><number>4</number><dates><year>2013</year></dates><isbn>1533-256X</isbn><urls></urls></record></Cite><Cite><Author>Riley</Author><Year>2018</Year><RecNum>191</RecNum><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539637407">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Riley, Ben J</author><author>Harvey, Peter</author><author>Crisp, Beth R</author><author>Battersby, Malcolm</author><author>Lawn, Sharon</author></authors></contributors><titles><title>Gambling-related harm as reported by concerned significant others: a systematic review and meta-synthesis of empirical studies</title><secondary-title>Journal of Family Studies</secondary-title></titles><periodical><full-title>Journal of Family Studies</full-title></periodical><pages>1-19</pages><dates><year>2018</year></dates><isbn>1322-9400</isbn><urls></urls></record></Cite></EndNote>(e.g. Kourgiantakis et al., 2013; Riley, Harvey, Crisp, Battersby, & Lawn, 2018). This subject position has been brought into being through the psychological notions of stress and strain: …when an individual has a gambling problem, this can be highly stressful for family members and should not be viewed as family pathology, but as stressful circumstances… [problem gambling] can put a strain on family members’ health and the higher the stress the greater the strain. This accounts for the high rates of mental and physical health problems in families coping with [problem gambling]. ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><Pages>296</Pages><DisplayText>(Kourgiantakis et al., 2018, p. 296)</DisplayText><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Kourgiantakis et al., 2018, p. 296)Drawing on a stress-strain-coping-support (SSCS) model of addiction, women could be positioned as ‘normal people placed in an abnormal situation’ PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5PcmZvcmQ8L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (e.g. Orford, Copello, Velleman, & Templeton, 2010; Orford, Templeton, Velleman, & Copello, 2005; Templeton, Velleman, & Russell, 2010). While the gambling situation produced their trauma and suffering, women could be supported to reduce their distress and cope more effectively, e.g.: …family members need to come to an understanding of the gambling problem and respond to or cope with this issue in ways the [family member] views as effective. This coping can help reduce the strain on family members… good quality social support is an important resource for coping… ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><Pages>296</Pages><DisplayText>(Kourgiantakis et al., 2018, p. 296)</DisplayText><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Kourgiantakis et al., 2018, p. 296)This position holds that while a) family focussed therapies can reduce the severity and range of harms individuals and families experience, and b) family involvement can improve treatment engagement and outcomes for problem gamblers: “It remains an open question whether these two outcomes are compatible.” ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>1994</Year><RecNum>183</RecNum><Pages>420</Pages><DisplayText>(Orford, 1994, p. 420)</DisplayText><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539291103">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>Empowering family and friends: a new approach to the secondary prevention of addiction</title><secondary-title>Drug and alcohol review</secondary-title></titles><periodical><full-title>Drug and alcohol review</full-title></periodical><pages>417-429</pages><volume>13</volume><number>4</number><dates><year>1994</year></dates><isbn>0959-5236</isbn><urls></urls></record></Cite></EndNote>(Orford, 1994, p. 420). Therefore, CSOs should become the focus of help and support in their own right, without necessary reference to the gambler’s needs or issues. For example a ‘5-step’ intervention (self-help and guided) for family members of those with gambling problems emphasises: Identifying stressors, increasing knowledge and understanding of gambling, evaluating and improving coping resources, identifying and developing ongoing social support networks ADDIN EN.CITE <EndNote><Cite><Author>Copello</Author><Year>2012</Year><RecNum>201</RecNum><DisplayText>(Copello, Bowden-Jones, Cousins, Orford, & George, 2012)</DisplayText><record><rec-number>201</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539739625">201</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Copello, Alex</author><author>Bowden-Jones, Henrietta</author><author>Cousins, J</author><author>Orford, Jim</author><author>George, S</author></authors></contributors><titles><title>Gambling, the Family, and You: A Self Help Workbook for Family Members</title></titles><dates><year>2012</year></dates><pub-location>UK</pub-location><publisher>The National Problem Gambling Clinic and the UK ADF Research Group</publisher><urls></urls></record></Cite></EndNote>(Copello, Bowden-Jones, Cousins, Orford, & George, 2012). The role of professional support is to facilitate this process:What primary health care workers can do…[is] Listen non-judgementally, provide useful information, counsel non-directively about ways of coping, help strengthen social support and joint problem-solving in the family. ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>1994</Year><RecNum>183</RecNum><Pages>425</Pages><DisplayText>(Orford, 1994, p. 425)</DisplayText><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539291103">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>Empowering family and friends: a new approach to the secondary prevention of addiction</title><secondary-title>Drug and alcohol review</secondary-title></titles><periodical><full-title>Drug and alcohol review</full-title></periodical><pages>417-429</pages><volume>13</volume><number>4</number><dates><year>1994</year></dates><isbn>0959-5236</isbn><urls></urls></record></Cite></EndNote>(Orford, 1994, p. 425)In contrast to the ‘needy enabler’ and ‘intervention ally’, the ‘woman under strain’ was not comfortably identified as a gendered subject. This body of literature charged previous research with “female bias” in over-researching women CSOs in treatment ADDIN EN.CITE <EndNote><Cite><Author>Bowden-Jones</Author><Year>2015</Year><RecNum>202</RecNum><DisplayText>(Bowden-Jones & George, 2015)</DisplayText><record><rec-number>202</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539740377">202</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Bowden-Jones, Henrietta</author><author>George, Sanju</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>George, Sanju</author></secondary-authors></contributors><titles><title>Family interventions in gambling</title><secondary-title>A clinician's guide to working with problem gamblers</secondary-title></titles><pages>163-171</pages><dates><year>2015</year></dates><pub-location>UK</pub-location><publisher>Routledge</publisher><isbn>1317560485</isbn><urls></urls></record></Cite></EndNote>(Bowden-Jones & George, 2015), noting that women and men are similarly identified as CSOs in population research ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2013</Year><RecNum>218</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Svensson, Romild, & Shepherdson, 2013)</DisplayText><record><rec-number>218</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1541635826">218</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author><author>Shepherdson, Emma</author></authors></contributors><titles><title>The concerned significant others of people with gambling problems in a national representative sample in Sweden–a 1 year follow-up study</title><secondary-title>BMC Public Health</secondary-title></titles><periodical><full-title>BMC public health</full-title></periodical><pages>1087</pages><volume>13</volume><number>1</number><dates><year>2013</year></dates><isbn>1471-2458</isbn><urls></urls></record></Cite></EndNote>(e.g. Svensson, Romild, & Shepherdson, 2013) and advocating that “future research should focus on male CSOs” ADDIN EN.CITE <EndNote><Cite><Author>Riley</Author><Year>2018</Year><RecNum>191</RecNum><Pages>15</Pages><DisplayText>(Riley et al., 2018, p. 15)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539637407">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Riley, Ben J</author><author>Harvey, Peter</author><author>Crisp, Beth R</author><author>Battersby, Malcolm</author><author>Lawn, Sharon</author></authors></contributors><titles><title>Gambling-related harm as reported by concerned significant others: a systematic review and meta-synthesis of empirical studies</title><secondary-title>Journal of Family Studies</secondary-title></titles><periodical><full-title>Journal of Family Studies</full-title></periodical><pages>1-19</pages><dates><year>2018</year></dates><isbn>1322-9400</isbn><urls></urls></record></Cite></EndNote>(Riley et al., 2018, p. 15).Positioning women ‘under strain’ seemed to create space for women to describe how the gambling is affecting them in their own terms. From this position, women were able to paint a visceral picture of their own fear, lack of safety, emotional and physical burn-out e.g.: Christine, for example, described her situation as so ‘frightening and confronting’ that she ‘felt like she was chained and drowning’, Similarly Gail stressed: “It was like trying to stop a tidal wave. Fear, incredible fear and issues of safety… Fear for your life. Fear for your future. I would be shaking with anger as I went through his stuff… there was a fear of finding something. I was a mess. ADDIN EN.CITE <EndNote><Cite><Author>Holdsworth</Author><Year>2013</Year><RecNum>224</RecNum><Pages>7</Pages><DisplayText>(Holdsworth, Nuske, Tiyce, et al., 2013, p. 7)</DisplayText><record><rec-number>224</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1542578245">224</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holdsworth, Louise</author><author>Nuske, Elaine</author><author>Tiyce, Margaret</author><author>Hing, Nerilee</author></authors></contributors><titles><title>Impacts of gambling problems on partners: partners’ interpretations</title><secondary-title>Asian Journal of Gambling Issues and Public Health</secondary-title></titles><periodical><full-title>Asian Journal of Gambling Issues and Public Health</full-title></periodical><pages>11</pages><volume>3</volume><number>1</number><dates><year>2013</year><pub-dates><date>June 20</date></pub-dates></dates><isbn>2195-3007</isbn><label>Holdsworth2013</label><work-type>journal article</work-type><urls><related-urls><url>;(Holdsworth, Nuske, Tiyce, et al., 2013, p. 7).As subject to strain caused by problem gambling others, women described seeking support to alleviate their suffering. Women seemed more able to place limits around their capacity to enter into a caregiver role e.g.:I can't put myself in that vulnerable situation. Aside from the gambling and the finance and the debts, he needs so much emotional support that he'll suck me dry and there'll be nothing… the intense emotional support he needs, there's nothing for myself. I think it'd just end in complete disaster, so I know there's no way I can put myself in that situation. ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2017</Year><RecNum>17</RecNum><Prefix>female affected other interviewed by </Prefix><Pages>106</Pages><DisplayText>(female affected other interviewed by Browne, Bellringer, et al., 2017, p. 106)</DisplayText><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511829103">17</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Bellringer, Maria</author><author>Greer, Nancy</author><author>Kolandai-Matchett, Komathi</author><author>Rawat, Vijay</author><author>Langham, Erika</author><author>Rockloff, Matthew</author><author>Palmer Du Preez, Katie</author><author>Abbott, Max</author></authors></contributors><titles><title>Measuring the burden of gambling harm in New Zealand</title></titles><dates><year>2017</year></dates><publisher>New Zealand Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(female affected other interviewed by Browne, Bellringer, et al., 2017, p. 106)One of the main things that my therapist had said to me was that I’m not his therapist… ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><Prefix>family member interviewed by </Prefix><Pages>301</Pages><DisplayText>(family member interviewed by Kourgiantakis et al., 2018, p. 301)</DisplayText><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(family member interviewed by Kourgiantakis et al., 2018, p. 301)The psychological profession could validate women’s personal boundaries and safety concerns. This offer of validation would seem to be important for women in light of persistent findings that people with gambling issues tend to downplay and/or deny the impact that their behaviour has on their partners PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DdW5oYTwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (see Cunha et al., 2015; Landon, Grayson, & Roberts, 2017; Patford, 2009). In addition, the question of whether or not to leave a physically, emotionally and/or financially abusive relationship has been highlighted as a key struggle for women with gambling partners, particularly those with children ADDIN EN.CITE <EndNote><Cite><Author>Patford</Author><Year>2009</Year><RecNum>186</RecNum><DisplayText>(Kourgiantakis et al., 2018; Patford, 2009)</DisplayText><record><rec-number>186</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539310722">186</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Patford, Janet</author></authors></contributors><titles><title>For worse, for poorer and in ill health: how women experience, understand and respond to a partner’s gambling problems</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>177-189</pages><volume>7</volume><number>1</number><dates><year>2009</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Kourgiantakis</Author><Year>2018</Year><RecNum>187</RecNum><record><rec-number>187</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539555974">187</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Facilitators and barriers to family involvement in problem gambling treatment</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>291-312</pages><volume>16</volume><number>2</number><dates><year>2018</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Kourgiantakis et al., 2018; Patford, 2009). In the gambling studies intervention literature reviewed, the opportunity to explore how gambling harm affects women, still tended to be narrowed by the deployment of psychological terms. These included “identifying stressors” followed by “advantages and disadvantages of how [the women] respond” to stress and the need to provide them with psychoeducation ADDIN EN.CITE <EndNote><Cite><Author>Bowden-Jones</Author><Year>2015</Year><RecNum>202</RecNum><Prefix>e.g. </Prefix><Pages>167</Pages><DisplayText>(e.g. Bowden-Jones & George, 2015, p. 167)</DisplayText><record><rec-number>202</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539740377">202</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Bowden-Jones, Henrietta</author><author>George, Sanju</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>George, Sanju</author></secondary-authors></contributors><titles><title>Family interventions in gambling</title><secondary-title>A clinician's guide to working with problem gamblers</secondary-title></titles><pages>163-171</pages><dates><year>2015</year></dates><pub-location>UK</pub-location><publisher>Routledge</publisher><isbn>1317560485</isbn><urls></urls></record></Cite></EndNote>(e.g. Bowden-Jones & George, 2015, p. 167). The woman under strain was largely positioned as an individual psychological subject, capable of learning about gambling problems and adaptive coping techniques in order to improve her wellbeing. However, given the level of distress women can be in, it seems possible that women affected by the gambling of others may indeed benefit from approaches which allow for “more in-depth healing than learning stress-coping skills” ADDIN EN.CITE <EndNote><Cite><Author>Lee</Author><Year>2014</Year><RecNum>162</RecNum><Pages>3</Pages><DisplayText>(Lee, 2014, p. 3)</DisplayText><record><rec-number>162</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537927065">162</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lee, Bonnie K</author></authors></contributors><titles><title>Where codependency takes us: A commentary</title></titles><dates><year>2014</year></dates><urls></urls></record></Cite></EndNote>(Lee, 2014, p. 3). For example, Ng? Pou W?hine provides a culturally embedded intervention to support M?ori women on a collective journey to develop and strengthen their potential, so that they are better positioned to address risky and problem gambling behaviours in families and communities ADDIN EN.CITE <EndNote><Cite><Author>Morrison</Author><Year>2013</Year><RecNum>315</RecNum><DisplayText>(Morrison & Wilson, 2013)</DisplayText><record><rec-number>315</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561931204">315</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Morrison, Laurie</author><author>Wilson, Denise</author></authors></contributors><titles><title>Ngā pou wāhine: A framework of empowerment for Māori women and gambling misuse</title><secondary-title>Mai Journal</secondary-title></titles><periodical><full-title>Mai Journal</full-title></periodical><volume>2</volume><number>2</number><dates><year>2013</year></dates><urls></urls></record></Cite></EndNote>(Morrison & Wilson, 2013).Gender discourses influenced women’s experiences of gambling related stress. For example, New Zealand women affected by the gambling of others, described negotiating powerful gender role ideals (e.g. carer, wife, and mother) that exacerbated their experience of gambling harm ADDIN EN.CITE <EndNote><Cite><Author>Palmer du Preez</Author><Year>2018</Year><RecNum>53</RecNum><DisplayText>(Palmer du Preez, Mauchline, et al., 2018)</DisplayText><record><rec-number>53</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520459120">53</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Palmer du Preez, K</author><author>Mauchline, L</author><author>Dyke, I</author><author>Will, U</author><author>Landon, J</author><author>Bellringer, M</author></authors></contributors><titles><title>Exploratory studies of gambling impacts on women in vulnerable populations</title><secondary-title>International Gambling Conference</secondary-title></titles><dates><year>2018</year><pub-dates><date>13 February</date></pub-dates></dates><pub-location>Auckland</pub-location><urls></urls></record></Cite><Cite><Author>Palmer du Preez</Author><Year>2018</Year><RecNum>53</RecNum><record><rec-number>53</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520459120">53</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Palmer du Preez, K</author><author>Mauchline, L</author><author>Dyke, I</author><author>Will, U</author><author>Landon, J</author><author>Bellringer, M</author></authors></contributors><titles><title>Exploratory studies of gambling impacts on women in vulnerable populations</title><secondary-title>International Gambling Conference</secondary-title></titles><dates><year>2018</year><pub-dates><date>13 February</date></pub-dates></dates><pub-location>Auckland</pub-location><urls></urls></record></Cite></EndNote>(Palmer du Preez, Mauchline, et al., 2018). Fear of being seen as a ‘bad mother’ or unable to care effectively for families can operate to prevent women, particularly those with children and/or other caring responsibilities, from accessing gambling support ADDIN EN.CITE <EndNote><Cite><Author>J?rvinen-Tassopoulos</Author><Year>2016</Year><RecNum>212</RecNum><DisplayText>(J?rvinen-Tassopoulos, 2016; Palmer du Preez, Mauchline, et al., 2018)</DisplayText><record><rec-number>212</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540775930">212</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>J?rvinen-Tassopoulos, Johanna</author></authors></contributors><titles><title>Problem gambling and drinking among Finnish women</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>27-42</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite><Cite><Author>Palmer du Preez</Author><Year>2018</Year><RecNum>53</RecNum><record><rec-number>53</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520459120">53</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Palmer du Preez, K</author><author>Mauchline, L</author><author>Dyke, I</author><author>Will, U</author><author>Landon, J</author><author>Bellringer, M</author></authors></contributors><titles><title>Exploratory studies of gambling impacts on women in vulnerable populations</title><secondary-title>International Gambling Conference</secondary-title></titles><dates><year>2018</year><pub-dates><date>13 February</date></pub-dates></dates><pub-location>Auckland</pub-location><urls></urls></record></Cite></EndNote>(J?rvinen-Tassopoulos, 2016; Palmer du Preez, Mauchline, et al., 2018). Gender discourses infusing social understandings of ‘successful womanhood’, make suggestions that services target CSOs in relation to their “own personal functioning” ADDIN EN.CITE <EndNote><Cite><Author>Makarchuk</Author><Year>2002</Year><RecNum>184</RecNum><Prefix>e.g. </Prefix><Pages>133</Pages><DisplayText>(e.g. Makarchuk et al., 2002, p. 133)</DisplayText><record><rec-number>184</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539292693">184</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Makarchuk, Karyn</author><author>Hodgins, David C</author><author>Peden, Nicole</author></authors></contributors><titles><title>Development of a brief intervention for concerned significant others of problem gamblers</title><secondary-title>Addictive Disorders & Their Treatment</secondary-title></titles><periodical><full-title>Addictive Disorders & Their Treatment</full-title></periodical><pages>126-134</pages><volume>1</volume><number>4</number><dates><year>2002</year></dates><isbn>1531-5754</isbn><urls></urls></record></Cite></EndNote>(e.g. Makarchuk et al., 2002, p. 133) problematic for some women, to the extent that they are required to identify themselves as ‘dysfunctional’ or ‘not coping’ in order to access support ADDIN EN.CITE <EndNote><Cite><Author>Aston</Author><Year>2009</Year><RecNum>146</RecNum><DisplayText>(Aston, 2009)</DisplayText><record><rec-number>146</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537307879">146</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Aston, Shaughney</author></authors></contributors><titles><title>Identities under construction: Women hailed as addicts</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>611-628</pages><volume>13</volume><number>6</number><dates><year>2009</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(Aston, 2009). Women gamblers are ‘risky gamblers’ Population gambling studies have charted a ‘feminization’ of gambling practices and problems ADDIN EN.CITE <EndNote><Cite><Author>Productivity Commission</Author><Year>1999</Year><RecNum>110</RecNum><Prefix>as first noted by </Prefix><DisplayText>(as first noted by Productivity Commission, 1999)</DisplayText><record><rec-number>110</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531779726">110</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Productivity Commission,</author></authors><tertiary-authors><author>AusInfo</author></tertiary-authors></contributors><titles><title>Australia's Gambling Industries (Report No. 10)</title></titles><dates><year>1999</year></dates><pub-location>Canberra</pub-location><urls></urls></record></Cite></EndNote>(as first noted by Productivity Commission, 1999). This notion holds that historical gender gaps in gambling participation and problem gambling have closed, due to increased accessibility and normalisation of gambling in society (e.g., Abbott, Romild, & Volberg, 2014; Abbott, Stone, Billi, & Yeung, 2015; Abbott, Volberg & R?nnberg, 2004). Population studies have made New Zealand women’s EGM gambling practices and problems increasingly visible, since the introduction and proliferation of EGMs in casinos, clubs and pubs PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYmJvdHQ8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Abbott, 2017b; Bunkle, 2009; Volberg, 2003). These gambling studies have established women who gamble as a legitimate group to be managed/addressed in the interests of population health and wellbeing. Accordingly, a body of literature has emerged to elucidate ‘gender differences’ in epidemiology and phenomenology to inform prevention and treatment efforts ADDIN EN.CITE <EndNote><Cite><Author>Merkouris</Author><Year>2016</Year><RecNum>49</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Merkouris et al., 2016)</DisplayText><record><rec-number>49</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520389105">49</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Merkouris, Stephanie S</author><author>Thomas, Anna C</author><author>Shandley, Kerrie A</author><author>Rodda, Simone N</author><author>Oldenhof, Erin</author><author>Dowling, Nicki A</author></authors></contributors><titles><title>An update on gender differences in the characteristics associated with problem gambling: a systematic review</title><secondary-title>Current Addiction Reports</secondary-title></titles><periodical><full-title>Current Addiction Reports</full-title></periodical><pages>254-267</pages><volume>3</volume><number>3</number><dates><year>2016</year></dates><isbn>2196-2952</isbn><urls></urls></record></Cite></EndNote>(e.g. Merkouris et al., 2016). Males, young adults, low‐income and non‐married people are held to be almost universally at elevated risk for problem gambling ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>245</RecNum><DisplayText>(Abbott, Binde, et al., 2018)</DisplayText><record><rec-number>245</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554758831">245</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Binde, Per</author><author>Clark, Luke</author><author>Hodgins, David</author><author>Johnson, Mark</author><author>Manitowabi, Darrel</author><author>Quilty, Lena</author><author>Sp?ngberg, Jessika</author><author>Volberg, Rachel</author><author>Walker, Douglas</author><author>Williams, Robert</author></authors></contributors><titles><title>Conceptual Framework of Harmful Gambling: An International Collaboration (Third Edition)</title></titles><dates><year>2018</year></dates><pub-location>Guelph, Ontario, Canada.</pub-location><publisher>Gambling Research Exchange Ontario (GREO)</publisher><urls></urls></record></Cite></EndNote>(Abbott, Binde, et al., 2018). Gender can also be seen as a ‘proxy’ for other factors held to produce risk more directly in men and women, such as game choice, drug and other substance use, and other sociodemographic factors PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5OZWxzb248L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Dowling & Oldenhof, 2017; Merkouris et al., 2016; Nelson, LaPlante, LaBrie, & Shaffer, 2006). Since the assertion of a ‘feminization’ of gambling, women gamblers could be constructed as “at special risk for harm from gambling” ADDIN EN.CITE <EndNote><Cite><Author>Rash</Author><Year>2017</Year><RecNum>85</RecNum><Pages>57</Pages><DisplayText>(Rash & Petry, 2017, p. 57)</DisplayText><record><rec-number>85</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1529635603">85</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Rash, C</author><author>Petry, N</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gambling disorder impacts homeless to affluent women in the US</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Rash & Petry, 2017, p. 57). Women’s reported preferences for more private escape-oriented gambling on gambling forms with minimal face-to-face contact (e.g. EGMs), can confer additional risk upon them:Gender-based differences were most pronounced for participation in various gambling forms. The only form posing a risk factor for both genders was EGMs, as previously implicated… This risk was heightened for female compared to male at-risk gamblers, and amongst 45–54 year old women. ADDIN EN.CITE <EndNote><Cite><Author>Hing</Author><Year>2016</Year><RecNum>8</RecNum><Pages>529</Pages><DisplayText>(Hing, Russell, Tolchard, & Nower, 2016, p. 529)</DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816406">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hing, Nerilee</author><author>Russell, Alex</author><author>Tolchard, Barry</author><author>Nower, Lia</author></authors></contributors><titles><title>Risk factors for gambling problems: An analysis by gender</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>511-534</pages><volume>32</volume><number>2</number><dates><year>2016</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(Hing, Russell, Tolchard, & Nower, 2016, p. 529) Women’s gambling is held to be especially dangerous because it is often ‘hidden’ from family members and friends, and takes place on those forms of gambling (e.g. EGMs) which tend to be ‘continuous’, permitting rapid re-engagement across a short period ADDIN EN.CITE <EndNote><Cite><Author>Dickerson</Author><Year>1993</Year><RecNum>225</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Dickerson, 1993)</DisplayText><record><rec-number>225</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543197076">225</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dickerson, Mark</author></authors></contributors><titles><title>Internal and external determinants of persistent gambling: Problems in generalising from one form of gambling to another</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>225-245</pages><volume>9</volume><number>3</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(e.g. Dickerson, 1993). Svensson and Romild (2014, p. 248) argued that when age and multiple gambling domains were controlled for, Swedish female regular gamblers were even more likely than male gamblers to be classified as problem gamblers: “These findings suggest that women who gamble regularly may have a higher susceptibility to gambling problems, although they gamble less”. The authors relate these findings to research identifying stress and loneliness as risk factors for problem gambling that may have particular relevance for women, given that Swedish women report more stress and anxiety than men. Ethnic minority women’s gambling on EGMs is identified as the riskiest of all. For example, Volberg ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><Pages>12</Pages><DisplayText>(2003, p. 12)</DisplayText><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(2003, p. 12) concluded that: “the relationship between gaming machines and problem gambling among women is stronger than this relationship among men and, further, that this relationship is particularly strong among minority women”. From this perspective, women gamblers could be constructed as a “subpopulation” with a different risk profile, leading to “idiosyncratic prevention and treatment” considerations ADDIN EN.CITE <EndNote><Cite><Author>Ladouceur</Author><Year>2017</Year><RecNum>111</RecNum><Pages>x</Pages><DisplayText>(Ladouceur, 2017, p. x)</DisplayText><record><rec-number>111</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531784721">111</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Ladouceur, Robert</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Book endorsement</title><secondary-title>Gambling disorders in women</secondary-title></titles><pages>Inside cover</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Routledge</publisher><urls></urls></record></Cite></EndNote>(Ladouceur, 2017, p. x). The construction of women’s EGM gambling practices as particularly ‘risky’, has allowed some further research to make the nuances of women’s gambling practices more visible, and to enable more targeted monitoring and intervention practices. For example, Delfabbro and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Delfabbro</Author><Year>2018</Year><RecNum>112</RecNum><DisplayText>(2018)</DisplayText><record><rec-number>112</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531788310">112</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Delfabbro, Paul</author><author>Thomas, Anna</author><author>Armstrong, Andrew</author></authors></contributors><titles><title>Gender differences in the presentation of observable risk indicators of problem gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>119-132</pages><volume>34</volume><number>1</number><dates><year>2018</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(2018) examined gender differences in behavioural ‘warning signs’ of problem gambling in venues. They suggested that female displays of emotion, particularly anger, indicated problems, as did a noticeable decline in personal grooming or asking for loans. It was held that identifying women exhibiting these problem indicators would allow specially trained venue staff to “deal more effectively” with them by offering assistance and empathy ADDIN EN.CITE <EndNote><Cite><Author>Delfabbro</Author><Year>2018</Year><RecNum>112</RecNum><Pages>130</Pages><DisplayText>(Delfabbro et al., 2018, p. 130)</DisplayText><record><rec-number>112</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531788310">112</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Delfabbro, Paul</author><author>Thomas, Anna</author><author>Armstrong, Andrew</author></authors></contributors><titles><title>Gender differences in the presentation of observable risk indicators of problem gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>119-132</pages><volume>34</volume><number>1</number><dates><year>2018</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(Delfabbro et al., 2018, p. 130). The authors noted that women experiencing problems could be more readily identified than men, because their departure from ‘normative’ gendered behaviour in EGM venues (presumably keeping to oneself, in agreeable temperament, and presenting attractively) was more pronounced. The Delfabbro ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Delfabbro</Author><Year>2018</Year><RecNum>112</RecNum><DisplayText>(2018)</DisplayText><record><rec-number>112</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531788310">112</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Delfabbro, Paul</author><author>Thomas, Anna</author><author>Armstrong, Andrew</author></authors></contributors><titles><title>Gender differences in the presentation of observable risk indicators of problem gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>119-132</pages><volume>34</volume><number>1</number><dates><year>2018</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(2018) study provides an example of how the ‘risky woman gambler’ can be deployed in ways which reify potentially unhelpful and restrictive gender stereotypes. Interventions which target women who gamble in public settings and who are not appropriately ‘feminine’ risk contributing to social processes which restrict legitimate and valued feminine identity PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MYWhhZDwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (see D. Butler, 2013; Lahad & Hazan, 2014; McRobbie, 2007). Aligning gambling interventions with social expectations surrounding appropriate feminine appearance and behaviour is problematic, and has the potential to compromise women’s health and wellbeing. Women who gamble and do not wish or are unable to consistently embody social norms of ‘good femininity’ run the risk of receiving additional attention from venue staff, which could be experienced as disciplinary. Clinical and population research also identifies problematic gambling as a risk factor for child neglect PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BZmlmaTwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (Afifi, Brownridge, MacMillan, & Sareen, 2010; Dowling et al., 2016; Roberts et al., 2016), and neglect of broader family responsibilities and roles ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>110</RecNum><DisplayText>(Dowling, Rodda, Lubman, & Jackson, 2014; Hodgins, Shead, & Makarchuk, 2007)</DisplayText><record><rec-number>110</rec-number><foreign-keys><key app="EN" db-id="tzptstftixaf2metpv5p9s0wf90pvfxasrfw" timestamp="1509586554">110</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dowling, Nicki</author><author>Rodda, Simone N</author><author>Lubman, Dan I</author><author>Jackson, Alun C</author></authors></contributors><titles><title>The impacts of problem gambling on concerned significant others accessing web-based counselling</title><secondary-title>Addictive Behaviors</secondary-title></titles><periodical><full-title>Addictive behaviors</full-title></periodical><pages>1253-1257</pages><volume>39</volume><number>8</number><dates><year>2014</year></dates><isbn>0306-4603</isbn><urls></urls></record></Cite><Cite><Author>Hodgins</Author><Year>2007</Year><RecNum>111</RecNum><record><rec-number>111</rec-number><foreign-keys><key app="EN" db-id="tzptstftixaf2metpv5p9s0wf90pvfxasrfw" timestamp="1509586647">111</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hodgins, David C</author><author>Shead, N Will</author><author>Makarchuk, Karyn</author></authors></contributors><titles><title>Relationship satisfaction and psychological distress among concerned significant others of pathological gamblers</title><secondary-title>The Journal of nervous and mental disease</secondary-title></titles><periodical><full-title>The Journal of nervous and mental disease</full-title></periodical><pages>65-71</pages><volume>195</volume><number>1</number><dates><year>2007</year></dates><isbn>0022-3018</isbn><urls></urls></record></Cite></EndNote>(Dowling, Rodda, Lubman, & Jackson, 2014; Hodgins, Shead, & Makarchuk, 2007). In this context, a particular construction of women who gamble as a risk to the safety and wellbeing of children has emerged ADDIN EN.CITE <EndNote><Cite><Author>Gavriel-Fried</Author><Year>2017</Year><RecNum>120</RecNum><DisplayText>(Gavriel-Fried, 2017)</DisplayText><record><rec-number>120</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532304687">120</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Gavriel-Fried, Belle</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>A mother and a gambler</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Gavriel-Fried, 2017). For example, that more women can be categorised as problem gamblers is held to be of particular concern because: “women are still generally the child’s primary caregiver” ADDIN EN.CITE <EndNote><Cite><Author>Darbyshire</Author><Year>2001</Year><RecNum>121</RecNum><Pages>25</Pages><DisplayText>(Darbyshire, Oster, & Carrig, 2001, p. 25)</DisplayText><record><rec-number>121</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532304971">121</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Darbyshire, Philip</author><author>Oster, Candice</author><author>Carrig, Helen</author></authors></contributors><titles><title>The experience of pervasive loss: Children and young people living in a family where parental gambling is a problem</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>23-45</pages><volume>17</volume><number>1</number><dates><year>2001</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Darbyshire, Oster, & Carrig, 2001, p. 25). The association of women who gamble with child harm and neglect, has informed qualitative exploration of gambling mothers ‘absence’ from the perspective of their children ADDIN EN.CITE <EndNote><Cite><Author>Darbyshire</Author><Year>2001</Year><RecNum>121</RecNum><DisplayText>(Corney & Davis, 2010b; Darbyshire et al., 2001)</DisplayText><record><rec-number>121</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532304971">121</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Darbyshire, Philip</author><author>Oster, Candice</author><author>Carrig, Helen</author></authors></contributors><titles><title>The experience of pervasive loss: Children and young people living in a family where parental gambling is a problem</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>23-45</pages><volume>17</volume><number>1</number><dates><year>2001</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite><Cite><Author>Corney</Author><Year>2010</Year><RecNum>123</RecNum><record><rec-number>123</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532305235">123</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Corney, Roslyn</author><author>Davis, Janette</author></authors></contributors><titles><title>Female frequent internet gamblers: A qualitative study investigating the role of family, social situation and work</title><secondary-title>Community, Work & Family</secondary-title></titles><periodical><full-title>Community, Work & Family</full-title></periodical><pages>291-309</pages><volume>13</volume><number>3</number><dates><year>2010</year></dates><isbn>1366-8803</isbn><urls></urls></record></Cite></EndNote>(Corney & Davis, 2010b; Darbyshire et al., 2001), and mothers’ own feelings of shame and guilt over ‘abandoning their children for gambling’ ADDIN EN.CITE <EndNote><Cite><Author>Brown</Author><Year>1997</Year><RecNum>124</RecNum><DisplayText>(Brown & Coventry, 1997)</DisplayText><record><rec-number>124</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532305389">124</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Brown, Sarah</author><author>Coventry, Louise</author></authors></contributors><titles><title>Queen of hearts: The needs of women with gambling problems</title></titles><dates><year>1997</year></dates><publisher>Financial & Consumer Rights Council</publisher><isbn>0646330942</isbn><urls></urls></record></Cite></EndNote>(Brown & Coventry, 1997). New Zealand longitudinal survey studies have identified associations between Pacific mothers’ gambling and the provision of poor household nutrition ADDIN EN.CITE <EndNote><Cite><Author>Schluter</Author><Year>2007</Year><RecNum>125</RecNum><DisplayText>(Schluter, Bellringer, & Abbott, 2007)</DisplayText><record><rec-number>125</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532305543">125</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schluter, Philip J</author><author>Bellringer, Maria</author><author>Abbott, Max</author></authors></contributors><titles><title>Maternal Gambling Associated With Families' Food, Shelter and Safety Needs: Findings From the Pacific Island Families Study</title></titles><dates><year>2007</year></dates><isbn>1494-5185</isbn><urls></urls></record></Cite></EndNote>(Schluter, Bellringer, & Abbott, 2007) and increased likelihood of children taking up gambling ADDIN EN.CITE <EndNote><Cite><Author>Bellringer</Author><Year>2017</Year><RecNum>126</RecNum><DisplayText>(Bellringer, Kolandai-Matchett, Taylor, & Abbott, 2017)</DisplayText><record><rec-number>126</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532305868">126</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Bellringer, M</author><author>Kolandai-Matchett, Komathi</author><author>Taylor, Steve</author><author>Abbott, M</author></authors></contributors><titles><title>Pacific islands families study 2014: Mother and youth gambling</title></titles><dates><year>2017</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University of Technology, Gambling and Addictions Research Centre</publisher><urls></urls></record></Cite></EndNote>(Bellringer, Kolandai-Matchett, Taylor, & Abbott, 2017). Pacific mothers who gamble have been positioned as a particular threat to child wellbeing, in need of targeted intervention and education practices aimed at reducing the risk they pose, e.g.: “Mothers’ gambling behaviours influence those of their children, so adult education and public health campaigns are vital to stem the negative effects of gambling and its transfer across generations” ADDIN EN.CITE <EndNote><Cite><Author>Bellringer</Author><Year>2018</Year><RecNum>128</RecNum><Prefix>media release issued by </Prefix><DisplayText>(media release issued by Bellringer, 2018)</DisplayText><record><rec-number>128</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532315863">128</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Bellringer, M</author></authors></contributors><titles><title>Research sheds light on gambling among Pacific youth and their mothers (Media Release)</title></titles><volume>2018</volume><number>23 July</number><dates><year>2018</year></dates><pub-location>NZ Doctor</pub-location><publisher>NZ Doctor</publisher><urls><related-urls><url>;(media release issued by Bellringer, 2018). Gambling studies’ positioning of ‘risky women gamblers’ appeared to reinforce some traditional constructions of women’s roles in the family. For example, New Zealand public commentary has taken up recent gambling studies research to reinforce the position of Pacific mothers as within the home and family: “Mothers are the cornerstone of Pasifika communities and yet what this research shows is that for many of our precious mums, they are being pulled away from their families by this destructive scourge.” ADDIN EN.CITE <EndNote><Cite><Author>Efeso Collins</Author><Year>2018</Year><RecNum>129</RecNum><DisplayText>(Efeso Collins, 2018)</DisplayText><record><rec-number>129</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532316085">129</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Efeso Collins, Fa'anana</author></authors></contributors><titles><title>Gambling for many is no longer just a choice, but an addiction</title></titles><volume>2018</volume><number>23 July</number><dates><year>2018</year></dates><publisher>Stuff: Manukau Courier</publisher><urls><related-urls><url>;(Efeso Collins, 2018). In this way, recent New Zealand evidence supports Wardle’s comment that: Rhetoric around women gambling still centres on common themes: largely that it is not a desirable activity for a woman, that more women engaging in gambling is something of a concern, and that women who gamble (may) neglect their other womanly duties of caregiving, running households and nurturing children. ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2017</Year><RecNum>90</RecNum><Pages>179</Pages><DisplayText>(Wardle, 2017, p. 179)</DisplayText><record><rec-number>90</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530063872">90</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wardle, Heather</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>The 'refeminisation' of gambling: Social, cultural and historical insights into female gambling behaviour in Great Britain</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Wardle, 2017, p. 179). Gambling studies literature has cited media reports of mothers abandoning their children in locked cars in gambling venue parking lots, as ‘evidence’ of the extremes to which some women will go to continue their gambling ADDIN EN.CITE <EndNote><Cite><Author>Darbyshire</Author><Year>2001</Year><RecNum>121</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Darbyshire et al., 2001; Schull, 2002)</DisplayText><record><rec-number>121</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532304971">121</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Darbyshire, Philip</author><author>Oster, Candice</author><author>Carrig, Helen</author></authors></contributors><titles><title>The experience of pervasive loss: Children and young people living in a family where parental gambling is a problem</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>23-45</pages><volume>17</volume><number>1</number><dates><year>2001</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite><Cite><Author>Schull</Author><Year>2002</Year><RecNum>44</RecNum><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520387689">44</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Schull, Natasha Dow</author></authors></contributors><titles><title>Escape mechanism: Women, caretaking, and compulsive machine gambling</title></titles><dates><year>2002</year></dates><publisher>Berkeley Collection of Working and Occasional Papers</publisher><urls></urls></record></Cite></EndNote>(e.g. Darbyshire et al., 2001; Schull, 2002). Concerns about the risk gambling poses to children, tends to construct women who gamble as ‘anti-mothers’ ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2015</Year><RecNum>119</RecNum><DisplayText>(Wardle, 2015)</DisplayText><record><rec-number>119</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532302957">119</key></foreign-keys><ref-type name="Thesis">32</ref-type><contributors><authors><author>Wardle, Heather</author></authors></contributors><titles><title>Female gambling behaviour: a case study of realist description</title></titles><dates><year>2015</year></dates><pub-location>Glasgow</pub-location><publisher>University of Glasgow</publisher><urls></urls></record></Cite></EndNote>(Wardle, 2015). For example, recent New Zealand media reports of: the (contested) assertion that a “young mum” left a baby alone outside a Northland gambling venue ADDIN EN.CITE <EndNote><Cite><Author>Woods</Author><Year>2018</Year><RecNum>127</RecNum><DisplayText>(Woods, 2018)</DisplayText><record><rec-number>127</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532314661">127</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Woods, Angela</author></authors></contributors><titles><title>Far North hotel dumps pokies after young mum leaves baby alone outside</title></titles><volume>2018</volume><number>23 July</number><dates><year>2018</year></dates><publisher>New Zealand Herald</publisher><urls><related-urls><url>;(Woods, 2018), and “A mum on a drug-fuelled crime spree gambled and stole while her baby was left screaming in a car strewn with used syringes” in Palmerston North ADDIN EN.CITE <EndNote><Cite><Author>Tuckey</Author><Year>2018</Year><RecNum>131</RecNum><DisplayText>(Tuckey, 2018)</DisplayText><record><rec-number>131</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1533691115">131</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Tuckey, Karoline</author></authors></contributors><titles><title>Baby left in car with used syringes while mum steals and gambles</title></titles><volume>2018</volume><number>8 August</number><dates><year>2018</year></dates><publisher>Stuff.co.nz</publisher><urls><related-urls><url>;(Tuckey, 2018). A baby was “left sweltering in hot car” in Hamilton by “a woman [who] was a regular at the bar, and she just plays pokies” ADDIN EN.CITE <EndNote><Cite><Author>Webb-Liddall</Author><Year>2018 </Year><RecNum>226</RecNum><DisplayText>(Webb-Liddall, 2018)</DisplayText><record><rec-number>226</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543197717">226</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Webb-Liddall, Alice</author></authors></contributors><titles><title>Baby left sweltering in hot car while caregiver plays the pokies</title></titles><volume>2018</volume><number>26 November</number><dates><year>2018</year></dates><publisher>Newshub</publisher><urls><related-urls><url>;(Webb-Liddall, 2018). There have been no comparative reports about fathers who gamble, reminiscent of Litzke’s ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Litzke</Author><Year>2005</Year><RecNum>290</RecNum><DisplayText>(2005)</DisplayText><record><rec-number>290</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559870690">290</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Litzke, Cheryl H</author></authors></contributors><titles><title>Social constructions of motherhood and mothers on drugs: Implications for treatment, policy, and practice</title><secondary-title>Journal of feminist family therapy</secondary-title></titles><periodical><full-title>Journal of feminist family therapy</full-title></periodical><pages>43-59</pages><volume>16</volume><number>4</number><dates><year>2005</year></dates><isbn>0895-2833</isbn><urls></urls></record></Cite></EndNote>(2005) point that the expression “substance-abusing fathers” is rarely, if ever, used. Constructions of women gamblers as risky, uncritically employed, can reinforce contextual factors which women identify as producing gambling harm. Women gamblers have been found to be “acutely aware of the stigma applied by society to a woman who fails to meet the high moral standards expected of women” ADDIN EN.CITE <EndNote><Cite><Author>Lesieur</Author><Year>1991</Year><RecNum>93</RecNum><Pages>190</Pages><DisplayText>(Lesieur & Blume, 1991, p. 190)</DisplayText><record><rec-number>93</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530498415">93</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Lesieur, HR</author><author>Blume, SB</author></authors><secondary-authors><author>Van Den Bergh, N</author></secondary-authors></contributors><titles><title>When lady luck loses: The female pathological gambler</title><secondary-title>Feminist perspectives on addictions</secondary-title></titles><periodical><full-title>Feminist perspectives on addictions</full-title></periodical><pages>181-197</pages><dates><year>1991</year></dates><pub-location>New York</pub-location><publisher>Springer</publisher><urls></urls></record></Cite></EndNote>(Lesieur & Blume, 1991, p. 190). Women have identified a heightened sense of shame, and perceived failure to live up to societal expectations, as barriers to accessing gambling support services ADDIN EN.CITE <EndNote><Cite><Author>Holdsworth</Author><Year>2013</Year><RecNum>132</RecNum><DisplayText>(Holdsworth, Nuske, & Breen, 2013; Piquette-Tomei, Norman, Dwyer, & McCaslin, 2008)</DisplayText><record><rec-number>132</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1533692600">132</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holdsworth, Louise</author><author>Nuske, Elaine</author><author>Breen, Helen</author></authors></contributors><titles><title>All mixed up together: Women’s experiences of problem gambling, comorbidity and co-occurring complex needs</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>315-328</pages><volume>11</volume><number>3</number><dates><year>2013</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Piquette-Tomei</Author><Year>2008</Year><RecNum>133</RecNum><record><rec-number>133</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1533692701">133</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Piquette-Tomei, N.</author><author>Norman, E.</author><author>Dwyer, S. C.</author><author>McCaslin, E.</author></authors></contributors><titles><title>Group therapy for women problem gamblers: A space of their own</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>275-296</pages><volume>22</volume><dates><year>2008</year></dates><urls></urls></record></Cite></EndNote>(Holdsworth, Nuske, & Breen, 2013; Piquette-Tomei, Norman, Dwyer, & McCaslin, 2008). Excessive familial and societal expectations, and demands placed on women are cited as key social determinants of women’s excessive gambling and harm ADDIN EN.CITE <EndNote><Cite><Author>Schull</Author><Year>2002</Year><RecNum>44</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Perese, 2009; Schull, 2002)</DisplayText><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520387689">44</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Schull, Natasha Dow</author></authors></contributors><titles><title>Escape mechanism: Women, caretaking, and compulsive machine gambling</title></titles><dates><year>2002</year></dates><publisher>Berkeley Collection of Working and Occasional Papers</publisher><urls></urls></record></Cite><Cite><Author>Perese</Author><Year>2009</Year><RecNum>73</RecNum><record><rec-number>73</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525126354">73</key></foreign-keys><ref-type name="Thesis">32</ref-type><contributors><authors><author>Perese, L</author></authors></contributors><titles><title>You bet your life... and mine! Contemporary Samoan gambling in New Zealand</title></titles><dates><year>2009</year></dates><publisher>ResearchSpace@ Auckland</publisher><urls></urls></record></Cite></EndNote>(e.g. Perese, 2009; Schull, 2002). Outside of gambling studies, a strong body of literature has highlighted the ways in which women can be subjected to intense moralising regulation as wives and mothers, which compromises their health and wellbeing PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5XYWxsPC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA (e.g. T. Miller, 2007; Raddon, 2002; Wall, 2001). This kind of moralising can be identified in the New Zealand gambling studies research and public commentary describing the impact of Pacific mothers’ gambling on their children ADDIN EN.CITE <EndNote><Cite><Author>Efeso Collins</Author><Year>2018</Year><RecNum>129</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Bellringer, 2018; Efeso Collins, 2018)</DisplayText><record><rec-number>129</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532316085">129</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Efeso Collins, Fa'anana</author></authors></contributors><titles><title>Gambling for many is no longer just a choice, but an addiction</title></titles><volume>2018</volume><number>23 July</number><dates><year>2018</year></dates><publisher>Stuff: Manukau Courier</publisher><urls><related-urls><url> app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532315863">128</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Bellringer, M</author></authors></contributors><titles><title>Research sheds light on gambling among Pacific youth and their mothers (Media Release)</title></titles><volume>2018</volume><number>23 July</number><dates><year>2018</year></dates><pub-location>NZ Doctor</pub-location><publisher>NZ Doctor</publisher><urls><related-urls><url>;(e.g. Bellringer, 2018; Efeso Collins, 2018). Gambling studies which operate unreflectively in relation to gender issues, may unwittingly contribute to, facilitate, and enable these problematic constructions to circulate. To avoid these unintentional consequences, women’s gambling and gambling harm could instead be positioned as always-already intertwined with the “given socioeconomic, historical, cultural, family, and personal circumstances in which these experiences are produced” ADDIN EN.CITE <EndNote><Cite><Author>Li</Author><Year>2007</Year><RecNum>234</RecNum><Pages>634</Pages><DisplayText>(Li, 2007, p. 634)</DisplayText><record><rec-number>234</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543461064">234</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Li, Jun</author></authors></contributors><titles><title>Women's ways of gambling and gender‐specific research</title><secondary-title>Sociological Inquiry</secondary-title></titles><periodical><full-title>Sociological Inquiry</full-title></periodical><pages>626-636</pages><volume>77</volume><number>4</number><dates><year>2007</year></dates><isbn>0038-0245</isbn><urls></urls></record></Cite></EndNote>(Li, 2007, p. 634).‘Vulnerable women gamblers’ Women who gambled and experienced distress or problems also became particularly visible at the nexus of public health and psychological discourses, through the notion of ‘psychiatric comorbidity’:Women who gamble on EGMs are considered to be a group that corresponds very closely with what Blaszczynski and Nower (2002) have classified as the ‘vulnerability’ pathway of problem gambling. Anxiety and depression are common co-morbid presentations in clinical or tertiary settings, so it is possible that some of these symptoms are emerging in venue environments, particularly when women are confronted by negative gambling events such as heavy losses. ADDIN EN.CITE <EndNote><Cite><Author>Delfabbro</Author><Year>2018</Year><RecNum>112</RecNum><Pages>128</Pages><DisplayText>(Delfabbro et al., 2018, p. 128)</DisplayText><record><rec-number>112</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531788310">112</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Delfabbro, Paul</author><author>Thomas, Anna</author><author>Armstrong, Andrew</author></authors></contributors><titles><title>Gender differences in the presentation of observable risk indicators of problem gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>119-132</pages><volume>34</volume><number>1</number><dates><year>2018</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(Delfabbro et al., 2018, p. 128)Women who gambled were produced as ‘complex cases’, where multiple psychological issues tend to be in play (e.g. Abbott, Williams, & Volberg, 2004a; Petry & Weinstock, 2007). Depression and anxiety were disproportionately identified for women who gambled (compared with women who did not gamble and men), as well as social discomfort, sensitivity to criticism, eating disorders, trauma and abuse, such that it was possible to state: …personal and family histories are highly relevant in rendering some women vulnerable to gambling related problems… [as well as] significant rates of current and lifetime psychological problems and concurrent life stress. ADDIN EN.CITE <EndNote><Cite><Author>Boughton</Author><Year>2007</Year><RecNum>5</RecNum><Pages>331</Pages><DisplayText>(Boughton & Falenchuk, 2007, p. 331)</DisplayText><record><rec-number>5</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1493688006">5</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Boughton, Roberta</author><author>Falenchuk, Olesya</author></authors></contributors><titles><title>Vulnerability and comorbidity factors of female problem gambling</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>323-334</pages><volume>23</volume><number>3</number><dates><year>2007</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Boughton & Falenchuk, 2007, p. 331) The ‘vulnerable woman’ who gambles was positioned as psychologically unhealthy, emotionally distressed, and with a propensity to rely on unhealthy activities, such as gambling, to manage her distress, e.g.:…it may be that anxious and depressed women are more attracted to gambling in the first place, rather than that the gambling is the cause of their problems… Specifically, women appear more likely than men to treat gambling as a way of escaping from, or relieving, negative mood states. ADDIN EN.CITE <EndNote><Cite><Author>Delfabbro</Author><Year>2000</Year><RecNum>94</RecNum><Pages>148</Pages><DisplayText>(Delfabbro, 2000, p. 148)</DisplayText><record><rec-number>94</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530658946">94</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Delfabbro, Paul</author></authors></contributors><titles><title>Gender differences in Australian gambling: A critical summary of sociological and psychological research</title><secondary-title>Australian Journal of Social Issues</secondary-title></titles><periodical><full-title>Australian Journal of Social Issues</full-title></periodical><pages>145-158</pages><volume>35</volume><number>2</number><dates><year>2000</year></dates><isbn>0157-6321</isbn><urls></urls></record></Cite></EndNote>(Delfabbro, 2000, p. 148)‘Escape gambling’ has emerged as a psychological discursive practice, constructing gambling as a maladaptive coping strategy for women experiencing stress in their lives: “As with other addictions, female pathological gambling basically represents a means of handling psychological suffering, for dealing with things that cannot be tackled…” ADDIN EN.CITE <EndNote><Cite><Author>Prever</Author><Year>2017</Year><RecNum>86</RecNum><Pages>130</Pages><DisplayText>(Prever & Locati, 2017, p. 130)</DisplayText><record><rec-number>86</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1529893399">86</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Prever, Fulvia</author><author>Locati, Valeria</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Female gambling in Italy: A specific clinical experience</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>124-140</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Prever & Locati, 2017, p. 130). Interventions were charged with failing to address the “psychiatric comorbidity and mood symptomatology that is characteristic of female problem gambling” ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Prefix>Toneatto et al cited by </Prefix><Pages>243</Pages><DisplayText>(Toneatto et al cited by Dowling, 2014, p. 243)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Toneatto et al cited by Dowling, 2014, p. 243). It was argued that women who gamble should be offered interventions targeting specific co-occurring psychological vulnerabilities and providing strategies to deal with emotional distress as an alternative to gambling. Mood/affective symptoms can be emphasised, including additional ‘skill training’ in emotion regulation and coping. Gambling-specific strategies such as setting limits and identifying alternative leisure activities, are supplemented with “components that [emphasise] the role of emotional factors and concurrent psychiatric disorders”, including “a focus on assertiveness training” ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Pages>233</Pages><DisplayText>(Dowling, 2014, p. 233)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Dowling, 2014, p. 233). Problem solving training may serve to address the need to gamble to escape life problems and some of the consequences of problem gambling. Similarly, communication training may be necessary to address a history of interpersonal conflict and gambling in order to escape the perceived demands of others. ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Pages>244</Pages><DisplayText>(Dowling, 2014, p. 244)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Dowling, 2014, p. 244)Intervention research suggested that women change their perception of and behaviour in relation to external pressures placed on them – thereby reducing their stress experience. Dowling ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><DisplayText>(2014)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(2014) provided a glimpse of how women themselves may take on this subject position. Case study ‘Jane’ identified herself as a “yes” person, who “passively accept[ed] the behaviour of others”. Jane reported that through treatment she had “become more assertive” by practicing “a range of assertive skills, such as learning to refuse and make requests and respond to criticism using role-playing techniques” ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Pages>241</Pages><DisplayText>(Dowling, 2014, p. 241)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Dowling, 2014, p. 241). Positioning herself as ‘vulnerable’, allowed ‘Jane’ to access a psychological support programme in which she was “enthusiastic” about modifying her “unhelpful” thought patterns and beliefs - such as engaging in “I should” self-talk, trying to mind-read others, and taking the actions/behaviours of others personally ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2014</Year><RecNum>100</RecNum><Pages>240</Pages><DisplayText>(Dowling, 2014, p. 240)</DisplayText><record><rec-number>100</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531266522">100</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author></authors><secondary-authors><author>Richard, David</author><author>Blaszczynski, Alex</author><author>Nower, Lia</author></secondary-authors></contributors><titles><title>The cognitive-behavioural treatment of female problem gambling</title><secondary-title>The Wiley-Blackwell Handbook of Disordered Gambling, First Edition</secondary-title></titles><pages>225-250</pages><dates><year>2014</year></dates><publisher>John Wiley & Sons, Ltd</publisher><urls></urls></record></Cite></EndNote>(Dowling, 2014, p. 240). Jane viewed the adoption of these techniques, as key to reducing her feelings of anxiety and depression. Jane shows how the position of ‘vulnerable woman gambler’ can again offer women alignment with the psychological profession, which is in turn empowered to provide support and training. Women are coached to manage distress in their lives differently which can be associated with the experience of improved emotional functioning. Psychological understandings of health and wellbeing tended to individualise women gamblers’ distress, emphasising the personal facets of health located within them as individuals: e.g. confidence and coping – rather than societal or environmental factors. E.g. the ‘vulnerable woman gambler’ was encouraged to carry out psychological practices (changing thought patterns, communication style), to achieve a particular kind of psychological health and wellbeing. This focus on individual women could obscure multiple external forces operating to produce and maintain gambling behaviour. These forces included caregiving and family responsibilities ADDIN EN.CITE <EndNote><Cite><Author>Schull</Author><Year>2002</Year><RecNum>44</RecNum><DisplayText>(Schull, 2002)</DisplayText><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520387689">44</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Schull, Natasha Dow</author></authors></contributors><titles><title>Escape mechanism: Women, caretaking, and compulsive machine gambling</title></titles><dates><year>2002</year></dates><publisher>Berkeley Collection of Working and Occasional Papers</publisher><urls></urls></record></Cite></EndNote>(Schull, 2002), poverty, and the concentration of gambling venues in relatively deprived areas ADDIN EN.CITE <EndNote><Cite><Author>Young</Author><Year>2012</Year><RecNum>227</RecNum><DisplayText>(Young et al., 2012)</DisplayText><record><rec-number>227</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543199287">227</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Young, Martin</author><author>Markham, Francis</author><author>Doran, Bruce</author></authors></contributors><titles><title>Too close to home? The relationships between residential distance to venue and gambling outcomes</title><secondary-title>International gambling studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>257-273</pages><volume>12</volume><number>2</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Young et al., 2012). Additionally, they include the development and marketing of technologically more advanced and more dangerous products, intense advertising and lobbying by the industry, or the co-option of researchers/scientists in diverse ways ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2007</Year><RecNum>150</RecNum><DisplayText>(P. J. Adams, 2007, 2016; Markham & Young, 2015)</DisplayText><record><rec-number>150</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537402593">150</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Gambling, freedom and democracy</title></titles><dates><year>2007</year></dates><publisher>Routledge</publisher><isbn>1135907293</isbn><urls></urls></record></Cite><Cite><Author>Adams</Author><Year>2016</Year><RecNum>156</RecNum><record><rec-number>156</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537407626">156</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Moral jeopardy: risks of accepting money from the alcohol, tobacco and gambling industries</title></titles><dates><year>2016</year></dates><publisher>Cambridge University Press</publisher><isbn>1107091209</isbn><urls></urls></record></Cite><Cite><Author>Markham</Author><Year>2015</Year><RecNum>153</RecNum><record><rec-number>153</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537406753">153</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Markham, Francis</author><author>Young, Martin</author></authors></contributors><titles><title>“Big gambling”: the rise of the global industry-state gambling complex</title></titles><dates><year>2015</year></dates><publisher>Taylor & Francis</publisher><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams, 2007, 2016; Markham & Young, 2015). 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ADDIN EN.CITE.DATA (Hing et al., 2018; Hing, Russell, Thomas, & Jenkinson, 2019; Russell, Hing, Browne, & Rawat, 2018). A recent review of gambling marketing research concluded that gambling marketing content is highly targeted to specific population groups ADDIN EN.CITE <EndNote><Cite><Author>Newall</Author><Year>2019</Year><RecNum>334</RecNum><DisplayText>(Newall et al., 2019)</DisplayText><record><rec-number>334</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563319735">334</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Newall, Philip WS</author><author>Moodie, Crawford</author><author>Reith, Gerda</author><author>Stead, Martine</author><author>Critchlow, Nathan</author><author>Morgan, Amber</author><author>Dobbie, Fiona</author></authors></contributors><titles><title>Gambling marketing from 2014 to 2018: A literature review</title><secondary-title>Current Addiction Reports</secondary-title></titles><periodical><full-title>Current Addiction Reports</full-title></periodical><pages>49-56</pages><volume>6</volume><number>2</number><dates><year>2019</year></dates><isbn>2196-2952</isbn><urls></urls></record></Cite></EndNote>(Newall et al., 2019). Gambling advertisements on television in the UK specifically focus on bingo and on encouraging women to gamble online ADDIN EN.CITE <EndNote><Cite><Author>Corney</Author><Year>2010</Year><RecNum>336</RecNum><DisplayText>(Corney & Davis, 2010a)</DisplayText><record><rec-number>336</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563321249">336</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Corney, Roslyn</author><author>Davis, Janette</author></authors></contributors><titles><title>The attractions and risks of Internet gambling for women: A qualitative study</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>121-139</pages><number>24</number><dates><year>2010</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Corney & Davis, 2010a). Australian women have described the way in which venue-based gambling (for example at EGM venues, racing events or casino gambling) is marketed to them as glamorous, social and safe ADDIN EN.CITE <EndNote><Cite><Author>Thomas</Author><Year>2012</Year><RecNum>337</RecNum><DisplayText>(Thomas, Lewis, McLeod, & Haycock, 2012)</DisplayText><record><rec-number>337</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563321283">337</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thomas, Samantha L</author><author>Lewis, Sophie</author><author>McLeod, Colin</author><author>Haycock, John</author></authors></contributors><titles><title>‘They are working every angle’. A qualitative study of Australian adults' attitudes towards, and interactions with, gambling industry marketing strategies</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>111-127</pages><volume>12</volume><number>1</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Thomas, Lewis, McLeod, & Haycock, 2012). New Zealand gambling advertising and marketing may serve to: make gamblers aware of new gambling promotions or opportunities and encourage gamblers to ‘try’ them, remind gamblers about their positive past experiences in gambling (including winning), encourage gamblers to reflect on how their life may change as a result of a win in gambling (particularly in lotto), and increase the perception that certain types of gambling are fun, exciting or glamorous (e.g., casinos, race days at the track) ADDIN EN.CITE <EndNote><Cite><Author>Schottler Consulting Pty Ltd</Author><Year>2012</Year><RecNum>335</RecNum><DisplayText>(Schottler Consulting Pty Ltd, 2012)</DisplayText><record><rec-number>335</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563320684">335</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Schottler Consulting Pty Ltd,</author></authors></contributors><titles><title>The marketing, advertising and sponsorship of gambling products and services within New Zealand, prepared for the New Zealand Ministry of Health </title></titles><dates><year>2012</year></dates><pub-location>Wellington</pub-location><publisher>Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Schottler Consulting Pty Ltd, 2012). However very little research has been conducted, and no gender analyses have been produced to date, limiting understanding of harm and effective policy and public health intervention for women. The position of the ‘vulnerable woman gambler’ emphasised women’s passivity in the face of emotional strain and linked this to problematic gambling behaviour – via the discursive practice of ‘escape gambling’. It also became possible to pathologise a wider range of women who gamble, whether or not the women identify their gambling as harmful. This seemed indicative of the ‘concept creep’ critique of psychology’s ever expanding constructions of pathology (and therefore capacity and authority to intervene) ADDIN EN.CITE <EndNote><Cite><Author>Haslam</Author><Year>2016</Year><RecNum>228</RecNum><Prefix>see </Prefix><DisplayText>(see Haslam, 2016; Rose, 1985a)</DisplayText><record><rec-number>228</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543199997">228</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Haslam, Nick</author></authors></contributors><titles><title>Concept creep: Psychology's expanding concepts of harm and pathology</title><secondary-title>Psychological Inquiry</secondary-title></titles><periodical><full-title>Psychological Inquiry</full-title></periodical><pages>1-17</pages><volume>27</volume><number>1</number><dates><year>2016</year></dates><isbn>1047-840X</isbn><urls></urls></record></Cite><Cite><Author>Rose</Author><Year>1985</Year><RecNum>229</RecNum><record><rec-number>229</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543200097">229</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Rose, Nikolas</author></authors></contributors><titles><title>The psychological complex</title></titles><dates><year>1985</year></dates><publisher>London: Routledge & Kegan Paul</publisher><urls></urls></record></Cite></EndNote>(see Haslam, 2016; Rose, 1985a). For example, Grant and Kim ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Grant</Author><Year>2004</Year><RecNum>101</RecNum><DisplayText>(2004)</DisplayText><record><rec-number>101</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531274026">101</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Grant, Jon E</author><author>Kim, S.W</author></authors><secondary-authors><author>Grant, Jon E</author><author>Potenza, Marc N</author></secondary-authors></contributors><titles><title>Gender differences</title><secondary-title>Pathological gambling: A clinical guide to treatment</secondary-title></titles><pages>97-109</pages><dates><year>2004</year></dates><pub-location>Washington DC</pub-location><publisher>American Psychiatric Publishing</publisher><urls></urls></record></Cite></EndNote>(2004) emphasised that while many women who gamble may not meet diagnostic criteria for mood or anxiety disorder they tend to have ‘subclinical mood symptoms’ that predispose them to gambling. These authors posit that evaluating the ‘emotional context’ in which gambling occurs is vital when seeking to understand and intervene in the gambling behaviours of women. In this way women gamblers could be saturated with potentially negative emotionality that must be made visible and addressed to promote their wellbeing. This process could reinforce unhelpful gender stereotypes, which equate femininity with vulnerability, inefficacy and passivity, which is problematic, and may be experienced as disempowering ADDIN EN.CITE <EndNote><Cite><Author>Frazier</Author><Year>2014</Year><RecNum>316</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Frazier & Falmagne, 2014)</DisplayText><record><rec-number>316</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561932417">316</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Frazier, Kathryn E</author><author>Falmagne, Rachel Joffe</author></authors></contributors><titles><title>Empowered victims? Women’s contradictory positions in the discourse of violence prevention</title><secondary-title>Feminism & Psychology</secondary-title></titles><periodical><full-title>Feminism & Psychology</full-title></periodical><pages>479-499</pages><volume>24</volume><number>4</number><dates><year>2014</year></dates><isbn>0959-3535</isbn><urls></urls></record></Cite></EndNote>(e.g. Frazier & Falmagne, 2014). In policy terms, it can result in an emphasis on individual interventions, known to be less effective than upstream interventions which limit supply or the structural characteristics of particular products ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><DisplayText>(Abbott, 2017a; P. J. Adams & Rossen, 2012)</DisplayText><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>6</RecNum><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502937388">6</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>The epidemiology and impact of gambling disorder and other gambling-related harm</title><secondary-title>2017 WHO Forum on alcohol, drugs and addictive behaviours</secondary-title></titles><dates><year>2017</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2017a; P. J. Adams & Rossen, 2012).Women’s gambling and harm as a socio-cultural phenomenon Evident in the early 1990s, and emerging again recently, is an area of gambling studies concerned with “collect[ing] and compar[ing] information that elucidat[es] the role of cultural and social norms, representations and regulations in constructing and nurturing gender realities in gambling” ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><Pages>46</Pages><DisplayText>(Kairouz et al., 2017, p. 46)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017, p. 46). Often informed by sociological theory and practice, this research highlights socio-cultural and environmental factors involved in producing and shaping women’s experiences of gambling, other addictions and harm. For example:… the patriarchal culture in which we live engenders conditions that cause people to feel inferior, powerless and alienated. Addictions develop as a way to anesthetise the pain of being “less than” and “left out” ADDIN EN.CITE <EndNote><Cite><Author>Van Den Bergh</Author><Year>1991</Year><RecNum>92</RecNum><Pages>28</Pages><DisplayText>(Van Den Bergh, 1991, p. 28)</DisplayText><record><rec-number>92</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530497768">92</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Van Den Bergh, Nan</author></authors><secondary-authors><author>Van Den Bergh, Nan</author></secondary-authors></contributors><titles><title>Having bitten the apple: A feminist perspective on addictions</title><secondary-title>Feminist perspectives on addictions</secondary-title></titles><periodical><full-title>Feminist perspectives on addictions</full-title></periodical><pages>3-28</pages><dates><year>1991</year></dates><publisher>Springer Publishing Company New York</publisher><isbn>0826173500</isbn><urls></urls></record></Cite></EndNote>(Van Den Bergh, 1991, p. 28)Gambling practices and settings can be seen as infused with gender norms, practices and implied values. For example, Svensson ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Svensson</Author><Year>2017</Year><RecNum>88</RecNum><Pages>153</Pages><DisplayText>(2017, p. 153)</DisplayText><record><rec-number>88</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1529896963">88</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Svensson, Jessika</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gambling and gender in Sweden</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>153-161</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(2017, p. 153) asserted that: “Gambling is an arena for expression and validation of masculinities and femininities”, and should be studied as such. Gender related issues, notions and practices form part of the structural system that influences which gambling activities people take up: …examining the socio-cultural determinants of female gambling behaviour… suggests that female gambling behaviour is influenced by a variety of contexts which shape the activities that (some) women do and do not feel comfortable engaging in. (Wardle, 2017, p. 174)For example, betting shops can be produced as masculine environments ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2014</Year><RecNum>206</RecNum><DisplayText>(Cassidy, 2014)</DisplayText><record><rec-number>206</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329729">206</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>‘A place for men to come and do their thing’: constructing masculinities in betting shops in L ondon</title><secondary-title>The British journal of sociology</secondary-title></titles><periodical><full-title>The British journal of sociology</full-title></periodical><pages>170-191</pages><volume>65</volume><number>1</number><dates><year>2014</year></dates><isbn>0007-1315</isbn><urls></urls></record></Cite></EndNote>(Cassidy, 2014) and certain gambling practices can be experienced as gender transgressive by women, e.g. playing poker ADDIN EN.CITE <EndNote><Cite><Author>Abarbanel</Author><Year>2012</Year><RecNum>205</RecNum><DisplayText>(Abarbanel & Bernhard, 2012)</DisplayText><record><rec-number>205</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329645">205</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abarbanel, B Lillian</author><author>Bernhard, Bo J</author></authors></contributors><titles><title>Chicks with decks: the female lived experience in poker</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>367-385</pages><volume>12</volume><number>3</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Abarbanel & Bernhard, 2012). Participation in the UK National Lottery has been found to be woven in to women’s enactment of caring roles in the family ADDIN EN.CITE <EndNote><Cite><Author>Casey</Author><Year>2006</Year><RecNum>207</RecNum><DisplayText>(Casey, 2006)</DisplayText><record><rec-number>207</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329968">207</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Casey, Emma</author></authors></contributors><titles><title>Domesticating gambling: Gender, caring and the UK National Lottery</title><secondary-title>Leisure studies</secondary-title></titles><periodical><full-title>Leisure studies</full-title></periodical><pages>3-16</pages><volume>25</volume><number>1</number><dates><year>2006</year></dates><isbn>0261-4367</isbn><urls></urls></record></Cite></EndNote>(Casey, 2006). Purchasing lottery tickets can be carried out in spaces where women are frequently located (domestic, community based), and seen as part of managing a household budget to give one’s family the best chances of success ADDIN EN.CITE <EndNote><Cite><Author>Casey</Author><Year>2006</Year><RecNum>207</RecNum><DisplayText>(Casey, 2006)</DisplayText><record><rec-number>207</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329968">207</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Casey, Emma</author></authors></contributors><titles><title>Domesticating gambling: Gender, caring and the UK National Lottery</title><secondary-title>Leisure studies</secondary-title></titles><periodical><full-title>Leisure studies</full-title></periodical><pages>3-16</pages><volume>25</volume><number>1</number><dates><year>2006</year></dates><isbn>0261-4367</isbn><urls></urls></record></Cite></EndNote>(Casey, 2006). From the perspective of the social determinants of gambling and harm, it becomes relevant that women are subjected to gender specific exclusion, marginalisation and violence, particularly in public spaces. Certain gambling environments are produced and marketed as ‘safe’ for women. In Canada, women’s casino gambling can be conceptualised as an available practice to maintain safety and comfort, in an unsafe environment ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><DisplayText>(Kairouz et al., 2017)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017). Gender is related to personal and social identify, but also the distribution of resources and social status ADDIN EN.CITE <EndNote><Cite><Author>Holdsworth</Author><Year>2012</Year><RecNum>4</RecNum><DisplayText>(Holdsworth et al., 2012)</DisplayText><record><rec-number>4</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1488855594">4</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holdsworth, Louise</author><author>Hing, Nerilee</author><author>Breen, Helen</author></authors></contributors><titles><title>Exploring women's problem gambling: A review of the literature</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>199-213</pages><volume>12</volume><number>2</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Holdsworth et al., 2012). Schüll ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Schüll</Author><Year>2012</Year><RecNum>154</RecNum><DisplayText>(2012)</DisplayText><record><rec-number>154</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537407575">154</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Schüll, Natasha Dow</author></authors></contributors><titles><title>Addiction by design: Machine gambling in Las Vegas</title></titles><dates><year>2012</year></dates><publisher>Princeton University Press</publisher><isbn>0691127557</isbn><urls></urls></record></Cite></EndNote>(2012) and Morrison ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Morrison</Author><Year>2015</Year><RecNum>208</RecNum><DisplayText>(2015)</DisplayText><record><rec-number>208</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540331552">208</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Morrison, Laurie</author><author>Wilson, Denise</author></authors></contributors><titles><title>A family affair: Indigenous women’s gambling journey</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>435-446</pages><volume>13</volume><number>4</number><dates><year>2015</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(2015) both draw attention to women’s socio-cultural positioning as primary caregivers in society, to make sense of women’s gambling and harm: Women video poker addicts, I argue, do not seek out gambling because they are bad mothers, but may become bad mothers because they discover in machine gambling a highly addictive relief mechanism - a means of escape from what they experience as an excess of demands and responsibilities to care for others. The desire for such an escape, I suggest, is symptomatic of unresolved anxieties and tensions surrounding the place of care in our discursively individualist society. ADDIN EN.CITE <EndNote><Cite><Author>Schüll</Author><Year>2012</Year><RecNum>154</RecNum><Pages>2</Pages><DisplayText>(Schüll, 2012, p. 2)</DisplayText><record><rec-number>154</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537407575">154</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Schüll, Natasha Dow</author></authors></contributors><titles><title>Addiction by design: Machine gambling in Las Vegas</title></titles><dates><year>2012</year></dates><publisher>Princeton University Press</publisher><isbn>0691127557</isbn><urls></urls></record></Cite></EndNote>(Schüll, 2012, p. 2)The majority of Māori women today live disproportionately in high deprivation neighbourhoods, with low incomes (often income supported benefits), overcrowded and substandard housing, and carry the burden of providing and caring for multiple generations… Māori are exposed to racism and discrimination at much higher levels, something Currie et al. (2013) indicated was a risk factor for gambling and the opportunity it provides to escape difficult realities. ADDIN EN.CITE <EndNote><Cite><Author>Morrison</Author><Year>2015</Year><RecNum>208</RecNum><Pages>443</Pages><DisplayText>(Morrison & Wilson, 2015, p. 443)</DisplayText><record><rec-number>208</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540331552">208</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Morrison, Laurie</author><author>Wilson, Denise</author></authors></contributors><titles><title>A family affair: Indigenous women’s gambling journey</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>435-446</pages><volume>13</volume><number>4</number><dates><year>2015</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Morrison & Wilson, 2015, p. 443)This perspective highlights racism, women’s poverty and responsibility for domestic and emotional labour as important issues to address, to reduce gambling harm. These issues can be seen as intersectional, showing how multiple dimensions of identity (e.g. gender, age, race, ethnicity, nationality, socioeconomic status) operate interdependently to influence people’s experiences ADDIN EN.CITE <EndNote><Cite><Author>Hancock</Author><Year>2007</Year><RecNum>117</RecNum><DisplayText>(A.-M. Hancock, 2007)</DisplayText><record><rec-number>117</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531870311">117</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hancock, Ange-Marie</author></authors></contributors><titles><title>When multiplication doesn't equal quick addition: Examining intersectionality as a research paradigm</title><secondary-title>Perspectives on politics</secondary-title></titles><periodical><full-title>Perspectives on politics</full-title></periodical><pages>63-79</pages><volume>5</volume><number>1</number><dates><year>2007</year></dates><isbn>1541-0986</isbn><urls></urls></record></Cite></EndNote>(A.-M. Hancock, 2007). J?rvinen-Tassopoulos ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>J?rvinen-Tassopoulos</Author><Year>2016</Year><RecNum>212</RecNum><DisplayText>(2016)</DisplayText><record><rec-number>212</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540775930">212</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>J?rvinen-Tassopoulos, Johanna</author></authors></contributors><titles><title>Problem gambling and drinking among Finnish women</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>27-42</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(2016) showed how traditional gendered roles of spouse and mother can operate to discipline Finnish women experiencing gambling problems, who fear losing their families if their problem is made visible. Patriarchal norms and culturally defined gender roles (e.g. males being providers and leaders) exacerbated women’s experiences of gambling harm in Pacific Island communities: …let’s say the husband or the father is the gambler, because he’s the one with the money, and the rest will, say the wife is just, her role is mainly domestic, looking after the kids, there is no voice at all. So the father makes all the decisions himself involving gambling or whatever… when mum is unable to speak up on their behalf so again, it ruins them internally and how they see their mum – she’s failing to stand up and they just split up. ADDIN EN.CITE <EndNote><Cite><Author>Kolandai-Matchett</Author><Year>2017</Year><RecNum>210</RecNum><Prefix>Pacific problem gambling service key informant interviewed by </Prefix><Pages>13</Pages><DisplayText>(Pacific problem gambling service key informant interviewed by Kolandai-Matchett, Langham, Bellringer, & Siitia, 2017, p. 13)</DisplayText><record><rec-number>210</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540766341">210</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kolandai-Matchett, Komathi</author><author>Langham, Erika</author><author>Bellringer, Maria</author><author>Siitia, Pesio Ah-Honi</author></authors></contributors><titles><title>How gambling harms experienced by Pacific people in New Zealand amplify when they are culture-related</title><secondary-title>Asian journal of gambling issues and public health</secondary-title></titles><periodical><full-title>Asian Journal of Gambling Issues and Public Health</full-title></periodical><pages>5</pages><volume>7</volume><number>1</number><dates><year>2017</year></dates><isbn>2195-3007</isbn><urls></urls></record></Cite></EndNote>(Pacific problem gambling service key informant interviewed by Kolandai-Matchett, Langham, Bellringer, & Siitia, 2017, p. 13)This perspective makes visible how gendered social categories and practices can constrain women’s ability to speak about and address gambling harm in their families. Perese and Faleafa ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Perese</Author><Year>2000</Year><RecNum>32</RecNum><DisplayText>(2000)</DisplayText><record><rec-number>32</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520382153">32</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Perese, L</author><author>Faleafa, M</author></authors></contributors><titles><title>The impact of gambling on some Samoan people's lives in Auckland</title></titles><dates><year>2000</year></dates><pub-location>Auckland</pub-location><publisher>The Compulsive Gambling Society of New Zealand</publisher><urls></urls></record></Cite></EndNote>(2000) identified Pacific women’s gambling as functioning to provide some personal autonomy in the context of traditional cultural gender norms imposed on them by husbands and families:I think that [gambling] was the only form of relaxation that I had. In terms of being a housewife, mother, blah, blah, blah. Then a Matai’s [family chief’s] wife. And having to cope with three families. My own family, my family, my married family, and my husband’s family. ADDIN EN.CITE <EndNote><Cite><Author>Perese</Author><Year>2000</Year><RecNum>32</RecNum><Prefix>Lisa interviewed by </Prefix><Pages>33</Pages><DisplayText>(Lisa interviewed by Perese & Faleafa, 2000, p. 33)</DisplayText><record><rec-number>32</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520382153">32</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Perese, L</author><author>Faleafa, M</author></authors></contributors><titles><title>The impact of gambling on some Samoan people's lives in Auckland</title></titles><dates><year>2000</year></dates><pub-location>Auckland</pub-location><publisher>The Compulsive Gambling Society of New Zealand</publisher><urls></urls></record></Cite></EndNote>(Lisa interviewed by Perese & Faleafa, 2000, p. 33)When women’s gambling harm is positioned as a socio-cultural phenomenon, space is created for practitioners to become advocates for women/families within health systems and broader society. Intervention can be directed at the systems, environments, notions and practices that are problematic for women rather than individual women per se, e.g.: ‘Treatment’ related to the depth of guilt and shame women can experience around gambling should involve challenging “sexism and traditional societal ideas of women’s place in the world…” ADDIN EN.CITE <EndNote><Cite><Author>Lesieur</Author><Year>1991</Year><RecNum>93</RecNum><Pages>193-194</Pages><DisplayText>(Lesieur & Blume, 1991, pp. 193-194)</DisplayText><record><rec-number>93</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530498415">93</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Lesieur, HR</author><author>Blume, SB</author></authors><secondary-authors><author>Van Den Bergh, N</author></secondary-authors></contributors><titles><title>When lady luck loses: The female pathological gambler</title><secondary-title>Feminist perspectives on addictions</secondary-title></titles><periodical><full-title>Feminist perspectives on addictions</full-title></periodical><pages>181-197</pages><dates><year>1991</year></dates><pub-location>New York</pub-location><publisher>Springer</publisher><urls></urls></record></Cite></EndNote>(Lesieur & Blume, 1991, pp. 193-194). Intervening to reduce gambling related harm for women would therefore require appropriate sensitivity to the reality of women's lives ADDIN EN.CITE <EndNote><Cite><Author>Boughton</Author><Year>2003</Year><RecNum>211</RecNum><DisplayText>(Boughton, 2003)</DisplayText><record><rec-number>211</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540772990">211</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Boughton, Roberta</author></authors></contributors><titles><title>A feminist slant on counselling the female gambler: Key issues and tasks</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Boughton, 2003). This could entail creating space for women to enjoy more/more varied leisure time, as well as encouraging more men to take up responsibility for emotional and domestic labour connected with family wellbeing. Nuske and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Nuske</Author><Year>2016</Year><RecNum>213</RecNum><DisplayText>(2016)</DisplayText><record><rec-number>213</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540777668">213</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nuske, Elaine Mary</author><author>Holdsworth, Louise</author><author>Breen, Helen</author></authors></contributors><titles><title>Significant life events and social connectedness in Australian women's gambling experiences</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>7-26</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(2016) examined significant life events and social connections that encourage some women to gamble in a way that creates problems for them. The availability of multiple and varied social networks was important for social and emotional wellbeing, particularly as women negotiated significant life events such as new motherhood, death or divorce. These authors advocated for community development interventions for women’s gambling harm, aimed at enhancing social connectedness and cohesion in general, and women’s social capital in particular. DiscussionThis poststructural analysis was intended to identify some of the ways in which women and gambling harm have been constructed in gambling studies. Exploring the range of ideas that guide our practices aimed at producing health and wellbeing in individuals and populations can reveal some current constraints, as well as open up opportunities for viewing problems and their solutions differently. Articulating a range of underpinning assumptions, constraints and possibilities for action, can bring critical attention to bear on systems and processes that tend to otherwise remain hidden and unexamined. Gambling studies have associated problem gambling and its treatment with men. This study has suggested that women affected others have been positioned as adjunct to the psychological treatment and support needs of gambling men. Intervention has therefore focussed on shaping individual women in ways that support gamblers’ recovery and reduce their own distress. While experienced as beneficial by many women, these practices can also buy-in to problematic gender dynamics which place responsibility for family wellbeing on to women, and operate to downplay the impact of social determinants of women’s gambling harm. More recently, women have been seen as under strain caused by the gambling of others, and in need of psychological support in their own right. From this perspective the psychological profession could validate women’s personal boundaries and safety concerns. However, the woman under strain was still largely positioned as an individual psychological subject, for whom interventions related to coping skills and ‘personal functioning’ were developed and trialled. Gender discourses infusing social understandings of ‘successful womanhood’, made the requirement for some women to identify themselves as ‘dysfunctional’ or ‘not coping’ in order to access support problematic.Population studies have made women’s gambling practices and problems visible, particularly in relation to EGM products. This has facilitated work to situate women in a constellation of risk and resiliency factors that are associated with gambling participation. Gambling studies’ positioning of risky women gamblers appeared to reinforce some traditional constructions of women’s roles in the family, particularly emphasising their responsibility for children. Again, constructions of women gamblers as risky could reinforce some contextual factors which women identify as producing gambling harm (e.g. familial and societal expectations that women provide ‘care’). This research appeared disconnected from broader women’s health literature suggesting that the ways in which women can be subjected to moralising regulation as wives and mothers, can compromise their health and wellbeing. A far smaller body of gambling studies research has produced women as subject to social and cultural determinants of gambling and gambling harm. In constructing gambling as ‘an arena for expression and validation of masculinities and femininities’, this research drew attention to women’s positioning as primary caregivers in society, to make sense of women’s gambling harm. This perspective highlighted women’s poverty and responsibility for domestic and emotional labour as important issues to address, to reduce gambling harm. When women’s gambling harm was positioned as a socio-cultural phenomenon, space was created for researchers and practitioners to advocate for women/families within health systems and broader society. Intervention could be directed at the systems, environments, notions and practices that are problematic for women rather than individual women per se.This discussion of implications argues that gambling studies lacking gender sensitivity may contribute to gambling harm, and should therefore be avoided. Uncritical psychological understandings of women harmed by gambling are likely to constrain intervention practice. Psychological perspectives have thus far dominated the field, and should be augmented with greater attention to elucidating and intervening in the social determinants of gambling consumption and harm. Gambling studies lacking gender sensitivity may contribute to harmGambling studies have presented gambling as inconsistent with ‘proper domestic family life’, and participated in policing the boundaries of ‘acceptable femininities’ which emphasise women’s responsibility for others’ wellbeing. One effect of the ‘feminization’ of risky gambling in gambling studies, appears to have been to perpetuate and reinforce some traditional and stereotypical constructions of women’s roles in the family. Gender discourses can operate through gambling studies, to reward women who are able to position themselves as capable wives, mothers and carers, and censure those who cannot or choose not to. Across gambling studies, there has been a lack of sensitivity to the particular issues women face, which form the cultural backdrop to their experiences of gambling and gambling harm ADDIN EN.CITE <EndNote><Cite><Author>McCarthy</Author><Year>2019</Year><RecNum>265</RecNum><DisplayText>(McCarthy et al., 2019)</DisplayText><record><rec-number>265</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081760">265</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCarthy, Simone</author><author>Thomas, Samantha L</author><author>Bellringer, Maria E</author><author>Cassidy, Rebecca</author></authors></contributors><titles><title>Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice</title><secondary-title>Harm reduction journal</secondary-title></titles><periodical><full-title>Harm reduction journal</full-title></periodical><pages>18</pages><volume>16</volume><number>1</number><dates><year>2019</year></dates><isbn>1477-7517</isbn><urls></urls></record></Cite></EndNote>(McCarthy et al., 2019). To avoid facilitating and perpetuating gambling harm, gambling studies should actively identify and operate reflectively in relation to gender issues. This analysis supports the notion that both research and intervention with the aim of reducing gambling related harm for women necessitates discussion of the broader conditions under which women live. These conditions include power dynamics, scope of action, resources, division of labour and the social construction of masculinities and femininities ADDIN EN.CITE <EndNote><Cite><Author>Hammarstr?m</Author><Year>2007</Year><RecNum>89</RecNum><DisplayText>(Hammarstr?m, 2007)</DisplayText><record><rec-number>89</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1529897171">89</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hammarstr?m, Anne</author></authors></contributors><titles><title>A tool for developing gender research in medicine: examples from the medical literature on work life</title><secondary-title>Gender medicine</secondary-title></titles><periodical><full-title>Gender medicine</full-title></periodical><pages>S123-S132</pages><volume>4</volume><dates><year>2007</year></dates><isbn>1550-8579</isbn><urls></urls></record></Cite></EndNote>(Hammarstr?m, 2007). Gender interacts with the social determinants of gambling harm through women’s exposure to poverty, discrimination, trauma and harassment, combined with socially and culturally prescribed responsibility for family wellbeing. These issues form the larger cultural context in which women’s gambling harm unfolds. Women affected by gambling harm are often also under economic pressure, burdened with both domestic and professional duties and relatively constrained by social role prescriptions.Feminist perspectives on gambling and addictions specifically, and health and wellbeing more generally, remain highly relevant for women’s harm reduction research and practice. The impact of “sexism and traditional societal ideas of women’s place in the world” on women’s wellbeing has been recognised by gambling research since the early 1990s ADDIN EN.CITE <EndNote><Cite><Author>Lesieur</Author><Year>1991</Year><RecNum>93</RecNum><Pages>193</Pages><DisplayText>(Lesieur & Blume, 1991, p. 193)</DisplayText><record><rec-number>93</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530498415">93</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Lesieur, HR</author><author>Blume, SB</author></authors><secondary-authors><author>Van Den Bergh, N</author></secondary-authors></contributors><titles><title>When lady luck loses: The female pathological gambler</title><secondary-title>Feminist perspectives on addictions</secondary-title></titles><periodical><full-title>Feminist perspectives on addictions</full-title></periodical><pages>181-197</pages><dates><year>1991</year></dates><pub-location>New York</pub-location><publisher>Springer</publisher><urls></urls></record></Cite></EndNote>(Lesieur & Blume, 1991, p. 193). More recently, and to an increasing extent, women’s socially prescribed responsibility for others’ wellbeing has been conceptualised as a public health issue which often operates to constrain women’s leisure opportunities, and ability to take care of themselves PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GdXJzbWFuPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48
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ADDIN EN.CITE.DATA (e.g. Craig, 2016; Fursman & Callister, 2009; Statistics New Zealand, 2001). Women’s disproportionate participation in unpaid caring work and volunteerism are crucial, yet undervalued aspects of population health and wellbeing ADDIN EN.CITE <EndNote><Cite><Author>Waring</Author><Year>1999</Year><RecNum>237</RecNum><DisplayText>(Waring, 1999)</DisplayText><record><rec-number>237</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543530273">237</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Waring, Marilyn</author></authors></contributors><titles><title>Counting for nothing: What men value and what women are worth</title></titles><dates><year>1999</year></dates><publisher>University of Toronto Press</publisher><isbn>0802082602</isbn><urls></urls></record></Cite></EndNote>(Waring, 1999), which can take their toll on women’s health ADDIN EN.CITE <EndNote><Cite><Author>Dinh</Author><Year>2017</Year><RecNum>303</RecNum><DisplayText>(Dinh, Strazdins, & Welsh, 2017)</DisplayText><record><rec-number>303</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560818173">303</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dinh, Huong</author><author>Strazdins, Lyndall</author><author>Welsh, Jennifer</author></authors></contributors><titles><title>Hour-glass ceilings: Work-hour thresholds, gendered health inequities</title><secondary-title>Social Science & Medicine</secondary-title></titles><periodical><full-title>Social Science & Medicine</full-title></periodical><pages>42-51</pages><volume>176</volume><dates><year>2017</year></dates><isbn>0277-9536</isbn><urls></urls></record></Cite></EndNote>(Dinh, Strazdins, & Welsh, 2017). Research exploring and promoting gender equality is recognised as a key strategy for improving the health and wellbeing of women and their communities worldwide ADDIN EN.CITE <EndNote><Cite><Author>World Health Organisation</Author><Year>2008</Year><RecNum>230</RecNum><DisplayText>(World Health Organisation, 2008)</DisplayText><record><rec-number>230</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543446113">230</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>World Health Organisation,</author></authors></contributors><titles><title>Women's empowerment and gender equality: Essential goals for saving women's lives</title></titles><dates><year>2008</year></dates><pub-location>Geneva</pub-location><publisher>Department of Gender, Women and Health</publisher><urls></urls></record></Cite></EndNote>(World Health Organisation, 2008). Such research should support efforts to increase women’s political, social and economic status and agency, ensuring participation and equal access to resources in society, so that women can determine the course of their own lives ADDIN EN.CITE <EndNote><Cite><Author>Charmes</Author><Year>2003</Year><RecNum>235</RecNum><DisplayText>(Charmes & Wieringa, 2003)</DisplayText><record><rec-number>235</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543529918">235</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Charmes, Jacques</author><author>Wieringa, Saskia</author></authors></contributors><titles><title>Measuring women's empowerment: an assessment of the gender-related development index and the gender empowerment measure</title><secondary-title>Journal of Human Development</secondary-title></titles><periodical><full-title>Journal of Human Development</full-title></periodical><pages>419-435</pages><volume>4</volume><number>3</number><dates><year>2003</year></dates><isbn>1464-9888</isbn><urls></urls></record></Cite></EndNote>(Charmes & Wieringa, 2003). Addressing gambling harm for women can be linked to improving the position of women in New Zealand society. In this vein, relevant research and policy issues are improving women’s pay parity by ethnicity, addressing the ‘motherhood pay penalty’ PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZXc8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFyPjxSZWNO
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ADDIN EN.CITE.DATA (Dew, 2017; McGregor, Davies, Giddings, & Pringle, 2017; Pacheco, Li, & Cochrane, 2017; Statistics New Zealand & Ministry for Women, 2017), and full and thorough recognition of women’s reproductive autonomy ADDIN EN.CITE <EndNote><Cite><Author>Auckland Women's Health Council</Author><Year>2018</Year><RecNum>232</RecNum><DisplayText>(Auckland Women's Health Council, 2018; Privacy Commissioner, 2018)</DisplayText><record><rec-number>232</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543448951">232</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Auckland Women's Health Council,</author></authors></contributors><titles><title>Abortion law reform submission from the Auckland Women's Health Council to the Law Commission</title></titles><volume>2018</volume><number>29 November</number><dates><year>2018</year></dates><pub-location>Auckland</pub-location><publisher>Auckland Women's Health Council</publisher><urls><related-urls><url> Commissioner</Author><Year>2018</Year><RecNum>231</RecNum><record><rec-number>231</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543448860">231</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Privacy Commissioner,</author></authors></contributors><titles><title>Privacy Commissioner's submission to the Law Commission on abortion law reform</title></titles><volume>2018</volume><number>29 November</number><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Privacy Commissioner</publisher><urls><related-urls><url>;(Auckland Women's Health Council, 2018; Privacy Commissioner, 2018). Exploring and finding ways to better recognise, support, share and reduce the domestic and emotional labour that tends to fall to women, remains a key concern, particularly for Māori and Pacific women ADDIN EN.CITE <EndNote><Cite><Author>Ministry for Women</Author><Year>2016</Year><RecNum>28</RecNum><DisplayText>(Ministry for Women, 2016a, 2016b)</DisplayText><record><rec-number>28</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520377110">28</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry for Women,</author></authors></contributors><titles><title>Pacific Women</title></titles><dates><year>2016</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls><related-urls><url> for Women</Author><Year>2016</Year><RecNum>29</RecNum><record><rec-number>29</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520377147">29</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry for Women,</author></authors></contributors><titles><title>Maori Women</title></titles><dates><year>2016</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls><related-urls><url>;(Ministry for Women, 2016a, 2016b). Asked to identify a major barrier standing in the way of full equality for women, Justice Ruth Bader Ginsburg said it depended on the answer to one question: Who will take responsibility for raising the next generation? Women will only have true equality when men share with them the responsibility of bringing up the next generation. ADDIN EN.CITE <EndNote><Cite><Author>Choo</Author><Year>2000</Year><RecNum>233</RecNum><Prefix>Ginsburg interviewed by </Prefix><DisplayText>(Ginsburg interviewed by Choo, 2000)</DisplayText><record><rec-number>233</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543449753">233</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Choo, Kristin</author></authors></contributors><titles><title>Justice Ginsburg recalls bias, expresses concerns</title></titles><volume>2018</volume><number>29 November</number><dates><year>2000</year></dates><pub-location>Women's E-News</pub-location><publisher>Women's E-News</publisher><urls><related-urls><url>;(Ginsburg interviewed by Choo, 2000). The impact of this fundamental structural challenge on the distribution of gambling harm is relativity poorly recognised in gambling studies research and policy at present.Psychological understandings of women harmed by gambling constrain intervention practiceDominant psychological understandings of health and wellbeing emphasised the personal facets of health that were located within women themselves: e.g. coping skills and emotion regulation, confidence and self-efficacy, knowledge and understanding of gambling issues. Gambling studies have tended to focus on individuals harmed by gambling or at most the inner processes and dynamics of families ADDIN EN.CITE <EndNote><Cite><Author>Orford</Author><Year>2014</Year><RecNum>164</RecNum><DisplayText>(Orford, 2014)</DisplayText><record><rec-number>164</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1538093362">164</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author></authors></contributors><titles><title>A response to Calderwood and Rajesparam's ideas on codependence</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><pages>1-4</pages><number>29</number><dates><year>2014</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Orford, 2014). 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ADDIN EN.CITE.DATA (e.g. Dowling, 2014; Kourgiantakis et al., 2018; Rodda et al., 2013). However, from a poststructural perspective, psychological discourses do not just make phenomena and issues such as ‘adaptive coping’ visible, but produce, and organise them. Rose ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Rose</Author><Year>1985</Year><RecNum>516</RecNum><DisplayText>(1985b)</DisplayText><record><rec-number>516</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1475017636">516</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rose, Nikolas</author></authors></contributors><titles><title>The psychological complex</title></titles><dates><year>1985</year></dates><pub-location>London</pub-location><publisher>Routledge & Kegan Paul</publisher><urls></urls></record></Cite></EndNote>(1985b) explains how psychology makes human beings thinkable as a certain mode of existence that must be addressed in a particular way. This process also tends to individualise the issues that people face e.g.: in some cases the idea that it is the woman’s inner cognitive distortions and misconceptions that must be addressed to return her to health. Psychological discourses tended to make women’s gambling behaviours, responses to gambling behaviours, thoughts and emotions problematic, illuminating them as issues to be dealt with or managed. Skills-based treatment may consider broader issues such as poverty, discrimination, and trauma, however this is done so at an individual level. In gambling studies literature, dominant psychological discourses produced responsibility for carrying out psychological practices (changing thought patterns, taking up particular activities), that the women must engage in to achieve ‘psychological health’. Psychological understandings, because they were so dominant in the literature, tended to obscure consideration of broader societal issues, gendered demands and expectations, poverty, victimisation and violence, leaving these issues comparatively unchallenged in relation to women’s gambling practices and harm. In a psychological therapeutic framework, experiences that align with psychological discourse tend to be validated, and change relies on the uncovering of essential ‘truth’ and healthfulness within individual selves ADDIN EN.CITE <EndNote><Cite><Author>Kitzinger</Author><Year>1993</Year><RecNum>591</RecNum><DisplayText>(Kitzinger & Perkins, 1993)</DisplayText><record><rec-number>591</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1476385911">591</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Kitzinger, Celia</author><author>Perkins, Rachel</author></authors></contributors><titles><title>Changing our minds: Lesbian feminism and psychology</title></titles><dates><year>1993</year></dates><publisher>NYU Press</publisher><isbn>0814746462</isbn><urls></urls></record></Cite></EndNote>(Kitzinger & Perkins, 1993). Collective experience of societal ills can be constrained as a resource for social change: “Therapists become the repositories of the stories we used to tell each other. But therapists can’t tell anyone else because of confidentiality rules” ADDIN EN.CITE <EndNote><Cite><Author>Rankine</Author><Year>1996</Year><RecNum>590</RecNum><Pages>14</Pages><DisplayText>(Rankine, 1996, p. 14)</DisplayText><record><rec-number>590</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1476385758">590</key></foreign-keys><ref-type name="Magazine Article">19</ref-type><contributors><authors><author>Rankine, Jenny</author></authors></contributors><titles><title>Putting therapy on the couch</title><secondary-title>Broadsheet</secondary-title></titles><pages>12-17</pages><volume>212</volume><dates><year>1996</year></dates><pub-location>Auckland</pub-location><publisher>Broadsheet Collective</publisher><urls></urls></record></Cite></EndNote>(Rankine, 1996, p. 14). Psychological gambling studies tended to constrain or narrow how we are able to think about intervention for women experiencing gambling harm. Since the early 1990s, there has been little analysis of gender as a social determinant of gambling harm. This narrowing phenomenon has been critiqued in addictions treatment more broadly, for example, more holistic discourses of health and wellbeing allowed ‘Susan’ to resist dominant addiction treatment ideology positioning her struggle as an individual condition:While acknowledging her need to address her temporary inability to stop using drugs, Susan refused to accept an identity based on powerlessness and composed of character defects… Susan saw the world in terms of power, privilege and difference; claiming powerlessness was ‘what women have been doing for years’ ADDIN EN.CITE <EndNote><Cite><Author>Aston</Author><Year>2009</Year><RecNum>146</RecNum><Pages>622</Pages><DisplayText>(Aston, 2009, p. 622)</DisplayText><record><rec-number>146</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537307879">146</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Aston, Shaughney</author></authors></contributors><titles><title>Identities under construction: Women hailed as addicts</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>611-628</pages><volume>13</volume><number>6</number><dates><year>2009</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(Aston, 2009, p. 622). Addictions treatment and self-help services (as well as researchers, government departments, and other stakeholders), produce authoritative knowledge statements about ‘addictions’ and ‘addicts’. These constructions can be problematic, and may or may not align with the lived experience of women or others, including those who may not identify as either male or female. Services can work consciously and actively to “respond to women in more gender compassionate ways that do not pathologize women or unwittingly exacerbate experiences of disempowerment or worthlessness” ADDIN EN.CITE <EndNote><Cite><Author>Aston</Author><Year>2009</Year><RecNum>146</RecNum><Pages>625</Pages><DisplayText>(Aston, 2009, p. 625)</DisplayText><record><rec-number>146</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537307879">146</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Aston, Shaughney</author></authors></contributors><titles><title>Identities under construction: Women hailed as addicts</title><secondary-title>Health:</secondary-title></titles><periodical><full-title>Health:</full-title></periodical><pages>611-628</pages><volume>13</volume><number>6</number><dates><year>2009</year></dates><isbn>1363-4593</isbn><urls></urls></record></Cite></EndNote>(Aston, 2009, p. 625). This would not invalidate psychological perspectives (and the benefits women and men may experience from psychological therapies), but instead would seek to balance them with a greater level of understanding and intervention across broader socio-cultural domains ADDIN EN.CITE <EndNote><Cite><Author>Hunter</Author><Year>2002</Year><RecNum>313</RecNum><Prefix>e.g. see </Prefix><DisplayText>(e.g. see Hunter, Ussher, Cariss, Browne, & Jelly, 2002; Ussher, Hunter, & Cariss, 2002)</DisplayText><record><rec-number>313</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561681077">313</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hunter, M</author><author>Ussher, JM</author><author>Cariss, M</author><author>Browne, S</author><author>Jelly, R</author></authors></contributors><titles><title>A randomised comparison of psychological (cognitive behaviour therapy, CBT), medical (fluoxetine) and combined (CBT and fluoxetine) treatment for women with Premenstrual Dysphoric Disorder</title><secondary-title>J Psychosom Obstet Gynaecol</secondary-title></titles><periodical><full-title>J Psychosom Obstet Gynaecol</full-title></periodical><dates><year>2002</year></dates><urls></urls></record></Cite><Cite><Author>Ussher</Author><Year>2002</Year><RecNum>221</RecNum><record><rec-number>221</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1542248045">221</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ussher, Jane M</author><author>Hunter, Myra</author><author>Cariss, Margaret</author></authors></contributors><titles><title>A woman‐centred psychological intervention for premenstrual symptoms, drawing on cognitive‐behavioural and narrative therapy</title><secondary-title>Clinical Psychology & Psychotherapy</secondary-title></titles><periodical><full-title>Clinical Psychology & Psychotherapy</full-title></periodical><pages>319-331</pages><volume>9</volume><number>5</number><dates><year>2002</year></dates><isbn>1063-3995</isbn><urls></urls></record></Cite></EndNote>(e.g. see Hunter, Ussher, Cariss, Browne, & Jelly, 2002; Ussher, Hunter, & Cariss, 2002).Rethinking gambling studies and intervention to reduce women’s gambling harm.Gambling studies’ focus on the ‘individual woman in therapy’ is disappointing given that the stress-strain-coping-support model has been seen as capable of “altering the focus of treatment from the individual to the social context within which the addictive behaviour takes place” ADDIN EN.CITE <EndNote><Cite><Author>Copello</Author><Year>2002</Year><RecNum>104</RecNum><Pages>1362</Pages><DisplayText>(Copello & Orford, 2002, p. 1362)</DisplayText><record><rec-number>104</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531354009">104</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Copello, Alex</author><author>Orford, Jim</author></authors></contributors><titles><title>Addiction and the family: is it time for services to take notice of the evidence?</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1361-1363</pages><volume>97</volume><number>11</number><dates><year>2002</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(Copello & Orford, 2002, p. 1362). A biopsychosocial approach to gambling has highlighted the importance of contextual factors in both research and clinical interventions ADDIN EN.CITE <EndNote><Cite><Author>Griffiths</Author><Year>2001</Year><RecNum>220</RecNum><DisplayText>(Griffiths & Delfabbro, 2001)</DisplayText><record><rec-number>220</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1542247591">220</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Griffiths, Mark D</author><author>Delfabbro, Paul</author></authors></contributors><titles><title>The biopsychosocial approach to gambling: Contextual factors in research and clinical interventions</title><secondary-title>Journal of Gambling Issues (JGI)</secondary-title></titles><periodical><full-title>Journal of Gambling Issues (JGI)</full-title></periodical><number>5</number><dates><year>2001</year></dates><urls></urls></record></Cite></EndNote>(Griffiths & Delfabbro, 2001). In addition, early definitions of gambling as a public health issue, included the need to address “not only the biological and behavioural dimensions related to gambling and health, but also the social and economic determinants such as income, employment and poverty” ADDIN EN.CITE <EndNote><Cite><Author>Korn</Author><Year>1999</Year><RecNum>137</RecNum><Pages>291</Pages><DisplayText>(Korn & Shaffer, 1999, p. 291)</DisplayText><record><rec-number>137</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536024466">137</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Korn, David A</author><author>Shaffer, Howard J</author></authors></contributors><titles><title>Gambling and the health of the public: Adopting a public health perspective</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>289-365</pages><volume>15</volume><number>4</number><dates><year>1999</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Korn & Shaffer, 1999, p. 291). Since the early 1990s, gambling research practices have produced gender-disaggregated data, and drawn attention to gender differences, mostly in the area of problem gambling and its psychological treatment. The social determinants of women’s gambling harm appear to have slipped down the gambling studies agenda, which has limited the development of interventions to address women’s gambling harm as a broader systemic issue. The analysis presented here draws attention to the ways that the practices of individual women affected by gambling harm tend to be problematised in gambling studies, while industry and governmental practices can remain unquestioned. Adams and Rossen ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><DisplayText>(2012)</DisplayText><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(2012) argued that a disproportionate focus on traditional psychological treatment services and regulation in New Zealand, has occurred at the expense of facilitating community engagement with gambling issues, supporting independent research, and addressing reliance on gambling profits. Critical gambling studies suggest that less attention be paid to internal “pathology” and more energy directed towards elucidating and intervening in the environmental circumstances producing gambling consumption and harm ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2007</Year><RecNum>59</RecNum><DisplayText>(P. J. Adams, 2007; Reith, 2007)</DisplayText><record><rec-number>59</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520541499">59</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>Gambling and the contradictions of consumption: A genealogy of the “pathological” subject</title><secondary-title>American behavioral scientist</secondary-title></titles><periodical><full-title>American behavioral scientist</full-title></periodical><pages>33-55</pages><volume>51</volume><number>1</number><dates><year>2007</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite><Cite><Author>Adams</Author><Year>2007</Year><RecNum>150</RecNum><record><rec-number>150</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537402593">150</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Gambling, freedom and democracy</title></titles><dates><year>2007</year></dates><publisher>Routledge</publisher><isbn>1135907293</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams, 2007; Reith, 2007). Gambling and governance appear inextricably connected in twenty first century capitalist economies ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2007</Year><RecNum>150</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. P. J. Adams, 2007; Markham & Young, 2015)</DisplayText><record><rec-number>150</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537402593">150</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Gambling, freedom and democracy</title></titles><dates><year>2007</year></dates><publisher>Routledge</publisher><isbn>1135907293</isbn><urls></urls></record></Cite><Cite><Author>Markham</Author><Year>2015</Year><RecNum>153</RecNum><record><rec-number>153</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537406753">153</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Markham, Francis</author><author>Young, Martin</author></authors></contributors><titles><title>“Big gambling”: the rise of the global industry-state gambling complex</title></titles><dates><year>2015</year></dates><publisher>Taylor & Francis</publisher><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(e.g. P. J. Adams, 2007; Markham & Young, 2015). 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ADDIN EN.CITE.DATA (Cosgrave, 2010; Livingstone et al., 2018; Reith, 2007). The notion of ‘dangerous consumption’ ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2005</Year><RecNum>157</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. P. J. Adams & Hodges, 2005)</DisplayText><record><rec-number>157</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537745144">157</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Hodges, Ian</author></authors></contributors><titles><title>Understanding dangerous consumptions: Moving forward with a national strategy for research on tobacco, alcohol, other drugs and gambling</title><secondary-title>Social Policy Journal of New Zealand</secondary-title></titles><periodical><full-title>Social Policy Journal of New Zealand</full-title></periodical><pages>17</pages><volume>26</volume><dates><year>2005</year></dates><isbn>1172-4382</isbn><urls></urls></record></Cite></EndNote>(e.g. P. J. Adams & Hodges, 2005) links gambling with other addictive products (such as alcohol, cannabis and tobacco), which pose particular challenges for public policies around the world:“On the one hand, governments are supposed to protect the health and well-being of their citizens, but on the other, the consumption of these products and services provides a lucrative source of public revenue, especially when income tax and corporate tax fail to provide enough… addictive forms of consumption (such as gambling and the use of alcohol, cannabis and tobacco) may well generate larger financial surpluses than other forms. This “addiction surplus” results from excessive consumption by those who are addicted” ADDIN EN.CITE <EndNote><Cite><Author>Nikkinen</Author><Year>2017</Year><RecNum>151</RecNum><Pages>476</Pages><DisplayText>(Nikkinen, 2017, p. 476)</DisplayText><record><rec-number>151</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537404000">151</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nikkinen, Janne</author></authors></contributors><titles><title>The legalization of dangerous consumption: a comparison of cannabis and gambling policies in three US states</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>476-484</pages><volume>25</volume><number>6</number><dates><year>2017</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(Nikkinen, 2017, p. 476).Gambling can be captured by corporate and state interests, and public consent cannot always be taken for granted ADDIN EN.CITE <EndNote><Cite><Author>Hellman</Author><Year>2017</Year><RecNum>152</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. P. J. Adams, 2007; Hellman, ?rnberg, & Livingstone, 2017)</DisplayText><record><rec-number>152</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537406088">152</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Hellman, Matilda</author><author>?rnberg, Jenny Cisneros</author><author>Livingstone, Charles</author></authors></contributors><titles><title>Gambling policy studies: a field that is growing in size and complexity</title></titles><dates><year>2017</year></dates><publisher>Taylor & Francis</publisher><isbn>1606-6359</isbn><urls></urls></record></Cite><Cite><Author>Adams</Author><Year>2007</Year><RecNum>150</RecNum><record><rec-number>150</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537402593">150</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Adams, P. J</author></authors></contributors><titles><title>Gambling, freedom and democracy</title></titles><dates><year>2007</year></dates><publisher>Routledge</publisher><isbn>1135907293</isbn><urls></urls></record></Cite></EndNote>(e.g. P. J. Adams, 2007; Hellman, ?rnberg, & Livingstone, 2017). Globally, full and thorough implementation of available and recommended gambling harm reduction measures is not generally carried out, and if effective would significantly curtail both industry and governmental revenue from gambling ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>6</RecNum><DisplayText>(Abbott, 2017a; Williams et al., 2012)</DisplayText><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502937388">6</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>The epidemiology and impact of gambling disorder and other gambling-related harm</title><secondary-title>2017 WHO Forum on alcohol, drugs and addictive behaviours</secondary-title></titles><dates><year>2017</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite><Cite><Author>Williams</Author><Year>2012</Year><RecNum>248</RecNum><record><rec-number>248</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1555022015">248</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Williams, Robert J</author><author>West, Beverly L</author><author>Simpson, Robert I</author></authors></contributors><titles><title>Prevention of problem gambling: A comprehensive review of the evidence and identified best practices</title></titles><dates><year>2012</year></dates><publisher>Ontario Problem Gambling Research Centre and the Ontario Ministry of Health?…</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2017a; Williams et al., 2012). Positioning gambling harm as a socio-cultural phenomenon, may create space for researchers and practitioners to recognise and reflect on how knowledge and practice systems may often have unanticipated effects. Critical psychological approaches suggest that clinicians and researchers work together to redefine the “detached, objective technician of the scientist-practitioner model” in favour of a more reflexive, engaged and invested social position (Bolam & Chamberlain, 2003, p. 216). Cassidy ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(2018)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite></EndNote>(2018) has advocated for critical gambling studies which work closely with those harmed by gambling and those engaged in their treatment, share knowledge in formats that are accessible, appropriate and useful to a variety of audiences including gamblers, and are fundamentally collaborative. Gambling studies researchers seeking to inform efforts to address gambling harm for women could also benefit from closer working relationships with women’s health researchers and advocates. Collaboration with advocacy and social justice groups may enhance efforts to reduce gambling harm for women by “promot[ing] political education and social action leading to health promoting cultures and organizations” ADDIN EN.CITE <EndNote><Cite><Author>Prilleltensky</Author><Year>2003</Year><RecNum>102</RecNum><Pages>199</Pages><DisplayText>(Prilleltensky & Prilleltensky, 2003, p. 199)</DisplayText><record><rec-number>102</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531276489">102</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Prilleltensky, Isaac</author><author>Prilleltensky, Ora</author></authors></contributors><titles><title>Towards a critical health psychology practice</title><secondary-title>Journal of health psychology</secondary-title></titles><periodical><full-title>Journal of health psychology</full-title></periodical><pages>197-210</pages><volume>8</volume><number>2</number><dates><year>2003</year></dates><isbn>1359-1053</isbn><urls></urls></record></Cite></EndNote>(Prilleltensky & Prilleltensky, 2003, p. 199). Effective interventions maintaining a dual focus on individual and social issues have been developed for women’s health issues ADDIN EN.CITE <EndNote><Cite><Author>Ussher</Author><Year>2002</Year><RecNum>221</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Ussher et al., 2002)</DisplayText><record><rec-number>221</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1542248045">221</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ussher, Jane M</author><author>Hunter, Myra</author><author>Cariss, Margaret</author></authors></contributors><titles><title>A woman‐centred psychological intervention for premenstrual symptoms, drawing on cognitive‐behavioural and narrative therapy</title><secondary-title>Clinical Psychology & Psychotherapy</secondary-title></titles><periodical><full-title>Clinical Psychology & Psychotherapy</full-title></periodical><pages>319-331</pages><volume>9</volume><number>5</number><dates><year>2002</year></dates><isbn>1063-3995</isbn><urls></urls></record></Cite></EndNote>(e.g. Ussher et al., 2002). As yet there is little evidence of this kind of critical psychological work in the area of gambling harm reduction for women or men. Critical psychology may offer opportunities to expand the role of gambling services to include community development and client-led practice. At a minimum, to avoid stereotypical labelling and victim blaming, women’s experiences of gambling harm should be positioned as always-already part of the socioeconomic, historical, cultural, family, and personal circumstances through which these experiences are produced ADDIN EN.CITE <EndNote><Cite><Author>Li</Author><Year>2007</Year><RecNum>234</RecNum><DisplayText>(Li, 2007)</DisplayText><record><rec-number>234</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543461064">234</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Li, Jun</author></authors></contributors><titles><title>Women's ways of gambling and gender‐specific research</title><secondary-title>Sociological Inquiry</secondary-title></titles><periodical><full-title>Sociological Inquiry</full-title></periodical><pages>626-636</pages><volume>77</volume><number>4</number><dates><year>2007</year></dates><isbn>0038-0245</isbn><urls></urls></record></Cite></EndNote>(Li, 2007).ConclusionCurrent conceptualisations of women in gambling studies tend to bring individual women affected by gambling harm into focus, obscuring the social determinants of gambling and harm, and sometimes reproducing some unhelpful gender stereotypes in the process. Gender disaggregated data, while necessary to identify disparities, are insufficient for understanding the underlying issues without analysis of gender as a social determinant of health and wellbeing. Key social determinants of women’s gambling harm include women’s exposure to poverty, discrimination, trauma and harassment, combined with socially and culturally prescribed responsibility for domestic and emotional labour. Addressing gambling harm for women can be linked to improving the position of women in New Zealand society more generally. Opportunities for orienting gambling services towards the social determinants of women’s gambling harm may be found in critical psychology, and/or approaches which emphasise collaborative collective action, community development and client-led practice.GENDER ANALYSIS OF EXPERIENCES OF GAMBLING HARMThe second component of this study involved secondary analysis of two existing qualitative datasets documenting New Zealanders’ experiences of gambling and harm. This involved consideration of the ways in which gambling harm can be seen as ‘gendered’. Gambling harm affects men and women relatively equally The health and social costs of gambling are estimated to be substantial when calculated using burden of harm methodologies. These studies try to elucidate and measure harms occurring for and around people at all gambling severity levels: low-risk, moderate-risk and problem gambling PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ccm93bmU8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Browne, Bellringer, et al., 2017; Browne, Greer, et al., 2017; Browne et al., 2016). Gambling can affect multiple domains of life including, but not limited to: financial hardship, poorer health, psychological and emotional distress, and impaired social and cultural relationships ADDIN EN.CITE <EndNote><Cite><Author>Langham</Author><Year>2015</Year><RecNum>79</RecNum><DisplayText>(Langham et al., 2015)</DisplayText><record><rec-number>79</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525134762">79</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Langham, Erika</author><author>Thorne, Hannah</author><author>Browne, Matthew</author><author>Donaldson, Phillip</author><author>Rose, Judy</author><author>Rockloff, Matthew</author></authors></contributors><titles><title>Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms</title><secondary-title>BMC public health</secondary-title></titles><periodical><full-title>BMC public health</full-title></periodical><pages>80</pages><volume>16</volume><number>1</number><dates><year>2015</year></dates><isbn>1471-2458</isbn><urls></urls></record></Cite></EndNote>(Langham et al., 2015). These issues can linger long after the gambling has stopped, as encapsulated by the notion of ‘legacy gambling harm’ ADDIN EN.CITE <EndNote><Cite><Author>Langham</Author><Year>2015</Year><RecNum>79</RecNum><DisplayText>(Langham et al., 2015)</DisplayText><record><rec-number>79</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525134762">79</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Langham, Erika</author><author>Thorne, Hannah</author><author>Browne, Matthew</author><author>Donaldson, Phillip</author><author>Rose, Judy</author><author>Rockloff, Matthew</author></authors></contributors><titles><title>Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms</title><secondary-title>BMC public health</secondary-title></titles><periodical><full-title>BMC public health</full-title></periodical><pages>80</pages><volume>16</volume><number>1</number><dates><year>2015</year></dates><isbn>1471-2458</isbn><urls></urls></record></Cite></EndNote>(Langham et al., 2015). Gambling-related harm is understood not only in terms of the effects on the person who gambles, but impacts that can occur to family, friends, whānau (extended family), and the broader community ADDIN EN.CITE <EndNote><Cite><Author>Goodwin</Author><Year>2017</Year><RecNum>95</RecNum><DisplayText>(Browne, Bellringer, et al., 2017; Goodwin, Browne, Rockloff, & Rose, 2017)</DisplayText><record><rec-number>95</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530752616">95</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Goodwin, Belinda C</author><author>Browne, Matthew</author><author>Rockloff, Matthew</author><author>Rose, Judy</author></authors></contributors><titles><title>A typical problem gambler affects six others</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>276-289</pages><volume>17</volume><number>2</number><dates><year>2017</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>Browne</Author><Year>2017</Year><RecNum>17</RecNum><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511829103">17</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Bellringer, Maria</author><author>Greer, Nancy</author><author>Kolandai-Matchett, Komathi</author><author>Rawat, Vijay</author><author>Langham, Erika</author><author>Rockloff, Matthew</author><author>Palmer Du Preez, Katie</author><author>Abbott, Max</author></authors></contributors><titles><title>Measuring the burden of gambling harm in New Zealand</title></titles><dates><year>2017</year></dates><publisher>New Zealand Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Browne, Bellringer, et al., 2017; Goodwin, Browne, Rockloff, & Rose, 2017). For example, two recent systematic reviews of population, clinical and community based research have illuminated the multifaceted and complex nature of gambling harm experienced by the significant others of gamblers ADDIN EN.CITE <EndNote><Cite><Author>Kourgiantakis</Author><Year>2013</Year><RecNum>190</RecNum><DisplayText>(Kourgiantakis et al., 2013; Riley et al., 2018)</DisplayText><record><rec-number>190</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539558737">190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kourgiantakis, Toula</author><author>Saint-Jacques, Marie-Christine</author><author>Tremblay, Jo?l</author></authors></contributors><titles><title>Problem gambling and families: A systematic review</title><secondary-title>Journal of Social Work Practice in the Addictions</secondary-title></titles><periodical><full-title>Journal of Social Work Practice in the Addictions</full-title></periodical><pages>353-372</pages><volume>13</volume><number>4</number><dates><year>2013</year></dates><isbn>1533-256X</isbn><urls></urls></record></Cite><Cite><Author>Riley</Author><Year>2018</Year><RecNum>191</RecNum><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1539637407">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Riley, Ben J</author><author>Harvey, Peter</author><author>Crisp, Beth R</author><author>Battersby, Malcolm</author><author>Lawn, Sharon</author></authors></contributors><titles><title>Gambling-related harm as reported by concerned significant others: a systematic review and meta-synthesis of empirical studies</title><secondary-title>Journal of Family Studies</secondary-title></titles><periodical><full-title>Journal of Family Studies</full-title></periodical><pages>1-19</pages><dates><year>2018</year></dates><isbn>1322-9400</isbn><urls></urls></record></Cite></EndNote>(Kourgiantakis et al., 2013; Riley et al., 2018). Similar numbers of women and men report experiencing harm from others’ gambling in population studies ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2013</Year><RecNum>218</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Svensson et al., 2013)</DisplayText><record><rec-number>218</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1541635826">218</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author><author>Shepherdson, Emma</author></authors></contributors><titles><title>The concerned significant others of people with gambling problems in a national representative sample in Sweden–a 1 year follow-up study</title><secondary-title>BMC Public Health</secondary-title></titles><periodical><full-title>BMC public health</full-title></periodical><pages>1087</pages><volume>13</volume><number>1</number><dates><year>2013</year></dates><isbn>1471-2458</isbn><urls></urls></record></Cite></EndNote>(e.g. Svensson et al., 2013), however women seem more likely to identify their spouse/partner as having a gambling problem than men, e.g. 2.9% cf. 1.5% in the New Zealand population ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2014</Year><RecNum>36</RecNum><DisplayText>(Abbott et al., 2014)</DisplayText><record><rec-number>36</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520383203">36</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garrett, N</author><author>Mundy-McPherson, S </author></authors></contributors><titles><title>New Zealand 2012 National Gambling Study: Gambling harm and problem gambling (Report No. 2)</title></titles><dates><year>2014</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University of Technology, Gambling & Addictions Research Centre</publisher><urls></urls></record></Cite></EndNote>(Abbott et al., 2014). This is important given the strong association between intimate partner relationship quality and health and wellbeing in Western cultures ADDIN EN.CITE <EndNote><Cite><Author>Kiecolt-Glaser</Author><Year>2017</Year><RecNum>12</RecNum><DisplayText>(Kiecolt-Glaser & Wilson, 2017)</DisplayText><record><rec-number>12</rec-number><foreign-keys><key app="EN" db-id="25rszwft292ev3esrpvpde0cpxrd9ex0xspp" timestamp="1536109307">12</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kiecolt-Glaser, Janice K</author><author>Wilson, Stephanie J</author></authors></contributors><titles><title>Lovesick: How couples’ relationships influence health</title><secondary-title>Annual review of clinical psychology</secondary-title></titles><periodical><full-title>Annual review of clinical psychology</full-title></periodical><pages>421-443</pages><volume>13</volume><dates><year>2017</year></dates><isbn>1548-5943</isbn><urls></urls></record></Cite></EndNote>(Kiecolt-Glaser & Wilson, 2017). Gambling research has previously tended to focus on young men, who are more likely to develop gambling problems than other demographic groups ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>245</RecNum><DisplayText>(Abbott, Binde, et al., 2018)</DisplayText><record><rec-number>245</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554758831">245</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Binde, Per</author><author>Clark, Luke</author><author>Hodgins, David</author><author>Johnson, Mark</author><author>Manitowabi, Darrel</author><author>Quilty, Lena</author><author>Sp?ngberg, Jessika</author><author>Volberg, Rachel</author><author>Walker, Douglas</author><author>Williams, Robert</author></authors></contributors><titles><title>Conceptual Framework of Harmful Gambling: An International Collaboration (Third Edition)</title></titles><dates><year>2018</year></dates><pub-location>Guelph, Ontario, Canada.</pub-location><publisher>Gambling Research Exchange Ontario (GREO)</publisher><urls></urls></record></Cite></EndNote>(Abbott, Binde, et al., 2018). Harms studies suggest that from a public health perspective, women are at least equally deserving of attention. In New Zealand, whilst men categorised as problem gamblers contributed more than twice the harm than women in the same category, the bulk of harm was seen to be occurring around less acute categories, and associated with the gambling of men and women equally ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2017</Year><RecNum>17</RecNum><DisplayText>(Browne, Bellringer, et al., 2017)</DisplayText><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511829103">17</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Bellringer, Maria</author><author>Greer, Nancy</author><author>Kolandai-Matchett, Komathi</author><author>Rawat, Vijay</author><author>Langham, Erika</author><author>Rockloff, Matthew</author><author>Palmer Du Preez, Katie</author><author>Abbott, Max</author></authors></contributors><titles><title>Measuring the burden of gambling harm in New Zealand</title></titles><dates><year>2017</year></dates><publisher>New Zealand Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Browne, Bellringer, et al., 2017). Gambling harm studies suggest that harm affecting men and women can be measured in a similar way, across the broad domains described above ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2018</Year><RecNum>243</RecNum><DisplayText>(Browne, Goodwin, & Rockloff, 2018)</DisplayText><record><rec-number>243</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554681705">243</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Browne, Matthew</author><author>Goodwin, Belinda C</author><author>Rockloff, Matthew J</author></authors></contributors><titles><title>Validation of the Short Gambling Harm Screen (SGHS): A tool for assessment of harms from gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>499-512</pages><volume>34</volume><number>2</number><dates><year>2018</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(Browne, Goodwin, & Rockloff, 2018). However, these studies also shed some light on how women and men’s gambling may be differently associated with the harm that is distributed across populations. In the Victorian gambling harms study, women in the low-risk problem gambling severity (PGSI) category contributed nearly one-third (28.9%) of the YLD (years of life lost to disability) associated with gambling ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2016</Year><RecNum>242</RecNum><DisplayText>(Browne et al., 2016)</DisplayText><record><rec-number>242</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554323555">242</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Langham, Erika</author><author>Rawat, Vijay</author><author>Greer, Nancy</author><author>Li, En</author><author>Rose, Judy</author><author>Rockloff, Matthew</author><author>Donaldson, Phillip</author><author>Thorne, Hannah</author><author>Goodwin, Belinda</author></authors></contributors><titles><title>Assessing gambling-related harm in Victoria: a public health perspective</title></titles><dates><year>2016</year></dates><pub-location>Melbourne, Australia</pub-location><publisher>Victorian Responsible Gambling Foundation</publisher><urls></urls></record></Cite></EndNote>(Browne et al., 2016). Women 55 years and over with low-risk gambling problems were associated with the largest proportion of the harms of any single category (14.5%). While men made up a higher proportion of problem and moderate risk gamblers, women were overrepresented in the low-risk category. The relatively high prevalence of low-level harms among women, particularly older women, and the fact that they make up a large proportion of the Victorian population, suggested that gender analysis of experiences of gambling harm should inform all harm prevention and reduction practice.A gender perspective on the social determinants of gambling harm In New Zealand, gambling related harm has been defined as: “Any initial or exacerbated adverse consequence due to an engagement with gambling that leads to a decrement to the health or wellbeing of an individual, family or whānau, community or population.” ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2017</Year><RecNum>17</RecNum><Pages>113</Pages><DisplayText>(Browne, Bellringer, et al., 2017, p. 113)</DisplayText><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511829103">17</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Bellringer, Maria</author><author>Greer, Nancy</author><author>Kolandai-Matchett, Komathi</author><author>Rawat, Vijay</author><author>Langham, Erika</author><author>Rockloff, Matthew</author><author>Palmer Du Preez, Katie</author><author>Abbott, Max</author></authors></contributors><titles><title>Measuring the burden of gambling harm in New Zealand</title></titles><dates><year>2017</year></dates><publisher>New Zealand Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Browne, Bellringer, et al., 2017, p. 113). Gambling can both exacerbate existing inequities and adverse health outcomes, as well as generate harms ADDIN EN.CITE <EndNote><Cite><Author>Currie</Author><Year>2009</Year><RecNum>246</RecNum><DisplayText>(Currie, Miller, Hodgins, & Wang, 2009)</DisplayText><record><rec-number>246</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554846855">246</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Currie, Shawn R</author><author>Miller, Natalie</author><author>Hodgins, David C</author><author>Wang, JianLi</author></authors></contributors><titles><title>Defining a threshold of harm from gambling for population health surveillance research</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>19-38</pages><volume>9</volume><number>1</number><dates><year>2009</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Currie, Miller, Hodgins, & Wang, 2009). The World Health Organisation stated that “a characteristic common to groups that experience health inequities—such as poor or marginalised persons, racial and ethnic minorities, and women—is lack of political, social or economic power” ADDIN EN.CITE <EndNote><Cite><Author>WHO</Author><Year>2018</Year><RecNum>21</RecNum><DisplayText>(WHO, 2018)</DisplayText><record><rec-number>21</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520373329">21</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>WHO,</author></authors></contributors><titles><title>Health Systems - Equity</title></titles><volume>2018</volume><number>7 March</number><dates><year>2018</year></dates><publisher>World Health Organisation</publisher><urls><related-urls><url>;(WHO, 2018). People’s experiences of gambling harm are related to their socio-economic and political positioning within society (e.g. deprivation, lack of representation); access to gambling venues; processes of colonisation, racism and discrimination; migration and acculturation; and cultural beliefs, values and practices ADDIN EN.CITE <EndNote><Cite><Author>Raylu</Author><Year>2004</Year><RecNum>22</RecNum><DisplayText>(Raylu & Oei, 2004; Rintoul, Livingstone, Mellor, & Jolley, 2013)</DisplayText><record><rec-number>22</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520373411">22</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Raylu, Namrata</author><author>Oei, Tian Po</author></authors></contributors><titles><title>Role of culture in gambling and problem gambling</title><secondary-title>Clinical psychology review</secondary-title></titles><periodical><full-title>Clinical psychology review</full-title></periodical><pages>1087-1114</pages><volume>23</volume><number>8</number><dates><year>2004</year></dates><isbn>0272-7358</isbn><urls></urls></record></Cite><Cite><Author>Rintoul</Author><Year>2013</Year><RecNum>23</RecNum><record><rec-number>23</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520373445">23</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rintoul, Angela C</author><author>Livingstone, Charles</author><author>Mellor, Andrew P</author><author>Jolley, Damien</author></authors></contributors><titles><title>Modelling vulnerability to gambling related harm: How disadvantage predicts gambling losses</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>329-338</pages><volume>21</volume><number>4</number><dates><year>2013</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(Raylu & Oei, 2004; Rintoul, Livingstone, Mellor, & Jolley, 2013). A combination of economic and social marginalisation and high gambling exposure plays a major part in the development of gambling problems and the proliferation of gambling harms in society ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>6</RecNum><DisplayText>(Abbott, 2017a)</DisplayText><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502937388">6</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>The epidemiology and impact of gambling disorder and other gambling-related harm</title><secondary-title>2017 WHO Forum on alcohol, drugs and addictive behaviours</secondary-title></titles><dates><year>2017</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite></EndNote>(Abbott, 2017a).More than a source of personal and social identity: gender, social class and ethnic categories shape most of the significant rewards and advantages available to people in industrial societies ADDIN EN.CITE <EndNote><Cite><Author>Rothman</Author><Year>2015</Year><RecNum>338</RecNum><Prefix>see </Prefix><DisplayText>(see Rothman, 2015)</DisplayText><record><rec-number>338</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563399871">338</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rothman, Robert A</author></authors></contributors><titles><title>Inequality and stratification: Race, class, and gender</title></titles><dates><year>2015</year></dates><publisher>Routledge</publisher><isbn>1317344189</isbn><urls></urls></record></Cite></EndNote>(see Rothman, 2015). Viewed in this way, it is possible to identify gender as interacting with the social determinants of gambling harm in important ways, e.g. through women’s particular experiences of poverty, discrimination, trauma and harassment. Relevant to women’s poverty in New Zealand, over the past 10 years there has been a significant gender pay gap of 12% that remains largely unexplained ADDIN EN.CITE <EndNote><Cite><Author>Pacheco</Author><Year>2017</Year><RecNum>24</RecNum><DisplayText>(Pacheco et al., 2017)</DisplayText><record><rec-number>24</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520374886">24</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Pacheco, G</author><author>Li, C</author><author>Cochrane, B</author></authors></contributors><titles><title>Empirical evidence of the gender pay gap in New Zealand</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls></urls></record></Cite></EndNote>(Pacheco et al., 2017). The gender pay gap has been explored against complex intersections of labour market de-regulation, family demands, work and the ‘costs of being female’ that all women must navigate ADDIN EN.CITE <EndNote><Cite><Author>McGregor</Author><Year>2017</Year><RecNum>25</RecNum><DisplayText>(McGregor et al., 2017; Statistics New Zealand & Ministry for Women, 2017)</DisplayText><record><rec-number>25</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520375772">25</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McGregor, Judy</author><author>Davies, Sharyn Graham</author><author>Giddings, Lynne S</author><author>Pringle, Judith</author></authors></contributors><titles><title>Pursuing equal pay: The perspectives of female engineers and potential policy interventions</title><secondary-title>Journal of Industrial Relations</secondary-title></titles><periodical><full-title>Journal of Industrial Relations</full-title></periodical><pages>3-21</pages><volume>59</volume><number>1</number><dates><year>2017</year></dates><isbn>0022-1856</isbn><urls></urls></record></Cite><Cite><Author>Statistics New Zealand</Author><Year>2017</Year><RecNum>26</RecNum><record><rec-number>26</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520376061">26</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Statistics New Zealand,</author><author>Ministry for Women,</author></authors></contributors><titles><title>Effect of motherhood on pay – summary of results: June 2016 quarter</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><urls><related-urls><url>;(McGregor et al., 2017; Statistics New Zealand & Ministry for Women, 2017). In this vein, the inequitable situation of low paid women in undervalued female dominated work has been brought to the fore ADDIN EN.CITE <EndNote><Cite><Author>Dew</Author><Year>2017</Year><RecNum>27</RecNum><DisplayText>(Dew, 2017; Ravenswood & Harris, 2016)</DisplayText><record><rec-number>27</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520376354">27</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Dew, M</author></authors></contributors><titles><title>The Equal Pay Act - Where is it at?</title></titles><volume>2018</volume><number>7 March</number><dates><year>2017</year></dates><publisher>New Zealand Law Society</publisher><urls><related-urls><url> app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559775715">283</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ravenswood, Katherine</author><author>Harris, Candice</author></authors></contributors><titles><title>Doing gender, paying low: gender, class and work–life balance in aged care</title><secondary-title>Gender, Work & Organization</secondary-title></titles><periodical><full-title>Gender, Work & Organization</full-title></periodical><pages>614-628</pages><volume>23</volume><number>6</number><dates><year>2016</year></dates><isbn>0968-6673</isbn><urls></urls></record></Cite></EndNote>(Dew, 2017; Ravenswood & Harris, 2016). While the gender pay gap is ostensibly lower between men and women at the bottom of the earnings distribution, women in lower paid work tend to be much more highly skilled than men - hence the recent public debate in New Zealand around how best to effect pay equity for women in combination with a living wage in society ADDIN EN.CITE <EndNote><Cite><Author>Pacheco</Author><Year>2017</Year><RecNum>24</RecNum><DisplayText>(Pacheco et al., 2017)</DisplayText><record><rec-number>24</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520374886">24</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Pacheco, G</author><author>Li, C</author><author>Cochrane, B</author></authors></contributors><titles><title>Empirical evidence of the gender pay gap in New Zealand</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls></urls></record></Cite></EndNote>(Pacheco et al., 2017).The interconnected nature of social categorisations such as race, class, and gender can create overlapping and interdependent systems of marginalisation, discrimination or disadvantage ADDIN EN.CITE <EndNote><Cite><Author>Hooks</Author><Year>1981</Year><RecNum>68</RecNum><DisplayText>(hooks, 1981)</DisplayText><record><rec-number>68</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1521159474">68</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>hooks, bell</author></authors></contributors><titles><title>Ain't I a Woman? Black Women and Feminism</title></titles><dates><year>1981</year></dates><pub-location>New York</pub-location><publisher>South End Press</publisher><urls></urls></record></Cite></EndNote>(hooks, 1981). For example, Māori and Pacific women are overrepresented among those who work in low-skilled manual occupations which pay less ADDIN EN.CITE <EndNote><Cite><Author>Ministry for Women</Author><Year>2016</Year><RecNum>28</RecNum><DisplayText>(Ministry for Women, 2016b)</DisplayText><record><rec-number>28</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520377110">28</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry for Women,</author></authors></contributors><titles><title>Pacific Women</title></titles><dates><year>2016</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls><related-urls><url>;(Ministry for Women, 2016b). Pākehā (New Zealand European) women earn between $3 and $6 more per hour than Māori, Pacific and Asian women; and $1 to $4 more per hour than Māori, Pacific and Asian men ADDIN EN.CITE <EndNote><Cite><Author>Statistics NZ</Author><Year>2013</Year><RecNum>54</RecNum><DisplayText>(Statistics NZ, 2013)</DisplayText><record><rec-number>54</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520460149">54</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Statistics NZ,</author></authors></contributors><titles><title>Census quick stats about families and households</title></titles><volume>2018</volume><number>7 March</number><dates><year>2013</year></dates><urls><related-urls><url>t.nz</url></related-urls></urls></record></Cite></EndNote>(Statistics NZ, 2013). Cultural norms also affect the ways women live their lives, with implications for their position in society. For example, women’s ethnicity also greatly influences their likelihood of living with and caring for an extended family. In New Zealand, 35 percent of Pacific females live in this type of household, compared with 20 percent of Māori females and 5 percent of European females ADDIN EN.CITE <EndNote><Cite><Author>Ministry for Women</Author><Year>2016</Year><RecNum>29</RecNum><DisplayText>(Ministry for Women, 2016a)</DisplayText><record><rec-number>29</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520377147">29</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry for Women,</author></authors></contributors><titles><title>Maori Women</title></titles><dates><year>2016</year></dates><pub-location>Wellington</pub-location><publisher>Ministry for Women</publisher><urls><related-urls><url>;(Ministry for Women, 2016a). Māori women spend more time caring for others in their household and do more voluntary and community work than women from any other ethnic group. The small amount of research that exists on Māori and Pacific women’s experiences of gambling harm in New Zealand suggests that an interrelationship between cultural and gender role expectations, disadvantage and trauma influences their experience of gambling harm ADDIN EN.CITE <EndNote><Cite><Author>Morrison</Author><Year>2004</Year><RecNum>33</RecNum><DisplayText>(Morrison, 2004; Perese & Faleafa, 2000)</DisplayText><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520382193">33</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Morrison, Laurie</author></authors></contributors><titles><title>Pokie gambling and Māori women: Friend or foe?</title></titles><dates><year>2004</year></dates><publisher>Journal of Gambling Issues (12)</publisher><urls><related-urls><url> app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520382153">32</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Perese, L</author><author>Faleafa, M</author></authors></contributors><titles><title>The impact of gambling on some Samoan people's lives in Auckland</title></titles><dates><year>2000</year></dates><pub-location>Auckland</pub-location><publisher>The Compulsive Gambling Society of New Zealand</publisher><urls></urls></record></Cite></EndNote>(Morrison, 2004; Perese & Faleafa, 2000). Gender related issues, notions and practices influence the way people live their lives, and gambling and gambling harm is produced and experienced PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYmJvdHQ8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Abbott, Binde, et al., 2018; Casey, 2006, 2007, 2016; Cassidy, 2014; Svensson & Romild, 2014; Svensson, Romild, Nordenmark, & M?nsdotter, 2011). A complex array of individual, relational, contextual, cultural and normative factors relate women and men to gambling and gambling harm differently ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><DisplayText>(Kairouz et al., 2017)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017). Adams et al. ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Adams</Author><Year>2009</Year><RecNum>247</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>247</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554849245">247</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Raeburn, John</author><author>De Silva, Kawshi</author></authors></contributors><titles><title>A question of balance: prioritizing public health responses to harm from gambling</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>688-691</pages><volume>104</volume><number>5</number><dates><year>2009</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(2009) outlined opportunities to respond to gambling as a public health issue afforded by New Zealand’s Gambling Act ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>New Zealand legislation</Author><Year>2003</Year><RecNum>161</RecNum><DisplayText>(2003)</DisplayText><record><rec-number>161</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537919074">161</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>New Zealand legislation,</author></authors></contributors><titles><title>Gambling Act</title></titles><volume>2018</volume><number>26 September</number><dates><year>2003</year></dates><pub-location>Wellington</pub-location><publisher>Parliamentary Counsel Office</publisher><urls><related-urls><url>;(2003) through: harm minimisation, health promotion and the political determinants of gambling consumption. A gender perspective on gambling and gambling harm should inform public health responses in this framework PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IaW5nPC9BdXRob3I+PFllYXI+MjAxNDwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA (Holdsworth et al., 2012; Romild et al., 2016; Svensson & Romild, 2014). This generally occurs in one of two ways: Either data are not examined separately for men and women (missing potentially important gender differences), or gender differences are stated without contextual analysis of gender as a social determinant of gambling practices and harm, thereby reinforcing unhelpful gender stereotypes ADDIN EN.CITE <EndNote><Cite><Author>Romild</Author><Year>2016</Year><RecNum>43</RecNum><DisplayText>(Romild et al., 2016; Volberg, 2003)</DisplayText><record><rec-number>43</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386899">43</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Romild, Ulla</author><author>Svensson, Jessika</author><author>Volberg, Rachel</author></authors></contributors><titles><title>A gender perspective on gambling clusters in Sweden using longitudinal data</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>43-60</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite><Cite><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Romild et al., 2016; Volberg, 2003). Methodology and methodsThis study drew on social models of addictions, to examine how gender-related issues, notions and practices may influence experiences of gambling harm in New Zealand. Social models of addictions draw attention to cultural and environmental influences on biological, psychological and other factors, with implications for both the experience of and interventions to address harm PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CZWNrZXI8L0F1dGhvcj48WWVhcj4yMDE2PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Becker, McClellan, & Reed, 2016; Griffiths & Delfabbro, 2001; Sharpe, 2002). Gender was understood as constituted through sociocultural processes which shape men (‘masculinity’) and women (‘femininity’) ADDIN EN.CITE <EndNote><Cite><Author>Becker</Author><Year>2016</Year><RecNum>250</RecNum><DisplayText>(Becker et al., 2016)</DisplayText><record><rec-number>250</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1555032657">250</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Becker, Jill B</author><author>McClellan, Michelle</author><author>Reed, Beth Glover</author></authors></contributors><titles><title>Sociocultural context for sex differences in addiction</title><secondary-title>Addiction biology</secondary-title></titles><periodical><full-title>Addiction biology</full-title></periodical><pages>1052-1059</pages><volume>21</volume><number>5</number><dates><year>2016</year></dates><isbn>1355-6215</isbn><urls></urls></record></Cite></EndNote>(Becker et al., 2016). The social construction of gender has important implications for the wellbeing of women who position themselves (or who are positioned) within and/or outside of normative boundaries ADDIN EN.CITE <EndNote><Cite><Author>Butler</Author><Year>1990</Year><RecNum>321</RecNum><DisplayText>(J. Butler, 1990)</DisplayText><record><rec-number>321</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563232464">321</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Butler, Judith</author></authors></contributors><titles><title>Gender trouble: Feminism and the subversion of identity</title></titles><dates><year>1990</year></dates><pub-location>US</pub-location><publisher>Routledge</publisher><isbn>1135959935</isbn><urls></urls></record></Cite></EndNote>(J. Butler, 1990). Two existing qualitative data sets related to gambling harm in New Zealand were identified as constituting a rich source of information regarding the gendered experience of gambling harm for women, as well as potential overlap/interactions with cultural identity. The two datasets are described below. Secondary analysis of these datasets was conducted to identify some of the gendered aspects of gambling harm and implications for New Zealand women who gamble and/or are affected by others’ gambling. An additional aim was to identify some of the ways in which gendered aspects of gambling harm are influenced by cultural context for Māori and Pacific women. Gambling Harms datasetIn 2014 the Ministry of Health commissioned Central Queensland University (CQU) in partnership with GARC to systematically investigate gambling-related harm in New Zealand, and to assess the aggregate ‘Burden of Harm’ caused by gambling (Gambling Harms Study). In investigating gambling related harm, this project involved extensive consultation with experts and community members ADDIN EN.CITE <EndNote><Cite><Author>Browne</Author><Year>2017</Year><RecNum>17</RecNum><DisplayText>(Browne, Bellringer, et al., 2017)</DisplayText><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511829103">17</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Browne, Matthew</author><author>Bellringer, Maria</author><author>Greer, Nancy</author><author>Kolandai-Matchett, Komathi</author><author>Rawat, Vijay</author><author>Langham, Erika</author><author>Rockloff, Matthew</author><author>Palmer Du Preez, Katie</author><author>Abbott, Max</author></authors></contributors><titles><title>Measuring the burden of gambling harm in New Zealand</title></titles><dates><year>2017</year></dates><publisher>New Zealand Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Browne, Bellringer, et al., 2017). Ethical approval for this study was granted by the Auckland University of Technology Ethics Committee (AUTEC approval numbers 14/335 and 15/13). As a result, a large qualitative dataset was produced, detailing New Zealander’s definitions, knowledge, experiences and ideas about gambling harm. In the Gambling Harms Study, three focus group interviews were held with 26 participants comprising professionals (including Māori, Pacific, Asian and European/Other people) involved in the provision of problem gambling treatment and allied support services (budget advice, social support), consumer representatives, regulators and academics. Eight focus group interviews (including two Māori groups) and six individual interviews were held with a total of fifty-one individuals (25 females) comprising community members and treatment seeking individuals who identified that they had experienced harm from either their own, or someone else’s gambling, and with staff of problem gambling treatment services (representing Pacific and Asian clients). Gender was not explicitly examined as a characteristic of interest in the qualitative component of the New Zealand Harms study. This main purpose of the collection of this data was to refine and validate a pre-existing definition, conceptual framework, and taxonomy of gambling-related harms (originally developed for an Australian context), to ensure it was reflective of the cultural communities within New Zealand. Qualitative content analysis was carried out in relation to the following participant characteristics only: whether a participant identified as a person who gambled, an affected other, or in a professional role, as well as their cultural identity. The absence of gender as an explicit focus of a relatively recent investigation of gambling harm in a public health framework, is indicative of the extent to which gender issues have been overlooked by gambling studies in recent years.Pacific Impacts datasetIn June 2010, GARC was commissioned by the Ministry of Health to conduct the research project ‘Exploration of the impact of gambling and problem gambling on Pacific families and communities in New Zealand’. The primary objective of this project was improve understanding of the impacts of gambling on the health and wellbeing of Pacific families and communities. Ethical approval for this project was obtained from AUTEC (Approval number 11/242).To this end in 2011, twelve focus groups were conducted with key Pacific stakeholders including gambling treatment providers, gambling venue staff, general community gamblers and non-gamblers, current/ex-problem gamblers, significant others of problem gamblers and church leaders. The purpose of the focus groups was to elicit views on Pacific people’s gambling (or non-gambling) in relation to Pacific culture, and the effects of gambling (and problem gambling) on Pacific families and communities. Focus groups were guided to discuss: what is meant by the term ‘gambling’, positive aspects and impacts of gambling specific to Pacific individuals, families and communities, negative aspects and impacts of gambling specific to Pacific individuals, families and communities as well as any culture-specific (including gender roles) relationships with gambling participation. As with the Burden of Harm study, gender was not explicitly examined as a characteristic of interest in analyses of Pacific Impacts focus group data. Analyses identified patterns in relation to: Pacific cultural differences overall and in relation to age and whether participants were born in New Zealand or the Pacific Islands.In the health equities field, performing secondary analysis is recognised as a useful way of reanalysing data that did not originally consider the concepts of sex and/or gender ADDIN EN.CITE <EndNote><Cite><Author>Johnson</Author><Year>2009</Year><RecNum>83</RecNum><DisplayText>(Johnson et al., 2009)</DisplayText><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525137660">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Johnson, Joy L</author><author>Greaves, Lorraine</author><author>Repta, Robin</author></authors></contributors><titles><title>Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research</title><secondary-title>International Journal for Equity in Health</secondary-title></titles><periodical><full-title>International Journal for Equity in Health</full-title></periodical><pages>14</pages><volume>8</volume><number>1</number><dates><year>2009</year></dates><isbn>1475-9276</isbn><urls></urls></record></Cite></EndNote>(Johnson et al., 2009). This provides the opportunity to explore previously unexamined dimensions of the research and ask additional questions not necessarily posed by the original researchers. Johnson and colleagues argue that asking gender-related questions of any health related work is always relevant and useful, and can apply to any stage of the research process ADDIN EN.CITE <EndNote><Cite><Author>Johnson</Author><Year>2009</Year><RecNum>83</RecNum><DisplayText>(Johnson et al., 2009)</DisplayText><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525137660">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Johnson, Joy L</author><author>Greaves, Lorraine</author><author>Repta, Robin</author></authors></contributors><titles><title>Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research</title><secondary-title>International Journal for Equity in Health</secondary-title></titles><periodical><full-title>International Journal for Equity in Health</full-title></periodical><pages>14</pages><volume>8</volume><number>1</number><dates><year>2009</year></dates><isbn>1475-9276</isbn><urls></urls></record></Cite></EndNote>(Johnson et al., 2009).Key research questions What gender or gender-related issues, notions or practices were discussed in relation to gambling harm?What are the implications of gender-related issues, notions or practices for women’s experiences of gambling harm?How/when is the gendered nature of gambling harm different for Māori and Pacific women?Data analysisData managementThe two qualitative datasets were combined and coded in relation to data production method (e.g. focus group/interviews, specific questions asked of participants), and the participants who were involved (e.g. stakeholder group, age, gender, ethnicity). An overview of the combined dataset is provided in REF _Ref10194189 \h Table 1. Techniques for the management of large qualitative datasets were employed, e.g. the production of case summaries and data matrices ADDIN EN.CITE <EndNote><Cite><Author>White</Author><Year>2012</Year><RecNum>69</RecNum><DisplayText>(White, Oelke, & Friesen, 2012)</DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1521587770">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>White, Debbie Elizabeth</author><author>Oelke, Nelly D</author><author>Friesen, Steven</author></authors></contributors><titles><title>Management of a large qualitative data set: Establishing trustworthiness of the data</title><secondary-title>International Journal of Qualitative Methods</secondary-title></titles><periodical><full-title>International Journal of Qualitative Methods</full-title></periodical><pages>244-258</pages><volume>11</volume><number>3</number><dates><year>2012</year></dates><isbn>1609-4069</isbn><urls></urls></record></Cite></EndNote>(White, Oelke, & Friesen, 2012) using the NVivo software programme. Table SEQ Table \* ARABIC 1: Overview of participants and perspectives included in the combined qualitative datasetParticipant groupCultural lens/perspectiveData collection Gender of participantsNumber of participantsStudyAffected othersService usersMāoriInterview Male1HarmsMāori , Pacific, AsianInterview Mixed2HarmsGeneral or not specificInterview Female1HarmsGeneral or not specificInterview Female1HarmsGeneral or not specificInterview Female1HarmsCommunityGeneral or not specificFocus groupMixed5HarmsPacificFocus groupMixed10PI#GamblersService usersGeneral or not specificFocus groupMixed7HarmsMāoriFocus groupMixed7HarmsCommunityGeneral or not specificFocus GroupMale3HarmsGeneral or not specificInterviewMale1HarmsGeneral or not specificInterviewMale1HarmsPacificFocus groupMixed6PI#Mix gamblers and affected othersService usersPacificFocus groupMixed11PI#CommunityPacificFocus groupMixed9PI#PacificFocus groupMixed8PI#PacificFocus groupMixed9PI#PacificFocus groupFemale5PI#PacificFocus groupMixed12PI#PacificFocus groupMixed10PI#Gambling support service providersService providersMāori Pacific Asian and generalFocus groupMixed11HarmsAsianFocus groupMixed7HarmsPacific Focus groupMixed5HarmsPacificFocus groupMixed5PI#MāoriFocus groupMixed6HarmsWider sector representativesProbation and community servicesGeneral or not specificFocus groupMixed7HarmsGovernment and academicsMāori Pacific Asian and generalFocus groupMixed9HarmsChurch leadersPacificFocus groupMixed5PI# # Pacific ImpactsAnalysis methodStep by step accounts of how to go about secondary analyses of qualitative data are rare. This approach drew on Bishop’s ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Bishop</Author><Year>2007</Year><RecNum>84</RecNum><DisplayText>(2007)</DisplayText><record><rec-number>84</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525138892">84</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bishop, Libby</author></authors></contributors><titles><title>A reflexive account of reusing qualitative data: Beyond primary/secondary dualism</title><secondary-title>Sociological Research Online</secondary-title></titles><periodical><full-title>Sociological Research Online</full-title></periodical><pages>1-14</pages><volume>12</volume><number>3</number><dates><year>2007</year></dates><isbn>1360-7804</isbn><urls></urls></record></Cite></EndNote>(2007) reflexive account of reusing qualitative data. Bishop’s project involved drawing on two very different existing qualitative data sets, to examine attitudes and practices around early forms of processed foods and the connection between sociality and food choices. One dataset was drawn from a project which was focussed on inter-generational transmission of deprivation using a sample of women in 58 three-generation families. Nutrition was one of several topics addressed in this project. The second dataset was drawn from a study which aimed to collect oral histories of daily life to establish the most important dimensions of social change in the early twentieth century. Detailed coding of the datasets was done only on sections that pertained to the author’s research questions, e.g. the sections relevant to food. In the current study, data were coded using an iterative framework method ADDIN EN.CITE <EndNote><Cite><Author>Gale</Author><Year>2013</Year><RecNum>70</RecNum><DisplayText>(Gale, Heath, Cameron, Rashid, & Redwood, 2013)</DisplayText><record><rec-number>70</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1521587928">70</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gale, Nicola K</author><author>Heath, Gemma</author><author>Cameron, Elaine</author><author>Rashid, Sabina</author><author>Redwood, Sabi</author></authors></contributors><titles><title>Using the framework method for the analysis of qualitative data in multi-disciplinary health research</title><secondary-title>BMC medical research methodology</secondary-title></titles><periodical><full-title>BMC medical research methodology</full-title></periodical><pages>117</pages><volume>13</volume><number>1</number><dates><year>2013</year></dates><isbn>1471-2288</isbn><urls></urls></record></Cite></EndNote>(Gale, Heath, Cameron, Rashid, & Redwood, 2013), for sections of text where participants were discussing gender or gender-related issues, notions or practices (as determined by the researchers’ understanding of gender described above). The aim here was to gather examples of how gender related issues, notions and practices were intertwined with some experiences of gambling harm, where these existed in the data. One third of the transcripts were coded independently by two researchers. To safeguard the rigour and trustworthiness of the data analysis process, an internal data auditing process was performed ADDIN EN.CITE <EndNote><Cite><Author>White</Author><Year>2012</Year><RecNum>69</RecNum><DisplayText>(White et al., 2012)</DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1521587770">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>White, Debbie Elizabeth</author><author>Oelke, Nelly D</author><author>Friesen, Steven</author></authors></contributors><titles><title>Management of a large qualitative data set: Establishing trustworthiness of the data</title><secondary-title>International Journal of Qualitative Methods</secondary-title></titles><periodical><full-title>International Journal of Qualitative Methods</full-title></periodical><pages>244-258</pages><volume>11</volume><number>3</number><dates><year>2012</year></dates><isbn>1609-4069</isbn><urls></urls></record></Cite></EndNote>(White et al., 2012). After 10, 20 and then 30 transcripts had been coded, three members of the study team met to review a selection of transcripts and workshop the emerging coding framework.Gender related issues, notions and practices identified during the coding process were used as a springboard for thematic analysis and discussion of the ways in which gender may influence women’s experiences of gambling harm, and implications for harm reduction. Patterns of meaning within the dataset were identified using the six phases described by Braun and Clarke ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Braun</Author><Year>2006</Year><RecNum>71</RecNum><DisplayText>(2006)</DisplayText><record><rec-number>71</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1521588113">71</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Braun, Virginia</author><author>Clarke, Victoria</author></authors></contributors><titles><title>Using thematic analysis in psychology</title><secondary-title>Qualitative research in psychology</secondary-title></titles><periodical><full-title>Qualitative research in psychology</full-title></periodical><pages>77-101</pages><volume>3</volume><number>2</number><dates><year>2006</year></dates><isbn>1478-0887</isbn><urls></urls></record></Cite></EndNote>(2006):Familiarisation with the data via reading, re-reading and making notesSort codes into potential themesReview potential themes for consistency with the codes across the entire data setIdentify and name the themes ensuring that they have a clear definitionWrite up findings, and select appropriate quotes that best capture the themes identified and relate the results to existing research.ResultsFour broad themes were identified describing the intersection between gender related issues notions and practices and women’s experiences of gambling and harm. Women’s socially prescribed responsibility for domestic and emotional labour was particularly prominent, in addition to the impact of the social role of motherhood on how gambling and harm is perceived and experienced. Less dominant, but consistent themes across the dataset, included links made between certain gambling practices (casino table games, betting) and traditional forms of masculinity, and the relationship between gambling and violence against women. Each theme is outlined below, followed by a discussion of the implications of this analysis for women’s gambling harm reduction/prevention activities in New Zealand.Women’s responsibility for domestic and emotional labour Participants emphasised how responsibility for the domestic and emotional labour that keeps families functioning, can be placed on women through traditional understandings of gender roles. This was by far the most dominant theme relating gender issues to women’s experiences of gambling harm in this study. Domestic labour included cooking and cleaning, organising and administrating a household, which often included multiple extended family members. Emotional labour involved being ‘a shoulder to cry on’, caring for others’ wellbeing, resolving disagreements between family members, and supporting family members dealing with trouble in all areas of their lives – including addressing gambling harm. Responsibility for both domestic and emotional labour were associated with being a wife, mother, sister or daughter.In Māori relationships, and others, it's normally the wife that's the dominant person in the relationship for keeping the family together, she's the one that makes sure that there's food on the table, that all the bills are paid and the children are well looked after. (Pacific service provider, Harms Study)From a mother’s perspective I run everything in my family. I make sure I pay all my bills and make sure that everything’s done for the kids, everyone has lunch and stuff. (Female community gambler, Pacific Impacts Study)Women were at times described as naturally suited to caring work carried out in families, by emphasising women’s innate emotional and interpersonal literacy: I give all the time, I mean I'm everything for everybody, but nothing for myself and that’s, I just think women are like that… I'm always there as the shoulder to cry on with everybody. But you know, not for myself, nah. (Female gambling support service user, Harms Study)In our family the women are always talking and working things out for everybody - I think we got that from our aunties down the line… We sit amongst each other and we always talk this stuff out. As to my brothers, when they have an issue, it just sits so heavy on their chest or it comes out when they're drunk. (Female client of Māori gambling service, Harms Study)The notion of women as natural carers and nurturers was contrasted with descriptions of men as providers, responsible for resourcing and protecting the home. One participant used the metaphor of the hunter-gatherer to explain how not being able to provide for his family, because of his gambling, produced a deep sense of shame for him. Another participant discussed his journey to health and wellbeing as stepping back in to a traditional provider role as head of the household: My father passed away back in 2000, but my whānau [family] - my journey is starting when I go back home to my own little back yard. It's going to be a tough journey but somebody has to stand up to the plate, and – well, be the tāne [man] of the whare [house], that brings home the bacon. If I can show that role model to my wahine [woman] and my tamariki [children] and my moko [grandchildren], I think that could do a bit of change. (Male client of gambling support service, Harms Study)Traditional patriarchal roles for men as the key decision makers in the family, were discussed as particularly prominent in some Māori, Pacific and Asian families. For example, men were seen as the: “lead of the family” (Asian gambling service provider, Harms Study), with women’s roles as “mainly domestic, looking after the kids, there is no voice at all.” (Pacific gambling service provider, Harms Study). These patriarchal notions and practices were described as limiting women’s decision-making power around personal and familial well-being, and gambling consumption within the family ADDIN EN.CITE <EndNote><Cite><Author>Kolandai-Matchett</Author><Year>2017</Year><RecNum>210</RecNum><Prefix>see </Prefix><Suffix> for a discussion of this phenomenon in Pacific families within the Harms dataset</Suffix><DisplayText>(see Kolandai-Matchett et al., 2017 for a discussion of this phenomenon in Pacific families within the Harms dataset)</DisplayText><record><rec-number>210</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540766341">210</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kolandai-Matchett, Komathi</author><author>Langham, Erika</author><author>Bellringer, Maria</author><author>Siitia, Pesio Ah-Honi</author></authors></contributors><titles><title>How gambling harms experienced by Pacific people in New Zealand amplify when they are culture-related</title><secondary-title>Asian journal of gambling issues and public health</secondary-title></titles><periodical><full-title>Asian Journal of Gambling Issues and Public Health</full-title></periodical><pages>5</pages><volume>7</volume><number>1</number><dates><year>2017</year></dates><isbn>2195-3007</isbn><urls></urls></record></Cite></EndNote>(see Kolandai-Matchett et al., 2017 for a discussion of this phenomenon in Pacific families within the Harms dataset).Women of all cultural backgrounds, including New Zealand European, described multiple familial demands on their time and energy that could at times be overwhelming. In the context of responsibility for domestic and emotional labour, women who gambled mentioned searching for space to be alone, to relax, apart from the requirements of others. Gambling was discussed as well-placed to fulfil this need, and therefore to become essential to everyday life, or even addictive:Go to housie [bingo], nobody calls us Mum. Go to the pokies [EGMs], there's no one to say “Mum can I?” Or “Hon, where's the remote? Where's my jeans?” For me it purely became about that, the gambling. Definitely for someone to grab an addiction so fast- you're missing something in life… In my family it was like my dad had four wives. I was the second eldest child, but I'm the girl. (Female client of gambling support service, Harms Study)The only reason why I got involved in this bad habit, I would say to myself that it would help stop me from thinking about the family. (Female client of Pacific gambling support service, Pacific Impacts Study)This point was echoed by another participant, who described the demands placed on her as the ‘matriarch’ of her extended family. Gambling on the pokies [EGMs], in a separate room at the pub, provided a space where she could be both physically and emotionally separate from these demands for a period of time.I'm held as the mother of the family, and I've got a big family. It's not just my family, it's my partner's family, and everybody relies on me. So I suppose when I got into gambling, I thought it was something for me. I thought it was special time for me. (Female client of gambling support service, Harms Study)Gambling in local pub venues was seen as both freeing from obligations to others, and able to be easily scheduled around these competing responsibilities – in short: gambling opportunities in community settings were well positioned to meet the needs of women with severe constraints on their leisure time:I don’t get to gamble like just when I want to. I have to put a certain amount of time, on the side of my week, which day it’s gonna be, where I can go, and if I know the kids are being looked after by my husband and the shopping’s already done. That’s my time. That’s my 2 hours or, or an hour and a half depending on whether I win or lose or how much time I’ve got. (Female general community gambler, Pacific Impacts Study)Gambling harm was explicitly associated with women being overly defined by their caring/familial roles. For example, stay-at-home mothers discussed the gap that opened up in their day when children had left for school, and their family and social group were all at work or otherwise engaged. The notion of ‘empty nest syndrome’ was invoked to describe the experience of some women who could no longer spend the bulk of their time caring for others. Gambling was also described as offering a sense of purpose and productivity for women out of paid work. She’s just bored. She just sits at home, does nothing and the pokie machine is like 200 metres away from her house. Her kids are older... She wants to find a job, but because of her health issues she can’t. (Pacific gambling support service provider, Pacific Impacts Study)Women’s EGM gambling could also be positioned as a way to process feelings of ambivalence, anger, and resentment towards their families. Gambling was regarded as a less harmful way of coping with familial distress than drinking alcohol, especially for mothers or women with family members at home who depended on them.It’s not as if my wife always goes to the [electronic gaming] machine… it’s only when there’s something she’s not happy about in my family or our relationship, she spends the money. It’s as if spending the money on that is her way of dealing with any anger towards the family. (Male significant other client of gambling support service, Pacific Impacts Study)It’s about whānau [family] relationships. You might have had an argument… and you think “well stuff this, I'm off” - I might as well go and try the pokies [EGMs]… rather than go to the pub and drink, I'll go and have a gamble. (Female client of Māori gambling service, Harms Study)In alignment with women’s social responsibility to care for others, women also described the strain of living with individual and personal responsibility for addressing gambling harm in their families. One participant described terminating a pregnancy in order to ensure she had the energy to support her gambling partner, who left her little capacity to consider taking care of a child:If there was no gambling we would be having the baby, but I can't put myself in that vulnerable situation. Aside from the gambling and the finance and the debts, he needs so much emotional support that he'll suck me dry and there'll be nothing left… the intense emotional support he needs, there's nothing for myself. I think it'd just end in complete disaster, so I know there's no way I can put myself in that situation. (Female affected other client of gambling treatment service, Harms Study)Women emphasised the health impacts of personal responsibility to care. They spoke of gambling harm in visceral terms, reporting continuous feelings of worry and concern when supporting family and friends dealing with a gambling problem. Feeling unable to help their loved ones had caused stomach ulcers, sleepless nights, lack of sleep, migraine and feelings of exhaustion.I tried my best to solve the problem by myself and when I was unsuccessful, it gave me bad stomach ulcers. Now I'm on medication, I suffer from migraine, lack of sleep because I can't give up on her [daughter] but there is absolutely nothing I can do… If she doesn't answer her phone. I'm thinking “uh oh, where is she? What is she up to?” Constant worry. So if it wasn't happening, I'd be more relaxed. I think my health would be so much better. (Female affected other client of gambling treatment service, Harms Study)Women described feelings of intense self-blame, shame and embarrassment when they were unable to address gambling harm through their caring roles. For example, one Pacific woman described how gambling was forbidden in her family, and she felt that she had failed to teach her sister their family’s cultural values. A sense of failure was repeatedly linked to women feeling unable to seek support around gambling harm. I always feel like: Where did I go wrong, in my responsibility? I wasn't able to instil our values. Our background - gambling was unheard of. Alcohol, my god. Women and alcohol and gambling, no-no… I've failed because she's like a daughter to me and I'll be embarrassed for the rest of my life. I don't talk about this to anyone. (Female affected other client of gambling treatment service, Harms Study)The issue of women’s responsibility for familial wellbeing also played out in two designated Māori focus groups, where mothers were identified as playing a key role in addressing gambling harm in families. In contrast, a shared sense of responsibility for addressing gambling harm in families seemed more available to some men who were affected by others’ gambling. These men described how they were not left alone to support their family member dealing with a gambling problem, but worked together with other family members and/or with professional treatment anisations that deal with gambling help me. They said to me, “Oh a guy on your own what you can do is actually let the school know”, all that sort of thing. There are people at school who will wait there while you're finishing up work and then pick up [the kids] for these programs they run at school or even the library. So in a way, there are always people that can help, work as a team of course, together to sort any problems or issues. (Male affected other client of gambling support service, Harms Study)Some men described their role as ‘advisors’ for loved ones affected by gambling problems, as opposed to ‘carers’ – clearly placing ultimate responsibility for improvement on the person with the gambling problem. These men emphasised how they provided support that aimed to solve the gambling problem: Males probably tend to deal with issues on a logical basis rather than emotionally… Females, more on a high emotion basis, whereas guys sit down and say, okay we need to do this, this, this and this and run through the steps logically. (Male affected other client of gambling support service, Harms Study)Emotionally I would say no, [wife’s gambling] didn't really affect me that much. Probably because I spent my time studying what's available and I mean getting a better understanding of addiction… So that enabled me to provide solutions and get her to understand that you've got a problem and this may be the solution to help mitigate their problem. It's more of a problem than a shame. It's a problem that we need to rectify. (Male community affected other, Harms Study).Collective and communal aspects of Māori and Pacific culture were explicitly identified as helping some families to share the responsibility of providing support for people affected by gambling harm:That's part of our [Māori] culture, is that if one family member is put out, then the whole family pulls in together at home, no matter what it is… you make the time to try and rectify the problem and issue together. (Male affected other client of Māori gambling support service, Harms Study)I've never seen a Samoan alone, they are never alone. So they're there with their cousins, they live together, they share together, they share their children together, they work together, they work really close. I've never seen a Samoan alone. (Community worker, Harms Study)Social and gender norms producing women as responsible for domestic and emotional wellbeing also positioned women as responsible for addressing gambling harm in families (and operated to absolve some men of this responsibility). These norms also formed the context/conditions of possibility for some women’s local community gambling practices. ‘Negligent mothers’: When children are harmed by gambling Participants described harm to children, as a particularly important and severe form of gambling harm. It was argued that in comparison to issues for gambling individuals, far too little attention is paid in research, policy and harm reduction practice to the seriousness of gambling harm affecting children. For example, one participant commented that: “Children who have their lives completely ruined don't have that much power… because of the gamblers’ rights” (Government/academic participant, Harms Study). Harm to children was associated with financial deprivation caused by diverting family funds for gambling.I mean for a lot of people, especially the worst harm is to the kids. Because they're the ones that don't have toys, they don't have food. (Male affected other client of gambling support service, Harms Study) How does a child make sense of when they walk to school in bare feet, not enough clothes, and then they see Mum and Dad drinking, putting money in the pokie machines? What messages do they get from that at six, seven, eight years old? (Gambling support service staff member, Harms Study).Harm to children was also described as deeply emotional/psychological: linked to being asked to keep family secrets, a lack of capacity to understand the ‘adult world’ of gambling and addiction, as well as witnessing arguments and violence in the home and the threatening behaviour of others (such as loan sharks). These experiences were seen to be ‘internalised’ by children, leading to self-blame, shame, insecure attachment styles and long lasting mental health issues: What is very harmful is damage to children's self-esteem. So even now they believe their parents don't want them, so for example one has developed very serious mental health issues… lost his confidence in university study, and has very low mood currently… [the parents] wanted to go together to gamble, they wondered “Why stay home for the children?” So it's very harmful, even after 10 years. (Gambling support service staff member, Harms Study).Especially in my community…nobody wants to get married to someone who is child of a problem gambler, because of strong stigma and these known [mental health] effects (Asian gambling support service providers, Harms study) Children were also discussed as susceptible to socially transmitted gambling problems, through inappropriate or premature exposure to gambling environments, parents’ gambling and normalisation of gambling behaviour in communities, e.g. as referred to by one participant as the ‘ripple effect’:I mean [gambling is] an addiction... So it has an impact on all the family members in terms of the behaviours and the way they cope in that family setting and the roles they take on. And it carries on unless they’re more vigilant around the children picking it up - it has the ripple effect. (Community worker, Harms Study)Some participants claimed that a form of responsible gambling meant keeping children away from gambling e.g. controlling children’s access to online gambling games played by adults at home, leaving children in the car when placing a bet at the TAB. Responsible gambling could also involve ensuring that children’s needs are met first, before using family funds to gamble. I call it the horsey place, the horsey shop. We're going to the horsey shop. If you stand there, I'll be two seconds. Every time I go into the TAB, that's literally all I do. I'll walk in, I'll withdraw as fast as I can, and I get my kids and I'm out of there. I don't like them being in there. I don't want them to know what it is. (Male general community gambler, Harms study)While mothers and fathers were both implicated in children’s gambling harm, the responsibility for causing and addressing the harm experienced by children was described differently for men and women through the social roles of fatherhood and motherhood. When gambling harm for children was described in relation to fathers, the most usual harms were not being able to provide for the family and not being able to spend enough leisure time with the children. For example, “My kids are running around, I probably should be playing with them rather than sitting in front of the computer.” (Male general community gambler, Harms study). One participant equated his inability to provide for the family, in the context of his wife’s gambling, with failing as a father: My youngest one, he was very, very upset because he couldn’t get the cricket gear or the rugby boots that he wanted. He liked to keep up with his friends and because his dad owned his own company, to him it was quite a high status and I couldn’t buy him a brand new pair of boots or buy what he wanted, it was quite upsetting. I just said to him, I just couldn’t do it. For me I felt like I had failed as a father, because I wasn’t able to provide for my children. (Male affected other client of gambling support service, Harms Study)In contrast, mothers were held to be the primary caregivers for children in their day-to-day lives. Consequently, women’s gambling was much more often judged against the effects it had on their children – e.g. “She hasn’t upset them or taken anything that the children own” (Male affected other client of gambling support service, Harms Study). Mothers were positioned as responsible for being with children at home. This included for example preparing food and picking the children up from school:My sister usually went to Housie [Bingo], and I found that really sad because the women should be home with their children. The women go Mondays in one place and Tuesdays in another and a Thursday. It’s like the whole week, this Housie. (Female general community affected other, Pacific Impacts Study)So often the stories for me are [women] saying that they realise now that they were spending time in front of the pokie machine, rather than picking their children up from school... they realised there was a cost, that their mum wasn't picking them up from school and she could. (Gambling support service staff member, Harms Study) Mothers who gambled and neglected their mothering roles, were identified as causing severe emotional harm to their children. Parental quality was more easily questioned when it was the mother in the family who was gambling. Indeed, gambling was portrayed as deeply incompatible with being a loving mother, good wife and prudent manager of household resources:Her husband couldn't believe that the woman he'd married turned out to be a gambler. He wanted to put ‘gambler’ on her gravestone. And the two boys, who idolised her, couldn't reconcile their mum who was down there hanging on to the drip… Well they felt quite betrayed. They thought they knew their mum really well, that she was a loving mother - but she just had to go up to that casino. (Community support worker, Harms Study)Social roles and expectations surrounding both motherhood and fatherhood were identified as producing shame and distress for people unable to fulfil them. However, gambling could be seen and experienced as particularly transgressive for mothers through societal, cultural and familial expectations that they prioritise their children’s needs: For me, personally, going from a mum and doing all that life, and then becoming a gambler, right to the last $2, and transferring my children's money over and stuff like that, and then thinking, have they got money saved? Yeah, it totally took me in a direction that I was not proud of… Then just feel the feelings that I got, of feeling emotionally sick, to the point where I couldn't even cry because I knew it was all my fault what I was doing. (Female client of Māori gambling support service, Harms Study)But it caused a lot of shame for her because she was such a strong woman that had gotten her kids through their mortgages, got them through university, she was a practising midwife, and so it caused a lot of shame for her, and hurt. With that her whole mental wellbeing was down the gurgler, spiritually she felt very low and quite suicidal. She's feeling a lot better today but it will always be that shame and hurt that she's presented to the kids, where she's gone and let them down as a Mum. (Pacific gambling support service staff member, Harms Study) That women as mothers may be judged more harshly in relation to harm experienced by children, had clear implications for help-seeking from support services. Women feared losing their children if gambling problems in the family, combined with their inability to cope on their own, became known: Yeah, confession is the hardest thing, yeah. As a mum, you lose your children. (Female general community affected other, Pacific Impacts)We haven't worked with the children. The families that I've worked with are very protective, the mother's very protective of the children. (Community worker, Harms Study)That's probably the biggest fear of families, coming and sharing that information [about gambling harm]. I mean Mums feeling that their kids would be uplifted. (Gambling support service staff member, Harms Study)One participant identified and challenged the construction of Māori and Pacific mothers who gamble as ‘negligent’, by highlighting the structural and environmental factors that can make gambling disproportionately attractive to them: You’ve got a hopeful not harmful mother there, okay. And the hopeful mother has $20… that mother is contemplating or thinking about trying to feed five mouths, put food on the table… you’ve got the notion of tika like with Māori, you’ve got the notion of mo’oni (the truth) and you’ve got all our values such as respect (ta’ofa), you know the humility and the faka’apa’apa we have. It underpins it all but again it contradicts us again, because you can have a mother who holds onto those Tongan values but in a different context, and in a different perspective and mind frame. That she will be practising gambling for a different kind of approach - to protect her kids. (General community participant, Pacific Impacts)When poverty places the ‘hopeful mother’ in an already impossible situation ($20 to feed five mouths), gambling and the possibility of winning enough money to provide food for her children can become a form of care. Casey ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Casey</Author><Year>2006</Year><RecNum>207</RecNum><DisplayText>(2006)</DisplayText><record><rec-number>207</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329968">207</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Casey, Emma</author></authors></contributors><titles><title>Domesticating gambling: Gender, caring and the UK National Lottery</title><secondary-title>Leisure studies</secondary-title></titles><periodical><full-title>Leisure studies</full-title></periodical><pages>3-16</pages><volume>25</volume><number>1</number><dates><year>2006</year></dates><isbn>0261-4367</isbn><urls></urls></record></Cite></EndNote>(2006) described how in low-income families in the UK, purchasing lottery tickets can be intertwined with women’s daily practices of caring for their families.From an intersectional perspective, colonisation was also identified as vital to understanding how the responsibilities placed on Māori mothers in their families, can be compounded by whānau/family and community disconnection and disempowerment:[Through] the historical trauma and the impact of colonisation, we’ve lost a lot of our cultural strengths, they’ve been systematically stripped by oppression. So we don’t have those systems in place - where we have the backups. Especially urbanised Māori, they don't have close family living nearby where they can say “Oh aunty can you watch the kids, mum’s going out for a while.” It’s not happening in an urban context. (Participant in government policy/academic focus group, Harms Study)The identification of poverty and colonisation as contextual factors for women’s gambling and harm problematised the judgement placed on ‘negligent mothers’. Participants pointed out how individual mothers may be constrained in their ability to live up to the social expectations surrounding ‘good mothers’ who always protect their children from gambling harm. These expectations tended not to be ascribed equally to fathers.“Balls of steel”: Masculinities and gambling practicesSome gambling practices were described as masculine pursuits, because they were perceived to involve skill, logic, strong nerve, strategy, a sporting commitment and/or camaraderie. While not explicitly describing aspects of women’s gambling and harm, this theme suggested factors that may exclude women from particular gambling practices and environments. Sports and track betting (TAB) and casino table gaming were especially positioned as enabling the demonstration of traits associated with traditional forms of masculinity: It’s for more mature men, the TAB is. Like, it’s not all about luck. You’ve gotta do your homework. You gotta read, the stats and stuff like that, yeah, so it’s more a man thing, aye? That the ladies don’t have, you know? (Male general community gambler, Pacific Impacts Study)The moment you lose control you might as well just empty your pocket and give it to them. The Australian casino in the Gold Coast: I went straight to the $100 minimum table. 15 years old. $100 down. Lost it. $300 to live. Put down another $100. Won it back. So I was even. I got up and walked away. So mate, I was 15 years old. Balls of steel. (Male general community gambler, Harms Study)Some men’s preference for having control over the outcome of a gamble was underlined by their avoidance of games that they identified as based on pure luck. For example one man described his “typical guy’s interest” in sport and making money out of something you can reasonably predict. For these men the pleasure of gambling was associated with using knowledge, strategy and willpower, to try to beat the odds.I do have one hate I suppose… I'm not just going to throw my dollar in that slot machine, because they're just a sucker's game. It really is. It's just total luck. There's no skill involved at all. At least in blackjack there are formulas and things that you can follow that improve your odds. With a simple slot machine there's nothing. It's just pure dumb luck. (Male general community gambler, Harms Study)Pokies [EGMs], yeah they bore me to a point. I can't see how you can sit and watch something go around and around. It just hasn't got the excitement and willpower of a horse race or something, not to me. (Male gambler client of Māori gambling support service, Harms Study)Men’s gambling could also be positioned within a traditional male provider role in families. The notions of ‘investment’ and ‘backing oneself’ was used to position some forms of gambling as entrepreneurial:I'll tell you one thing - I suppose it can justify my gambling a little bit, is if I go to the TAB and I blow out $50, and I'll spend an hour or two hours or whatever building that $50 up, and then I go and spend that $50 on groceries, or on my boys basketball fees. Well that's fine. So effectively my investment of time and money has now been beneficial to the family. (Male general community gambler, Harms Study)When you're watching sport without a bet, you haven't backed yourself and invested on the outcome. You want to multiply the investment of time and what you’re putting in to benefit your children or your family. So in that respect, it’s not gambling. (Male general community gambler, Pacific Impacts).Men who could use a skill or knowledge set to turn a profit could be celebrated. In referencing “balls of steel” above, this participant invoked a James Bond style figure, on display on the casino floor, having held his nerve he “got up and walked away” - a success. Having access to visible and/or socially validated signs of success was linked to aspirational masculinities by one man who commented that: “Success, means you are ‘the man’, on top of the world!” (Male client of gambling support service, Harms Study). A specialised Asian support service worker noted that when men make fast money through gambling, they can become “an instant success”, a position that can seem otherwise unattainable. Those men who were unsuccessful gamblers, could be derided by their peers: He always paid his mates back – when he had a good week: “That's what I owe you and there's next week's as well” But when he lost that $20,000-odd of the boss's money that was when he was just the joke for all the boys. Unfortunately we couldn’t take him seriously then. (Male general community gambler, Harms Study)One woman pointed out how dominant Western models of ‘success’ in life, for example as defined by the attainment of financial goals or particular material possessions, can come to dominate and/or supplant other modes of living well: I grew up in Tonga, living a Tongan way of life, the running of the house is Tongan, but the materials and the resources are of overseas. Colonisation comes with the more convenient materials, more cars, and fancy lifestyle. We didn’t know what a fancy-fancy lifestyle is ‘til they came and set the boundaries to let us know, living in our own country, saying this is how you should live. It is better than how you are now. (Female general community gambler, Pacific Impacts)While far less prominent in the data, women’s gambling preferences and practices could also be identified with aspects of traditional femininity, such as relationality. For example, one participant described her attachment to a particular pokie machine [EGM] in almost romantic terms:There’s a relationship between you and the pokie [EGM]... because women have that relationship with the pokie machine [EGM]… at the time you’re doing it, it’s just you and the machine. You don’t think of anything else but the sound of the machine going bing bing bing you know? It’s communicating with you saying come be with me, you know, donate some money to me (Female current or ex problem gambling client of gambling support service, Pacific Impacts)Gambling and violence against womenViolence against women was explicitly linked to men failing to establish or maintain influence or control over women’s gambling behaviour. To the extent that men expected to be able to influence the behaviour of their partners, inability to do so was described as causing frustration which could be expressed violently: I [treated] a husband who went in [to prison] for domestic violence and I found out later that it was because of the wife’s gambling… she’s the cause of his anger management [issues] and frustration. He got so frustrated, didn’t know exactly how to take control. (Pacific gambling support service staff member, Pacific Impacts) Someone actually was telling me last week about his partner constantly asking for more money while they're out, to put in the pokies [EGMs]. By the time they'd had several drinks it turned into a domestic violence incident. [Facilitator: So he was the perpetrator?] Yeah and she was the gambler, so she was the victim. But he's actually the one whose ended up with a [prison] sentence. (Community support worker, Harms Study)The incidents above were described as “severe” and “extreme” cases of physical violence against women, which resulted in conviction and imprisonment. Verbal abuse, intimidation and threats of violence were often experienced by women whose gambling had been hidden and was then discovered by, or made known to her partner. Participants also described the anger and frustration displayed by fathers and male partners who felt they had lost control over their own gambling, and therefore power and/or respect within their families: Failure as a man, triggers a whole lot of other negative attributes. One of them is anger, being driven to anger and violence (Male client of gambling support service, Harms Study)When my dad lost money he became less in our eyes. He was then maybe really grumpy and shitty and probably more abusive to my mum. A lot of my uncles were that way to their family as well as to the kids as well. When they won it was all like yeah, you know it was all happy, happy, happy. (Participant in Māori gambler and affected other community members focus group, Harms Study)Within patriarchal family structures, women could also be threatened and intimidated into providing funds for gambling, and remaining in relationships with gambling men:I feel sorry for the mothers, you know, cause in some families, the men they got the power, and they just demand, “Give me the money, I’ll do whatever I wanna do with it. (Female general community affected other, Pacific Impacts)He would turn up demanding money because he didn’t have any petrol, couldn't get to work and it was quite menacing at the time. But then it didn’t fit into the ‘battered women syndrome’ as far as the women's refuge go, because he didn't actually ever hit me, but there was that intimidation that he needed money and he needed it now and who else was he going to get it from - you know? (Female general community affected other, Harms Study)These women described how men’s coercive and controlling behaviours limited their personal autonomy, and ability to care for themselves, their children and other family members, causing shame and isolation. Some women who gambled also discussed community electronic gaming machine (EGM) gambling environments (i.e. local bars/pubs) as offering them a safe, quiet, easily accessible activity, to spend time away from an abusive home life.But where it started was that I met up with this other tāne [man] and he was a heavy drinker, quite abusive verbally. Not so much as hitting me like my ex did - but I sort of started rebelling, getting away… I just one day went to the pub and this old Māori lady said to me – “try this” - and I said I have no idea how to play it, but she showed me how to do it... I suppose that it [started] from there before it got out of hand (Female gambler, Māori community support service, Harms Study)Some women also identified the impact of childhood abuse and historical intimate partner violence on the role that gambling played in their later lives to help them manage trauma.Abuse. I'll tell you my [story]. There's sexual abuse, there's mental abuse, there's my mum passing when I was [a child]. There's finding a man whose family way was alcohol and hitting… When I went off to go get my own addiction, it became something that just was able to keep me there away from it all, and just hold me there longer than anyone else normally would be. (Female client of Māori gambling support service, Harms Study)As with women’s responsibility for domestic and emotional labour, the relationship between gambling and violence against women was contextualised as exacerbated by socioeconomic and health inequities, and processes of colonisation.You look at South Auckland again, you've got the alcohol addictions, you've got drug, you've got gambling, you've got domestic violence. It is, it's all in this area of low socio-economic stress. When you look at it, it's a cycle. (Māori gambling support service staff, Harms Study)The imposition of Western ways of living, and Western models of health and wellbeing, were described as weakening community-based safeguards and support systems. For Māori and Pacific families particularly, this could produce situations of low social and cultural cohesion: In the old days domestic violence wasn’t a thing in Māori culture. There's a saying that it takes a whole village to raise a child… with the Māori culture, if you stepped out of line, if one person stepped out of line, whether it would be hitting a child or a woman, that person would be dealt to. It's not just by one person, it's by the whole village. (Male affected other client, Māori gambling support service)There’s an Island way that, no one else can solve a mother and a father’s domestic [violence] but from their mother and their father… doing counselling for Family Violence is the Europeans way of solving things. It does not fit into the Pacific way of solving stuff. It has to be a holistic approach. You gotta look at it from the spirit, body and mind. You gotta cover all those and … you bring in the whole community. (Pacific gambling support service staff member, Pacific Impacts). In emphasising the social determinants of health and wellbeing, these participants advocated for more holistic and community development-oriented activities to support women to address socioeconomic and health inequalities, gambling harm, and violence together. For example, one Pacific woman spoke about support groups run through Churches specifically for women: Within the Church we have different auxiliaries where the women can come together each Sunday and there’s specific lessons that are taught, like sometimes it’s around budgeting… but really it’s kind of like a support group for the women, and they always talk about problems and how we can overcome these problems, how we can help each other. (Female general community participant, Pacific Impacts).Other participants explicitly advocated for preventing gambling harm and other coexisting issues, as opposed to treating them after they have developed. These participants could link the notion of health promotion to caretaking, creating healthy environments for the benefit of future generations:I always feel that when, when there’s a problem that maybe there was a way to prevent the problem you know, looking at prevention especially, with the next generation coming up. (Female general community participant, Pacific Impacts)Participants articulated a need to prevent gambling harm through community connectedness. In doing so they referenced the Māori notion of kaitiakitanga - the process and practices of protecting and looking after the environment. As a concept, kaitiakitanga can align with a public health focus on shaping the environments in which health is produced (Wilson, 2008).Discussion This research has shown how many traditional understandings of the separate spheres of life appropriate for men and women (e.g. domestic vs public), and feminine and masculine attributes (e.g. caring vs. logical), remain in active circulation in New Zealand society. These understandings were involved in shaping (and were in turn shaped) by the gambling activities that women and men reported engaging in. Sports and track betting (TAB) and casino table gaming facilitated the demonstration of traits associated with traditional forms of masculinity, and suggested the active exclusion of women from these environments. The ways in which gambling spaces can become masculinised spaces has been explored in betting shops in the UK ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2014</Year><RecNum>206</RecNum><DisplayText>(Cassidy, 2014)</DisplayText><record><rec-number>206</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329729">206</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>‘A place for men to come and do their thing’: constructing masculinities in betting shops in L ondon</title><secondary-title>The British journal of sociology</secondary-title></titles><periodical><full-title>The British journal of sociology</full-title></periodical><pages>170-191</pages><volume>65</volume><number>1</number><dates><year>2014</year></dates><isbn>0007-1315</isbn><urls></urls></record></Cite></EndNote>(Cassidy, 2014), and poker tournaments in the US ADDIN EN.CITE <EndNote><Cite><Author>Abarbanel</Author><Year>2012</Year><RecNum>205</RecNum><DisplayText>(Abarbanel & Bernhard, 2012)</DisplayText><record><rec-number>205</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329645">205</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abarbanel, B Lillian</author><author>Bernhard, Bo J</author></authors></contributors><titles><title>Chicks with decks: the female lived experience in poker</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>367-385</pages><volume>12</volume><number>3</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Abarbanel & Bernhard, 2012).Women’s socially prescribed responsibilities for familial and child wellbeing, were factors that shaped some New Zealand women’s gambling practices (particularly EGM gambling in community settings), and experiences of gambling harm (through shame and the adoption of personal responsibility). These findings support the argument that women’s socio-cultural positioning as primary caregivers contributes to gambling harm: by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing and access support PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3JyaXNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+
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ADDIN EN.CITE.DATA (J?rvinen-Tassopoulos, 2016; Morrison & Wilson, 2015; Schull, 2002). Addressing issues of gender, power and privilege played out in families and communities Hilary Graham ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Graham</Author><Year>1982</Year><RecNum>275</RecNum><DisplayText>(1982)</DisplayText><record><rec-number>275</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559766931">275</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Graham, Hilary</author></authors><secondary-authors><author>Friedman, S</author><author>Sarah, E</author></secondary-authors></contributors><titles><title>Coping: Or how mothers are seen and not heard</title><secondary-title>On the problem of men: Two Feminist Conferences</secondary-title></titles><pages>101-106</pages><dates><year>1982</year></dates><pub-location>London</pub-location><publisher>The Women's Press</publisher><urls></urls></record></Cite></EndNote>(1982) described the “ideology of coping” as the essence of contemporary motherhood, where mothers are expected to be selfless, self-sacrificing and able to handle the pressures of the everyday life singlehandedly, in a calm and effective way. New Zealanders emphasised the shame of being positioned as a negligent gambling mother, or failing to address gambling harm in a caring role as a wife, daughter, sister or aunt. Shame has been identified as a powerful ‘affective determinant’ of health and wellbeing, related to suffering, negative health outcomes, and compromised health relationships and service provision ADDIN EN.CITE <EndNote><Cite><Author>Dolezal</Author><Year>2017</Year><RecNum>274</RecNum><DisplayText>(Dolezal & Lyons, 2017)</DisplayText><record><rec-number>274</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559765906">274</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dolezal, Luna</author><author>Lyons, Barry</author></authors></contributors><titles><title>Health-related shame: an affective determinant of health?</title><secondary-title>Medical Humanities</secondary-title></titles><periodical><full-title>Medical Humanities</full-title></periodical><pages>257-263</pages><volume>43</volume><number>4</number><dates><year>2017</year></dates><isbn>1468-215X</isbn><urls></urls></record></Cite></EndNote>(Dolezal & Lyons, 2017). Conversely, of concern is the suggestion that women’s gambling in New Zealand community settings may be normalised, or seen as a less harmful way of coping with familial distress, than alcohol or smoking. A particular gendered cultural meaning of community based EGM gambling may be in operation – one that recalls the historical positioning of certain prescription drugs and forms of alcohol as “Mother’s little helper” ADDIN EN.CITE <EndNote><Cite><Author>Chandler</Author><Year>2014</Year><RecNum>273</RecNum><DisplayText>(Chandler et al., 2014)</DisplayText><record><rec-number>273</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559692413">273</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chandler, Amy</author><author>Whittaker, Anne</author><author>Williams, Nigel</author><author>McGorm, Kelly</author><author>Cunningham-Burley, Sarah</author><author>Mathews, Gillian</author></authors></contributors><titles><title>Mother’s little helper? Contrasting accounts of benzodiazepine and methadone use among drug-dependent parents in the UK</title><secondary-title>Drugs: Education, Prevention and Policy</secondary-title></titles><periodical><full-title>Drugs: education, prevention and policy</full-title></periodical><pages>470-475</pages><volume>21</volume><number>6</number><dates><year>2014</year></dates><isbn>0968-7637</isbn><urls></urls></record></Cite></EndNote>(Chandler et al., 2014). This social meaning and practice should be explored further in targeted research, and health promotion/harm reduction work. Broader research identifies how ‘the family’ can be a problematic space for women in regards to health and wellbeing. Division of labour in the home remains an important gender-equity issue ADDIN EN.CITE <EndNote><Cite><Author>Waring</Author><Year>1999</Year><RecNum>278</RecNum><DisplayText>(Choo, 2000; Waring, 1999)</DisplayText><record><rec-number>278</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559769924">278</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Waring, Marilyn</author></authors></contributors><titles><title>Counting for nothing: What men value and what women are worth</title></titles><dates><year>1999</year></dates><publisher>University of Toronto Press</publisher><isbn>0802082602</isbn><urls></urls></record></Cite><Cite><Author>Choo</Author><Year>2000</Year><RecNum>233</RecNum><record><rec-number>233</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543449753">233</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Choo, Kristin</author></authors></contributors><titles><title>Justice Ginsburg recalls bias, expresses concerns</title></titles><volume>2018</volume><number>29 November</number><dates><year>2000</year></dates><pub-location>Women's E-News</pub-location><publisher>Women's E-News</publisher><urls><related-urls><url>;(Choo, 2000; Waring, 1999). Internationally, inequity in the home remains negatively associated with women’s mental health ADDIN EN.CITE <EndNote><Cite><Author>Lively</Author><Year>2010</Year><RecNum>276</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Lively, Steelman, & Powell, 2010)</DisplayText><record><rec-number>276</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559769392">276</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lively, Kathryn J</author><author>Steelman, Lala Carr</author><author>Powell, Brian</author></authors></contributors><titles><title>Equity, emotion, and household division of labor response</title><secondary-title>Social Psychology Quarterly</secondary-title></titles><periodical><full-title>Social Psychology Quarterly</full-title></periodical><pages>358-379</pages><volume>73</volume><number>4</number><dates><year>2010</year></dates><isbn>0190-2725</isbn><urls></urls></record></Cite></EndNote>(e.g. Lively, Steelman, & Powell, 2010), restricted access to health and wellbeing benefits of employment ADDIN EN.CITE <EndNote><Cite><Author>Schnittker</Author><Year>2007</Year><RecNum>277</RecNum><DisplayText>(Schnittker, 2007)</DisplayText><record><rec-number>277</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559769479">277</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schnittker, Jason</author></authors></contributors><titles><title>Working more and feeling better: women's health, employment, and family life, 1974-2004</title><secondary-title>American Sociological Review</secondary-title></titles><periodical><full-title>American Sociological Review</full-title></periodical><pages>221-238</pages><volume>72</volume><number>2</number><dates><year>2007</year></dates><isbn>0003-1224</isbn><urls></urls></record></Cite></EndNote>(Schnittker, 2007), and income inequality with men ADDIN EN.CITE <EndNote><Cite><Author>Kleven</Author><Year>2018</Year><RecNum>279</RecNum><DisplayText>(Kleven, Landais, & Egholt S?gaard, 2018)</DisplayText><record><rec-number>279</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559770527">279</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Kleven, Henrik </author><author>Landais, Camille</author><author>Egholt S?gaard, Jakob </author></authors></contributors><titles><title>Children and Gender Inequality: Evidence from Denmark</title><secondary-title>NBER Working Paper No. 24219</secondary-title></titles><dates><year>2018</year></dates><pub-location>Cambridge, MA</pub-location><publisher>National Bureau of Economnic Research </publisher><urls></urls></record></Cite></EndNote>(Kleven, Landais, & Egholt S?gaard, 2018). Women continue to be positioned as primary carers in families, through representations of guilt, responsibility, work—family balance issues, and dominant forms of masculinity ADDIN EN.CITE <EndNote><Cite><Author>Wall</Author><Year>2007</Year><RecNum>254</RecNum><DisplayText>(Wall & Arnold, 2007)</DisplayText><record><rec-number>254</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558049757">254</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wall, Glenda</author><author>Arnold, Stephanie</author></authors></contributors><titles><title>How involved is involved fathering? An exploration of the contemporary culture of fatherhood</title><secondary-title>Gender & Society</secondary-title></titles><periodical><full-title>Gender & Society</full-title></periodical><pages>508-527</pages><volume>21</volume><number>4</number><dates><year>2007</year></dates><isbn>0891-2432</isbn><urls></urls></record></Cite></EndNote>(Wall & Arnold, 2007). In New Zealand, women still spend 2–3 times as much time as men on unpaid household and caregiving work ADDIN EN.CITE <EndNote><Cite><Author>Fursman</Author><Year>2009</Year><RecNum>75</RecNum><DisplayText>(Fursman & Callister, 2009)</DisplayText><record><rec-number>75</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525127243">75</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Fursman, Lindy</author><author>Callister, Paul</author></authors></contributors><titles><title>Men's participation in unpaid care: a review of the literature</title></titles><dates><year>2009</year></dates><pub-location>Wellington</pub-location><publisher>Department of Labour and Ministry of Women's Affairs,</publisher><urls></urls></record></Cite></EndNote>(Fursman & Callister, 2009). Consequently, boys and men can experience profound difficulties participating actively in families, and sharing the tasks of providing emotional intimacy or personal care that are integral to family life and wellbeing ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2005</Year><RecNum>255</RecNum><DisplayText>(M. Adams & Coltrane, 2005)</DisplayText><record><rec-number>255</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558049925">255</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Adams, Michele</author><author>Coltrane, Scott</author></authors><secondary-authors><author>Kimmel, Michael S</author><author>Hearn, Jeff </author><author>Connell, Robert W</author></secondary-authors></contributors><titles><title>Boys and men in families: The domestic production of gender, power, and privilege</title><secondary-title>Handbook on studies on men and masculinities</secondary-title></titles><periodical><full-title>Handbook on studies on men and masculinities</full-title></periodical><pages>230-248</pages><dates><year>2005</year></dates><urls></urls></record></Cite></EndNote>(M. Adams & Coltrane, 2005). Australian large-scale national research has recently identified some concerning core narratives on gender equality, e.g. strongly negative views of women in leadership roles, and social norms which continue to restrict women (and deny men access) to traditional familial and caring roles ADDIN EN.CITE <EndNote><Cite><Author>Evans</Author><Year>2018</Year><RecNum>280</RecNum><DisplayText>(Evans, Haussegger, Halupka, & Rowe, 2018)</DisplayText><record><rec-number>280</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559773156">280</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Evans, M</author><author>Haussegger, V</author><author>Halupka, M</author><author>Rowe, P</author></authors></contributors><titles><title>From girls to men: Social attitudes to gender equality in Australia</title></titles><dates><year>2018</year></dates><pub-location>Canberra</pub-location><publisher>50/50 by 2030 Foundation at the University of Canberra</publisher><urls><related-urls><url>;(Evans, Haussegger, Halupka, & Rowe, 2018). The foregoing raises important considerations for health promotion and gambling harm. Gender dynamics should be carefully considered, to avoid adding to women’s social burden, and exacerbating harm. Gender-aware family and community interventions would work with families and communities to identify and challenge gender narratives that may be experienced as restrictive, and find and advocate for creative ways to redistribute responsibility for providing care ADDIN EN.CITE <EndNote><Cite><Author>Lesieur</Author><Year>1991</Year><RecNum>93</RecNum><DisplayText>(Lesieur & Blume, 1991)</DisplayText><record><rec-number>93</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530498415">93</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Lesieur, HR</author><author>Blume, SB</author></authors><secondary-authors><author>Van Den Bergh, N</author></secondary-authors></contributors><titles><title>When lady luck loses: The female pathological gambler</title><secondary-title>Feminist perspectives on addictions</secondary-title></titles><periodical><full-title>Feminist perspectives on addictions</full-title></periodical><pages>181-197</pages><dates><year>1991</year></dates><pub-location>New York</pub-location><publisher>Springer</publisher><urls></urls></record></Cite></EndNote>(Lesieur & Blume, 1991). Gambling interventions should find ways to include men in conversations about gender equality in the home, and in broader society. The Australian research cited above found that the majority (62%) of Australians subscribed to moderate views around gender equality (broadly egalitarian but tempered by rising concern over what they understood as the growing impact of ‘political correctness’) ADDIN EN.CITE <EndNote><Cite><Author>Evans</Author><Year>2018</Year><RecNum>280</RecNum><DisplayText>(Evans et al., 2018)</DisplayText><record><rec-number>280</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559773156">280</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Evans, M</author><author>Haussegger, V</author><author>Halupka, M</author><author>Rowe, P</author></authors></contributors><titles><title>From girls to men: Social attitudes to gender equality in Australia</title></titles><dates><year>2018</year></dates><pub-location>Canberra</pub-location><publisher>50/50 by 2030 Foundation at the University of Canberra</publisher><urls><related-urls><url>;(Evans et al., 2018). Men with these moderate views held a strong desire to see men represented in all public discussion of gender equality issues. Structural barriers to men’s participation in domestic life should be identified and challenged. There is a longstanding political commitment in Sweden to fostering equality between men and women. This is defined as men and women having the same opportunities, rights and responsibilities in all important areas of social life, including employment and parenting ADDIN EN.CITE <EndNote><Cite><Author>Government Offices of Sweden</Author><Year>2009</Year><RecNum>339</RecNum><DisplayText>(Government Offices of Sweden, 2009)</DisplayText><record><rec-number>339</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563401684">339</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Government Offices of Sweden,</author></authors></contributors><titles><title>The Swedish government’s gender equality policy</title></titles><dates><year>2009</year></dates><pub-location>Stockholm</pub-location><publisher>Ministry of Integration and Gender Equality</publisher><urls></urls></record></Cite></EndNote>(Government Offices of Sweden, 2009). Substantial shifts in the practices of fatherhood have occurred in Sweden, to the extent that it is now common for Swedish fathers to take parental leave and share housework and childcare with their partners ADDIN EN.CITE <EndNote><Cite><Author>Duvander</Author><Year>2017</Year><RecNum>340</RecNum><DisplayText>(Duvander, Haas, & Thalberg, 2017)</DisplayText><record><rec-number>340</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563401963">340</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Duvander, Ann-Zofie</author><author>Haas, Linda</author><author>Thalberg, Sara</author></authors></contributors><titles><title>Fathers on Leave Alone in Sweden: Toward More Equal Parenthood?</title><secondary-title>Comparative Perspectives on Work-Life Balance and Gender Equality</secondary-title></titles><pages>125-145</pages><dates><year>2017</year></dates><publisher>Springer, Cham</publisher><urls></urls></record></Cite></EndNote>(Duvander, Haas, & Thalberg, 2017). These shifts have been supported by specific policies such as non-transferrable parental leave of three months for fathers.Patriarchal understandings of men’s entitlement to power and control within the family context, were linked to some women’s experiences of gambling harm through intimate partner violence and coercion. Patriarchal ideology limited some women’s ability to make decisions about gambling and family funds, take care of their families and themselves. For Māori and Pacific families, patriarchal notions, gambling and violence were positioned as complex and intersectional issues, exacerbated by the ongoing effects of colonisation and historical trauma PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Vbml0ZWQgTmF0aW9uczwvQXV0aG9yPjxZZWFyPjIwMTQ8
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ADDIN EN.CITE.DATA (as also argued by Dyall, 2010; Levy, 2015; Morrison & Wilson, 2015; United Nations, 2014). Challenging patriarchal family structures and practices, in ways that are effective, culturally nuanced and appropriate, remains an ongoing challenge ADDIN EN.CITE <EndNote><Cite><Author>Hunnicutt</Author><Year>2009</Year><RecNum>286</RecNum><DisplayText>(Hunnicutt, 2009)</DisplayText><record><rec-number>286</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559778937">286</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hunnicutt, Gwen</author></authors></contributors><titles><title>Varieties of patriarchy and violence against women: Resurrecting “patriarchy” as a theoretical tool</title><secondary-title>Violence against women</secondary-title></titles><periodical><full-title>Violence against women</full-title></periodical><pages>553-573</pages><volume>15</volume><number>5</number><dates><year>2009</year></dates><isbn>1077-8012</isbn><urls></urls></record></Cite></EndNote>(Hunnicutt, 2009). In New Zealand, a Whānau Ora approach is a potential strengths-based intervention strategy, including a focus on supporting broader family and community systems to conceptualise and address issues that are complicated and interrelated ADDIN EN.CITE <EndNote><Cite><Author>Ministry of Health</Author><Year>2015</Year><RecNum>45</RecNum><DisplayText>(Levy, 2015; Ministry of Health, 2015)</DisplayText><record><rec-number>45</rec-number><foreign-keys><key app="EN" db-id="tzptstftixaf2metpv5p9s0wf90pvfxasrfw" timestamp="1488934142">45</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Ministry of Health,</author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Wh</style><style face="normal" font="default" charset="186" size="100%">ānau Ora programme</style></title></titles><volume>2017</volume><number>8 March</number><dates><year>2015</year></dates><pub-location>Wellington</pub-location><publisher>Ministry of Health</publisher><urls><related-urls><url> app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563842359">342</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Levy, Michelle</author></authors></contributors><titles><title>The impacts of gambling for Maori families and communities: A strengths-based approach to achieving Whanau Ora</title></titles><dates><year>2015</year></dates><pub-location>Hamilton</pub-location><publisher><style face="normal" font="default" size="100%">Te R</style><style face="normal" font="default" charset="186" size="100%">ūnanga o Kirikiriroa </style></publisher><urls></urls></record></Cite></EndNote>(Levy, 2015; Ministry of Health, 2015). From this perspective, engagement with women’s own definitions and practices of ‘safety’ and ‘autonomy’ is identified as vital. For example, some Māori women view safety as a holistic concept involving confidence that their community supports and accepts them as Māori women, as well as a strong sense of connectedness with other women ADDIN EN.CITE <EndNote><Cite><Author>Wilson</Author><Year>2016</Year><RecNum>292</RecNum><DisplayText>(Wilson, Jackson, & Herd, 2016)</DisplayText><record><rec-number>292</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560220472">292</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author><author>Jackson, Debra</author><author>Herd, Ruth</author></authors></contributors><titles><title>Confidence and connectedness: Indigenous Māori women's views on personal safety in the context of intimate partner violence</title><secondary-title>Health care for women international</secondary-title></titles><periodical><full-title>Health care for women international</full-title></periodical><pages>707-720</pages><volume>37</volume><number>7</number><dates><year>2016</year></dates><isbn>0739-9332</isbn><urls></urls></record></Cite></EndNote>(Wilson, Jackson, & Herd, 2016). This definition of safety suggests initiatives focus on challenging problematic narratives about Māori women (e.g. as ‘at-risk’, powerless or troubled), and strengths-based community development work with women specifically ADDIN EN.CITE <EndNote><Cite><Author>Wilson</Author><Year>2008</Year><RecNum>217</RecNum><DisplayText>(Wilson, 2008; Wilson et al., 2016)</DisplayText><record><rec-number>217</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1541541370">217</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author></authors></contributors><titles><title>The significance of a culturally appropriate health service for Indigenous Māori women</title><secondary-title>Contemporary Nurse</secondary-title></titles><periodical><full-title>Contemporary Nurse</full-title></periodical><pages>173-188</pages><volume>28</volume><number>1-2</number><dates><year>2008</year></dates><isbn>1037-6178</isbn><urls></urls></record></Cite><Cite><Author>Wilson</Author><Year>2016</Year><RecNum>292</RecNum><record><rec-number>292</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560220472">292</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author><author>Jackson, Debra</author><author>Herd, Ruth</author></authors></contributors><titles><title>Confidence and connectedness: Indigenous Māori women's views on personal safety in the context of intimate partner violence</title><secondary-title>Health care for women international</secondary-title></titles><periodical><full-title>Health care for women international</full-title></periodical><pages>707-720</pages><volume>37</volume><number>7</number><dates><year>2016</year></dates><isbn>0739-9332</isbn><urls></urls></record></Cite></EndNote>(Wilson, 2008; Wilson et al., 2016). Improving support and recreational opportunities available for women in their communities Community gambling venues (pubs and clubs) provided some women with easily accessible, convenient and safe spaces, in the context of an often palpable lack of social support in their lives. Providing women with alternative spaces to relax, be alone and/or to connect with others in their communities, remains an appropriate response to women’s gambling harm PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYXN0ZXJtYW4tU21pdGg8L0F1dGhvcj48WWVhcj4yMDAx
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ADDIN EN.CITE.DATA (as previously advanced by Hraba & Lee, 1996; Masterman-Smith, Martin, & McMillen, 2001; Nuske et al., 2016). Access to work-life balance and quality leisure time is understood as a complex gender, race and class issue in New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Harris</Author><Year>2007</Year><RecNum>282</RecNum><DisplayText>(Harris & Pringle, 2007; Ravenswood & Harris, 2016)</DisplayText><record><rec-number>282</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559775664">282</key></foreign-keys><ref-type name="Conference Proceedings">10</ref-type><contributors><authors><author>Harris, Candice</author><author>Pringle, Judith</author></authors></contributors><titles><title>Work-Life balance: Who is the target for this silver bullet</title><secondary-title>ACREW workshop</secondary-title></titles><dates><year>2007</year></dates><urls></urls></record></Cite><Cite><Author>Ravenswood</Author><Year>2016</Year><RecNum>283</RecNum><record><rec-number>283</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559775715">283</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ravenswood, Katherine</author><author>Harris, Candice</author></authors></contributors><titles><title>Doing gender, paying low: gender, class and work–life balance in aged care</title><secondary-title>Gender, Work & Organization</secondary-title></titles><periodical><full-title>Gender, Work & Organization</full-title></periodical><pages>614-628</pages><volume>23</volume><number>6</number><dates><year>2016</year></dates><isbn>0968-6673</isbn><urls></urls></record></Cite></EndNote>(Harris & Pringle, 2007; Ravenswood & Harris, 2016). Gambling support services could position themselves to identify, meet and advocate for the needs of women in this area specifically. For example, the provision of free childcare facilities and/or child friendly spaces in local community based gambling support services could be standardised. Collaboration between gambling support services and women’s centres and groups around broader social issues for women, would identify further implications for practice. Nuske and colleagues (2016) examined the impact of significant life events and social connectedness on women’s gambling experiences in Australia. The availability of multiple and varied social networks was important for social and emotional wellbeing, particularly as women negotiated significant life events such as new motherhood, death or divorce. These authors advocated for gambling harm reduction activities aimed at enhancing women’s ability to frequently and safely connect with others socially. The need for services to operate more holistically in addressing mental health and addictions, and the sociocultural determinants of health, has been recognised by a recent New Zealand government inquiry ADDIN EN.CITE <EndNote><Cite><Author>Paterson</Author><Year>2018</Year><RecNum>294</RecNum><DisplayText>(Paterson et al., 2018)</DisplayText><record><rec-number>294</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560467934">294</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Paterson, R</author><author>Disley, B</author><author>Tiatia-Seath, J</author><author>Durie, M</author><author>Rangihuna, D</author><author>Tualamali'i J</author></authors></contributors><titles><title>He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Givernment Inquiry into Mental Health and Addiction</publisher><urls></urls></record></Cite></EndNote>(Paterson et al., 2018). Pacific understandings of health and wellbeing are well-placed to address issues of gender, power and privilege played out in families and communities that are implicated in women’s gambling harm ADDIN EN.CITE <EndNote><Cite><Author>Perese</Author><Year>2009</Year><RecNum>73</RecNum><DisplayText>(Paterson et al., 2018; Perese, 2009)</DisplayText><record><rec-number>73</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1525126354">73</key></foreign-keys><ref-type name="Thesis">32</ref-type><contributors><authors><author>Perese, L</author></authors></contributors><titles><title>You bet your life... and mine! Contemporary Samoan gambling in New Zealand</title></titles><dates><year>2009</year></dates><publisher>ResearchSpace@ Auckland</publisher><urls></urls></record></Cite><Cite><Author>Paterson</Author><Year>2018</Year><RecNum>294</RecNum><record><rec-number>294</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560467934">294</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Paterson, R</author><author>Disley, B</author><author>Tiatia-Seath, J</author><author>Durie, M</author><author>Rangihuna, D</author><author>Tualamali'i J</author></authors></contributors><titles><title>He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Givernment Inquiry into Mental Health and Addiction</publisher><urls></urls></record></Cite></EndNote>(Paterson et al., 2018; Perese, 2009). For example the fa’asamoa (Samoan worldview) notion of ‘va’ can be understood as the space that relates people, their environments and gods ADDIN EN.CITE <EndNote><Cite><Author>Wendt</Author><Year>1999</Year><RecNum>295</RecNum><DisplayText>(Wendt, 1999)</DisplayText><record><rec-number>295</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560469390">295</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wendt, Albert</author></authors><secondary-authors><author>Hereniko, V</author><author>Wilson, R</author></secondary-authors></contributors><titles><title>Afterword: Tatauing the post-colonial body</title><secondary-title>Inside out: Literature, cultural politics, and identity in the new Pacific</secondary-title></titles><periodical><full-title>Inside out: Literature, cultural politics, and identity in the new Pacific</full-title></periodical><pages>399-412</pages><dates><year>1999</year></dates><pub-location>Maryland
</pub-location><publisher>Rowman & Littlefield</publisher><urls></urls></record></Cite></EndNote>(Wendt, 1999). Va can be nurtured and/or disrespected/tarnished. The concept of va highlights how maintaining balanced and reciprocal relationships is vital to health and wellbeing ADDIN EN.CITE <EndNote><Cite><Author>Seiuli</Author><Year>2013</Year><RecNum>296</RecNum><DisplayText>(Seiuli, 2013; Suaalii-Sauni et al., 2009)</DisplayText><record><rec-number>296</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560469793">296</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Seiuli, Byron Malaela Sotiata</author></authors></contributors><titles><title>Counselling psychology from a Samoan perspective</title><secondary-title>New Zealand Journal of Psychology</secondary-title></titles><periodical><full-title>New Zealand Journal of Psychology</full-title></periodical><pages>50-58</pages><volume>42</volume><number>3</number><dates><year>2013</year></dates><isbn>0112-109X</isbn><urls></urls></record></Cite><Cite><Author>Suaalii-Sauni</Author><Year>2009</Year><RecNum>297</RecNum><record><rec-number>297</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560469862">297</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Suaalii-Sauni, Tamasailau</author><author>Wheeler, Amanda</author><author>Saafi, Etuate</author><author>Robinson, Gail</author><author>Agnew, Francis</author><author>Warren, Helen</author><author>Erick, Maliaga</author><author>Hingano, Tevita</author></authors></contributors><titles><title>Exploration of Pacific perspectives of Pacific models of mental health service delivery in New Zealand</title><secondary-title>Pacific Health Dialog</secondary-title></titles><periodical><full-title>Pacific Health Dialog</full-title></periodical><pages>18-27</pages><volume>15</volume><number>1</number><dates><year>2009</year></dates><urls></urls></record></Cite></EndNote>(Seiuli, 2013; Suaalii-Sauni et al., 2009). Integral to this concept is the notion that the wellbeing of individuals is never separate from the balance and reciprocity that exists within the family, community and broader society in which people live. Multiple service delivery models aligned with Pacific holism exist, and have relevance for enhancing more general approaches, but tend to exist in silos (e.g. the notion of ‘specialist services’) and are rarely applied across mental health and addictions policy ADDIN EN.CITE <EndNote><Cite><Author>Paterson</Author><Year>2018</Year><RecNum>294</RecNum><DisplayText>(Paterson et al., 2018)</DisplayText><record><rec-number>294</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560467934">294</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Paterson, R</author><author>Disley, B</author><author>Tiatia-Seath, J</author><author>Durie, M</author><author>Rangihuna, D</author><author>Tualamali'i J</author></authors></contributors><titles><title>He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Givernment Inquiry into Mental Health and Addiction</publisher><urls></urls></record></Cite></EndNote>(Paterson et al., 2018). All gambling support services could benefit from existing guidelines for holistic practice, e.g. as outlined in the Uloa model of practice for working with Tongan people experiencing distress ADDIN EN.CITE <EndNote><Cite><Author>Vaka</Author><Year>2016</Year><RecNum>298</RecNum><DisplayText>(Vaka, 2016)</DisplayText><record><rec-number>298</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560477573">298</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vaka, Sione</author></authors></contributors><titles><title>Uloa: A model of practice for working with Tongan people experiencing mental distress</title><secondary-title>New Zealand Sociology</secondary-title></titles><periodical><full-title>New Zealand Sociology</full-title></periodical><pages>123</pages><volume>31</volume><number>2</number><dates><year>2016</year></dates><urls></urls></record></Cite></EndNote>(Vaka, 2016), and the Popao model of Pacific recovery and strength ADDIN EN.CITE <EndNote><Cite><Author>Fotu</Author><Year>2009</Year><RecNum>299</RecNum><DisplayText>(Fotu & Tafa, 2009)</DisplayText><record><rec-number>299</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560477704">299</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fotu, Manu</author><author>Tafa, Taitoko</author></authors></contributors><titles><title>The Popao model: a Pacific recovery and strength concept in mental health</title><secondary-title>Pacific health dialog</secondary-title></titles><periodical><full-title>Pacific Health Dialog</full-title></periodical><pages>164-170</pages><volume>15</volume><number>1</number><dates><year>2009</year></dates><urls></urls></record></Cite></EndNote>(Fotu & Tafa, 2009).ConclusionGender norms, and particularly women’s social responsibilities for familial and child wellbeing, shaped some New Zealand women’s gambling practices (EGM gambling in community settings), and experiences of gambling harm (through shame and the adoption of personal responsibility for addressing harm). Gambling support service provision for women should show awareness of gender issues and harm (e.g. through the provision of free childcare facilities), and integrate gender equality issues into health promotion and harm reduction work (e.g. identify and actively challenge problematic gender narratives, and engage in community development work with women specifically). More broadly, and in recognition of the gendered harm caused by gambling and the widely accepted principle of 'polluter pays’, gambling revenue could be directed towards achieving gender equality goals.GENDER ANALYSIS OF NEW ZEALAND POPULATION DATA The third component of this study comprised new gender analyses of existing New Zealand representative population data relevant to gambling, health and wellbeing.IntroductionResponses to preventing and minimising women’s gambling harm have been shaped, and arguably constrained, by population research which continues to identify male gender as a key risk factor for gambling problems PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Eb3dsaW5nPC9BdXRob3I+PFllYXI+MjAxNzwvWWVhcj48
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ADDIN EN.CITE.DATA (e.g. Abbott et al., 2014; Abbott, Stone, Billi, & Yeung, 2016; Abbott, Volberg, & R?nnberg, 2004). Gender differences in problem gambling are discussed as related to motivation and preferred gambling forms. Specifically, that men with problems tend to report gambling for the excitement, while women with problems gamble mostly to escape, and tend to favour the riskier more private and chance-based gambling forms such as EGMs PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DcmlzcDwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PFJl
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DcmlzcDwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (e.g. Crisp et al., 2004; Crisp et al., 2000; Svensson & Romild, 2014). Gender is likely to play an indirect, rather than direct, role in the development of problem gambling through numerous other demographic, economic, and health-related issues PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NZXJrb3VyaXM8L0F1dGhvcj48WWVhcj4yMDE2PC9ZZWFy
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ADDIN EN.CITE.DATA (Dowling et al., 2017; Merkouris et al., 2016; Nelson et al., 2006). High quality population data provide an opportunity to explore gender, gambling behaviour and varying factors associated with men and women experiencing problems, in a particular country or jurisdiction PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IaW5nPC9BdXRob3I+PFllYXI+MjAxNDwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA (Dowling & Oldenhof, 2017; Hing, Russell, Tolchard, & Nower, 2014; Hing et al., 2016; Romild et al., 2016; Svensson & Romild, 2014; Svensson et al., 2011). Gender informed analyses have rarely been conducted, and gambling studies have given insufficient attention to gender as an analytical category and/or theoretical construct PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib2xkc3dvcnRoPC9BdXRob3I+PFllYXI+MjAxMjwvWWVh
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ADDIN EN.CITE.DATA (Holdsworth et al., 2012; Kairouz et al., 2017; Merkouris et al., 2016). In recent years, increasingly sophisticated gender analyses have been conducted on representative population datasets in Sweden, Canada and Australia, which support and encourage increased gender sensitivity in prevention and harm minimisation efforts. For example, in Sweden, population data was used to examine sociodemographic differences between men and women among different types of gamblers, generating clusters defined by similar gambling behaviour (seldom, occasional, habitual, social and heavy gamblers) ADDIN EN.CITE <EndNote><Cite><Author>Romild</Author><Year>2016</Year><RecNum>43</RecNum><DisplayText>(Romild et al., 2016)</DisplayText><record><rec-number>43</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386899">43</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Romild, Ulla</author><author>Svensson, Jessika</author><author>Volberg, Rachel</author></authors></contributors><titles><title>A gender perspective on gambling clusters in Sweden using longitudinal data</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>43-60</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(Romild et al., 2016). Within clusters, gambling forms were typically gendered, with men more likely to gamble on horses and sports, and women preferring bingo and lotteries. Gambling clusters were also gendered, social and heavy gamblers tended to be men, seldom gamblers were largely women and occasional gamblers were mixed gender. Importantly, this study found that the development of gambling problems was similar for men and women within each cluster. Although men and women may gamble on different forms (with men more likely to gamble, and on multiple forms), they may be similar in gambling magnitude and in relation to how problems develop. Indeed, Svensson and Romild (2014) argued that Swedish women who gamble regularly may have a higher susceptibility to gambling problems than men who gamble regularly. Previously evident gender differences can become less clear-cut once gambling location and context is taken into account. For example, in Canada, men are 6.5 times more likely to play poker compared to women – in line with international Western trends ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><DisplayText>(Kairouz et al., 2017)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017). Exploration of patterns of poker play by gender in a representative adult population sample showed that when women played poker, they played with similar frequency to men across private, public and online settings, and spent a similar amount of money online and in public venues (men spent more in private residences) ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><DisplayText>(Kairouz et al., 2017)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017). That men and women play online poker in a similar way, regarding frequency, spend and length of play, is an important consideration for harm minimisation and reduction planning and practice. Australian population research has suggested some problem gambling risk and protective factors that may function differently by gender. For example, Hing and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Hing</Author><Year>2016</Year><RecNum>8</RecNum><DisplayText>(2016)</DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511816406">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hing, Nerilee</author><author>Russell, Alex</author><author>Tolchard, Barry</author><author>Nower, Lia</author></authors></contributors><titles><title>Risk factors for gambling problems: An analysis by gender</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>511-534</pages><volume>32</volume><number>2</number><dates><year>2016</year></dates><isbn>1573-3602</isbn><urls></urls></record></Cite></EndNote>(2016) found engaging in private betting, scratch tickets and bingo were risk-factors for women (and not men), while low education combined with engaging in table games, race or sports betting and lotteries were risk factors for men (and not women). Dowling and Oldenhof ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Dowling</Author><Year>2017</Year><RecNum>258</RecNum><DisplayText>(2017)</DisplayText><record><rec-number>258</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558565811">258</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author><author>Oldenhof, Erin</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender differences in risk and protective factors for problem gambling</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>247-267</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(2017) showed that some domains of quality of life may function differently in relation to gambling risk for men and women, e.g. physical health was identified as a protective factor for women but not for men. From a public health perspective, gender perspectives on gambling and leisure practices and contexts are highly relevant ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2011</Year><RecNum>39</RecNum><DisplayText>(Svensson et al., 2011)</DisplayText><record><rec-number>39</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520385155">39</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author><author>Nordenmark, Mikael</author><author>M?nsdotter, Anna</author></authors></contributors><titles><title>Gendered gambling domains and changes in Sweden</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>193-211</pages><volume>11</volume><number>2</number><dates><year>2011</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Svensson et al., 2011). Rapid growth in the availability of legal gambling opportunities has enabled gambling to be positioned as a legitimate leisure activity, set in the context of everyday leisure opportunities ADDIN EN.CITE <EndNote><Cite><Author>Casey</Author><Year>2007</Year><RecNum>91</RecNum><DisplayText>(Casey, 2007)</DisplayText><record><rec-number>91</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530486139">91</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Casey, Emma</author></authors><secondary-authors><author>Casey, Emma</author><author>Martens, Lydia</author></secondary-authors></contributors><titles><title>Gambling and everyday life: Working class mothers and domestic spaces of consumption</title><secondary-title>Gender and consumption: Domestic cultures and the commercialisation of everyday life</secondary-title></titles><pages>123-139</pages><dates><year>2007</year></dates><pub-location>Hampshire, England</pub-location><publisher>Ashgate Publishing</publisher><urls></urls></record></Cite></EndNote>(Casey, 2007). Population time use data suggests gender differences in the quantity and quality of leisure time, with particular constraints on the quality of women’s leisure time ADDIN EN.CITE <EndNote><Cite><Author>Bittman</Author><Year>2000</Year><RecNum>259</RecNum><DisplayText>(Bittman & Wajcman, 2000)</DisplayText><record><rec-number>259</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558573453">259</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bittman, Michael</author><author>Wajcman, Judy</author></authors></contributors><titles><title>The rush hour: The character of leisure time and gender equity</title><secondary-title>Social forces</secondary-title></titles><periodical><full-title>Social forces</full-title></periodical><pages>165-189</pages><volume>79</volume><number>1</number><dates><year>2000</year></dates><isbn>1534-7605</isbn><urls></urls></record></Cite></EndNote>(Bittman & Wajcman, 2000). This may facilitate and/or inhibit gambling practices in different ways. For example, Casey ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Casey</Author><Year>2006</Year><RecNum>207</RecNum><DisplayText>(2006)</DisplayText><record><rec-number>207</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329968">207</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Casey, Emma</author></authors></contributors><titles><title>Domesticating gambling: Gender, caring and the UK National Lottery</title><secondary-title>Leisure studies</secondary-title></titles><periodical><full-title>Leisure studies</full-title></periodical><pages>3-16</pages><volume>25</volume><number>1</number><dates><year>2006</year></dates><isbn>0261-4367</isbn><urls></urls></record></Cite></EndNote>(2006) has pointed out how constraints on women’s leisure time are bound up with ‘domestic gambling’ practices e.g. lotteries, that more easily fit around women’s responsibilities for the home. Despite growing evidence that as gambling availability and acceptability has changed, more women are experiencing gambling problems than in the past, there remains a knowledge gap in understanding the risk of problem gambling from a gender perspective ADDIN EN.CITE <EndNote><Cite><Author>Dowling</Author><Year>2017</Year><RecNum>258</RecNum><DisplayText>(Dowling & Oldenhof, 2017)</DisplayText><record><rec-number>258</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558565811">258</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Dowling, NA</author><author>Oldenhof, Erin</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender differences in risk and protective factors for problem gambling</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>247-267</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Dowling & Oldenhof, 2017). Informed and effective gender-specific public health measures are necessary in primary prevention so that gambling-related harms can be addressed and so that vulnerable and high-risk groups can be adequately protected ADDIN EN.CITE <EndNote><Cite><Author>Castrén</Author><Year>2018</Year><RecNum>257</RecNum><DisplayText>(Castrén, Heiskanen, & Salonen, 2018)</DisplayText><record><rec-number>257</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1558564313">257</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Castrén, Sari</author><author>Heiskanen, Maria</author><author>Salonen, Anne H</author></authors></contributors><titles><title>Trends in gambling participation and gambling severity among Finnish men and women: cross-sectional population surveys in 2007, 2010 and 2015</title><secondary-title>BMJ open</secondary-title></titles><periodical><full-title>BMJ open</full-title></periodical><pages>e022129</pages><volume>8</volume><number>8</number><dates><year>2018</year></dates><isbn>2044-6055</isbn><urls></urls></record></Cite></EndNote>(Castrén, Heiskanen, & Salonen, 2018).The National Gambling Study (NGS) 2012 baseline dataset provides a depth and breadth of nationally representative population data on New Zealanders’ gambling and leisure activity participation, as well as problem gambling, a wide range of measures of health and well-being, and demographic information. No systematic gender analysis of this data set has been performed, limiting our understanding of complex patterns of gambling in the New Zealand population, and our ability to make international comparisons.Key research questions were as follows:To what extent and how is gambling participation in New Zealand gendered?What are the relationships between gendered gambling participation and age, ethnicity and gambling problems?How do factors associated with problematic gambling interact with gender?MethodsRecruitment and samplingNew analyses were conducted on baseline data from the New Zealand National Gambling Study (NGS), a nationally representative prospective cohort study of gambling and health in adults aged 18+ years ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>252</RecNum><Prefix>see full design and methods reported in </Prefix><DisplayText>(see full design and methods reported in Abbott, Bellringer, Garrett, & Kolandai-Matchett, 2017)</DisplayText><record><rec-number>252</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1557264233">252</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, Maria</author><author>Garrett, Nick</author><author>Kolandai-Matchett, Komathi</author></authors></contributors><titles><title>Design and Methods of the New Zealand National Gambling Study, a Prospective Cohort Study of Gambling and Health: 2012–2019</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>1242-1269</pages><volume>15</volume><number>6</number><dates><year>2017</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(see full design and methods reported in Abbott, Bellringer, Garrett, & Kolandai-Matchett, 2017). Ethical approval for the NGS was granted by a regional Health and Disability Ethics Committee (HDEC Reference: NTY/11/04/040 and NTY/11/04/040/AM02). From March to October 2012, participants (N=6,251, Wave 1) were recruited via face-to-face household recruitment and interviewed using face-to-face computer-assisted personal interviews (CAPI). Geographically, the NGS covered all areas of New Zealand’s North and South Islands and Waiheke Island. The survey frame was selected from a list of 41,384 Statistics New Zealand meshblocks (the smallest geographical statistical unit for data collection) within this geographical coverage. The NGS used a systematic probability proportional to size (PPS) sampling ADDIN EN.CITE <EndNote><Cite><Author>Chromy</Author><Year>2008</Year><RecNum>352</RecNum><DisplayText>(Chromy, 2008)</DisplayText><record><rec-number>352</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1564353102">352</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Chromy, J. R. </author></authors><secondary-authors><author>Lavrakas, P.J</author></secondary-authors></contributors><titles><title>Probability proportional to size (PPS) sampling</title><secondary-title>Encyclopedia of survey research methods</secondary-title></titles><dates><year>2008</year></dates><publisher>Thousand Oaks: Sage Publications, Inc</publisher><urls></urls></record></Cite></EndNote>(Chromy, 2008) without replacement, in which a random selection of 1000 primary sampling units (PSUs) was taken from the sample frame of PSUs. This was followed by a random selection of private dwellings within each meshblock and finally an eligible respondent from each dwelling. The participation rate (calculated by dividing the number of interviews by the number of estimated eligible participants) was 63.7%. Major ethnic minority groups (Māori, Pacific, and Asian) were oversampled to enable ethnic comparisons. The unweighted percentage of female participants was 57.7%. The unweighted percentages of participants who identified with each prioritised ethnic group, were Māori (18.6%), Pacific (12.4%), Asian (12.8%), European/Other (55.25), and not reported (1%).MeasuresThe survey instrument for the 2012 National Gambling Survey was extensive. Key areas utilised in the following analyses included:Gambling participation (frequency and expenditure)All participants were asked about past year participation in different gambling activities. For each activity reported, participants were asked additional questions such as frequency, typical monthly expenditure, typical session length (in relation to electronic gaming machines only), reasons for gambling, and gambling wins/losses. Survey instrument content for gambling participation appears in Figure 1 below.Figure 1: NGS survey instrument measures for gambling participation reproduced from Abbott et al (2017). Leisure activitiesAssessment of leisure activities places gambling participation in a wider context ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2011</Year><RecNum>272</RecNum><DisplayText>(Wardle et al., 2011)</DisplayText><record><rec-number>272</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559168541">272</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Wardle, Heather</author><author>Moody, A</author><author>Spence, S</author><author>Orford, J</author><author>Volberg, R</author><author>Jotangia, D</author><author>Griffiths, M</author><author>Hussey, D</author><author>Dobbie, F</author></authors></contributors><titles><title>British Gambling Prevalence Survey 2010</title></titles><dates><year>2011</year></dates><pub-location>London: National Centre for Social Research</pub-location><publisher>The Gambling Commission</publisher><urls></urls></record></Cite></EndNote>(Wardle et al., 2011). The assessment of specific leisure activities in the NGS followed the measure used in the 2010 British Prevalence survey ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2011</Year><RecNum>272</RecNum><DisplayText>(Wardle et al., 2011)</DisplayText><record><rec-number>272</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559168541">272</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Wardle, Heather</author><author>Moody, A</author><author>Spence, S</author><author>Orford, J</author><author>Volberg, R</author><author>Jotangia, D</author><author>Griffiths, M</author><author>Hussey, D</author><author>Dobbie, F</author></authors></contributors><titles><title>British Gambling Prevalence Survey 2010</title></titles><dates><year>2011</year></dates><pub-location>London: National Centre for Social Research</pub-location><publisher>The Gambling Commission</publisher><urls></urls></record></Cite></EndNote>(Wardle et al., 2011). As it elicits information on how leisure time is spent more broadly, it enables identification of risk and protective factors for problem gambling prevalence and incidence. Survey instrument content for participation in leisure activities appears in REF _Ref15294059 \h Figure 2 below.Figure 2: NGS survey instrument measures for leisure participation reproduced from Abbott et al (2017)Problem gamblingProblem Gambling Severity Index. The nine-item Problem Gambling Severity Index (PGSI) (Ferris & Wynne, 2001) was used to measure severity of gambling problems in a past 12 month time frame.Significant life eventsParticipants were asked whether they had experienced any of the following life events in the past 12 months: Death of someone close to you, divorce, legal difficulties, major injury or illness, marriage or finding a relationship partner, troubles with work boss or superiors, retirement, pregnancy or new family addition, major change to financial situation, taking on a mortgage or significant loan, increase in arguments with someone you are close to, moving house, moving to a new town/city, major change in living or work conditions, earthquake or natural disaster, any other significant life event.Mental healthGeneral psychological distressThe Kessler-10 (K-10) questionnaire was included to provide a continuous measure of general psychological distress that is responsive to change over time. The K-10 has been well validated internationally. Its brevity and simple response format are attractive features. It also produces a summary measure indicating probability of currently experiencing an anxiety or depressive disorder (Kessler & Mroczek, 1994).Quality of life assessed by the WHOQoL-8, an eight item version of a widely used measure. This short form has been used in a number of countries, is robust psychometrically, and overall performance is strongly correlated with scores from the original WHOQoL instrument (Schmidt, Muhlan & Power, 2005).Alcohol use/misuseTo identify hazardous alcohol consumption or active alcohol use disorders (including alcohol abuse or dependence) a brief version (AUDIT-C, three-item scale) of the Alcohol Use Disorders Identification Test (AUDIT) (Saunders et al., 1993) was administered.Substance use/misuseTobaccoSurvey instrument content for tobacco use appears in Figure 3 below.Figure 3: NGS survey instrument measures for tobacco use, reproduced from Abbott et al (2017). Other drugsSurvey instrument content for other drug use appears in Figure 4 below. Figure 4: NGS survey instrument measures for other drug use, reproduced from Abbott et al (2017).New Zealand Deprivation IndexThe New Zealand Deprivation Index measures the level of socio-economic deprivation in meshblock geographical areas. It is created from Census data. The 2006 version was used, based on the latest census at the time. The index data are based on average socio-economic circumstances of the population in a meshblock and not to individuals. It is a ten-item scale with a score of 1 indicating residence in the least deprived decile and a score of 10 indicating residence in the most deprived decile (Salmond, Crampton & Atkinson, 2007).DemographicsDemographic questions included ethnicity, age, country of birth, educational attainment, employment status, religion, household size, and personal and household income, see Abbott et al (2017). AnalysesWeightingsTo ensure national representativeness, each of the survey participants was assigned a survey weight. Weighting calculation details are reported in full by Abbott and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Abbott</Author><Year>2017</Year><RecNum>252</RecNum><DisplayText>(2017)</DisplayText><record><rec-number>252</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1557264233">252</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, Maria</author><author>Garrett, Nick</author><author>Kolandai-Matchett, Komathi</author></authors></contributors><titles><title>Design and Methods of the New Zealand National Gambling Study, a Prospective Cohort Study of Gambling and Health: 2012–2019</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>1242-1269</pages><volume>15</volume><number>6</number><dates><year>2017</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(2017). In brief, each respondent represented between 200 and 500 adults in the New Zealand population. Benchmark adjustments amended any disproportions in participants’ age, gender, or ethnicity relative to the 2013 Census expectations. The sums of the population weights within 24 demographic cells were compared with the Census 2013 counts within those cells. The nested cells used for these comparisons were gender (two levels), age group (three levels), and ethnicity (four levels). The population weights were adjusted by the factor E i / O i where E i is the Census 2013 count for the ith.cell and O i is the sum of the population weights for the ith.cell.Descriptive analyses Descriptive tables were produced, adjusted by the sample weights to examine the differences by gender. Numbers and frequencies were produced for the dichotomous (Yes/No) and categorical variables, such as age group and gambling participation, and differences were examined using chi-square tests. For the continuous expenditure measures, number that participated in that gambling activity, mean expenditure and standard deviation, Median expenditure, and range of expenditures were produced for those that participated. Differences between genders were examined using the Wilcoxon Rank-Sum test.Construction of gambling and leisure behaviour categories and analysis by genderThe NGS includes a mixture of ordinal and continuous measures for gambling participation and expenditure, most of which are not normally distributed. Gambling behaviour categories were constructed by reducing the multitude of gambling behaviour variables using exploratory factor analysis. The resultant factors suggested some underlying dimensions of the gambling behaviour and hence core profiles of gambling behaviour within the sample. After categories were constructed, gender differences were examined adjusting for age and ethnicity as well as the standard sample weights used throughout the analyses.Factor analysis procedureThe dataset was limited to participants who had reported gambling on at least one activity in the last 12 months. Gambling variables were then limited to those where participation was greater than 3% for the unweighted data (note that participation rates are adjusted for sample weights in below tables). Ten variables were removed: Poker for money/prizes online, poker for money/prizes in a commercial venue, Keno online, sports betting via TAB (NZ terrestrial, NZ telephone/internet, overseas organisation), horse/dog race betting (overseas betting organisation or TAB), text games or competitions, and overseas internet gambling for money/prizes. Factor analysis was carried out on weighted data.To further reduce complexity, and reduce the impact on analysis of small numbers associated with some specific categories, the 11 ordinal gambling frequency categories were collapsed into the following standardised ordinal categories: Frequency Recoding= 0-if no gambling in this activity in last year 1-if less than once per month 2-if between once once per week and once per month3-if more than once per week Large variability and skewed distributions of expenditure across the gambling activities was managed by 33% percentile categorisation. For each gambling activity where the expenditure was greater than 0, one third of the participants that reported that activity were allocated to each of the categories:Expenditure Recoding= 0-if no expeniture in this activity in last year 1-if less than 33% percentile 2-if between 33% percentile and 66% percentile 3-if more than 66% percentile A factor analysis was then undertaken to identify the key dimensions of gambling across the reported activities. A varimax rotation was undertaken to assist with the optimal choice of factor composition. Kaiser’s criterion was used to determine the optimal number of factors.The results of the factor analysis were then utilised to create two types of factor scores for individuals. The first summed the scores of the individual variables within each factor, to produce scores of magnitude of gambling (incorporating factor loadings for both frequencies and expenditure measures). The second was coded ‘Yes’ or “No” as to whether any of the categorised activities were reported i.e. a measure of individual alignment with the gambling behaviour.Leisure activities engaged in in a typical month (including gambling as a leisure activity), were coded as 1 or 0 (‘Yes’ or ‘No’) for participation. Factor analysis was utilised to create factors that were then coded ‘Yes’ or “No” as to whether any of those activities were reported i.e. a measure of prevalence of these combined activities. To examine the differences in gender participation for the factor categories a logistic regression analysis was undertaken with participation as the outcome variables and examining the gender difference with the female gender as the reference group. The results were adjusted for age and ethnicity as well as sample weights. Magnitude measures across genders were then compared using a Wilcoxon rank sum test.Modelling of factors for at risk gambling by genderThe dataset was limited to those who had gambled in the last year, and who were classified into ‘Not at risk’ (PGSI score of 0) and ‘At risk” (PGSI score >0). A multiple variable logistic regression was undertaken to examine the impact of gambling and leisure behaviour categorisation on at-risk gambling by gender. The first step was to investigate which subset of the confounding factors was associated with at risk gambling, these factors included mental health (K-10), tobacco and drug use, WHO Quality of Life, NZ Individual Deprivation Index (NZiDep), migrant status, number of life events in last year, income (personal and household), education, employment status, religion, household size, and geographical region; adjusting for age, ethnicity, and sampling weights. The final step of modelling, starting with these confounding factors, examined the impact of the gambling and leisure behaviour categories, including interactions with gender. The resultant model included only the statistically significant factors and interactions. Separate models by gender were also developed to examine whether there were major gender differences in confounding and behaviour factors.ResultsDescriptive statisticsFew demographic differences between men and women There were no significant differences between men and women for the majority of socio-demographic variables measured in the NGS ( REF _Ref8204944 \h \* MERGEFORMAT Table 2). A higher proportion of men (42.6%) were not religious compared with women (33.7%). It was also found that a slightly higher proportion of women (11.1%) reported living alone than men (8.1%). Table SEQ Table \* ARABIC 2: Social demographics by gender?FemaleMale?Social demographic variablesN%N%p-value*Total32611002990100?Age Group 18 – 24 years33510.339413.10.10 25 – 34 years55517.048616.2 35 – 44 years60918.752917.7 45 – 54 years63019.356919.0 55 – 64 years48614.945515.2 65+ years64019.655518.5?Ethnic Group European/Other236272.4220073.50.66 Māori34910.630310.1 Asian33610.330210.1 Pacific1614.91484.9 Not reported531.6371.2?Arrival in NZ NZ Born231270.9211870.80.97 Before 200878724.171924.0 2008 or later1624.91525.0?Religion No religion110233.7127542.6<0.001 Anglican53116.245315.1 Catholic46414.233611.2 Presbyterian34310.52678.9 Other Christian54716.743314.4 Other religion2678.12237.4 Religion not reported70.220?Household Size136411.12438.10.012109733.6107135.8354916.853918.0467520.761220.45+57417.652417.5?Location Auckland9803089529.90.06 Wellington34010.432410.8 Christchurch1795.42237.4 Rest of NZ176354.0154851.7?*chi-square testMore women reported deprivation than menMore women reported a lower personal income than men, for example 71% of women earned less than $40,000 per year, compared with 48% of men ( REF _Ref8204996 \h \* MERGEFORMAT Table 3). Fewer women reported earning more than $80,000 per year in comparison to men (5.4% vs. 17.8%). There was less difference between men and women in regard to household income, 35.6% of women had a household income of $40,000 or less, in comparison to 27.2% of men. Overall, women reported more deprivation, as measured by NZiDep, in comparison to men. A greater proportion of men (60.7%) than women (52.8%) reported no deprivation (scored 0 on the NZiDep). A greater proportion of women than men scored 3 or higher on the scale (11.8% vs. 9.2%), though the difference in percentage points reduced as deprivation increased. More men held a vocational or trade qualification than women (31.6% vs. 13.7%), however more women had gained a university degree or higher (44.5% vs. 32.4%). A greater proportion of men were employed than women (71% vs. 57.6%), and more women identified as being a student/homemaker or retired in comparison to men (33.2% vs. 20.7%).Table SEQ Table \* ARABIC 3: Socioeconomic status by gender?FemaleMaleSocioeconomic variablesN%N%p-value*?Total32611002990100Highest Education QualificationNo formal Qualification52916.242614.2<0.001Secondary School Qualification83025.464821.6Vocational or Trade Qualification44913.794531.6University Degree or higher145244.597032.4Employment StatusEmployed188157.6212371.0<0.001Unemployed2728.32327.7Student/Homemaker/Retired108533.262020.7Other220.6140.4Personal Income<$20,000124641.070824.8<0.001$20,001-$40,00091730.268424.0$40,001-$60,00047815.755419.4$60,001-$80,0002287.539113.7$80,001-$100,000782.52157.5>$100,000892.929510.3Household Income<$20,00051918.134212.6<0.001$20,001-$40,00050217.539714.6$40,001-$60,00038313.337813.9$60,001-$80,00038013.238414.2$80,001-$100,00036412.738214.1>$100,0007162582130.3Individual NZ Deprivation Index0172352.8181760.7<0.001171922.062921.0242212.92608.731474.51244.141183.6832.75641.9421.46411.2210.67190.5100.3860.130.1?*chi-square testWomen reported more psychological distress than menAs outlined in REF _Ref9238597 \h \* MERGEFORMAT Table 4, while the majority of women and men were in the low probability range for psychological distress, a higher proportion of women compared with men had a very high probability of distress (2.1% vs. 1.3%). Proportionally more men than women showed hazardous alcohol use (42.0% vs. 32.7%), used recreational drugs (19.3% vs. 10.4%), and were either current smokers (21.2% vs. 16.3%) or ex-smokers (59.2% vs. 27.3%). On the other hand, there were no significant differences between the number of significant life events men and women experienced in the past 12 months, and quality of life scores.Table SEQ Table \* ARABIC 4: Life events, quality of life, mental health, and tobacco and drug use by gender?FemaleMale?N%N%?p-value*Total32611002990100?Number of Life Events in past yearNone87126.783928.10.12182825.481827.4264219.750917.0338311.734411.542377.32428.15+3019.22357.9Not Reported1?1??WHO Quality of LifeBelow Median (0-24)138542.5124941.80.25Median Score (25)3099.533911.3Above Median (26-32)156348139946.8Not Reported4?3??Psychological distress (Kessler scores)Low probability (10-15)232471.3227376.10.001Moderate probability (16-21)65920.254518.3High probability (22-29)2086.41314.4Very high probability (30-50)672.1391.3Not Reported3?1??At Risk Alcohol Use (AUDIT-C)No219167.3173458.0<0.0001Yes106532.7125442.0Not Reported5?2??Recreational Drug UseNo292089.5241480.8<0.0001Yes34110.457619.3?Tobacco SmokingCurrent Smoker53016.363321.2<0.0001Ex-Smoker80024.581627.3Never Smoker193059.2154051.5Not Reported1?1??*chi-square testMen and women reported broadly similar past year gambling participation A similar proportion of women and men reported that they did not engage in any gambling activities over the past year (20.4% c.f. 20.0%), REF _Ref8209384 \h \* MERGEFORMAT Table 5. Further the order of the most popular activities (lottery, raffles, scratch tickets, bets with friends, pub and casino EGMS) did not much differ by gender. No significant gender differences were detected between participation rates for casino and club EGMS, horse/dog track betting (NZ track or overseas), lotto online, overseas casino gambling, keno (online or in store), or overseas internet gambling. Women were more likely than men to gamble on New Zealand raffles/lotteries (49.9% vs. 43.4%), Instant Kiwi or other scratch tickets (36.3% vs. 28.0%), text games or competitions (3.2% vs. 2.1%), and Housie or bingo (2.2% vs. 0.09%). While men were statistically more likely than females to report buying lotto tickets from a store (62.7% vs. 59.1%), placing bets with friends/workmates (17.1% vs. 12.3%) and gambling on pub EGMs (12.6% vs 10.3), the percentage differences were small. Activities more clearly preferred by men than women included TAB in person (9.6% vs. 5.9%), playing cards for money (14.8% vs. 4%), casino table games in New Zealand (5.3% vs. 2.2%), and TAB gambling at an event, in person, or using telephone, online, or an interactive TV (12.4% vs. 2.7%). Table SEQ Table \* ARABIC 5: Total participation in gambling activities in the past 12 months by gender?FemaleMale?Gambling activityNo.%No.%p-valueNo gambling in last 12 months66420.459720.00.72Lotto from a store192959.1187662.70.02New Zealand raffle/lottery162949.9130043.4<0.0001Instant Kiwi tickets or other scratch tickets118536.384228.1<0.0001Bets with friends/workmates for money/prizes40212.351217.1<0.0001Pub EGMs33810.337912.60.02Casino EGMs2467.52719.00.08Horse/dog race betting (at the track)2397.32618.70.1Horse/dog race betting (TAB in person)1935.92889.6<0.0001Club EGMs1885.71615.30.57Lotto online1454.41605.30.18Casino (overseas)1163.51123.70.73Text game or competition1053.2642.10.04Cards for money (not in casino)732.21936.4<0.0001Casino table games (New Zealand)732.21595.3<0.0001Keno from a store732.2722.40.69Housie or bingo752.2300.10.0002Horse/dog race betting (TAB telephone, online, interactive TV)541.61284.2<0.0001Poker for money/prizes (friends/family private residence)401.21464.8<0.0001Sports betting (TAB at event)381.11374.5<0.0001Sports betting (TAB in person)280.81515.0<0.0001Sports betting (TAB telephone, online, interactive TV)280.8882.9<0.0001Poker for money/prizes (commercial venue in NZ)190.5872.9<0.0001Short-term speculative investment170.5401.30.004Keno online190.5230.70.44Overseas internet gambling for money/prizes180.5210.60.59Horse/dog race betting (overseas betting organisation or TAB)120.3140.40.66Poker for money/prizes online40.1240.7<0.0001Sports betting (overseas TAB, organisation/website)60.1160.50.15Men were more likely than women to gamble at least monthlyWomen (58.5%) were more likely than men (51.7%) to gamble less frequently than monthly ( REF _Ref9328961 \h \* MERGEFORMAT Table 6). The only gambling activity that women were more likely than men to participate in at least monthly was housie or bingo (0.7% c.f. 0.2). At least monthly participation in EGM gambling in casinos and/or clubs did not differ by gender, but men (4.4%) were more likely than women (2.4%) to gamble on EGMs in pubs. Men were also more likely than women to frequently bet (2.5% c.f. 0.6%) or play cards (2.0% c.f. 0.6%) with friends/others for money, engage in all modes of horse/dog race betting (6.3% c.f. 1.3%), poker (2.4% c.f. 0.1%) and sports betting (3.4% c.f. 0.1%).Table SEQ Table \* ARABIC 6: Total at least monthly participation in gambling activities by gender.?FemaleMale?Gambling activityNo.%No.%p-valueGambles less than monthly190558.5154351.7<0.001Lotto from a store99730.5109536.6<0.0001Instant Kiwi tickets or other scratch tickets39912.235111.70.61New Zealand raffle/lottery34610.633811.30.43Lotto online872.6913.00.45Pub EGMs 812.41334.4<0.0001Club EGMs541.6401.30.35Keno from a store341321.00.84Housie or bingo260.780.20.009Text game or competition240.7150.40.36Bets with friends/workmates for money/prizes210.6752.5<0.0001Cards for money (not in casino)220.6602.0<0.0001Casino EGMs (New Zealand)220.6331.10.14Horse/dog race betting (TAB in person)220.6993.3<0.0001Horse/dog race betting (at the track)140.4331.00.007Horse/dog race betting (TAB telephone, online, interactive TV)130.3561.8<0.0001Keno online130.3140.40.66Overseas internet gambling for money/prizes110.350.10.3Casino table games or EGMs (overseas)40.1100.09Poker for money/prizes (friends/family private residence)60.1421.3<0.0001Short-term speculative investments60.1140.40.1Sports betting (TAB at event)40.1391.20.006Casino table games (New Zealand)30100.30.17Horse/dog race betting (overseas betting organisation or TAB)1080.20.04Poker for money/prizes (commercial venue in NZ)30260.8<0.0001Poker for money/prizes online10110.3<0.0001Sports betting (TAB in person)10311.0<0.0001Sports betting (TAB telephone, online, interactive TV)10361.2<0.0001Sports betting (overseas TAB, organisation/website)-60.2Men tended to spend more per month on gambling than women on averageOn average, men had a higher total expenditure per month than women (median $34.12 vs. $23.61), REF _Ref15469530 \h Table 7. It should be recalled for context that women reported higher levels of financial deprivation and this section should be read with the likely impact of this on proportion of income spent on gambling in mind. Men also tended on average to spend more money than women on: Casino table games, horse/dog race betting, sports betting, casino EGMs, cards for money, lotto online, text games or competitions, instant kiwi and keno online. There was one gambling activity where women appeared, on average, to have significantly higher expenditure than men: Club EGMs (mean $43.17 vs. $32.48). However the median spend on this activity for men and women was similar, and the standard error for women’s spend was high, suggesting that there are some women (outliers) who spend a large amount of money on club EGMs. Women and men on average spent similar amounts on pub EGMs per month (median $16.25 cf. $17.46 respectively), and the remaining activities: casino table games, poker for money, house/bingo, keno from a store, raffle/lottery, lotto from a store, sports betting via TAB online, track betting, and short term speculative investments. Table SEQ Table \* ARABIC 7: Typical monthly expenditure on different gambling activities by gender?FemaleMale??No.MeanSEMedian(Min, Max)No.MeanSEMedian(Min, Max)p-valueTotal expenditure in $258980.1615.5123.61(1, 50528)2382190.4929.3434.12(1, 50304)<0.0001Short-term speculative investments174,006.70665.38609.94(28, 50000)366557.121435.423681.87(10, 50000)0.23Housie or bingo7540.625.3324.36(1, 480)3025.369.169.63(1, 200)0.22Casino EGMs (New Zealand)24548.455.3319.29(1, 1000)27160.457.2518.47(1, 1500)0.002Casino table games (New Zealand)7152.039.9918.64(1, 500)15882.1814.6436.11(2, 1200)0.12Horse/dog race betting (at the track)23923.442.1218.18(1, 500)25962.205.2239.31(1, 500)0.13Poker for money/prizes (commercial venue in NZ)19123.7495.7817.34(1, 3120)8737.225.1516.34(1, 800)0.25Club EGMs18843.1712.3016.31(1, 1000)16132.484.8716.88(1, 1200)0.002Pub EGMs33644.458.8416.25(1, 3500)37939.454.4117.46(1, 1300)0.23Casino table games or EGMs (overseas)11547.749.2915.87(1, 500)112109.8633.3428.86(1, 2000)0.01Lotto from a store192723.160.8814.29(1, 814)187527.060.7815.97(1, 1200)0.21Lotto online14521.461.7412.32(1, 150)15824.801.9818.58(2, 104)<0.0001Horse/dog race betting (TAB telephone, online, interactive TV)5423.633.6311.39(1, 100)12865.2714.7115.92(1, 1000)0.0002Horse/dog race betting (TAB in person)19318.372.119.36(1, 500)28844.505.1413.51(1, 660)<0.0001Cards for money (not in casino)7323.704.659.04(1, 400)19234.698.1714.89(1, 1000)<0.0001Poker for money/prizes (friends/family private residence)4024.366.068.51(1, 320)14628.865.579.92(1, 800)0.29Overseas internet gambling for money/prizes1734.803.758.02(1, 600)2185.8210.1733.99(3, 500)0.10Keno online1911.881.467.99(1, 80)2312.913.205.45(1, 60)0.0004Keno from a store719.951.076.54(1, 80)7210.822.215.35(1, 160)0.87Horse/dog race betting (overseas betting organisation or TAB)1216.193.386.52(2, 50)1282.643.7541.4(10, 200)0.73Sports betting (TAB in person)289.741.236.42(2, 50)15121.232.579.27(1, 240)0.0009Sports betting (TAB telephone, online, interactive TV)2810.261.696.15(1, 20)8822.863.899.55(1, 400)0.08Sports betting (TAB at event)389.641.916.11(1, 50)13735.179.8411.00(1, 2000)0.006New Zealand raffle/lottery16268.520.434.30(1, 1610)129711.450.674.69(1, 1200)0.62Bets with friends/workmates for money/prizes4038.070.634.18(1, 130)51213.820.977.74(1, 200)0.56Instant Kiwi tickets or other scratch tickets11856.700.324.09(1, 336)8408.100.774.29(1, 410)0.05Sports betting (overseas TAB, organisation/website)65.54-3.00(3, 10)16102.7334.869.72(1, 1010)0.06Text game or competition1054.041.091.00(1, 99)646.592.591.00(1, 100)<0.0001Poker for money/prizes (online)44.190.902.55(1, 10)2373.8724.7015.84(1, 500)0.95Men had higher odds than women of being classified as problem gamblers Examination of the association between PGSI and gender, demonstrated that men had higher odds of problem gambling (OR 2.56) than women ( REF _Ref11313116 \h \* MERGEFORMAT Table 8).Table SEQ Table \* ARABIC 8: Problem Gambling Severity Index (PGSI) scores by gender?FemaleMaleOR (95% CI)?p-valueNo.%No.%No gambling in last 12 months66420.459720.0 1.00No risk gambling239273.3214371.71.00 (0.86, 1.16)Low risk gambling1434.41645.51.28 (0.94, 1.73)Moderate risk gambling511.6571.91.25 (0.80, 1.96)Problem gambling120.4280.92.56 (1.30, 5.05)0.02More often than not, participation in leisure activities differed by gender REF _Ref9335761 \h Table 9 shows that for 11 out of 22 leisure activities, a greater proportion of women than men identified they participated in them in the last 12 months. Women were more likely than men to do arts and crafts (35.6% c.f. 12.8%), go shopping (65.7% c.f. 49.7%), read for pleasure (73.8% c.f. 58.5%), engage in meditation or other spiritual activities (15.0% c.f. 8.5%), engage in online social networking (29.2% c.f. 23.7%), take part in volunteer or unpaid community work (27.0% c.f. 21.6%), attend religious services (24.9% c.f. 19.8%), and visit museums or galleries (19.7% c.f. 15.2%). Men were more likely than women to go to pubs, clubs, and bars (32.5% c.f. 19.2%), play computer games (33.7% c.f. 23.0%), place bets and/or gamble (21.8% c.f. 15.2%), play a musical instrument (15.4% c.f. 9.6%), browse the internet (66.7% c.f. 61.2%), engage in sports activities and/or exercise (64.7% c.f. 60.5%), DIY activities or gardening (61.8% c.f. 57.9%), or other activities (6.0% c.f. 3.3%). For the three most popular leisure activities, the gender difference was negligible: Spending time with friends and/or family (95% c.f. 93.5%), watching television (92% c.f. 90.2%) and listening to music (79.2% c.f.76.1%). Men and women were also equally likely to identify: eating out at restaurants (47.4% c.f. 48%), going to the cinema, theatre, or to a concert (36.2% c.f. 33.5%), and shopping online (29.5% c.f. 29%) as leisure activities in which they participate.Table SEQ Table \* ARABIC 9: Participation in leisure activities by gender?FemaleMale??No.%No.%p-valueSpend time with friends/family310095279693.50.02Watch TV300292269990.20.04Listen to Music258379.2227576.10.01Read for pleasure240873.8175158.5<0.0001Go shopping214365.7148849.7<0.0001Browse the internet199961.2199466.70.0001Do sports/exercise197460.5193664.70.003Do DIY or gardening188857.9185061.80.0008Eat out at restaurants154847.4143648.00.71Go to cinema/theatre/concert118336.2100233.50.06Do art or craft116235.638412.8<0.0001Shop online96329.586729.00.71Online chat rooms or social networking sites95429.270923.7<0.0001Volunteer/Unpaid community work88127.064821.6<0.0001Attend religious services81224.959519.8<0.0001Play computer games75023.0100933.7<0.0001Visit museum or galleries64519.745515.2<0.0001Go to Pubs/Clubs/Bars62919.297232.5<0.0001Bet/Gamble49915.265421.8<0.0001Do Mediation/yoga/spiritual activities49115.02558.5<0.0001Play a musical instrument3149.646115.4<0.0001Other leisure activities1103.31806.0<0.0001No leisure activities-?20-Gender analysis of gambling and leisure engagement categoriesEleven underlying categories for gambling engagementFactor analysis identified 11 components with eigenvalues over Kaisers criterion of 1. Communalities for the frequency and expenditure categories were all >0.3, confirming that each of these variables share some common variance with the others. As such, all 11 of the components were retained in the final analysis. Component loadings and communalities of the rotated factor solution are presented in REF _Ref11313885 \h \* MERGEFORMAT Table 10. Each of the factors within the analysis are composed of both gambling activities and gambling expenditure variables. The results of the analysis show that, for the most part, gambling activities exist as distinct variables with the same underlying construct. The factors were as follows:Six components loaded onto Factor 1. The six variables consisted of the various types of horse/dog race betting (at the track; at the TAB in person; TAB telephone, online, interactive TV), and encompassed both frequency and expenditure variables. This factor was labelled “Horse/dog race betting”.Factor 2 contained both frequency and expenditure variables for cards for money (not in a casino), as well as the frequency and expenditure variables for poker for money/prizes (friends/family private residence). This factor was labelled “Cards not in a casino”.Factor 3 consisted of the frequency and expenditure variables for Pub EGMs as well as Club EGMs. This factor was labelled “Non-casino EGMs”.Factor 4 encompassed both frequency and expenditure variables for casino table games (New Zealand) as well as casino EGMs (New Zealand). This factor was labelled “Casino”.Factor 5 consisted of the frequency and expenditure variables for placing bets with friends/workmates for money/prizes, as well as sports betting (TAB at event). The label for this factor is “Betting with friends/sports betting”.Factor 6 contains the frequency and expenditure variables for buying Keno in a store, as well as for buying Lotto in a store. The label for this factor is “Lotto shop”Factor 7 consists of the frequency and expenditure variables for Housie or bingo. The label for this factor is “Housie/bingo”.Factor 8 consists of the frequency and expenditure variables for Lotto online and is labelled “Online Lotto”.Factor 9 contains the frequency and expenditure variables for casino table games or EGMs (overseas) and is labelled “Overseas casino”.Factor 10 contains the frequency and expenditure variables for Instant Kiwi or other scratch tickets and is labelled “Instant Kiwi”.Factor 11 consists of the frequency and expenditure variables for New Zealand raffles/lotteries and is labelled “New Zealand raffles”.?Factor 1Factor 2Factor 3Factor 4Factor 5Factor 6Factor 7Factor 8Factor 9Factor 10Factor 11Scale ItemsHorse/dog race bettingCards not in a casinoNon-casino EGMsCasinoBetting with friends/ sports bettingLotto ShopHousie/ bingoOnline LottoOverseas CasinoInstant KiwiNew Zealand RafflesHorse/dog race betting (at the track)- expenditure0.89Horse/dog race betting (at the track)- frequency0.86Horse/dog race betting (TAB in person)- expenditure0.85Horse/dog race betting (TAB in person)- frequency0.82Horse/dog race betting (TAB telephone, online, interactive TV)- expenditure0.77Horse/dog race betting (TAB telephone, online, interactive TV)- frequency0.75Cards for money- Non-casino- frequency0.93Poker for money/prizes (friends/family private residence)- frequency0.93Cards for money- Non-casino- expenditure0.92Poker for money/prizes (friends/family private residence)- expenditure0.92Club EGMs- expenditure0.81Club EGMs- frequency0.78Pub EGMs- expenditure0.75Pub EGMs- frequency0.68Casino table games or EGMs (New Zealand)- frequency0.83Casino table games or EGMs (New Zealand)- expenditure0.82Casino EGMs (New Zealand)- frequency0.80Casino EGMs (New Zealand)- expenditure0.74Bets with friends/workmates for money/prizes- expenditure0.89Bets with friends/workmates for money/prizes- frequency0.76Sports betting (TAB at event)- frequency0.48Sports betting (TAB at event)- expenditure0.48Keno from a store- expenditure0.92Keno from a store- frequency0.87Lotto from a store- expenditure0.39Lotto from a store- frequency0.15Housie or bingo- frequency0.93Housie or bingo- expenditure0.91Lotto online- frequency0.96Lotto online- expenditure0.93Casino table games or EGMs (overseas)- frequency0.90Casino table games or EGMs (overseas)- expenditure0.89Instant Kiwi or other scratch tickets- expenditure0.94Instant Kiwi or other scratch tickets- frequency0.81New Zealand raffle/lottery- expenditure0.97New Zealand raffle/lottery-frequency0.78Table SEQ Table \* ARABIC 10: Results of factor analysis of gambling activitiesSimilar leisure activities were reduced to six underlying leisure categoriesA factor analysis examining the communality between leisure activities found that there were six components that had eigenvalues over Kaisers criterion of 1. Communalities for the leisure categories were all >0.3, which confirms that each of the variables shares common variance with the others. One item, ‘go shopping’, loaded onto more than one factor with the same amount of communality. The item ‘go shopping’ was therefore considered to be a component of two factors. Component loadings and communalities of the rotated solution are shown in REF _Ref9337319 \h \* MERGEFORMAT Table 11.Each of the factors within the analysis are composed of a varying range of leisure activities. The results of the analysis show that leisure activities that participants identified as participating in often coincide with other activities that share some latent construct. The factors are as follows:Factor 1 was made up of four variables: browsing the internet; online chatrooms/social networking sites; shop online; and play computer games. The label chosen for this factor was “Online leisure” as all the variables were related to leisure activities whose participation involves using the internet.Factor 2 consisted of seven variables: do DIY or gardening; read for pleasure; do arts or crafts; voluntary or unpaid community work; do meditation/yoga/spiritual activities; do sports/exercise; and spend time with friends/family. This factor was labelled “Home/recreation” as the variables that fall into this factor are related to activities that can either be done at home, or just for fun.Factor 3 was made up of four variables: going to the cinema, theatre, or music concerts; eating out at restaurants; visit museums or galleries; and go shopping (to the high street or shopping mall). The label for this factor is “Going out” as the activities within this factor all involve doing things outside of the house. The variable ‘go shopping (to the high street or shopping mall) was also included in Factor 5 as the communalities were the same for both factors.Factor 4 consisted of three variables” play a musical instrument, listen to music, and attend religious service/place of worship. The label for this factor is “Music/religion”. As the relationship between attending religious services/places of worship and playing a musical instrument is unclear, it was decided that this label would better reflect the variables within this factor.Factor 5 consisted of two variables: go shopping (to the high street or shopping mall) and Watch TV. As with Factor 4, the relationship between these variables is unclear. The label for this factor is “TV/shopping” in order to make clear the two variables within this factor.Factor 6 consisted of two variables: going to pubs/bars/clubs; and betting or gambling. The label for this factor is “Pubs or gambling”Table SEQ Table \* ARABIC 11: Factor analysis of leisure activitiesFactor 1Factor 2Factor 3Factor 4Factor 5Factor 6ItemsOnline leisureHome/ recreationGoing outMusic/ religionTV/ shoppingPubs or gamblingBrowsing the internet0.93Online chat rooms/social networking sites0.70Shop online0.67Play computer games0.45Do DIY or gardening0.62Read for pleasure0.55Do arts or crafts0.50Voluntary or unpaid community work0.47Do meditation/yoga/spiritual activities0.41Do sports/exercise0.38Spend time with friends/family0.32Go to the cinema, theatre, or music concerts0.69Eat out at restaurants0.63Visit museums or galleries0.57Go shopping (to the high street or shopping mall)0.360.36Play a musical instrument0.66Listen to music0.44Attend religious service/place of worship0.36Watch TV0.78Go to pubs/bars/clubs0.69Betting or gambling0.32There were gender differences in most gambling engagement categories Multiple logistic regression analyses showed that gender differences existed in gambling activity preference ( REF _Ref9410253 \h \* MERGEFORMAT Table 12). Men had higher odds than women for engaging in card games not in a casino (OR 3.02), betting with friends/sports betting (OR 1.62), casino table and EGM gambling (OR 1.39), horse/dog race betting (OR 1.33), and buying Lotto products from a shop (OR 1.22). Men had lower odds than women for gambling on housie/bingo (OR 0.42), Instant Kiwi (OR 0.66) and NZ raffles (OR 0.78). No gender differences were identified for gambling on non-casino EGMs, at overseas casinos or on online Lotto. Engagement in leisure activity categories differed markedly by gender Gender differences in engagement in leisure categories were also found ( REF _Ref9410253 \h \* MERGEFORMAT Table 12). Men had lower odds than women for engagement in tv/shopping (OR 0.67), going out (0.71), music/religion (0.77). Men had higher odds than women for engagement with pubs or gambling (OR 1.81) as a leisure activity, and online leisure activities (OR 1.16). Only one leisure participation category was found to have no difference by gender: home/recreation.Gambling and leisure engagement did not appear to differ by age or ethnicityAdjustment of results for gambling and leisure engagement for any impact of age and ethnicity was marginal ( REF _Ref9410253 \h Table 12). Given that adjusted and unadjusted results seem very similar, age and ethnicity were unlikely to have an impact on whether someone engaged in a particular category of gambling or leisure activity or not.Table SEQ Table \* ARABIC 12: Logistic regression for associations with gender vs. gambling participation categories?FemalesMalesUnadjustedAdjusted*Gambling Participation CategoriesNPrev. %NPrev. %Odds ratio (95% CI)p-valueOdds ratio (95% CI)p-valueHorse/dog race betting33410.339713.31.34(1.11, 1.62)0.0031.33(1.10, 1.61)0.004Cards not in a casino732.21936.43.02(2.21, 4.13)<0.00013.02(2.20, 4.16)<0.0001Non-casino EGMs43413.342314.21.07(0.90, 1.28)0.451.04(0.87, 1.25)0.67Casino2618.0329111.42(1.15, 1.76)0.0011.39(1.12, 1.73)0.003Betting with friends/sports betting41212.756518.91.61(1.36, 1.90)<0.00011.62(1.35, 1.90)<0.0001Lotto Shop193059.2188062.91.17(1.03, 1.32)0.011.22(1.08, 1.39)0.002Housie/Bingo752.3301.00.43(0.27, 0.68)0.00040.42(0.26, 0.67)0.0003Online Lotto1454.51605.31.21(0.92, 1.60)0.181.23(0.93, 1.62)0.16Overseas casino1163.61123.81.03(0.76, 1.49)0.731.04(0.74, 1.46)0.84Instant Kiwi118536.384228.20.69(0.60, 0.78)<0.00010.66(0.58, 0.75)<0.0001New Zealand Raffles162950.0130043.50.77(0.68, 0.87)<0.00010.78(0.69, 0.88)<0.0001Leisure Participation CategoriesNPrev. %NPrev. %Odds ratio (95% CI)p-valueOdds ratio (95% CI)p-valueOnline Leisure229370.3220273.71.18(1.04, 1.34)0.011.16(1.02, 1.34)0.03Home/Recreation323399.1295398.80.69(0.42, 1.16)0.160.69(0.41, 1.16)0.16Going Out260379.8220573.70.71(0.62, 0.81)<0.00010.71(0.61, 0.81)<0.0001Music/Religion274784.2240880.60.78(0.67, 0.91)0.0010.77(0.65, 0.89)0.001TV/Shopping311495.5279093.30.67(0.51, 0.86)0.0020.67(0.52, 0.88)0.003Pubs or Gambling96429.6129043.31.82(1.60, 2.06)<0.00011.81(1.59, 2.06)<0.0001*adjusted for age and ethnicityWomen gambled to a similar extent to men in most gambling engagement categories REF _Ref9413061 \h \* MERGEFORMAT Table 13 shows participants’ composite scores for frequency and level of expenditure for the gambling engagement categories. These scores provide a measure of the magnitude of gambling engagement. For most gambling categories, magnitude of engagement was found to be similar for men and women. Men were shown to have a higher level of gambling magnitude than women in Casino table and EGM gambling, Horse/dog race betting, and Betting with Friends/Sports Betting.Table SEQ Table \* ARABIC 13: Composite scores by gender for the participation categories. ?FemaleMale?Gambling Participation CategoryNo.MeanMedianIQRNo.MeanMedianIQRp-valueCasino (/12)2615.725(4 – 6)3296.315(5 – 8)0.04Horse/dog race betting (/18)3346.735(4 – 9)3978.038(5 – 11)<0.0001Cards not in a Casino (/12)727.078(4 – 10)1937.908(6 – 10)0.69Non-casino EGMs (/12)4345.495(4 – 6)4235.725(4 -10)0.66Betting with friends/ Sports betting (/12)4124.925(4 – 5)5655.615(4 – 6)<0.0001Lotto Shop (/12)19304.104(4 – 4)18804.174(4 – 4)0.06Housie/bingo (/6)754.284(4 – 5)304.244(4 – 5)0.68Online Lotto (/6)1453.804(3 – 4)1603.934(3 – 4)0.87Overseas Casino (/6)1164.915(4 – 6)1125.145(4 – 6)0.13Instant Kiwi (/6)11844.424(4 – 5)8424.344(4 – 5)0.08New Zealand Raffles (/6)16294.364(4 – 5)13004.434(4 – 5)0.054Modelling of factors predicting at-risk gambling by genderEngagement in most gambling categories predicted at-risk gambling regardless of gender Multiple variable logistic regression examining problem gambling risk (at-risk vs no-risk) by gender showed that 8 gambling and leisure engagement categories were associated with increased risk for both men and women ( REF _Ref9413890 \h \* MERGEFORMAT Table 14). Those who played cards not in a casino has almost 3 times the odds of gambling in a risky manner compared with those who did not gamble on cards at a casino (OR 2.98). Similarly, engagement in casino tables or EGMs (OR 2.21), housie/bingo (OR 2.15), horse/dog race betting (OR 1.55), Lotto (OR 1.47) or Instant Kiwi (OR 1.37) was associated with risky gambling compared with men and women who did not take part in these activities. Going to the pub or gambling as a leisure activity (OR 1.51) was also associated with risky gambling compared with those who do not engage in this category of leisure activity. Engagement in online leisure activities (OR 0.72) was associated with lower odds for risky gambling compared with those who did not engage in leisure online.Table SEQ Table \* ARABIC 14: Examination of at-risk gambling behaviour by gender??At Risk Gambling** (%)OR*95% CI*p-value*CasinoNo71.00-Yes25.62.21(1.55, 3.15)<0.0001Horse/dog race bettingNo81.00-Yes16.21.55(1.10, 2.20)0.01Cards not in a CasinoNo7.91.00-Yes32.82.98(1.94, 4.57)<0.0001Non-casino EGMs x GenderFemale No EGM4.31.00-Female EGM25.74.15(2.76, 6.24)Male EGM24.83.65(2.38, 5.61)Male No EGM7.51.76(1.26, 2.44)<0.0001Lotto ShopNo71.00-Yes9.91.47(1.02, 2.12)0.04Housie/bingoNo8.71.00-Yes32.22.15(1.30, 1.81)0.003Instant KiwiNo6.21.00-Yes13.51.37(1.04, 1.81)0.03Leisure: Online LeisureNo8.61.00-Yes9.40.72(0.54, 0.98)0.04Leisure: Pub or GamblingNo6.21.00-Yes13.51.51(1.14, 2.01)0.005*adjusted for age, ethnicity, NZDI, K-10, as well as sample weights.**at risk gambling (scoring low, moderate, problem gambler on PGSI). Adjusted for sample weights.Women who gambled on non-casino EGMs were at even greater gambling risk than men Engagement with non-casino EGMs was a gambling risk factor for both women and men ( REF _Ref9413890 \h Table 14). Gender also interacted with non-casino EGM engagement, to suggest heightened risk for women (4.15 times), compared to men (3.65 times) in relation to women who do not engage. Men who did not gamble on non-casino EGMs had 1.76 times the odds of at-risk gambling, compared with women who did not participate on non-casino EGMs, suggesting that these men experienced some harm from other gambling forms. Women were at greatest gambling risk when engaging with non-casino EGMs or cards When risk factors were modelled separately for women, the gambling engagement categories associated with the greatest gambling risk were non-casino EGMs, and cards not in a casino ( REF _Ref9422037 \h \* MERGEFORMAT Table 15). Women who participated in these activities had nearly four times the odds of gambling at a risky level (OR 3.92 and 3.86 respectively) compared with women who did not participate. Women who engaged in housie/bingo or casino table/EGM gambling had over twice the odds for risky gambling compared with women who did not engage in these activities (OR 2.31 and 2.27 respectively). Women who engaged in horse/dog race betting and instant kiwi had roughly one and a half times the odds of gambling at a risky level compared with women who did not engage in these activities (OR 1.68 and 1.53). Women who identified going to pubs and gambling as leisure activities had nearly twice the odds for risky gambling compared with women who did not count these activities as part of their leisure time (OR 1.91). Table SEQ Table \* ARABIC 15: Examination of at-risk gambling behaviour for women??At Risk Gambling** (%)OR*95% CI*p-value*CasinoNo6.11.00-Yes24.32.27(1.39, 3.73)0.001Horse/ dog race bettingNo6.81.00-Yes15.41.68(1.03, 2.74)0.04Cards not in a CasinoNo7.11.00-Yes37.93.86(1.81, 8.20)0.0005Non-casino EGMsNo4.31.00-Yes25.73.92(2.50, 6.14)<0.0001Housie/bingoNo7.21.00-Yes33.02.31(1.18, 4.51)0.01Instant KiwiNo4.61.00-Yes11.91.53(1.02, 2.31)0.04Pubs or GamblingNo4.91.00-Yes141.91(1.27, 2.87)0.002*adjusted for age, ethnicity, NZDI, K-10, as well as sample weights**at-risk gambling (scoring low, moderate, problem gambler on PGSI). Adjusted for sample weightsMen at-risk were more likely to gamble on non-casino EGMs, cards, casino gambling and lotto.Four gambling engagement categories were identified as being risk-factors for men, as outlined in REF _Ref9424004 \h \* MERGEFORMAT Table 16. Cards not in a casino was the category identified as causing the most risk, with men who participate in this category having three times the odds (OR 3.1) of gambling at a risky level compared with men who do not participate. Engagement in non-casino EGM gambling, casino gambling and lotto each carried at least twice the odds of risky gambling compared with those men who did not engage. As with women, non-casino EGMs were shown to be a risk factor, though there was less risk for men (OR 2.65) in comparison to men who did not engage in this form, than there was for women. One gambling engagement category that was shown to be a risk factor for men, but not for women, was buying Lotto in a shop. Men who bought lotto had twice the odds (OR 2.15) of gambling at a risky level compared with men who did not buy lotto.Table SEQ Table \* ARABIC 16: Examination of at-risk gambling behaviour for males??At Risk Gambling** (%)OR*95% CI*p-value*CasinoNo8.01.00-Yes26.62.34(1.42, 3.87)0.0009Cards not in a CasinoNo8.71.00-Yes30.93.10(1.84, 5.23)<0.0001Non- Casino EGMsNo7.51.00-Yes24.82.65(1.69, 4.16)<0.0001Lotto ShopNo7.81.00-Yes11.32.15(1.23, 3.73)0.007Music/ReligionNo10.81.00-Yes10.50.64(0.41, 0.99)0.05*adjusted for age, ethnicity, NZDI, K-10, as well as sample weights**at-risk gambling (scoring low, moderate, problem gambler on PGSI). Adjusted for sample weightsMen who identified music/religion as leisure activities were less likely to be gambling at a risky levelIf men identified music/religion as leisure activity, they were less likely to be classified as gambling at a risky level (OR 0.64), than men who did not identify music/leisure. There were no leisure activities that were associated with greater odds of at-risk gambling for men. This is contrary to women, for whom engaging in pub/gambling activities was associated with at-risk gambling. Discussion The purpose of this study was to explore the extent and nature of ‘gendered’ gambling participation in New Zealand, the relationships with age and ethnicity, and how factors associated with problematic gambling may interact with gender. Engagement in gambling and leisure activities was found to be unrelated to age and ethnicity in this study. Therefore this discussion focuses on the relationship between engagement and problem gambling risk for men and women. Gambling engagement in New Zealand appears gendered, particularly for men Overall, New Zealand women participated in fewer forms of gambling activities in comparison to men, and men gambled more frequently, on a wider range of activities, and with greater expenditure. 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ADDIN EN.CITE.DATA (Hing & Breen, 2001; Nelson et al., 2006; Wenzel & Dahl, 2009). Gambling engagement in New Zealand also appeared to be gendered in many of the generally accepted ways, suggesting that women tend to favour more chance-based gambling, while more men are drawn to participate in a wider range of activities and perceived skill-based gambling ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2014</Year><RecNum>42</RecNum><DisplayText>(Svensson & Romild, 2014)</DisplayText><record><rec-number>42</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386457">42</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author></authors></contributors><titles><title>Problem gambling features and gendered gambling domains amongst regular gamblers in a Swedish population-based study</title><secondary-title>Sex Roles</secondary-title></titles><periodical><full-title>Sex Roles</full-title></periodical><pages>240-254</pages><volume>70</volume><number>5-6</number><dates><year>2014</year></dates><isbn>0360-0025</isbn><urls></urls></record></Cite></EndNote>(Svensson & Romild, 2014). When similar activities were collapsed into 11 broad categories for gambling engagement (incorporating measurement of type of activity, frequency and expenditure), the most gendered gambling engagement category was card games and poker not in a casino, where men had over three times the odds of engaging compared to women. This is in line with population studies in Sweden and Canada ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2014</Year><RecNum>42</RecNum><DisplayText>(Kairouz et al., 2017; Svensson & Romild, 2014)</DisplayText><record><rec-number>42</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386457">42</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author></authors></contributors><titles><title>Problem gambling features and gendered gambling domains amongst regular gamblers in a Swedish population-based study</title><secondary-title>Sex Roles</secondary-title></titles><periodical><full-title>Sex Roles</full-title></periodical><pages>240-254</pages><volume>70</volume><number>5-6</number><dates><year>2014</year></dates><isbn>0360-0025</isbn><urls></urls></record></Cite><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017; Svensson & Romild, 2014). Men also had higher odds than women of engaging in betting with friends/sports betting, casino gambling, and horse/dog race betting, and lower odds of engaging in housie/bingo, instant kiwi and raffles, also broadly in line with traditionally observed gender differences PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Qb3RlbnphPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48
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ADDIN EN.CITE.DATA (Grant & Kim, 2004; Grant, Odlaug, & Mooney, 2012; Potenza, Maciejewski, & Mazure, 2006). New Zealand men had slightly greater odds of buying lottery tickets from a shop than women. This finding is more congruent with Swedish and UK population research which has found that buying lottery tickets to be popular among both men and women ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2014</Year><RecNum>42</RecNum><DisplayText>(Svensson & Romild, 2014; Wardle et al., 2011)</DisplayText><record><rec-number>42</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386457">42</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author></authors></contributors><titles><title>Problem gambling features and gendered gambling domains amongst regular gamblers in a Swedish population-based study</title><secondary-title>Sex Roles</secondary-title></titles><periodical><full-title>Sex Roles</full-title></periodical><pages>240-254</pages><volume>70</volume><number>5-6</number><dates><year>2014</year></dates><isbn>0360-0025</isbn><urls></urls></record></Cite><Cite><Author>Wardle</Author><Year>2011</Year><RecNum>272</RecNum><record><rec-number>272</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559168541">272</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Wardle, Heather</author><author>Moody, A</author><author>Spence, S</author><author>Orford, J</author><author>Volberg, R</author><author>Jotangia, D</author><author>Griffiths, M</author><author>Hussey, D</author><author>Dobbie, F</author></authors></contributors><titles><title>British Gambling Prevalence Survey 2010</title></titles><dates><year>2011</year></dates><pub-location>London: National Centre for Social Research</pub-location><publisher>The Gambling Commission</publisher><urls></urls></record></Cite></EndNote>(Svensson & Romild, 2014; Wardle et al., 2011). In Sweden, gambling domains are described as strongly gendered, and men are consistently over-represented in gambling activities associated with high risk of gambling problems ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2011</Year><RecNum>39</RecNum><DisplayText>(Romild et al., 2016; Svensson et al., 2011)</DisplayText><record><rec-number>39</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520385155">39</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author><author>Nordenmark, Mikael</author><author>M?nsdotter, Anna</author></authors></contributors><titles><title>Gendered gambling domains and changes in Sweden</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>193-211</pages><volume>11</volume><number>2</number><dates><year>2011</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>Romild</Author><Year>2016</Year><RecNum>43</RecNum><record><rec-number>43</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386899">43</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Romild, Ulla</author><author>Svensson, Jessika</author><author>Volberg, Rachel</author></authors></contributors><titles><title>A gender perspective on gambling clusters in Sweden using longitudinal data</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>43-60</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(Romild et al., 2016; Svensson et al., 2011). In in the current New Zealand study there were no gender differences in engagement in non-casino EGM gambling – a form of gambling consistently associated with increased risk of experiencing problems ADDIN EN.CITE <EndNote><Cite><Author>Dickerson</Author><Year>1993</Year><RecNum>225</RecNum><DisplayText>(Dickerson, 1993)</DisplayText><record><rec-number>225</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543197076">225</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dickerson, Mark</author></authors></contributors><titles><title>Internal and external determinants of persistent gambling: Problems in generalising from one form of gambling to another</title><secondary-title>Journal of Gambling Studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>225-245</pages><volume>9</volume><number>3</number><dates><year>1993</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Dickerson, 1993). Analysis of Swedish population data has suggested that gender differences in the prevalence of gambling problems in Sweden may be at least partly explained by higher relapse rates among men ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>353</RecNum><DisplayText>(Abbott, Romild, & Volberg, 2018)</DisplayText><record><rec-number>353</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1564451738">353</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author><author>Romild, Ulla</author><author>Volberg, Rachel</author></authors></contributors><titles><title>The prevalence, incidence, and gender and age‐specific incidence of problem gambling: results of the Swedish longitudinal gambling study (Swelogs)</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>699-707</pages><volume>113</volume><number>4</number><dates><year>2018</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(Abbott, Romild, & Volberg, 2018). Swedish women and men have similar first‐time problem gambling incidence rates, therefore current gender prevalence differences may diminish in the future ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>353</RecNum><DisplayText>(Abbott, Romild, et al., 2018)</DisplayText><record><rec-number>353</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1564451738">353</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author><author>Romild, Ulla</author><author>Volberg, Rachel</author></authors></contributors><titles><title>The prevalence, incidence, and gender and age‐specific incidence of problem gambling: results of the Swedish longitudinal gambling study (Swelogs)</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>699-707</pages><volume>113</volume><number>4</number><dates><year>2018</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(Abbott, Romild, et al., 2018). The current findings support the notion that the availability of EGM gambling in community settings can contribute to making gambling accessible to women, exposing more women to gambling risk ADDIN EN.CITE <EndNote><Cite><Author>Volberg</Author><Year>2003</Year><RecNum>15</RecNum><DisplayText>(Volberg, 2003)</DisplayText><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1511824549">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Volberg, Rachel A</author></authors></contributors><titles><title>Has there been a" feminization" of gambling and problem gambling in the United States?</title><secondary-title>Journal of Gambling Issues</secondary-title></titles><periodical><full-title>Journal of Gambling Issues</full-title></periodical><number>8</number><dates><year>2003</year></dates><isbn>1910-7595</isbn><urls></urls></record></Cite></EndNote>(Volberg, 2003). They also align with research from the UK. Overall it seems that gambling participation in the UK is now relatively similar amongst males and females, with some differences in the mode of gambling engaged with that are similar to those identified in the current study (Wardle et al., 2011). In the UK, gambling has traditionally been associated with products available through outlets primarily dedicated to gambling (e.g., casinos, betting shops, bingo halls). Increasingly gambling opportunities have become available in environments in which gambling is not the primary activity available (e.g., supermarkets, pubs, social clubs, online), and women feel comfortable/accepted ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2015</Year><RecNum>119</RecNum><DisplayText>(Wardle, 2015, 2017)</DisplayText><record><rec-number>119</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1532302957">119</key></foreign-keys><ref-type name="Thesis">32</ref-type><contributors><authors><author>Wardle, Heather</author></authors></contributors><titles><title>Female gambling behaviour: a case study of realist description</title></titles><dates><year>2015</year></dates><pub-location>Glasgow</pub-location><publisher>University of Glasgow</publisher><urls></urls></record></Cite><Cite><Author>Wardle</Author><Year>2017</Year><RecNum>90</RecNum><record><rec-number>90</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530063872">90</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wardle, Heather</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>The 'refeminisation' of gambling: Social, cultural and historical insights into female gambling behaviour in Great Britain</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Wardle, 2015, 2017). In the current study, when New Zealand women gambled, they gambled to a similar extent (composite scores for frequency and level of expenditure) to men. Men were shown to have a higher gambling magnitude than women in three categories only: Casino gambling (table and EGM), Horse/dog race betting, and Betting with Friends/Sports Betting. This is in line with the findings from the UK described above, but may associate some New Zealand gender differences in gambling engagement, with activities and environments that encourage participation by men, and may conversely be less accessible to women. Casino table gambling can be constructed as conducive to performances of traditional forms of masculinity ADDIN EN.CITE <EndNote><Cite><Author>Hunt</Author><Year>2018</Year><RecNum>262</RecNum><DisplayText>(Hunt & Gonsalkorale, 2018)</DisplayText><record><rec-number>262</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559005548">262</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hunt, Christopher John</author><author>Gonsalkorale, Karen</author></authors></contributors><titles><title>Conformity to masculine norms among treatment-seeking male problem gamblers</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>408-419</pages><volume>18</volume><number>3</number><dates><year>2018</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Hunt & Gonsalkorale, 2018), e.g. takes place in public ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2017</Year><RecNum>88</RecNum><DisplayText>(Svensson, 2017)</DisplayText><record><rec-number>88</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1529896963">88</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Svensson, Jessika</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gambling and gender in Sweden</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>153-161</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Svensson, 2017), facilitates gambling as a ‘rush’ and/or display of cognitive ability ADDIN EN.CITE <EndNote><Cite><Author>Walker</Author><Year>2005</Year><RecNum>261</RecNum><DisplayText>(Walker, Hinch, & Weighill, 2005)</DisplayText><record><rec-number>261</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559005071">261</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Walker, Gordon J</author><author>Hinch, Thomas D</author><author>Weighill, AJ</author></authors></contributors><titles><title>Inter-and intra-gender similarities and differences in motivations for casino gambling</title><secondary-title>Leisure Sciences</secondary-title></titles><periodical><full-title>Leisure Sciences</full-title></periodical><pages>111-130</pages><volume>27</volume><number>2</number><dates><year>2005</year></dates><isbn>0149-0400</isbn><urls></urls></record></Cite></EndNote>(Walker, Hinch, & Weighill, 2005), and a sense of competing with/against others ADDIN EN.CITE <EndNote><Cite><Author>Burger</Author><Year>2006</Year><RecNum>260</RecNum><DisplayText>(Burger, Dahlgren, & MacDonald, 2006)</DisplayText><record><rec-number>260</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559005027">260</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Burger, Terry D</author><author>Dahlgren, Donna</author><author>MacDonald, Christine D</author></authors></contributors><titles><title>College students and gambling: An examination of gender differences in motivation for participation</title><secondary-title>College Student Journal</secondary-title></titles><periodical><full-title>College Student Journal</full-title></periodical><pages>704-715</pages><volume>40</volume><number>3</number><dates><year>2006</year></dates><isbn>0146-3934</isbn><urls></urls></record></Cite></EndNote>(Burger, Dahlgren, & MacDonald, 2006). Cassidy ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Cassidy</Author><Year>2014</Year><RecNum>206</RecNum><DisplayText>(2014)</DisplayText><record><rec-number>206</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329729">206</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>‘A place for men to come and do their thing’: constructing masculinities in betting shops in L ondon</title><secondary-title>The British journal of sociology</secondary-title></titles><periodical><full-title>The British journal of sociology</full-title></periodical><pages>170-191</pages><volume>65</volume><number>1</number><dates><year>2014</year></dates><isbn>0007-1315</isbn><urls></urls></record></Cite></EndNote>(2014) explored how the legalisation and commercialisation of cash betting, produced betting shops in London as traditionally working class masculinised places, where sexism is actively maintained. In this sense, it is not so much that women prefer bingo/housie, and men bookmakers/TAB, but rather that environments produce and shape gender and gambling practices ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2017</Year><RecNum>90</RecNum><DisplayText>(Wardle, 2017)</DisplayText><record><rec-number>90</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1530063872">90</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Wardle, Heather</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>The 'refeminisation' of gambling: Social, cultural and historical insights into female gambling behaviour in Great Britain</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Wardle, 2017). The current research suggests that in New Zealand, the way in which casino, racing and betting contexts may provide a setting for masculinities to be performed could be explored, and implications for harm prevention identified.Given women’s higher levels of socioeconomic deprivation, it is possible that women gambled a greater proportion of their available resources than men. This could render gender differences in gambling engagement negligible in relation to potential impacts on wellbeing, or even point to greater proportional investment of time and money in gambling by women. While the current study did not explore this, future research should explore gendered gambling engagement (time and money spent) in relation to leisure time and disposable income available to men and women.Heightened risk for women, especially in non-casino EGM contextsThis study has demonstrated a strong association between engagement with non-casino EGMs and gambling that can be considered risky, for both genders. While New Zealand women and men engaged in non-casino EGM gambling to a similar extent, the gambling risk associated with this practice was heightened for women – over and above the effects of many other factors usually related to gambling risk (e.g. age, ethnicity, socio-economic deprivation and psychological distress and other coexisting issues). These findings support international gender analyses of population datasets which seek to add nuance to the oft reported notion that males are universally found to be at elevated risk for problem gambling ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>6</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Abbott, 2017a; Abbott, Binde, et al., 2018)</DisplayText><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502937388">6</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>The epidemiology and impact of gambling disorder and other gambling-related harm</title><secondary-title>2017 WHO Forum on alcohol, drugs and addictive behaviours</secondary-title></titles><dates><year>2017</year></dates><pub-location>Geneva</pub-location><publisher>World Health Organisation</publisher><urls></urls></record></Cite><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>245</RecNum><record><rec-number>245</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554758831">245</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Binde, Per</author><author>Clark, Luke</author><author>Hodgins, David</author><author>Johnson, Mark</author><author>Manitowabi, Darrel</author><author>Quilty, Lena</author><author>Sp?ngberg, Jessika</author><author>Volberg, Rachel</author><author>Walker, Douglas</author><author>Williams, Robert</author></authors></contributors><titles><title>Conceptual Framework of Harmful Gambling: An International Collaboration (Third Edition)</title></titles><dates><year>2018</year></dates><pub-location>Guelph, Ontario, Canada.</pub-location><publisher>Gambling Research Exchange Ontario (GREO)</publisher><urls></urls></record></Cite></EndNote>(e.g. Abbott, 2017a; Abbott, Binde, et al., 2018). For example, controlling for age and multiple gambling domains, Swedish female regular gamblers were even more likely than male gamblers to be classified as problem gamblers ADDIN EN.CITE <EndNote><Cite><Author>Svensson</Author><Year>2014</Year><RecNum>42</RecNum><DisplayText>(Svensson & Romild, 2014)</DisplayText><record><rec-number>42</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386457">42</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author></authors></contributors><titles><title>Problem gambling features and gendered gambling domains amongst regular gamblers in a Swedish population-based study</title><secondary-title>Sex Roles</secondary-title></titles><periodical><full-title>Sex Roles</full-title></periodical><pages>240-254</pages><volume>70</volume><number>5-6</number><dates><year>2014</year></dates><isbn>0360-0025</isbn><urls></urls></record></Cite></EndNote>(Svensson & Romild, 2014). This analysis has yet to be replicated in New Zealand, and is worthy of further exploration. Indeed, the present study support Svensson and Romild’s ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Svensson</Author><Year>2014</Year><RecNum>42</RecNum><DisplayText>(2014)</DisplayText><record><rec-number>42</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520386457">42</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Svensson, Jessika</author><author>Romild, Ulla</author></authors></contributors><titles><title>Problem gambling features and gendered gambling domains amongst regular gamblers in a Swedish population-based study</title><secondary-title>Sex Roles</secondary-title></titles><periodical><full-title>Sex Roles</full-title></periodical><pages>240-254</pages><volume>70</volume><number>5-6</number><dates><year>2014</year></dates><isbn>0360-0025</isbn><urls></urls></record></Cite></EndNote>(2014) suggestion that although proportionally fewer women gambling than men, it may be somewhat ‘riskier’ for women to gamble on many gambling forms, than it is for men – with implications for health promotion for women as a population group. Conceptually, this notion recalls analysis of a ‘bimodal’ distribution for gambling among Pacific peoples (Abbott and Volberg, 2000). A bimodal distribution occurs where the population group contains proportionately large numbers of non- and infrequent gamblers as well as frequent-participation/high-expenditure gamblers. Gambling risk for women was associated with six gambling engagement categories in order of risk magnitude: non-casino EGMs, cards not in a casino, housie/bingo, casino gambling, horse/dog race betting and Instant Kiwi. Risky gambling for men was associated with only four gambling categories: cards not in a casino, non-casino EGMs, casino gambling and buying lottery tickets from a shop. This finding supports the exploration of the contextual factors for risky gambling for women across each of the different gambling forms, and the development of gender-aware public health strategies and interventions. The role of environmental factors in promoting women’s gambling and heightened risk, including advertising and other industry practices is undertheorised and underexplored in gambling studies ADDIN EN.CITE <EndNote><Cite><Author>McCarthy</Author><Year>2019</Year><RecNum>265</RecNum><DisplayText>(McCarthy et al., 2019; Newall et al., 2019)</DisplayText><record><rec-number>265</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081760">265</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCarthy, Simone</author><author>Thomas, Samantha L</author><author>Bellringer, Maria E</author><author>Cassidy, Rebecca</author></authors></contributors><titles><title>Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice</title><secondary-title>Harm reduction journal</secondary-title></titles><periodical><full-title>Harm reduction journal</full-title></periodical><pages>18</pages><volume>16</volume><number>1</number><dates><year>2019</year></dates><isbn>1477-7517</isbn><urls></urls></record></Cite><Cite><Author>Newall</Author><Year>2019</Year><RecNum>334</RecNum><record><rec-number>334</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563319735">334</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Newall, Philip WS</author><author>Moodie, Crawford</author><author>Reith, Gerda</author><author>Stead, Martine</author><author>Critchlow, Nathan</author><author>Morgan, Amber</author><author>Dobbie, Fiona</author></authors></contributors><titles><title>Gambling marketing from 2014 to 2018: A literature review</title><secondary-title>Current Addiction Reports</secondary-title></titles><periodical><full-title>Current Addiction Reports</full-title></periodical><pages>49-56</pages><volume>6</volume><number>2</number><dates><year>2019</year></dates><isbn>2196-2952</isbn><urls></urls></record></Cite></EndNote>(McCarthy et al., 2019; Newall et al., 2019). A clearer picture of sociocultural and environmental factors influencing women’ gambling and harm is emerging, which challenges assumptions by researchers about how (and why) gambling is gendered, and how these patterns are maintained and changed. Factors to do with the setting and location in which an activity occurs (e.g. organisation of space, social dynamics) influence the gambling experience ADDIN EN.CITE <EndNote><Cite><Author>Reith</Author><Year>2005</Year><RecNum>267</RecNum><DisplayText>(Reith, 2005)</DisplayText><record><rec-number>267</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559093322">267</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Reith, Gerda</author></authors></contributors><titles><title>The age of chance: Gambling in Western culture</title></titles><dates><year>2005</year></dates><publisher>Routledge</publisher><isbn>1134680309</isbn><urls></urls></record></Cite></EndNote>(Reith, 2005). For example, Kairouz and colleagues demonstrated how gambling settings and a range of associated contextual factors influenced time and money spent by university students in Québec, Canada across gambling sessions ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2015</Year><RecNum>268</RecNum><DisplayText>(Kairouz, Paradis, & Monson, 2015)</DisplayText><record><rec-number>268</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559093540">268</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Paradis, Catherine</author><author>Monson, Eva</author></authors></contributors><titles><title>Does context matter? A multilevel analysis of gambling settings among undergraduates</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>518-527</pages><volume>23</volume><number>6</number><dates><year>2015</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(Kairouz, Paradis, & Monson, 2015). The current findings associate gambling risk for New Zealand women, with the non-casino EGM gambling context specifically (as opposed to EGM gambling in general). Additionally, identifying spending time in potential non-casino EGM venues (pubs) and gambling as leisure activities conferred additional risk on women, but not men. This suggests that New Zealand community pub environments may be particularly problematic for women in relation to gambling risk. Multiple individual level factors have been linked to women’s EGM gambling practices and problems, e.g. loneliness, isolation, avoidance, boredom, emotional distress, and intensity seeking ADDIN EN.CITE <EndNote><Cite><Author>Nower</Author><Year>2004</Year><RecNum>263</RecNum><DisplayText>(Nower, Derevensky, & Gupta, 2004; Trevorrow & Moore, 1998)</DisplayText><record><rec-number>263</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081589">263</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nower, Lia</author><author>Derevensky, Jeffrey L</author><author>Gupta, Rina</author></authors></contributors><titles><title>The relationship of impulsivity, sensation seeking, coping, and substance use in youth gamblers</title><secondary-title>Psychology of addictive behaviors</secondary-title></titles><periodical><full-title>Psychology of addictive behaviors</full-title></periodical><pages>49</pages><volume>18</volume><number>1</number><dates><year>2004</year></dates><isbn>1939-1501</isbn><urls></urls></record></Cite><Cite><Author>Trevorrow</Author><Year>1998</Year><RecNum>264</RecNum><record><rec-number>264</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081681">264</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Trevorrow, Karen</author><author>Moore, Susan</author></authors></contributors><titles><title>The association between loneliness, social isolation and women's electronic gaming machine gambling</title><secondary-title>Journal of gambling studies</secondary-title></titles><periodical><full-title>Journal of Gambling Studies</full-title></periodical><pages>263-284</pages><volume>14</volume><number>3</number><dates><year>1998</year></dates><isbn>1050-5350</isbn><urls></urls></record></Cite></EndNote>(Nower, Derevensky, & Gupta, 2004; Trevorrow & Moore, 1998). There remains insufficient attention to how environmental and industry factors contribute to gambling harm for women ADDIN EN.CITE <EndNote><Cite><Author>McCarthy</Author><Year>2019</Year><RecNum>265</RecNum><DisplayText>(McCarthy et al., 2019)</DisplayText><record><rec-number>265</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081760">265</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCarthy, Simone</author><author>Thomas, Samantha L</author><author>Bellringer, Maria E</author><author>Cassidy, Rebecca</author></authors></contributors><titles><title>Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice</title><secondary-title>Harm reduction journal</secondary-title></titles><periodical><full-title>Harm reduction journal</full-title></periodical><pages>18</pages><volume>16</volume><number>1</number><dates><year>2019</year></dates><isbn>1477-7517</isbn><urls></urls></record></Cite></EndNote>(McCarthy et al., 2019). Environmental and sociocultural factors create the conditions of possibility for gambling problems and harm ADDIN EN.CITE <EndNote><Cite><Author>Clarke</Author><Year>2006</Year><RecNum>266</RecNum><DisplayText>(Clarke et al., 2006)</DisplayText><record><rec-number>266</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081899">266</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Clarke, Dave</author><author>Tse, Samson</author><author>Abbott, Max</author><author>Townsend, Sonia</author><author>Kingi, Pefi</author><author>Manaia, Wiremu</author></authors></contributors><titles><title>Key indicators of the transition from social to problem gambling</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>247</pages><volume>4</volume><number>3</number><dates><year>2006</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Clarke et al., 2006). The current study suggests that women’s gambling harm minimisation and reduction efforts should engage with the particular experiences of women, and consider the role that community pub engagement specifically, plays in their lives. Gambling on card games or poker in private settings may be as risky for women as for men Though a much smaller proportion of women engaged in card games or poker compared with men (6.4% men, 2.2% women), women engaged in a way that was broadly similar to men (in terms of frequency and level of expenditure), and was associated with a similar gambling risk level. Any engagement with card games or poker in a private/non-casino setting was associated with 3 times the gambling risk, regardless of gender. Engaging in these activities/settings was associated with the highest odds ratio for risky gambling for men (OR 3.1), and the second highest for women (OR 3.86), in comparison to all other gambling engagement categories.Canadian research supports the notion that the setting in which poker takes place (online, public, private residence) can influence the relationship between gender and problem gambling severity index scores, poker spend and poker debt ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2017</Year><RecNum>136</RecNum><DisplayText>(Kairouz et al., 2017)</DisplayText><record><rec-number>136</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1535585834">136</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Monson, Eva</author><author>Robillard, Chantal</author></authors><secondary-authors><author>Bowden-Jones, Henrietta</author><author>Prever, Fulvia</author></secondary-authors></contributors><titles><title>Gender comparitive analysis of gambling patterns in Canada</title><secondary-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</secondary-title></titles><periodical><full-title>Gambling Disorders in Women: An International Female Perspective on Treatment and Research</full-title></periodical><pages>173-186</pages><dates><year>2017</year></dates><pub-location>New York</pub-location><publisher>Taylor & Francis</publisher><isbn>1317238591</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2017). However, this research found that while women were much less likely to gamble on poker, when they did engage they did so with similar frequency and spend to men across online and public settings, but not in private spaces. Raisborough and Bhatti ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Raisborough</Author><Year>2007</Year><RecNum>269</RecNum><DisplayText>(2007)</DisplayText><record><rec-number>269</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559166759">269</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Raisborough, Jayne</author><author>Bhatti, Mark</author></authors></contributors><titles><title>Women's leisure and auto/biography: Empowerment and resistance in the garden</title><secondary-title>Journal of leisure research</secondary-title></titles><periodical><full-title>Journal of leisure research</full-title></periodical><pages>459-476</pages><volume>39</volume><number>3</number><dates><year>2007</year></dates><isbn>0022-2216</isbn><urls></urls></record></Cite></EndNote>(2007) argued that male dominated gambling activities can be experienced as a means of empowerment for women, allowing them to play with and resist socially recognised gender norms. Research on women’s card game and poker experiences is extremely limited. Abarbanel ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Abarbanel</Author><Year>2012</Year><RecNum>205</RecNum><DisplayText>(2012)</DisplayText><record><rec-number>205</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329645">205</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abarbanel, B Lillian</author><author>Bernhard, Bo J</author></authors></contributors><titles><title>Chicks with decks: the female lived experience in poker</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>367-385</pages><volume>12</volume><number>3</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(2012) explored how gender dynamics are a key feature of poker play in public spaces in the U.S, which tended to be both male dominated and openly hostile to women (reminiscent of Cassidy’s 2014 experience of betting shops in London, UK). Some women poker players described how it was important for them to actively challenge stereotypes about women (e.g. as sensitive and/or accommodating) through aggressive high-stakes poker play at mixed tables ADDIN EN.CITE <EndNote><Cite><Author>Abarbanel</Author><Year>2012</Year><RecNum>205</RecNum><DisplayText>(Abarbanel & Bernhard, 2012)</DisplayText><record><rec-number>205</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329645">205</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abarbanel, B Lillian</author><author>Bernhard, Bo J</author></authors></contributors><titles><title>Chicks with decks: the female lived experience in poker</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>367-385</pages><volume>12</volume><number>3</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Abarbanel & Bernhard, 2012). Other women described entering women-only poker tournaments as a way of protecting themselves from sexism, and allowing them to focus on building their skill in the game. New Zealand competitive poker player Renae Baker has commented publicly that the strength of women’s poker is growing and that from her perspective “female intuition” gives women an advantage in the game ADDIN EN.CITE <EndNote><Cite><Author>Rotorua Daily Post</Author><Year>2019</Year><RecNum>314</RecNum><DisplayText>(Rotorua Daily Post, 2019)</DisplayText><record><rec-number>314</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561685544">314</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Rotorua Daily Post,</author></authors></contributors><titles><title>Rotorua's Renae Baker takes home $19,650 in World Poker Tour final</title></titles><volume>2019</volume><number>28 June</number><dates><year>2019</year></dates><publisher>NZ Herald Online</publisher><urls><related-urls><url>;(Rotorua Daily Post, 2019).Taken together, the above suggests that from a public health perspective, those who engage with card games/poker in private spaces in New Zealand are an important group to consider in relation to harm prevention and reduction strategies. Gender dynamics may provide context to women’s practices, and risk, particularly if women are engaging in risky/aggressive play strategies to actively counter gender stereotypes in poker environments. Further research into New Zealanders’ gambling on card games or poker, particularly in private settings is necessary to understand risk, prevention, and the role of gender dynamics for this not insignificant population group. ConclusionThis study has identified gender differences in gambling engagement, combined with heightened gambling risk for women in particular community gambling contexts (pubs and private residences) in New Zealand. The results presented here add further support to the notion that gambling contexts and environments are involved in producing/shaping gender differences in gambling practices and risk, and should be understood if effective interventions are to be developed ADDIN EN.CITE <EndNote><Cite><Author>Kairouz</Author><Year>2015</Year><RecNum>268</RecNum><DisplayText>(Kairouz et al., 2015)</DisplayText><record><rec-number>268</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559093540">268</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kairouz, Sylvia</author><author>Paradis, Catherine</author><author>Monson, Eva</author></authors></contributors><titles><title>Does context matter? A multilevel analysis of gambling settings among undergraduates</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>518-527</pages><volume>23</volume><number>6</number><dates><year>2015</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(Kairouz et al., 2015). These results highlight the importance of multidisciplinary approaches which go beyond psychological framings to consider gambling spaces, products and behaviours in their social and historical contexts. Community gambling venues offer women a safe and secure recreational environment, as well as a place of social acceptance in the context of broader societal marginalisation ADDIN EN.CITE <EndNote><Cite><Author>Holdsworth</Author><Year>2012</Year><RecNum>4</RecNum><DisplayText>(Holdsworth et al., 2012; McCarthy et al., 2019)</DisplayText><record><rec-number>4</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1488855594">4</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holdsworth, Louise</author><author>Hing, Nerilee</author><author>Breen, Helen</author></authors></contributors><titles><title>Exploring women's problem gambling: A review of the literature</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>199-213</pages><volume>12</volume><number>2</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>McCarthy</Author><Year>2019</Year><RecNum>265</RecNum><record><rec-number>265</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559081760">265</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCarthy, Simone</author><author>Thomas, Samantha L</author><author>Bellringer, Maria E</author><author>Cassidy, Rebecca</author></authors></contributors><titles><title>Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice</title><secondary-title>Harm reduction journal</secondary-title></titles><periodical><full-title>Harm reduction journal</full-title></periodical><pages>18</pages><volume>16</volume><number>1</number><dates><year>2019</year></dates><isbn>1477-7517</isbn><urls></urls></record></Cite></EndNote>(Holdsworth et al., 2012; McCarthy et al., 2019). These spaces may also offer women the opportunity to actively challenge gender norms ADDIN EN.CITE <EndNote><Cite><Author>Abarbanel</Author><Year>2012</Year><RecNum>205</RecNum><DisplayText>(Abarbanel & Bernhard, 2012; Raisborough & Bhatti, 2007)</DisplayText><record><rec-number>205</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540329645">205</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abarbanel, B Lillian</author><author>Bernhard, Bo J</author></authors></contributors><titles><title>Chicks with decks: the female lived experience in poker</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>367-385</pages><volume>12</volume><number>3</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite><Cite><Author>Raisborough</Author><Year>2007</Year><RecNum>269</RecNum><record><rec-number>269</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559166759">269</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Raisborough, Jayne</author><author>Bhatti, Mark</author></authors></contributors><titles><title>Women's leisure and auto/biography: Empowerment and resistance in the garden</title><secondary-title>Journal of leisure research</secondary-title></titles><periodical><full-title>Journal of leisure research</full-title></periodical><pages>459-476</pages><volume>39</volume><number>3</number><dates><year>2007</year></dates><isbn>0022-2216</isbn><urls></urls></record></Cite></EndNote>(Abarbanel & Bernhard, 2012; Raisborough & Bhatti, 2007). Gender sensitive and context specific research should inform targeted women’s gambling harm reduction and health promotion practices, particularly in community spaces in New Zealand.ADDRESSING GAMBLING HARM FOR WOMEN IN NEW ZEALANDThe current study considered women’s gambling harm as a multi-faceted phenomenon. It has demonstrated how gambling studies can be complicit in perpetuating problematic and restrictive constructions of women (e.g. as responsible for familial wellbeing, and saturated with potentially negative emotion). It has suggested that gambling studies can also function as a key site for the individualisation of women’s gambling and harm, obscuring consideration of social and contextual determinants which include gender discourses. Analysis of experiences of harm has shown how gender issues and ideology can infuse both gambling practices and harm. Community gambling venues provided some New Zealand women with easily accessible, convenient and safe spaces, in the context of material constraints on their lives produced by gender roles and ideology, coercive control and violence. Gender discourses which privileged men within families were found to both produce and exacerbate gambling harm for women, whether they were gambling themselves or experiencing the effects of someone else’s gambling. Gender analysis of population data suggested that gender is related to gambling practices and risk, and that community gambling contexts (pubs and private residences) are particularly associated with women’s gambling risk in New Zealand.This study highlights some key tensions between positioning women’s gambling harm as an individual issue (to be ‘treated’), and a public health approach which necessitates attending to the social contexts and environments in which gambling and harm for women is produced and experienced. Adams et al. ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Adams</Author><Year>2009</Year><RecNum>247</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>247</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554849245">247</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Raeburn, John</author><author>De Silva, Kawshi</author></authors></contributors><titles><title>A question of balance: prioritizing public health responses to harm from gambling</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>688-691</pages><volume>104</volume><number>5</number><dates><year>2009</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(2009) outlined opportunities to respond to gambling as a public health issue afforded by New Zealand’s Gambling Act ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>New Zealand legislation</Author><Year>2003</Year><RecNum>161</RecNum><DisplayText>(2003)</DisplayText><record><rec-number>161</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537919074">161</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>New Zealand legislation,</author></authors></contributors><titles><title>Gambling Act</title></titles><volume>2018</volume><number>26 September</number><dates><year>2003</year></dates><pub-location>Wellington</pub-location><publisher>Parliamentary Counsel Office</publisher><urls><related-urls><url>;(2003) through: harm minimisation, health promotion, and the political determinants of gambling consumption. These authors provided the metaphor of the jaw, to describe how these elements function together. Harm minimisation is the top-down force addressing harm through governmental policies and practices. Health promotion supports communities to influence the environments in which health (and gambling) is produced in a bottom-up manner. Advocacy and critical gambling studies work to stimulate the political impetus or ‘bite’ that keeps the jaw engaged. The current study points to multiple promising avenues for addressing gambling harm for women via: reduction in EGM gambling opportunities in local community settings (harm minimisation), facilitating gender equality and community connectedness (health promotion), and gender-aware gambling harm reduction research and practice. This analysis of opportunities to address gambling harm for women in New Zealand is informed by critical gambling studies, intended to provoke and to stimulate engagement at all points on the harm prevention, minimisation and reduction continuum. Reducing EGM gambling opportunities in community settings Proximity and access to EGMs has long been related to harm across populations in New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>7</RecNum><DisplayText>(Abbott, 2017b; Pearce et al., 2008)</DisplayText><record><rec-number>7</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502938121">7</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>Gambling and Gambling Harm in New Zealand: A 28-Year Case Study</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>1-21</pages><dates><year>2017</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite><Cite><Author>Pearce</Author><Year>2008</Year><RecNum>312</RecNum><record><rec-number>312</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561672680">312</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pearce, Jamie</author><author>Mason, K</author><author>Hiscock, Rosemary</author><author>Day, Peter</author></authors></contributors><titles><title>A national study of neighbourhood access to gambling opportunities and individual gambling behaviour</title><secondary-title>Journal of Epidemiology & Community Health</secondary-title></titles><periodical><full-title>Journal of Epidemiology & Community Health</full-title></periodical><pages>862-868</pages><volume>62</volume><number>10</number><dates><year>2008</year></dates><isbn>0143-005X</isbn><urls></urls></record></Cite></EndNote>(Abbott, 2017b; Pearce et al., 2008), and internationally ADDIN EN.CITE <EndNote><Cite><Author>Rintoul</Author><Year>2013</Year><RecNum>23</RecNum><DisplayText>(Rintoul et al., 2013; Young et al., 2012)</DisplayText><record><rec-number>23</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520373445">23</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rintoul, Angela C</author><author>Livingstone, Charles</author><author>Mellor, Andrew P</author><author>Jolley, Damien</author></authors></contributors><titles><title>Modelling vulnerability to gambling related harm: How disadvantage predicts gambling losses</title><secondary-title>Addiction Research & Theory</secondary-title></titles><periodical><full-title>Addiction Research & Theory</full-title></periodical><pages>329-338</pages><volume>21</volume><number>4</number><dates><year>2013</year></dates><isbn>1606-6359</isbn><urls></urls></record></Cite><Cite><Author>Young</Author><Year>2012</Year><RecNum>227</RecNum><record><rec-number>227</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1543199287">227</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Young, Martin</author><author>Markham, Francis</author><author>Doran, Bruce</author></authors></contributors><titles><title>Too close to home? The relationships between residential distance to venue and gambling outcomes</title><secondary-title>International gambling studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>257-273</pages><volume>12</volume><number>2</number><dates><year>2012</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Rintoul et al., 2013; Young et al., 2012). EGMs have been constituted as a type of ‘environmental toxin’ from a public health perspective, such that “the primary cause of EGM-related harm is the design and delivery of the EGM product itself i.e. as first line of perpetration [of harm]” ADDIN EN.CITE <EndNote><Cite><Author>Borrell</Author><Year>2008</Year><RecNum>291</RecNum><Pages>270</Pages><DisplayText>(Borrell, 2008a, p. 270)</DisplayText><record><rec-number>291</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560120283">291</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Borrell, Jennifer</author></authors></contributors><titles><title>The ‘Public Accountability Approach’: suggestions for a framework to characterise, compare, inform and evaluate gambling regulation</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>265-281</pages><volume>6</volume><number>2</number><dates><year>2008</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Borrell, 2008a, p. 270). In New Zealand, very high problem gambling prevalence rates in deprived neighbourhoods are seen as a consequence of living with high concentrations of EGMs and socioeconomic deprivation ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2014</Year><RecNum>36</RecNum><DisplayText>(Abbott et al., 2014)</DisplayText><record><rec-number>36</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520383203">36</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garrett, N</author><author>Mundy-McPherson, S </author></authors></contributors><titles><title>New Zealand 2012 National Gambling Study: Gambling harm and problem gambling (Report No. 2)</title></titles><dates><year>2014</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University of Technology, Gambling & Addictions Research Centre</publisher><urls></urls></record></Cite></EndNote>(Abbott et al., 2014). Though heavily clustered in low-income communities, EGMs are widely accessible in pubs and clubs throughout New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2017</Year><RecNum>7</RecNum><DisplayText>(Abbott, 2017b)</DisplayText><record><rec-number>7</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1502938121">7</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>Gambling and Gambling Harm in New Zealand: A 28-Year Case Study</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>1-21</pages><dates><year>2017</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Abbott, 2017b). Regular contact with EGMs is also considered to be a class issue ADDIN EN.CITE <EndNote><Cite><Author>Markham</Author><Year>2015</Year><RecNum>153</RecNum><DisplayText>(Markham & Young, 2015)</DisplayText><record><rec-number>153</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537406753">153</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>Markham, Francis</author><author>Young, Martin</author></authors></contributors><titles><title>“Big gambling”: the rise of the global industry-state gambling complex</title></titles><dates><year>2015</year></dates><publisher>Taylor & Francis</publisher><isbn>1606-6359</isbn><urls></urls></record></Cite></EndNote>(Markham & Young, 2015). In New Zealand, people who lack formal qualifications or are unemployed are over-represented among regular EGM gamblers, and report high community-based EGM expenditure. This is despite overall population reductions in expenditure in recent years ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2014</Year><RecNum>36</RecNum><DisplayText>(Abbott et al., 2014)</DisplayText><record><rec-number>36</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520383203">36</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garrett, N</author><author>Mundy-McPherson, S </author></authors></contributors><titles><title>New Zealand 2012 National Gambling Study: Gambling harm and problem gambling (Report No. 2)</title></titles><dates><year>2014</year></dates><pub-location>Auckland</pub-location><publisher>Auckland University of Technology, Gambling & Addictions Research Centre</publisher><urls></urls></record></Cite></EndNote>(Abbott et al., 2014). Non-casino EGMs are associated with high problem gambling relapse rates, which partially explain static population gambling risk levels in the context of declining overall gambling participation in New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>135</RecNum><DisplayText>(Abbott, Bellringer, et al., 2018)</DisplayText><record><rec-number>135</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1534887305">135</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garret, N</author></authors></contributors><titles><title>New Zealand National Gambling Study: Wave 4 2015, Report number 6</title></titles><dates><year>2018</year></dates><pub-location>Auckland</pub-location><publisher>Gamblign and Addictions Research Centre, AUT University</publisher><urls></urls></record></Cite></EndNote>(Abbott, Bellringer, et al., 2018).Recent synthesis of evidence for effective harm reduction policy across multiple fields of ‘dangerous consumption’ (alcohol, tobacco, and gambling) has concluded that:Accessibility and exposure to gambling products, and to the promotion of these, is a key determinant of propensity to use and thus of propensity for harm… there is considerable scope for more nuanced and carefully considered action for harm prevention and minimisation. In particular, decision making around changes to accessibility are of considerable importance in determining the pattern of harmful gambling, its regressivity and impacts. Accessibility also needs to be re-framed around such issues as venue and site operating hours, average number of EGMs within venues, and the relationship of access to specific harms. ADDIN EN.CITE <EndNote><Cite><Author>Livingstone</Author><Year>2019</Year><RecNum>311</RecNum><Suffix> emphasis added</Suffix><Pages>5</Pages><DisplayText>(Livingstone et al., 2019, p. 5 emphasis added)</DisplayText><record><rec-number>311</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561672303">311</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Livingstone, Charles</author><author>Rintoul, Angela</author><author>De Lacy-Vawdon, C</author><author>Borland, R</author><author>Dietze, P</author><author>Jenkinson, R</author><author>Livingston, M</author><author>Room, R</author><author>Smith, B</author><author>Stoove, M</author><author>Winter, R</author><author>Hill, P</author></authors></contributors><titles><title>Identifing effective policy interventions to prevent gambling-related harm</title></titles><dates><year>2019</year></dates><pub-location>Melbourne</pub-location><publisher>Victorian Responsible Gambling Foundation</publisher><urls></urls></record></Cite></EndNote>(Livingstone et al., 2019, p. 5 emphasis added) Abbott ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Abbott</Author><Year>2006</Year><RecNum>300</RecNum><DisplayText>(2006)</DisplayText><record><rec-number>300</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560735448">300</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Abbott, Max</author></authors></contributors><titles><title>Do EGMs and problem gambling go together like a horse and carriage?</title><secondary-title>Gambling Research: Journal of the National Association for Gambling Studies (Australia)</secondary-title></titles><periodical><full-title>Gambling Research: Journal of the National Association for Gambling Studies (Australia)</full-title></periodical><pages>7</pages><volume>18</volume><number>1</number><dates><year>2006</year></dates><urls></urls></record></Cite></EndNote>(2006) argued that individual and environmental factors are likely to moderate the effects of exposure to EGMs, and that these factors must be thoroughly understood if intervention is to be successful. This study has suggested that contact with community-based EGMs is a gender issue in New Zealand. Gender norms, and socially prescribed responsibilities for familial and child wellbeing, actively facilitated some women’s regular contact with EGM gambling in their communities. These social norms and influences kept women close to home, and constrained their participation in alternative activities. Accordingly, while New Zealand women and men engaged in non-casino EGM gambling to a similar extent, the gambling risk associated with this practice was heightened for women (4.15 times the odds), compared to men (3.65 times the odds) in relation to women who do not engage. This analysis has suggested that in the context of broader societal constructions of gender and gender roles, community-based EGMs constitute a serious health-risk for women. Community EGM venue operators have a legal responsibility to look after their gambling patrons, akin to the care and consideration required when serving alcohol ADDIN EN.CITE <EndNote><Cite><Author>DIA</Author><Year>2014</Year><RecNum>307</RecNum><DisplayText>(DIA, 2014)</DisplayText><record><rec-number>307</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561595297">307</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Mystery shopper information summary: Class 4 venues</title></titles><dates><year>2014</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(DIA, 2014). Host responsibility practices are inconsistently carried out in New Zealand community EGM venues ADDIN EN.CITE <EndNote><Cite><Author>DIA</Author><Year>2017</Year><RecNum>306</RecNum><DisplayText>(DIA, 2014, 2017b)</DisplayText><record><rec-number>306</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561591270">306</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Sector report: Gaming machine mystery shopper exercise results</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite><Cite><Author>DIA</Author><Year>2014</Year><RecNum>307</RecNum><record><rec-number>307</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561595297">307</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Mystery shopper information summary: Class 4 venues</title></titles><dates><year>2014</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(DIA, 2014, 2017b). This is despite the availability of multiple products and initiatives designed to support venue staff to recognise signs of harmful gambling and respond appropriately ADDIN EN.CITE <EndNote><Cite><Author>HPA</Author><Year>2019</Year><RecNum>308</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. HPA, 2019)</DisplayText><record><rec-number>308</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561595463">308</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>HPA,</author></authors></contributors><titles><title>Gambling Host Responsibility</title></titles><volume>2019</volume><number>27 June</number><dates><year>2019</year></dates><pub-location>Wellington</pub-location><publisher>Health Promotion Agency</publisher><urls><related-urls><url>;(e.g. HPA, 2019). Industry representatives have identified a transient low skilled workforce as a fundamental barrier to the effective implementation of host responsibility training and practices in pubs ADDIN EN.CITE <EndNote><Cite><Author>DIA</Author><Year>2017</Year><RecNum>309</RecNum><DisplayText>(DIA, 2017a)</DisplayText><record><rec-number>309</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561596892">309</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>DIA,</author></authors><tertiary-authors><author>New Zealand Government</author></tertiary-authors></contributors><titles><title>Appendix F: Sector feedback on the results of gaming machine mystery shopper exercise</title></titles><dates><year>2017</year></dates><pub-location>Wellington</pub-location><publisher>Department of Internal Affairs</publisher><urls></urls></record></Cite></EndNote>(DIA, 2017a). A group of ten community EGM venue managers and staff canvassed about a harm minimisation tool in 2011 disagreed with the notion that gamblers could lose control or gamble for longer than they planned; any intervention to assist control was therefore perceived as either patronising or interfering ADDIN EN.CITE <EndNote><Cite><Author>Palmer du Preez</Author><Year>2014</Year><RecNum>310</RecNum><DisplayText>(Palmer du Preez et al., 2014)</DisplayText><record><rec-number>310</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561597545">310</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Palmer du Preez, K</author><author>Landon, J</author><author>Garrett, N</author><author>Bellringer, M</author><author>Page, A</author><author>Coomarasamy, C</author><author>Abbott, M</author></authors></contributors><titles><title>Investigation into the effects of gambling game characteristics, PIDs and pop-up technology on gambling and problem gambling behaviour in New Zealand</title></titles><dates><year>2014</year></dates><pub-location>Auckland</pub-location><publisher>Gambling and Addictions Research Centre, AUT University</publisher><urls></urls></record></Cite></EndNote>(Palmer du Preez et al., 2014). Venue managers spoken to in this study did not view gambling as their ‘core’ business; rather for some, it seemed that the gambling component of their work was an unwanted addition and the occasional extra work was a source of frustration. These notions and views may remain in circulation, effectively constraining the establishment of a culture of in-venue care. Barriers to effective host responsibility can only be understood and ameliorated through place-based studies which consider how help and harm are distributed in actual gambling environments. Bold policy action is called for to prevent gambling harm that is clearly associated with the availability of particular products in particular settings ADDIN EN.CITE <EndNote><Cite><Author>Wardle</Author><Year>2019</Year><RecNum>293</RecNum><DisplayText>(Wardle et al., 2019)</DisplayText><record><rec-number>293</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560223569">293</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wardle, Heather</author><author>Reith, Gerda</author><author>Langham, Erika</author><author>Rogers, Robert D</author></authors></contributors><titles><title>Gambling and public health: we need policy action to prevent harm</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>l1807</pages><volume>365</volume><dates><year>2019</year></dates><isbn>0959-8138</isbn><urls></urls></record></Cite></EndNote>(Wardle et al., 2019). New Zealand’s public health approach necessitates attending to the contexts in which gambling harm for women is occurring, at the level of the consumption environment and the nature of the products available ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2009</Year><RecNum>247</RecNum><DisplayText>(P. J. Adams et al., 2009)</DisplayText><record><rec-number>247</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554849245">247</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Raeburn, John</author><author>De Silva, Kawshi</author></authors></contributors><titles><title>A question of balance: prioritizing public health responses to harm from gambling</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>688-691</pages><volume>104</volume><number>5</number><dates><year>2009</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams et al., 2009). The current findings associate gambling risk for New Zealand women with the non-casino EGM gambling context specifically (as opposed to EGM gambling in general). Identifying spending time in potential non-casino EGM venues (pubs) and gambling as leisure activities conferred additional risk on women, but not men. This suggests that New Zealand community pub environments may be particularly problematic for women in relation to gambling risk. The current study strongly supports work which suggests that removing EGMs from all community venues is highly likely to have a positive effect on gambling harm for women and other groups, in combination with facilitating gender equality and community connectedness PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib2xkc3dvcnRoPC9BdXRob3I+PFllYXI+MjAxMjwvWWVh
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ADDIN EN.CITE.DATA (Holdsworth et al., 2012; Holdsworth, Nuske, & Breen, 2013; Nuske et al., 2016). The New Zealand Ministry of Health has recently suggested incentivising operators of non-casino EGMs located in socioeconomically deprived areas, to move in to higher socioeconomic areas as a harm minimisation measure ADDIN EN.CITE <EndNote><Cite><Author>Ministry of Health</Author><Year>2018</Year><RecNum>160</RecNum><DisplayText>(Ministry of Health, 2018b)</DisplayText><record><rec-number>160</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537915769">160</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Ministry of Health,</author></authors></contributors><titles><title>Strategy to Prevent and Minimise Gambling Harm 2019/20 to 2021/22: Consultation document</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Ministry of Health, 2018b). This suggestion is highly problematic in the context of the current research. Community-based EGM engagement was associated with heightened risk for women (and high risk for men), independently of the impacts of socioeconomic deprivation, psychological distress, other coexisting issues, age and ethnicity. Further, simply spending time in community pubs as a leisure activity was associated with twice the gambling risk for women (compared with women who did not spend time in pubs). This suggests that it is the availability of these products in community environments that is problematic for women’s wellbeing, independently of socioeconomic variables. This finding is in line with Pearce and colleagues’ ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Pearce</Author><Year>2008</Year><RecNum>312</RecNum><DisplayText>(2008)</DisplayText><record><rec-number>312</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561672680">312</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pearce, Jamie</author><author>Mason, K</author><author>Hiscock, Rosemary</author><author>Day, Peter</author></authors></contributors><titles><title>A national study of neighbourhood access to gambling opportunities and individual gambling behaviour</title><secondary-title>Journal of Epidemiology & Community Health</secondary-title></titles><periodical><full-title>Journal of Epidemiology & Community Health</full-title></periodical><pages>862-868</pages><volume>62</volume><number>10</number><dates><year>2008</year></dates><isbn>0143-005X</isbn><urls></urls></record></Cite></EndNote>(2008) study of the relationship between access to gambling opportunities, gambling behaviour and risk involving 38,350 neighbourhoods and 12,529 participants throughout New Zealand. Access to gambling opportunities predicted gambling and problem gambling over and above neighbourhood deprivation ADDIN EN.CITE <EndNote><Cite><Author>Pearce</Author><Year>2008</Year><RecNum>312</RecNum><DisplayText>(Pearce et al., 2008)</DisplayText><record><rec-number>312</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561672680">312</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pearce, Jamie</author><author>Mason, K</author><author>Hiscock, Rosemary</author><author>Day, Peter</author></authors></contributors><titles><title>A national study of neighbourhood access to gambling opportunities and individual gambling behaviour</title><secondary-title>Journal of Epidemiology & Community Health</secondary-title></titles><periodical><full-title>Journal of Epidemiology & Community Health</full-title></periodical><pages>862-868</pages><volume>62</volume><number>10</number><dates><year>2008</year></dates><isbn>0143-005X</isbn><urls></urls></record></Cite></EndNote>(Pearce et al., 2008).Promoting gender equality for women’s gambling harm prevention and reduction A public health approach necessitates attending to the understandings and views that influence patterns of consumption and harm ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2009</Year><RecNum>247</RecNum><DisplayText>(P. J. Adams et al., 2009)</DisplayText><record><rec-number>247</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554849245">247</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Raeburn, John</author><author>De Silva, Kawshi</author></authors></contributors><titles><title>A question of balance: prioritizing public health responses to harm from gambling</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>688-691</pages><volume>104</volume><number>5</number><dates><year>2009</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams et al., 2009). This research has suggested that gender inequalities in the home and broader society are involved in shaping gambling practises, producing and exacerbating harm. Women’s socio-cultural positioning as primary caregivers for families contributed to gambling harm by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing, access leisure and support. Gender ideology positioning women in primary caregiver roles was associated with women’s gambling-related shame, and the adoption of personal responsibility for addressing gambling harm (eschewing personal or formal support available). Though evident across ethnic groups, Māori and Pacific women and their families were particularly affected. These effects of gender inequalities were evident regardless of whether women were gambling themselves or experiencing the effects of another person’s gambling. This analysis supports Schüll’s ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Schüll</Author><Year>2012</Year><RecNum>154</RecNum><Pages>2</Pages><DisplayText>(2012, p. 2)</DisplayText><record><rec-number>154</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537407575">154</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Schüll, Natasha Dow</author></authors></contributors><titles><title>Addiction by design: Machine gambling in Las Vegas</title></titles><dates><year>2012</year></dates><publisher>Princeton University Press</publisher><isbn>0691127557</isbn><urls></urls></record></Cite></EndNote>(2012, p. 2) suggestion that gambling harm for women “is symptomatic of unresolved anxieties and tensions surrounding the place of care in our discursively individualist society”. The pervasiveness of these tensions is reflected in international research detailing how 75% of unpaid work is done by women globally ADDIN EN.CITE <EndNote><Cite><Author>Institute</Author><Year>2015</Year><RecNum>301</RecNum><DisplayText>(McKinsey Global Institute, 2015)</DisplayText><record><rec-number>301</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560817625">301</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>McKinsey Global Institute,</author></authors></contributors><titles><title>The power of parity: How advancing women’s equality can add $12 trillion to global growth</title></titles><dates><year>2015</year></dates><pub-location>New York</pub-location><publisher>McKinsey & Company</publisher><urls><related-urls><url>;(McKinsey Global Institute, 2015). The persistence of these tensions is shown in global synthesis reports: Women still do the majority of household caring work regardless of the income they bring in ADDIN EN.CITE <EndNote><Cite><Author>Chopra</Author><Year>2017</Year><RecNum>302</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Chopra & Zambelli, 2017)</DisplayText><record><rec-number>302</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560817927">302</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Chopra, Deepta</author><author>Zambelli, Elena</author></authors></contributors><titles><title>No Time to Rest: Womens Lived Experiences of Balancing Paid Work and Unpaid Care Work. Global Synthesis Report </title></titles><dates><year>2017</year></dates><pub-location>Brighton: IDS</pub-location><publisher>Womens Economic Empowerment Policy and Programming</publisher><urls></urls></record></Cite></EndNote>(e.g. Chopra & Zambelli, 2017). Because balance between work and non-work hours is important for health and wellbeing ADDIN EN.CITE <EndNote><Cite><Author>Harris</Author><Year>2007</Year><RecNum>282</RecNum><DisplayText>(Harris & Pringle, 2007)</DisplayText><record><rec-number>282</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1559775664">282</key></foreign-keys><ref-type name="Conference Proceedings">10</ref-type><contributors><authors><author>Harris, Candice</author><author>Pringle, Judith</author></authors></contributors><titles><title>Work-Life balance: Who is the target for this silver bullet</title><secondary-title>ACREW workshop</secondary-title></titles><dates><year>2007</year></dates><urls></urls></record></Cite></EndNote>(Harris & Pringle, 2007), women’s responsibility for domestic and emotional labour produces gendered health inequities, e.g. as shown in recent nationally representative Australian population research ADDIN EN.CITE <EndNote><Cite><Author>Dinh</Author><Year>2017</Year><RecNum>303</RecNum><DisplayText>(Dinh et al., 2017)</DisplayText><record><rec-number>303</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560818173">303</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dinh, Huong</author><author>Strazdins, Lyndall</author><author>Welsh, Jennifer</author></authors></contributors><titles><title>Hour-glass ceilings: Work-hour thresholds, gendered health inequities</title><secondary-title>Social Science & Medicine</secondary-title></titles><periodical><full-title>Social Science & Medicine</full-title></periodical><pages>42-51</pages><volume>176</volume><dates><year>2017</year></dates><isbn>0277-9536</isbn><urls></urls></record></Cite></EndNote>(Dinh et al., 2017). Dinh and colleagues’ ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Dinh</Author><Year>2017</Year><RecNum>303</RecNum><DisplayText>(2017)</DisplayText><record><rec-number>303</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560818173">303</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dinh, Huong</author><author>Strazdins, Lyndall</author><author>Welsh, Jennifer</author></authors></contributors><titles><title>Hour-glass ceilings: Work-hour thresholds, gendered health inequities</title><secondary-title>Social Science & Medicine</secondary-title></titles><periodical><full-title>Social Science & Medicine</full-title></periodical><pages>42-51</pages><volume>176</volume><dates><year>2017</year></dates><isbn>0277-9536</isbn><urls></urls></record></Cite></EndNote>(2017) research used six waves of data from a nationally representative sample of Australian adults (24–65 years), surveyed in the Household Income Labour Dynamics of Australia Survey (n = 3828 men; 4062 women). Researchers showed how women’s non-work time was so constrained, that it significantly lowered the point at which paid work hours affected women’s health (relative to men) because of time conflict, fatigue and stress:There is an hour-glass ceiling for those who have care [responsibilities], and if this is not addressed then women will be choosing between working longer hours and compromising their mental health to earn equal income, or working fewer hours than men and entrenching gender inequality. ADDIN EN.CITE <EndNote><Cite><Author>Dinh</Author><Year>2017</Year><RecNum>303</RecNum><Pages>50</Pages><DisplayText>(Dinh et al., 2017, p. 50)</DisplayText><record><rec-number>303</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560818173">303</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dinh, Huong</author><author>Strazdins, Lyndall</author><author>Welsh, Jennifer</author></authors></contributors><titles><title>Hour-glass ceilings: Work-hour thresholds, gendered health inequities</title><secondary-title>Social Science & Medicine</secondary-title></titles><periodical><full-title>Social Science & Medicine</full-title></periodical><pages>42-51</pages><volume>176</volume><dates><year>2017</year></dates><isbn>0277-9536</isbn><urls></urls></record></Cite></EndNote>(Dinh et al., 2017, p. 50) This research suggests that addressing the attitudes about gender that produce the ‘hour-glass ceiling’, would also ameliorate the conditions driving some women’s gambling and experiences of harm. The 2017 Gender Attitudes Survey explored ideas about gender and gender roles with a nationally representative sample of 1,251 New Zealanders, identifying that a sizable proportion of New Zealanders hold views that disadvantage women across four key areas: education, economic independence, influence and decision making, and safety and health ADDIN EN.CITE <EndNote><Cite><Author>Research New Zealand</Author><Year>2018</Year><RecNum>304</RecNum><DisplayText>(Research New Zealand, 2018)</DisplayText><record><rec-number>304</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560821283">304</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Research New Zealand, </author></authors></contributors><titles><title>Gender Equality in New Zealand A Report Based on a Public Opinion Survey Completed in July-August 2017</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Research New Zealand and Gender Equal NZ</publisher><urls></urls></record></Cite></EndNote>(Research New Zealand, 2018). For example, 53% agreed that women are pressured to choose between being a good wife/mother or having a professional career, 11% felt fathers should have more say than mothers in making family decisions, 19% felt that it is more important for men than women to be in positions of power and influence, and 9% agreed that men make better leaders than women ADDIN EN.CITE <EndNote><Cite><Author>Research New Zealand</Author><Year>2018</Year><RecNum>304</RecNum><DisplayText>(Research New Zealand, 2018)</DisplayText><record><rec-number>304</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560821283">304</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Research New Zealand, </author></authors></contributors><titles><title>Gender Equality in New Zealand A Report Based on a Public Opinion Survey Completed in July-August 2017</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Research New Zealand and Gender Equal NZ</publisher><urls></urls></record></Cite></EndNote>(Research New Zealand, 2018).The current study supports finding new and creative ways to support gender equality in New Zealand families, and question women’s socially prescribed responsibility for family wellbeing. Such efforts are appropriate health promotion activities to prevent and reduce women’s gambling harm. Gender equality and women’s wellbeing should be supported in ways that are culturally nuanced, appropriate, and identified/defined by New Zealand women ADDIN EN.CITE <EndNote><Cite><Author>Wilson</Author><Year>2008</Year><RecNum>217</RecNum><DisplayText>(Wilson, 2008; Wilson et al., 2016)</DisplayText><record><rec-number>217</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1541541370">217</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author></authors></contributors><titles><title>The significance of a culturally appropriate health service for Indigenous Māori women</title><secondary-title>Contemporary Nurse</secondary-title></titles><periodical><full-title>Contemporary Nurse</full-title></periodical><pages>173-188</pages><volume>28</volume><number>1-2</number><dates><year>2008</year></dates><isbn>1037-6178</isbn><urls></urls></record></Cite><Cite><Author>Wilson</Author><Year>2016</Year><RecNum>292</RecNum><record><rec-number>292</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560220472">292</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author><author>Jackson, Debra</author><author>Herd, Ruth</author></authors></contributors><titles><title>Confidence and connectedness: Indigenous Māori women's views on personal safety in the context of intimate partner violence</title><secondary-title>Health care for women international</secondary-title></titles><periodical><full-title>Health care for women international</full-title></periodical><pages>707-720</pages><volume>37</volume><number>7</number><dates><year>2016</year></dates><isbn>0739-9332</isbn><urls></urls></record></Cite></EndNote>(Wilson, 2008; Wilson et al., 2016). Māori women’s own understandings of safety in the context of intimate partner violence identified wellbeing strategies: Maintaining close connections and sharing experiences with other women, regularly checking on the welfare of friends, sisters, cousins, daughters, mothers, and aunties, and creating opportunities and platforms for women to speak authentically about violence and impacts ADDIN EN.CITE <EndNote><Cite><Author>Wilson</Author><Year>2016</Year><RecNum>292</RecNum><DisplayText>(Wilson et al., 2016)</DisplayText><record><rec-number>292</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560220472">292</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wilson, Denise</author><author>Jackson, Debra</author><author>Herd, Ruth</author></authors></contributors><titles><title>Confidence and connectedness: Indigenous Māori women's views on personal safety in the context of intimate partner violence</title><secondary-title>Health care for women international</secondary-title></titles><periodical><full-title>Health care for women international</full-title></periodical><pages>707-720</pages><volume>37</volume><number>7</number><dates><year>2016</year></dates><isbn>0739-9332</isbn><urls></urls></record></Cite></EndNote>(Wilson et al., 2016). Nuske and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Nuske</Author><Year>2016</Year><RecNum>213</RecNum><DisplayText>(2016)</DisplayText><record><rec-number>213</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540777668">213</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nuske, Elaine Mary</author><author>Holdsworth, Louise</author><author>Breen, Helen</author></authors></contributors><titles><title>Significant life events and social connectedness in Australian women's gambling experiences</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>7-26</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(2016) also engaged with women’s own definitions and experiences of gambling and harm. These authors identified the construction of women’s community, social and recreational spaces as key to reducing the physical, emotional and social isolation that can contribute to women’s gambling harm ADDIN EN.CITE <EndNote><Cite><Author>Nuske</Author><Year>2016</Year><RecNum>213</RecNum><DisplayText>(Nuske et al., 2016)</DisplayText><record><rec-number>213</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1540777668">213</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nuske, Elaine Mary</author><author>Holdsworth, Louise</author><author>Breen, Helen</author></authors></contributors><titles><title>Significant life events and social connectedness in Australian women's gambling experiences</title><secondary-title>Nordic Studies on Alcohol and Drugs</secondary-title></titles><periodical><full-title>Nordic Studies on Alcohol and Drugs</full-title></periodical><pages>7-26</pages><volume>33</volume><number>1</number><dates><year>2016</year></dates><isbn>1455-0725</isbn><urls></urls></record></Cite></EndNote>(Nuske et al., 2016). For Māori women especially, creating emotionally and physically safe spaces to engage in empowering activities (e.g. waka ama, regular whānau celebrations of meaningful events, and whānau focused and inclusive recreational activities) reduces gambling opportunities and harm ADDIN EN.CITE <EndNote><Cite><Author>Morrison</Author><Year>2004</Year><RecNum>33</RecNum><DisplayText>(Levy, 2015; Morrison, 2004)</DisplayText><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1520382193">33</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Morrison, Laurie</author></authors></contributors><titles><title>Pokie gambling and Māori women: Friend or foe?</title></titles><dates><year>2004</year></dates><publisher>Journal of Gambling Issues (12)</publisher><urls><related-urls><url> app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563842359">342</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Levy, Michelle</author></authors></contributors><titles><title>The impacts of gambling for Maori families and communities: A strengths-based approach to achieving Whanau Ora</title></titles><dates><year>2015</year></dates><pub-location>Hamilton</pub-location><publisher><style face="normal" font="default" size="100%">Te R</style><style face="normal" font="default" charset="186" size="100%">ūnanga o Kirikiriroa </style></publisher><urls></urls></record></Cite></EndNote>(Levy, 2015; Morrison, 2004).The Ministry of Health is responsible for contracting providers to deliver gambling public health activities including: promoting healthy public policy, increasing individual and community awareness and action and creating supportive environments. Gambling public health practice is accountable to competency standards developed by the Public Health Association of New Zealand ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Public Health Association of New Zealand</Author><Year>2007</Year><RecNum>341</RecNum><DisplayText>(2007)</DisplayText><record><rec-number>341</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563838798">341</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Public Health Association of New Zealand,</author></authors></contributors><titles><title>Generic competencies for public health in Aotearoa-New Zealand</title></titles><dates><year>2007</year></dates><pub-location>Wellington</pub-location><publisher>Public Health Association of New Zealand</publisher><urls></urls></record></Cite></EndNote>(2007). These standards emphasise that practice should be responsive to the determining factors that affect health and health inequalities in New Zealand, including gender as well as ethnicity, geographical region, socio-economic group and access to material resources e.g. income, education, employment, and housing ADDIN EN.CITE <EndNote><Cite><Author>Public Health Association of New Zealand</Author><Year>2007</Year><RecNum>341</RecNum><DisplayText>(Public Health Association of New Zealand, 2007)</DisplayText><record><rec-number>341</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563838798">341</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Public Health Association of New Zealand,</author></authors></contributors><titles><title>Generic competencies for public health in Aotearoa-New Zealand</title></titles><dates><year>2007</year></dates><pub-location>Wellington</pub-location><publisher>Public Health Association of New Zealand</publisher><urls></urls></record></Cite></EndNote>(Public Health Association of New Zealand, 2007). Demonstrating cultural competence requires nuanced attention to how culture influences public health including “patterns of housing, family structure and child rearing practices” ADDIN EN.CITE <EndNote><Cite><Author>Public Health Association of New Zealand</Author><Year>2007</Year><RecNum>341</RecNum><Pages>22</Pages><DisplayText>(Public Health Association of New Zealand, 2007, p. 22)</DisplayText><record><rec-number>341</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563838798">341</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Public Health Association of New Zealand,</author></authors></contributors><titles><title>Generic competencies for public health in Aotearoa-New Zealand</title></titles><dates><year>2007</year></dates><pub-location>Wellington</pub-location><publisher>Public Health Association of New Zealand</publisher><urls></urls></record></Cite></EndNote>(Public Health Association of New Zealand, 2007, p. 22). Culture includes gender, as well as ethnicity, age, disability, sexual orientation, religious or spiritual belief, socio-economic status, occupation and organisational background ADDIN EN.CITE <EndNote><Cite><Author>Public Health Association of New Zealand</Author><Year>2007</Year><RecNum>341</RecNum><Pages>22</Pages><DisplayText>(Public Health Association of New Zealand, 2007, p. 22)</DisplayText><record><rec-number>341</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563838798">341</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Public Health Association of New Zealand,</author></authors></contributors><titles><title>Generic competencies for public health in Aotearoa-New Zealand</title></titles><dates><year>2007</year></dates><pub-location>Wellington</pub-location><publisher>Public Health Association of New Zealand</publisher><urls></urls></record></Cite></EndNote>(Public Health Association of New Zealand, 2007, p. 22).There is little evidence of gender equality in women’s gambling harm prevention and reduction practice at present. The Ministry could require all gambling support services to demonstrate how public health practice is currently engaging with issues of gender equality/inequality, as a condition of funding and results based accountability. In the absence of explicit directive to promote gender equality, current public health practice is unlikely to be adequately responsive to gender related issues. For example, the New Zealand Health Promotion Agency (HPA) responsible for minimising gambling harm, currently focuses on: “increasing the number of at-risk gamblers who check whether their gambling is okay, motivating at-risk gamblers to use appropriate self-help approaches and seek professional help when needed, and increasing the use of appropriate harm minimisation practices in gambling environments such as pubs and clubs with pokie machines” ADDIN EN.CITE <EndNote><Cite><Author>HPA</Author><Year>2018</Year><RecNum>305</RecNum><DisplayText>(HPA, 2018)</DisplayText><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560823140">305</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>HPA,</author></authors></contributors><titles><title>What does HPA do?</title></titles><volume>2019</volume><number>18 June</number><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Health Promotion Agency</publisher><urls><related-urls><url>;(HPA, 2018). The strategies and practices of the HPA in recent years, have increasingly focussed on individuals experiencing problems (as encapsulated by the invocation of personal choice in the campaign slogan “Choice Not Chance”) ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><DisplayText>(P. J. Adams & Rossen, 2012)</DisplayText><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams & Rossen, 2012). Some current health promotion messaging and imagery targeting women encourages them to ‘put time into family/whānau not pokies’ (e.g. REF _Ref11760045 \h Figure 5).Figure 5. Health promotion imagery reproduced from HPA website ADDIN EN.CITE <EndNote><Cite><Author>HPA</Author><Year>2018</Year><RecNum>305</RecNum><DisplayText>(HPA, 2018)</DisplayText><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560823140">305</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>HPA,</author></authors></contributors><titles><title>What does HPA do?</title></titles><volume>2019</volume><number>18 June</number><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Health Promotion Agency</publisher><urls><related-urls><url>;(HPA, 2018)This messaging is concerning in the context of the findings of this study, where gendered responsibility for family (and child) wellbeing, were found to be contextual factors for women’s problematic gambling and harm. 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ADDIN EN.CITE.DATA (Dinh et al., 2017; Dolezal & Lyons, 2017; Lively et al., 2010; Schnittker, 2007). This disconnect suggests that a return to earlier HPA (previously Health Sponsorship Council) conceptualisation of community ownership and influence over gambling harm is necessary, e.g. ‘problem gambling: our communities, our families, our problem’ ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><Prefix>HSC 2009 cited in </Prefix><DisplayText>(HSC 2009 cited in P. J. Adams & Rossen, 2012)</DisplayText><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(HSC 2009 cited in P. J. Adams & Rossen, 2012). Action should be re-oriented to the conditions of possibility for gambling practices and harm: “getting society to understand the questions and issues around gambling harm” ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><Prefix>HSC 2009 as cited in </Prefix><Pages>1052</Pages><DisplayText>(HSC 2009 as cited in P. J. Adams & Rossen, 2012, p. 1052)</DisplayText><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(HSC 2009 as cited in P. J. Adams & Rossen, 2012, p. 1052). This includes supporting communities to conceptualise the social and political determinants of gambling harm, identify and action potential solutions ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(Cassidy, 2018; Livingstone et al., 2018)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite><Cite><Author>Livingstone</Author><Year>2018</Year><RecNum>108</RecNum><record><rec-number>108</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531707448">108</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Livingstone, Charles</author><author>Adams, Peter</author><author>Cassidy, Rebecca</author><author>Markham, Francis</author><author>Reith, Gerda</author><author>Rintoul, Angela</author><author>Dow Schüll, Natasha</author><author>Woolley, Richard</author><author>Young, Martin</author></authors></contributors><titles><title>On gambling research, social science and the consequences of commercial gambling</title><secondary-title>International Gambling Studies</secondary-title></titles><periodical><full-title>International Gambling Studies</full-title></periodical><pages>56-68</pages><volume>18</volume><number>1</number><dates><year>2018</year></dates><isbn>1445-9795</isbn><urls></urls></record></Cite></EndNote>(Cassidy, 2018; Livingstone et al., 2018). Health promotion has been given far less attention than harm minimisation in New Zealand and international research and practice PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BZGFtczwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (Abbott, 2017a; P. J. Adams et al., 2009; P. J. Adams & Rossen, 2012). Partnerships with New Zealand women’s health and gender equality organisations, in combination with gender-sensitive research, may support and increase the quality of health promotion initiatives to reduce gambling harm for women ADDIN EN.CITE <EndNote><Cite><Author>Prilleltensky</Author><Year>2003</Year><RecNum>102</RecNum><DisplayText>(Prilleltensky & Prilleltensky, 2003)</DisplayText><record><rec-number>102</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531276489">102</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Prilleltensky, Isaac</author><author>Prilleltensky, Ora</author></authors></contributors><titles><title>Towards a critical health psychology practice</title><secondary-title>Journal of health psychology</secondary-title></titles><periodical><full-title>Journal of health psychology</full-title></periodical><pages>197-210</pages><volume>8</volume><number>2</number><dates><year>2003</year></dates><isbn>1359-1053</isbn><urls></urls></record></Cite></EndNote>(Prilleltensky & Prilleltensky, 2003). The Ottawa Charter for Health Promotion ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Organization</Author><Year>1986</Year><RecNum>887</RecNum><DisplayText>(1986)</DisplayText><record><rec-number>887</rec-number><foreign-keys><key app="EN" db-id="ez5zzp2rp2wpwgezzx0vpp2t2w225v5trafx" timestamp="1481168591">887</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>World Health Organization,</author></authors></contributors><titles><title>Ottawa charter for health promotion</title></titles><dates><year>1986</year></dates><pub-location>Ottawa, Canada</pub-location><publisher>First International Conference on Health Promotion</publisher><urls></urls></record></Cite></EndNote>(1986) states that health promotion includes strengthening community action for health, building healthy public policy, creating health-supportive physical and social environments, and reorienting health services from reactive to more holistic approaches. Supporting gender equality aligns with key public health opportunities to address gambling harm: increasing community and broader societal accountability, and enhancing community engagement in decision making about health promoting/constraining environments ADDIN EN.CITE <EndNote><Cite><Author>Adams</Author><Year>2009</Year><RecNum>247</RecNum><DisplayText>(P. J. Adams et al., 2009; P. J. Adams & Rossen, 2012)</DisplayText><record><rec-number>247</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1554849245">247</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Raeburn, John</author><author>De Silva, Kawshi</author></authors></contributors><titles><title>A question of balance: prioritizing public health responses to harm from gambling</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>688-691</pages><volume>104</volume><number>5</number><dates><year>2009</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite><Cite><Author>Adams</Author><Year>2012</Year><RecNum>142</RecNum><record><rec-number>142</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1536194580">142</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Adams, P. J</author><author>Rossen, Fiona</author></authors></contributors><titles><title>A tale of missed opportunities: pursuit of a public health approach to gambling in New Zealand</title><secondary-title>Addiction</secondary-title></titles><periodical><full-title>Addiction</full-title></periodical><pages>1051-1056</pages><volume>107</volume><number>6</number><dates><year>2012</year></dates><isbn>0965-2140</isbn><urls></urls></record></Cite></EndNote>(P. J. Adams et al., 2009; P. J. Adams & Rossen, 2012). Strategies suggested by the current research are consistent with those articulated by Levy ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Levy</Author><Year>2015</Year><RecNum>342</RecNum><DisplayText>(2015)</DisplayText><record><rec-number>342</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563842359">342</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Levy, Michelle</author></authors></contributors><titles><title>The impacts of gambling for Maori families and communities: A strengths-based approach to achieving Whanau Ora</title></titles><dates><year>2015</year></dates><pub-location>Hamilton</pub-location><publisher><style face="normal" font="default" size="100%">Te R</style><style face="normal" font="default" charset="186" size="100%">ūnanga o Kirikiriroa </style></publisher><urls></urls></record></Cite></EndNote>(2015) regarding strength-based approaches for enhancing the full participation of Māori in society: supported opportunities for women and whānau to influence policy and practice should be created and funded. Approaches to preventing and addressing gambling related harm within communities should actively facilitate community control over the placement of social and health hazards, such as gambling and liquor outlets ADDIN EN.CITE <EndNote><Cite><Author>Dyall</Author><Year>2007</Year><RecNum>343</RecNum><DisplayText>(Dyall, 2007)</DisplayText><record><rec-number>343</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563845077">343</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dyall, Lorna</author></authors></contributors><titles><title>Gambling, social disorganisation and deprivation</title><secondary-title>International Journal of Mental Health and Addiction</secondary-title></titles><periodical><full-title>International Journal of Mental Health and Addiction</full-title></periodical><pages>320-330</pages><volume>5</volume><number>4</number><dates><year>2007</year></dates><isbn>1557-1874</isbn><urls></urls></record></Cite></EndNote>(Dyall, 2007). This involves supporting women and whānau to understand and operate the mechanisms (e.g. legislation) that can be utilised to exert more control over their community environments. Emerging leaders within communities most affected by gambling harm should be identified, funded and supported to develop initiatives to create safe and nurturing environments for women and whānau ADDIN EN.CITE <EndNote><Cite><Author>Levy</Author><Year>2015</Year><RecNum>342</RecNum><DisplayText>(Levy, 2015)</DisplayText><record><rec-number>342</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563842359">342</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Levy, Michelle</author></authors></contributors><titles><title>The impacts of gambling for Maori families and communities: A strengths-based approach to achieving Whanau Ora</title></titles><dates><year>2015</year></dates><pub-location>Hamilton</pub-location><publisher><style face="normal" font="default" size="100%">Te R</style><style face="normal" font="default" charset="186" size="100%">ūnanga o Kirikiriroa </style></publisher><urls></urls></record></Cite></EndNote>(Levy, 2015).Gender-aware gambling harm reduction research, policy and practiceThis study has demonstrated the importance of integrating a broad awareness of how gender-related issues, notions and practices shape gambling and harm into all efforts to reduce gambling harm, particularly for women. This awareness is vital to avoid unwittingly contributing to stereotypical constructions of women and gender roles, which can constrain women’s health and wellbeing and access to resources and support. Key issues identified included: women’s socially prescribed responsibility for others’ wellbeing, disproportionate participation in caring work, and exposure to poverty, discrimination, violence, trauma and harassment. In the context of these issues, gambling venues in local communities appear to offer women respite, distraction, comfort, time-out and/or connection – while placing them at risk of experiencing problems and harm. This study has also offered glimpses and suggestions of what gambling harm reduction research, policy and practice could look like – if women and gender issues were carefully considered in research, policy and intervention design and practice. Gender-aware gambling studies Gambling studies have perpetuated some problematic and restrictive constructions of women and women’s roles, and gambling harm. Gambling studies should therefore work consciously to balance a historical focus on the ‘individual woman in therapy’, with research elucidating the social determinants of women’s gambling harm and supporting transformation in the environmental conditions of possibility for women’s gambling harm. This work has the potential to benefit more groups than just women. Multiple avenues are suggested by this study, including: The gendered cultural meanings of community based EGM gambling e.g. ethnographic in-venue studies of social interactions, behaviours, and perceptions that occur within community gambling venues.Environmental and industry factors contributing to gambling harm for women e.g. critical analysis of gambling venue marketing strategies and their impact on behaviour, analysis of available recreational opportunities particularly in community contexts.Exploration of the contextual factors for gambling and harm for women across each of the different gambling forms e.g. multi-faceted exploration of gambling on card games or poker in private settings.A focus on producing high quality actionable research together with those who are experiencing harm, and those in a position to implement findings, is rare in the gambling studies field ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2018</Year><RecNum>147</RecNum><DisplayText>(Cassidy, 2018)</DisplayText><record><rec-number>147</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1537311790">147</key></foreign-keys><ref-type name="Conference Paper">47</ref-type><contributors><authors><author>Cassidy, Rebecca</author></authors></contributors><titles><title>What are critical gambling studies?</title><secondary-title>International Think Tank on Gambling Research, Policy and Practice</secondary-title></titles><dates><year>2018</year><pub-dates><date>April</date></pub-dates></dates><pub-location>Auckland, New Zealand</pub-location><urls></urls></record></Cite></EndNote>(Cassidy, 2018). Recent meetings of the International Think Tank on Gambling Research, Policy and Practice have acknowledged the need for more transformative, participatory, and action oriented research to help bridge gaps that can emerge between groups and communities experiencing gambling harm, gambling harm reduction research, policy and practice ADDIN EN.CITE <EndNote><Cite><Author>Alberta Gambling Research Institute</Author><Year>2017</Year><RecNum>77</RecNum><Prefix>e.g. </Prefix><DisplayText>(e.g. Alberta Gambling Research Institute & Gambling and Addictions Research Centre, 2017)</DisplayText><record><rec-number>77</rec-number><foreign-keys><key app="EN" db-id="25rszwft292ev3esrpvpde0cpxrd9ex0xspp" timestamp="1551134056">77</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Alberta Gambling Research Institute,</author><author>Gambling and Addictions Research Centre,</author></authors></contributors><titles><title>Ntes from the North American Think Tank (NATT)</title></titles><dates><year>2017</year></dates><pub-location>Alberta, Canada</pub-location><publisher>Alberta Gambling Research Institute</publisher><urls><related-urls><url>;(e.g. Alberta Gambling Research Institute & Gambling and Addictions Research Centre, 2017). Transformative research explicitly aims to change or improve systems and structures, to support the wellbeing of marginalised and/or underserved groups ADDIN EN.CITE <EndNote><Cite><Author>Mertens</Author><Year>2007</Year><RecNum>113</RecNum><DisplayText>(Mertens, 2007, 2012)</DisplayText><record><rec-number>113</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531866188">113</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mertens, Donna M</author></authors></contributors><titles><title>Transformative paradigm: Mixed methods and social justice</title><secondary-title>Journal of mixed methods research</secondary-title></titles><periodical><full-title>Journal of mixed methods research</full-title></periodical><pages>212-225</pages><volume>1</volume><number>3</number><dates><year>2007</year></dates><isbn>1558-6898</isbn><urls></urls></record></Cite><Cite><Author>Mertens</Author><Year>2012</Year><RecNum>46</RecNum><record><rec-number>46</rec-number><foreign-keys><key app="EN" db-id="25rszwft292ev3esrpvpde0cpxrd9ex0xspp" timestamp="1550452992">46</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mertens, Donna M</author></authors></contributors><titles><title>Transformative mixed methods: Addressing inequities</title><secondary-title>American Behavioral Scientist</secondary-title></titles><periodical><full-title>American Behavioral Scientist</full-title></periodical><pages>802-813</pages><volume>56</volume><number>6</number><dates><year>2012</year></dates><isbn>0002-7642</isbn><urls></urls></record></Cite></EndNote>(Mertens, 2007, 2012). Action research holds that the purpose of academic research is not just to describe, understand and explain the world, but also to try to support and effect positive and collaborative change ADDIN EN.CITE <EndNote><Cite><Author>Reason</Author><Year>2001</Year><RecNum>114</RecNum><DisplayText>(Reason & Torbert, 2001)</DisplayText><record><rec-number>114</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1531866786">114</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reason, Peter</author><author>Torbert, William</author></authors></contributors><titles><title>The action turn: Toward a transformational social science</title><secondary-title>Concepts and transformation</secondary-title></titles><periodical><full-title>Concepts and transformation</full-title></periodical><pages>1-37</pages><volume>6</volume><number>1</number><dates><year>2001</year></dates><isbn>1569-9692</isbn><urls></urls></record></Cite></EndNote>(Reason & Torbert, 2001). Transformative, action and critical research traditions hold great promise for reducing harm for women in New Zealand. For example, Orford’s ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Orford</Author><Year>2009</Year><RecNum>50</RecNum><DisplayText>(2009)</DisplayText><record><rec-number>50</rec-number><foreign-keys><key app="EN" db-id="25rszwft292ev3esrpvpde0cpxrd9ex0xspp" timestamp="1550453823">50</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Orford, Jim</author><author>Templeton, Lorna</author><author>Copello, Alex</author><author>Velleman, Richard</author><author>Ibanga, Akan</author><author>Binnie, Charlotte</author></authors></contributors><titles><title>Increasing the involvement of family members in alcohol and drug treatment services: The results of an action research project in two specialist agencies</title><secondary-title>Drugs: education, prevention and policy</secondary-title></titles><periodical><full-title>Drugs: education, prevention and policy</full-title></periodical><pages>379-408</pages><volume>16</volume><number>5</number><dates><year>2009</year></dates><isbn>0968-7637</isbn><urls></urls></record></Cite></EndNote>(2009) action research worked with service teams to increase the involvement of family members in the provision of two alcohol and drug treatment services. This research produced a nuanced and critical account of the types of family work conducted, social issues and barriers affecting family involvement, and whether changes in practice were likely to be sustainable in these particular organisations. Earlier phases of Orford’s research involved detailed qualitative and quantitative investigations of the experiences of family members, leading to development and elaboration of the stress–strain–coping–support model. Similar work could be carried out to support the orientation of gambling services towards women’s health and wellbeing in ways that are culturally nuanced and appropriate. Gambling studies should include a mechanism for involving people with lived experience of gambling harm in research design and practice.The current research has also demonstrated the value of mixed methods studies and research approaches capable of engaging in data triangulation across multiple sources, in exploring complex issues. Research approaches that incorporate nuance and complexity are less likely to contribute to unintended consequences, e.g. reinforce gender stereotypes or individualise gambling harm in ways that run counter to public health harm prevention and reduction work. These approaches can also point out situations where research, theory and practice may be misaligned and/or operating at odds. Ethnographic research methodologies conducted in gambling sites have the potential to detail the material conditions through which gambling practices and harm are produced, and to make visible any disconnect between policy, beliefs/ideas about gambling and embodied practice ADDIN EN.CITE <EndNote><Cite><Author>Reeves</Author><Year>2008</Year><RecNum>344</RecNum><DisplayText>(Reeves, Kuper, & Hodges, 2008)</DisplayText><record><rec-number>344</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563923356">344</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reeves, Scott</author><author>Kuper, Ayelet</author><author>Hodges, Brian David</author></authors></contributors><titles><title>Qualitative research methodologies: ethnography</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>a1020</pages><volume>337</volume><dates><year>2008</year></dates><isbn>0959-8138</isbn><urls></urls></record></Cite></EndNote>(Reeves, Kuper, & Hodges, 2008). Within these research approaches, gambling industries must be taken as seriously as individuals engaging in and harmed by gambling, as objects of analysis and discussion ADDIN EN.CITE <EndNote><Cite><Author>Cassidy</Author><Year>2013</Year><RecNum>345</RecNum><DisplayText>(Cassidy et al., 2013)</DisplayText><record><rec-number>345</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563924196">345</key></foreign-keys><ref-type name="Edited Book">28</ref-type><contributors><authors><author>Cassidy, Rebecca</author><author>Pisac, Andrea</author><author>Loussouarn, Claire</author></authors></contributors><titles><title>Qualitative research in gambling: Exploring the production and consumption of risk</title></titles><dates><year>2013</year></dates><pub-location>London</pub-location><publisher>Routledge</publisher><isbn>1134445857</isbn><urls></urls></record></Cite></EndNote>(Cassidy et al., 2013).Gender-aware gambling harm prevention and reduction policy Suggestions for gender-aware policy supported by this study include making participation in gambling harm prevention and reduction research a condition of the licensing of all entities providing gambling opportunities in New Zealand. The cooperation of gambling operators in gambling research projects and programmes cannot be relied upon at present. This places significant limits and constraint around naturalistic and real-world research necessary to explore the conditions in which women’s gambling harm is produced and efforts to prevent and reduce harm are undertaken – particularly in community EGM settings. The findings of this research support recently announced Ministry strategic initiatives including the establishment of a gambling consumer network and peer support, along with a focus on co-design and including the voices of people with lived experiences of gambling harm in the development, delivery and evaluation of services and programmes ADDIN EN.CITE <EndNote><Cite><Author>Ministry of Health</Author><Year>2019</Year><RecNum>346</RecNum><DisplayText>(Ministry of Health, 2019)</DisplayText><record><rec-number>346</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1563926150">346</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Ministry of Health,</author></authors></contributors><titles><title>Strategy to Prevent and Minimise Gambling Harm 2019/20 to 2021/22</title></titles><dates><year>2019</year></dates><pub-location>Wellington</pub-location><publisher>Ministry of Health</publisher><urls></urls></record></Cite></EndNote>(Ministry of Health, 2019). In addition, policy makers and funders should insist that gender equality is a priority in all service provision and evaluation. Analysis of gambling studies literature has shown that to avoid stereotypical labelling and victim blaming, women’s experiences of gambling harm should be centralised and understood within the “given socioeconomic, historical, cultural, family, and personal circumstances in which these experiences are produced” (Li, 2007, p. 634). Gender analysis and meaningful involvement of people with lived experiences of gambling harm should also be made a prerequisite for all Ministry funded research to ensure that this is achieved.Gender-aware gambling harm prevention and reduction practiceThis study has presented evidence that women’s gambling harm is a social phenomenon, shaped by societal understandings and environments that affect women differently to men. For example, the responsibility for causing and addressing the gambling harm experienced by children and families was ascribed differently to men and women through the social roles of husband, wife, mother, father, sister and brother. Particular community gambling contexts (non-casino EGMs and card games) appear to play a particular social role for many women in the context of gender inequality, and come with additional risk. These findings support the development of and broader social interventions for gender equality, as well as critical psychological work explicitly maintaining a dual focus on individual and social issues as responses to women’s gambling harm. These kinds of individual-social interventions have been developed in the women’s health field. Ussher and colleagues ADDIN EN.CITE <EndNote><Cite ExcludeAuth="1"><Author>Ussher</Author><Year>2002</Year><RecNum>221</RecNum><DisplayText>(2002)</DisplayText><record><rec-number>221</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1542248045">221</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ussher, Jane M</author><author>Hunter, Myra</author><author>Cariss, Margaret</author></authors></contributors><titles><title>A woman‐centred psychological intervention for premenstrual symptoms, drawing on cognitive‐behavioural and narrative therapy</title><secondary-title>Clinical Psychology & Psychotherapy</secondary-title></titles><periodical><full-title>Clinical Psychology & Psychotherapy</full-title></periodical><pages>319-331</pages><volume>9</volume><number>5</number><dates><year>2002</year></dates><isbn>1063-3995</isbn><urls></urls></record></Cite></EndNote>(2002) designed a material-discursive-intrapsychic model of premenstrual symptoms. The materiality of PMS involves hormone levels, sensitivity to pain, presence of life stressors, gender economic and health inequities e.g. period poverty, trauma and abuse. This materiality exists in a complex relationship with the way that our culture defines PMS and femininity, e.g. social attitudes towards women’s bodies, period blood, and ‘women’s trouble’ not taken seriously. Intrapsychic factors operate at the level of the psychological and individual – bringing in psychological theory and constructs e.g. perceptions and attributions for symptoms, low self-esteem, guilt and shame as relevant to women’s coping. A women-centred intervention based on this model included critical discussion of the social expectations placed upon women, in particular that of caring for others before caring for self, and the implications of multiple and often conflicting roles. Women were supported to explore and collectively advocate for alternative framings and support systems that might lead to better outcomes for them in their lives. This intervention was found to be as effective as selective serotonin reuptake inhibitors (SSRIs) in reducing moderate or severe premenstrual symptoms ADDIN EN.CITE <EndNote><Cite><Author>Hunter</Author><Year>2002</Year><RecNum>313</RecNum><Prefix>RCT`, n=108 </Prefix><DisplayText>(RCT, n=108 Hunter et al., 2002)</DisplayText><record><rec-number>313</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1561681077">313</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hunter, M</author><author>Ussher, JM</author><author>Cariss, M</author><author>Browne, S</author><author>Jelly, R</author></authors></contributors><titles><title>A randomised comparison of psychological (cognitive behaviour therapy, CBT), medical (fluoxetine) and combined (CBT and fluoxetine) treatment for women with Premenstrual Dysphoric Disorder</title><secondary-title>J Psychosom Obstet Gynaecol</secondary-title></titles><periodical><full-title>J Psychosom Obstet Gynaecol</full-title></periodical><dates><year>2002</year></dates><urls></urls></record></Cite></EndNote>(RCT, n=108 Hunter et al., 2002). Reconsideration of the New Zealand Health Promotion Agency approach to women’s gambling harm prevention and reduction should involve engagement with women’s experiences of harm to identify key messages, and consultation with key stakeholders to identify any potential unintended consequences. Key messaging suggested by the current study include: Promoting the availability of accessible supportive spaces for women and their children, and community discussion of the broader systemic drivers of gambling behaviour and harm such as poverty, gender inequality, racism and low levels of social cohesion. This could include discussion forums and workshops to promote public submissions on legislative, governance and policy issues related to gambling provision and harm minimisation. A holistic health and wellbeing framework allows for discussion of ‘intervention’ beyond individuals, invoking a political space where women (and their families and communities) are supported to identify and address the structural and social determinants of gambling and harm.Finally, the current study suggests the following avenues hold promise in orienting the practices of gambling support towards the needs of women in New Zealand:Co-design of community-based service environments and practices with women, women’s groups and women’s health organisations (including Māori and Pacific women’s groups).Holistic support services drawing on multiple existing models for improved Māori and Pacific health. This will reduce the need for women to identify themselves and/or families as ‘problem gambling’ or ‘not coping’ to access information and support, countering the impact of shame and a sense of ‘failure to care’.Gender equality as a core consideration of all service environments, design and delivery, e.g. through the availability of childcare facilities and supportive communal spaces, and by working with women and their communities to identify barriers and promote gender equality including shared caring responsibilities in families and broader society.Exploring these avenues is in alignment with changes recommended by the recent New Zealand government inquiry, to improve New Zealand’s current approach to mental health and addictions ADDIN EN.CITE <EndNote><Cite><Author>Paterson</Author><Year>2018</Year><RecNum>294</RecNum><DisplayText>(Paterson et al., 2018)</DisplayText><record><rec-number>294</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1560467934">294</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Paterson, R</author><author>Disley, B</author><author>Tiatia-Seath, J</author><author>Durie, M</author><author>Rangihuna, D</author><author>Tualamali'i J</author></authors></contributors><titles><title>He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction</title></titles><dates><year>2018</year></dates><pub-location>Wellington</pub-location><publisher>Givernment Inquiry into Mental Health and Addiction</publisher><urls></urls></record></Cite></EndNote>(Paterson et al., 2018). This inquiry has highlighted putting people with lived experience of harm at the centre of support systems, while actively recognising and promoting a holistic and shared responsibility for improving health and wellbeing in our society.LimitationsIt is acknowledged here that the New Zealand harms and population datasets accessed for analysis in this study are somewhat dated – collected between 2010 and 2014. The gambling environment has changed considerably in the last 9 years, for example online gambling is more available in New Zealand, and the uptake of online gambling has increased ADDIN EN.CITE <EndNote><Cite><Author>Abbott</Author><Year>2018</Year><RecNum>135</RecNum><DisplayText>(Abbott, Bellringer, et al., 2018)</DisplayText><record><rec-number>135</rec-number><foreign-keys><key app="EN" db-id="rpt5255teda5p3exew8ptpftwv0s20t2xd2a" timestamp="1534887305">135</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Abbott, Max</author><author>Bellringer, M</author><author>Garret, N</author></authors></contributors><titles><title>New Zealand National Gambling Study: Wave 4 2015, Report number 6</title></titles><dates><year>2018</year></dates><pub-location>Auckland</pub-location><publisher>Gamblign and Addictions Research Centre, AUT University</publisher><urls></urls></record></Cite></EndNote>(Abbott, Bellringer, et al., 2018). This may particularly affect women (and men) who can now gamble in the comfort of their own homes. This study has demonstrated the importance and value of understanding how gender related issues notions and practices are related to gambling and harm. Gender-aware research should keep pace with emerging and changing gambling forms. There are limitations of each of the three methodologies employed in this study. Poststructural discourse analysis is effective as a diagnostic tool, prompting critical reflection and creative imagining of how conceptualisation and practice could be otherwise. It is less definitive on ‘the best course of action’ to take, favouring opening up possibilities rather than settling them/narrowing them down. Data accessed for thematic analysis of experiences of gambling harm were not produced with gender analysis in mind. It is possible that many more gender related issues, notions and practices would be identified in data explicitly produced with this purpose and related questions. Limitations of the gender analysis of population data include that the NGS was primarily designed to examine gambling prevalence in NZ, and this gender analysis was a secondary analysis of this data. The analysis was limited to the data available in the survey. The analysis also only focused on the 2012 NGS data which is cross-sectional in nature and was therefore focused on associations and not causal linkages. As the focus was on gambling behaviour the analysis was limited to the approx. 80% of the survey population who participated in gambling. The interaction of gender with our primary factors was considered, however interactions between different gambling forms were not examined as in many cases the numbers were too small to robustly examine statistically. A key strength of the mixed methods design employed in this study is in mitigating these issues through data triangulation and consideration of women’s gambling harm across the multiple perspectives engaged.ConclusionWomen’s gambling harm in New Zealand is a multi-faceted phenomenon. Gambling studies has shaped and arguably constrained responses to preventing and minimising women’s gambling harm: tending to focus attention narrowly on individual women’s psychological wellbeing. Gender issues and ideology infuse both gambling practices and harm. Women’s socio-cultural positioning as primary caregivers for families contributes to gambling harm by placing unrealistic expectations on women, while simultaneously constraining their ability to prioritise their own wellbeing, and access rest, relaxation and support. 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