Casino expansion associated with decreased childhood risk of obesity

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1. Casino addition and expansion in tribal areas was positively associated with increased per capita income among American Indians

2. Casino addition and expansion was significantly associated with a decrease in overweight/obese American Indian children

Evidence Rating Level: 3 (Fair)          

Study Rundown: Previous studies examining the relationship between casinos and health outcomes have produced mixed results. This study sought to identify the effect of casinos on economic resources in the surrounding community and childhood obesity among American Indians. The authors found that casino addition/expansion was positively associated with increased per capita income and decreased percentage of population living in poverty. Moreover, casino addition/expansion in an area was significantly associated with a decreased risk of a child being overweight/obese. While statistical associations are demonstrated, much further research is needed to elucidate the underlying mechanism for these findings.

Click to read the study in JAMA

Click to read the accompanying editorial in JAMA

Relevant Reading: Positive income shocks and accidental deaths among Cherokee Indians: a natural experiment

In-Depth [observational study]: This study included 22 863 measurements of American Indian students in 117 Californian school districts. For every additional slot machine in a district, the average per capita income among American Indians increased by an estimated $541 (95%CI $245-$836) and the percentage of population living in poverty decreased by 0.6% (95%CI -1.1% to -0.20%). In addition, each additional slot per capita was significantly associated with a 0.19 percentage-point decrease in the percentage of overweight/obese based on BMI (95%CI -0.26 to -0.11 percentage points) and a decrease in BMI z score of 0.003 (95%CI -0.005 to -0.0002). The average increase in slots per capita, thirteen, produced a 5.1% decrease in the mean prevalence of 48% overweight/obese.

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