Gambling and Migration – The Role of Culture and Family

This study provides some important insights into the role of culture and migration for gambling and PG. The participants had all experienced negative consequences from gambling and often self-described as ‘problem gamblers’. The results suggest that experiences related to migration, integration and culture could have an important role in shaping the relationship to gambling, and to the development of PG. The results can largely be understood as being in line with the two-process model proposed by Okuda et al. (2016), where culture affects both which risk factors are present, but also the susceptibility for those risk factors. In this study, we suggest that the exposure to everyday gambling at young age is an example of the first, and the stigma surrounding PG an example of the latter.

The participants differed in age of migration and during which time period they migrated to Sweden. However, it was clear that experiences that could be related to migration play an important role in their relationship to gambling, as accounted for in the Acculturation and gambling theme. This included gambling as a response to experiences of economic hardship due to the migration, language barriers, alienation or lack of a sense of coherence, gambling as a way of passing time and coping pressing life circumstances, unpreparedness for gambling availability and advertisements which seem to confirm previous findings (Wardle et al., 2019). In some instances, it also entailed an unexpected and markedly higher and economic status that could trigger gambling. It should be stressed, however, that the participants also highlighted processes and factors unrelated to migration and culture in relation to gambling and the development of PG, such as the games’ inherently reinforcing properties and the availability of gambling at venues serving alcohol.

The perhaps most salient result from this study was how the participants considered gambling, and PG, to be substantially more stigmatized in the origin countries compared to in Sweden, described under the Shame and stigma subtheme. The participants talk about gambling being seen as “a disgrace”, “not something to be talked about” or “haram”, referencing a term in Islamic nomenclature denouncing something as forbidden or unlawful. These norms regarding gambling are also mirrored in the legal framework of the origin countries of the participants, where gambling is forbidden in all countries except Turkey, where some lotteries are allowed (DLA Piper, 2022). This could also be an explanation for why some of the participants claimed to have very limited prior knowledge about gambling before coming to Sweden, and could also increase vulnerability to gambling advertising. The stigma surrounding gambling and PG is seen as a barrier to seek treatment, which corroborates claims from numerous previous studies (Gainsbury et al., 2014; Suurvali et al., 2009), and seem to prompt individuals with PG to rather handle the problems by themselves or within the family. Several participants also highlighted the important role the family and relatives had in supporting someone with PG, in contrast to more individualistic practices in Sweden, where family members are encouraged by counselors to avoid paying for gambling-related expenses for example. The participants generally had a favorable view of treatment for PG, but asserted that ‘others’ with similar cultural background as themselves would generally be reluctant to seek formal treatment or support, which has been found in previous studies of groups with a similar background (Mazbouh-Moussa & Ohtsuka, 2017). A recent study from Norway indicated that people with a migrant background were more likely to have PG but less likely to seek treatment for it, but with time and after obtaining citizenship they became more likely to seek treatment for PG (Aarestad et al., 2023). This is also similar to previous studies on treatment seeking for mental problems among populations with a migrant background that have found lower levels of treatment seeking relative to the rest of the population, despite similar levels of mental health problems (Hollander et al., 2020). This has partly been explained by differences in ‘health literacy’ i.e., the capacity for an individual to receive and understand fundamental health information and make informed decisions (Nutbeam, 2008), but also by a lack of culturally attuned treatment options (Wong et al., 2015).

Despite the marked stigma surrounding gambling, several participants described gambling as an integral part of everyday life in their origin countries and cultures. This type of gambling, however, is different from the type of organized and commercial gambling we usually refer to when talking about gambling. Instead, this type of gambling was described as betting between friends about everyday events, card games and dice games involving small sums of money or tokens such as chewing gums or candies. Different cultural contexts will influence how this type of gambling is perceived, as described by Egerer and Marionneau (2019). In their study French and Finnish gamblers had markedly different views on what was described as ‘convenience gambling’, which, albeit commercial, is reminiscent of the type of gambling described by the respondents in our study. However, since early exposure to, and participation in, gambling has been found to be a possible risk factor for developing PG (Freund et al., 2022), this type of gambling could have a role in the development of PG for some individuals. In a recent study of PG among minority groups (Grant & Chamberlain, 2023), using pooled data from ten different studies on PG, the age of first gambling was significantly lower among treatment-seeking individuals from minority groups (age 14 on average) compared to non-minority treatment-seekers (age 22 on average), indicating that early onset gambling could be an important factor explaining some of the difference in PG prevalence.

One finding from this study suggested that cultural norms encouraging aspirations for a high and highly visible economic status could be important reasons to gamble. This was also linked to a certain way of gambling, where extravagance and fearlessness could be preferred over more restrictive and cunning styles of play, despite worse outcomes. This echoes some previous findings among Americans with Iranian background, where culturally driven desires to achieve and maintain high economic status has been proposed to partly explain elevated PG prevalence figures (Parhami et al., 2012). For some participants, earning money to send to family members in the origin country had also been a reason to gamble. Some of these findings could be interpreted as a part of a specifically masculine context, since all of the participants were male. Gambling and PG is generally more common among males, and masculine norms regarding risk taking, competition, status and help-seeking could have an influence on gambling and the development of PG (Hunt & Gonsalkorale, 2018). On a population level, female migrants are more likely to migrate as relatives, thus arriving to an existing familial network, while male migrants are more likely to be refugees or migrant laborers without existing networks and contacts, which could be a risk factor for gambling (Allami et al., 2021).

This study is one of the first studies on the experiences of gambling and PG among people with a migrant background, despite approximately 14.6% of the US population being foreign-born (United States Census Bureau, 2021) and 8.4% of the EU population being born outside the EU (European Comission, 2021), for example. However, the sheer number of individuals this entails also calls for some caution when interpreting the results of this and other studies on migration background; the participants’ culture, socio-economic status, education level and reasons to migrate might differ substantially and contribute in different ways. It is also important to stress that the term ‘culture’ can sometimes be misleading, since it might indicate that customs, traditions, beliefs and values in a certain community, country or region are static or easily described, whereas in reality ‘culture’ is an ongoing process that can vary substantially between time periods, location and how it is experienced and perceived. It is also important not to overstate the role of culture, when other aspects such as socio-economic status or masculinity might be equally, or more, important.

In sum, cultural factors and experiences from the migration and integration process can be understood to have played an important role in the participants’ relationship to gambling and development of PG. Stigma seemed to be an important barrier for seeking treatment, which together with a culturally ill-adapted health care system might deter certain groups to seek treatment. This study highlights the need to reconsider how treatments are offered, where an overly narrow focus on the individual might clash with culturally rooted understandings of PG as a problem to solve within or with the support of the family. Previous studies lend preliminary support for the viability of culturally adapted PG treatment programs for minorities (Bertossa, 2022; Richard et al., 2017; Wong et al., 2015). Other studies have for example investigated the different views and experiences held by older generations compared to the rest of the population (Heiskanen & Matilainen, 2020), highlighting the importance of an intersectional approach that take into account different demographic, cultural or social backgrounds when preventing and treating PG.

In conclusion, this study lends some support to the notion that cultural practices and experiences specific to migrants could influence the risk of developing PG. Given the elevated prevalence of PG among many minorities, and the challenge to reach and provide relevant prevention and treatment programs for these groups, there is an urgent need to better understand cultural aspects in relation to gambling and PG. The results from this study could help inform prevention programs on relevant and culturally attuned themes regarding for example stigma surrounding PG, the role of gambling to achieve higher social status and what role gambling can play in coping with adaptation and integration into a new society. But the experiences of the participants also highlighted the need to address the knowledge gap regarding the risks of gambling demonstrated by some migrants with little prior experience of gambling or gambling advertisements in their origin countries. Future studies should further investigate the role different specific cultural practices could have in shaping the relationship to gambling, which could help build a theoretical model for how to understand PG in minority groups.