A synthesis of explanations for spatial inequalities in gambling harm: integrating social and material dimensions of place

Place matters for understanding patterns of gambling harm as shown by the spatial clustering of both 'vulnerable' people and gambling outlets. Harms are experienced at a community level (and never restricted to individuals) and are spread unequally across communities of place. Following the liberalisation of gambling laws in the UK in the 1990s, gambling outlets and advertising have proliferated in many economically disadvantaged places, with the gambling industries in some cases appearing to target these areas. Despite growing recognition of place-based inequalities in the harms caused by gambling, there have been limited efforts to understand gambling as a spatial practice that reflects and produces inequalities in health. This paper presents a synthesis of theories and explanations in the social science and public health literature about the unequal harms from gambling experienced by people in different places. We draw on a socio-material approach in our synthesis to show how different assemblages of gambling products, venues, marketing materials and collective histories form in different localities to influence different gambling practices with varying consequences for health. The synthesis foregrounds how different levels of power and influence in the production, regulation and experience of space across communities shape i) the meanings of gambling as a social practice and ii) the collective resources of communities to protect themselves from gambling harms. The analysis thus points to socio-material spaces as sites for interventions to reduce inequalities in harm.