Beyond the Individual: Rethinking Public Health Approaches to Gambling‐Related Harm

ABSTRACT Public health approaches to gambling‐related harm have increasingly shifted from individual pathology to population‐level frameworks. However, these approaches remain under strain, as they continue to individualize harm while attempting to address broader structural conditions. Here, we examine three dominant paradigms to show how they shape the framing of harm and the design of interventions. First, medicalization legitimizes gambling‐related harm within clinical systems but reinforces pathologized identities and professional authority. Second, stigma frameworks highlight processes of exclusion and barriers to help‐seeking but often remain insufficiently attuned to institutional and structural power. Third, structural perspectives situate harm within neoliberal governance, market expansion, and regulatory environments, yet they are unevenly translated into policy and practice. We further illustrate these tensions through the prevention paradox, which reveals a persistent mismatch between the distribution of harm and the focus of interventions. We conclude by arguing that more effective public health responses require reorienting existing frameworks toward structural accountability, with greater attention to commercial determinants, regulatory reform, and lived experience.