3. ASPECTO METODOLOGICO
3.1 Prospectiva para la difusión y ventas de nuevos productos
This thesis set out to investigate the impacts of EGMs, an entrenched social and public health issue, using health geographic approaches. In particular, it set out to develop small area estimates of problem gambling in order to inform regulation and research. This primary goal has been achieved, with the research in this thesis developing an empirically-calibrated set of prevalence estimates for spatial units of around 400 persons.
In doing so, this thesis has made several other contributions. It has applied existing geographic methods such as spatial interaction modelling to the domain of EGM gambling. More significantly, it has contributed to refining spatial microsimulation, a recently-developed geographical method, by demonstrating how microsimulation estimates can be improved by incorporating spatially-referenced ancillary data sources. This thesis has also made a significant contribution to the epidemiological understanding of the relationship of EGM gambling losses and problem gambling, investigating the association between EGM spending and harm at three spatial scales. Most importantly, this thesis has demonstrated that, contrary to the consensus understanding in the literature, the dose-response relationship between EGM losses and problem gambling risk is not J-shaped, a finding that has important implications for how EGMs should be regulated. Finally, this thesis has begun the work of applying health geographic methods to investigate the spatio-temporal relationships between EGM accessibility and gambling-related harms, an area of research that has been little developed in the academic literature.
The research developed in this thesis has contributed toward bringing knowledge of the geography of the impacts of EGMs closer to that of cognate public health issues such as alcohol and tobacco. In the main, it is hoped that the approaches developed in this thesis
and the research findings will contribute to improving the regulation of EGMs and thereby reduce the incidence of gambling-related harms.
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