Lower incomes are associated with higher obesity, though lower income in America is very much a relative term. Poor and minority kids lead the country in bedroom television ownership, so being poor in the US is not the same as in other countries.

Native Americans have an advantage over other countries too; they can open casinos even when they would otherwise be illegal. Most communities are concerned about crime and other issues related to gambling but a new paper in JAMA finds that the opening or expansion of a casino in a community is associated with increased family income, decreased poverty rates and a decreased risk of childhood overweight or obesity.

So we should have a casino in every neighborhood, right? People want ladders for social opportunity and wealth helps. 


Jessica C. Jones-Smith, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues hypothesize that casinos could alter individual, family, or community resources, reducing barriers to healthful eating and physical activity and decreasing the risk of overweight/obesity. “These resources could include increased income, either via employment or per capita payments, and health-promoting community resources, such as housing, recreation and community centers, and health clinics,” they write.

And kids will get thinner too.

The researchers used body mass index (BMI) measurements from American Indian children (ages 7-18 years) from 117 school districts that encompassed tribal lands in California between 2001 and 2012 and compared children in districts with tribal lands that either did or did not gain or expand a casino. Besides BMI, other measures included in the analysis were per capita annual income, median (midpoint) annual household income, percentage of population in poverty and total population.

Of the 117 school districts, 57 either opened or expanded a casino, 24 had a preexisting casino but did not undergo expansion, and 36 did not have a casino at any time during the study period. Forty-eight percent of the measurements of the children (n = 11,048) were classified as overweight/obese. The researchers found that every 1 casino slot per capita gained was associated with an increase in average per capita annual income, a decrease in the percentage of the population living in poverty, and a decrease in the percentage of overweight/obesity.

The authors speculate that the association found in this study between casinos and childhood overweight/obesity may be from both increased family/individual and community economic resources. They emphasize that further research is needed to better understand the mechanisms underlying this association.

Citation: JAMA March 5 2014, doi:10.1001/jama.2014.604