NEW YORK (Reuters Health) - After American Indians built
casinos on California tribal lands, their incomes rose and their
children's obesity rates fell, according to a new study.
The study's authors sought to highlight the merits of
investing in communities to prevent disease. They found that an
infusion of resources was linked to a reduction in poverty and
youth health risks.
"The casino is serving as a proxy," Dr. Neal Halfon told
Reuters Health. "If we had some kind of big syringe, and we
inject money into a community, it does change the odds. Here it
Halfon directs the Center for Healthier Children, Families
and Communities at the University of California, Los Angeles. He
was not involved in the current study but wrote an accompanying
editorial in the Journal of the American Medical Association.
"An enormous loss of human potential results from unsafe,
uncertain, stressful childhood environments," Halfon writes in
his editorial. "A casino in every neighborhood is not the
answer, but increasing family income and removing other
pressures that reduce the capacity of families to invest in
their children should be part of the solution."
American Indian children have disproportionately high rates
of obesity, the study says. An estimated 48 percent of them are
overweight or obese, and they are one and a half times more
likely to be overweight than other American youth, lead author
Jessica C. Jones-Smith told Reuters Health.
Jones-Smith, from the Johns Hopkins Bloomberg School of
Public Health in Baltimore, and her team used data from the U.S.
Census and California physical fitness programs to measure the
impact an influx of funds into a community has on its youth.
They examined the heights and weights of American Indian
children ages seven to 18 from California public school
districts in areas with tribal lands. Then they tracked what
happened when some of those communities built or expanded
casinos between 2001 and 2012.
Of the 117 public school districts included in the study, 57
either opened or expanded casinos. Of the remaining districts,
24 had existing casinos that did not expand and 36 had none.
Districts that opened or expanded casinos added an average
of 13 slot machines per resident. Such a change was associated
with a drop in the proportion of local youth who were overweight
or obese by 2.5 percent, Jones-Smith said.
The researchers counted students as overweight if their
weight was in the 85th percentile or above on the pediatric
"We weren't trying to weigh in on whether casinos should be
held up as an example of economic development," Jones-Smith
said. "Instead, we were trying to isolate the impact of economic
resources on kids' health."
Although why obesity rates fell in communities that added or
expanded casinos remains unknown, Jones-Smith has some ideas.
Her study suggested an addition of 13 slot machines per
capita in a community was linked to an increase in annual income
of $7,000 for each resident. The increased income might allow
families to purchase healthier, less fattening food, she said.
Federal law mandates that casinos return profits to their
communities or make charitable donations, Jones-Smith said. As a
result, she said tribes often build recreation centers, parks
and playing fields - places where youth participate in sports
and other weight-reducing activities.
Halfon said this study and others "demonstrating the health
benefits of alleviating poverty are particularly important given
the growing income inequalities, persistently high rates of
childhood poverty and stagnant wage growth in families with
Almost half of American children grow up in poor or "near
poor" families, he writes in his editorial.
UNICEF, the United Nations Children's Fund, ranked the U.S.
26th out of 29 developed countries on children's overall
well-being last year, Halfon noted.
"All we have to do is look at other nations and see what
they do to raise the children out of poverty," he said.
"Many of these countries are spending the same overall on
health and social programs. They spend it earlier in the
lifespan so they're launching their children into a healthy
trajectory, rather than waiting until their adults are burdened
with lots of chronic health problems and having to pay for