Demographic Risk Factors and Gambling Preference May Not Explain the High Prevalence of Gambling Problems Among the Population with Migration Background: Results from a German Nationwide Survey.

There are high proportions of problem gamblers among individuals who themselves or whose parents immigrated to Germany. This study aimed to examine whether demographic risk factors and gambling preference may explain the higher prevalence of gambling problems among those with migration background (MB). Data was obtained from a nationwide telephone survey which was part of the project "Pathological Gambling and Epidemiology" (PAGE). The sample comprised 15,023 study participants aged 14-64 years living in Germany. Participants who had reported gambling within their lifetime (n = 6,406) were defined as gamblers and categorized according to their MB (n = 1,209 with MB), additional demographic characteristics (sex, age, marital status, household size, education, occupation), preferred types of gambling (21 categories covering the gambling types available in Germany), and the count of lifetime gambling problem symptoms (0-10 criteria of the fourth Diagnostic and Statistical Manual of Mental Disorders). Estimates from a negative binomial regression revealed that there is a 146.2% increase in the expected count of gambling problem symptoms for gamblers with MB compared to those without MB. The percentage decreased to 102.5 and 97.6% after adjustment for demographic characteristics and further adjustment for preferred types of gambling, respectively. Demographic risk factors and gambling preference may partially mediate but not completely explain the higher prevalence of gambling problems among the population with MB. Having an MB may be considered as an independent risk factor for gambling problems, which indicates a need for culturally sensitive prevention and treatment measures.