TY  - JOUR
AU  - Oddo, Vanessa M.
AU  - Walkinshaw, Lina Pinero
AU  - Jones-Smith, Jessica C.
PY  - 2019
TI  - Casino Ownership and Health-Related Community Resources Among Native American Tribes in California
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E14
VL  - 16
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - INTRODUCTION  Casinos are significantly associated with improved health among some Native Americans living on tribal lands. An increase in health-related community resources related to tribal ownership of casinos may be one mechanism through which the health of Native Americans is improved. However, no studies have quantitatively assessed whether casinos are associated with having more community resources. METHODS  To investigate the association between casino ownership and health-related community resources among Native Americans, we surveyed 81 of California's 110 federally recognized tribes about casino ownership and health-related community resources during 2015 and 2016. We created a total health-related community resources score (maximum of 50 points) by grouping resources into 5 subdomains (community infrastructure, health care and education, social determinants, recreational infrastructure, and recreation programs), which we scored for a maximum of 10 points each and then summed. Casino ownership was our independent variable. We used adjusted linear regression models to test the association between casino ownership and health-related community resources. RESULTS  Half (49%) of the tribes surveyed owned a casino. Compared with tribes without casinos, tribes with casinos had higher total health-related community resource scores (beta = 5.09; 90% confidence interval [CI], 1.17-9.01). Casino-owning tribes had more resources related to community infrastructure (beta = 1.81; 90% CI, 0.81-2.80), social determinants of health (beta = 1.45; 90% CI, 0.24-2.67) and recreational infrastructure (beta = 1.08; 90% CI, 0.24-1.92) compared with tribes without casinos. CONCLUSIONS  Casino ownership is significantly associated with health-related community resources. Future research should assess whether community resources mediate the relationship between economic resources and health among Native Americans.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd16.180252
DO  - 10.5888/pcd16.180252
ER  - 
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