Improving spatial microsimulation estimates of health outcomes by including geographic indicators of health behaviour: The example of problem gambling.

Gambling is an important public health issue, with recent estimates ranking it as the third largest contributor of disability adjusted life years lost to ill-health. However, no studies to date have estimated the spatial distribution of gambling-related harm in small areas on the basis of surveys of problem gambling. This study extends spatial microsimulation approaches to include a spatially-referenced measure of health behaviour as a constraint variable in order to better estimate the spatial distribution of problem gambling. Specifically, this study allocates georeferenced electronic gaming machine expenditure data to small residential areas using a Huff model. This study demonstrates how the incorporation of auxiliary spatial data on health behaviours such as gambling expenditure can improve spatial microsimulation estimates of health outcomes like problem gambling.