Population Research and Policy Review 19: 551–570, 2000.
© 2000 Kluwer Academic Publishers. Printed in the Netherlands.
Visitor suicide risk in casino resort areas
KENNETH S. Y. CHEW, RICHARD McCLEARY, VINCENT MERRILL
& CAROL NAPOLITANO
Department of Environmental Analysis & Design, School of Social Ecology, University of
California at Irvine, USA
Abstract. In a well-publicized analysis of visitor suicides in three casino areas (Atlantic
City, Las Vegas, and Reno), elevated suicide risk among interstate visitors was attributed to
the presence of legalized gambling. A fundamental limitation of the analysis, however, was
the absence of estimates for at-risk populations. In the present paper, an analysis of 1995
visitor-suicide rates (incorporating estimates for at-risk population) for 310 large US counties,
including places both with and without gambling casinos, yields no evidence to support a
Keywords: Suicide, Casino area, Gambling
An analysis of recent suicides in Las Vegas, Reno, and Atlantic City con-
cludes that: [g]ambling or some factor closely associated with gambling
settings is linked to elevated suicide levels. These ﬁndings raise the possibility
that the recent expansion of legalized gambling and the consequent increase
in gambling settings may be accompanied by an increase in US suicides
(Phillips et al. 1997: 378). In that study’s casino areas, suicides account for a
greater proportion of all deaths than suicides in non-casino areas. Moreover,
the apparent surplus of suicide in gambling areas affects both their residents
and their visitors alike (Phillips et al. 1997).
In the present article, we use additional data and reﬁned methodology
to reexamine the relationship between casino gambling and visitor sui-
cide. Though resident and visitor suicides share common elements, they
are theoretically distinct: residents and visitors populate divergent niches in
the ecology of gambling settings, requiring commensurately divergent ap-
proaches to explanation. Moreover, analyses of resident and visitor suicides
pose distinct methodological challenges. The present analysis, therefore,
focuses exclusively on visitor suicide.