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Gambling and Poverty Hub at the MAP Centre for Urban Health Solutions,
St. Michael's Hospital

Elderly man scratching lotto ticket

Gambling, Gaming & Technology Use
Knowledge Exchange

Gambling and Poverty Hub at the Centre for Urban Health Solutions, St. Michael's Hospital

Problem Gambling, Poverty and Homelessness


Gambling occurs at a very high rate among people experiencing poverty and homelessness. In fact, 35% of men using shelter services in Toronto have reported serious or even severe gambling problems at some point in their lives. This is nine times higher than the general population.

The relationship between problem gambling and poverty can be complicated by experiences of homelessness, trauma, violence, mental illness and substance use. These experiences are also impacted by intersections of class, race, culture, sex and gender identity. Our research has identified a need for:

  • stronger awareness of problem gambling, homelessness, mental illness and substance use disorders among service providers
  • integrated service delivery plans to address concurrent disorders
  • empathetic, sincere and well-communicated person-centred care
  • holistic life plans for clients with an emphasis on personal empowerment and autonomy.

Click here to read personal stories shared with our research team.

Gambling Among Adults Experiencing Poverty and Homelessness: A Training Video 


People who are experiencing poverty and/or homelessness along with problem gambling can benefit from supports and services that are customized to their needs. This video describes the case management approach of the Gambling Addiction Program at the Good Shepherd Ministries in Toronto, a unique and first of its kind program in Canada. Melinda, a gambling addiction case worker in the program, highlights her client- centred approach and viewers will gain insight into the circumstances of people experiencing homelessness and problem gambling. Strategies of how service providers and others can effectively work with this population are also highlighted. The video was developed in partnership with Good Shepherd Ministries and St. Michael’s Hospital. (13.35 minutes in length).

Our Mission​

There is a gap in knowledge—and knowledge sharing—related to the health of people who face gambling concerns and the complex consequences of poverty (e.g., homelessness, poor health, etc.).

The Gambling and Poverty Hub at the MAP Centre for Urban Health Solutions of St. Michael's Hospital is dedicated to:

  • understanding the range of experiences of people who endure problem gambling and homelessness through methods such as:
    • peer interviewing (face-to-face interviews)
    • World Cafés, a uniquely interactive method of conversation between service providers and people experiencing gambling and housing concerns
  • using research and evaluation with our community partners to create tailored supports for their clients
  • building awareness about problem gambling and the social determinants of health through knowledge translation.
Illustration of person struggling with gambling addiction as Sisyphus

Our Hub and the Gambling Research Exchange of Ontario

Our Gambling and Poverty Knowledge Hub, led by Dr. Flora Matheson and supported by the Gambling Research Exchange Ontario (GREO), generates knowledge and awareness about problem gambling and poverty research. In 2017 and 2018, Dr. Matheson received funding to support two projects:

Raising awareness: Multi-sector engagement to enhance understanding of gambling and poverty

In 2014, Dr. Matheson conducted a prevalence study that found a higher rate of problem gambling among people living in homeless shelters than the general population. In order to inform stakeholders and the public about this problem, the Raising Awareness project began. In collaboration with Dr. Matheson's team and Community Advisory Committee members, four university students created knowledge translation products based on Dr. Matheson's research. Pamphlets for youth and women, a whiteboard video for youth, a digital story and written feature documenting adult male experiences for adults, and a training module for service providers were created. See them in our Guides and Resources section.

Women creating community: Supporting women to manage problem gambling through arts-based programming

The Women Creating Community Project  is a collaboration between St. Michael’s Hospital, The Jean Tweed Centre, Fred Victor, and the Gambling Research Exchange Ontario, with support from a community advisory committee comprised of people with lived experience of gambling concerns, community service providers, and community stakeholders The project team recognize the potential of art therapies to improve well-being, and chose to focus a program towards women who experience gambling harms. These women may choose to gamble to relieve stress, loneliness, or traumatic memories. The program provided an opportunity for women to gain new skills, have fun and create social connections with other women experiencing similar life circumstances.

Guides and Resources

Problem Gambling: A Guide for Helping People Experiencing Poverty cover

Problem Gambling: A guide for helping people experiencing poverty

With Gambling, Gaming & Technology Use at the Centre for Addiction and Mental Health and Good Shepherd Ministries, the Gambling and Poverty Hub at the Centre for Urban Health Solutions co-developed a manual to guide social and health service providers working with people who have low incomes, housing concerns and concerns with gambling.

Don't Leave it to Chance: Problem Gambling Facts for Women Pamphlet thumb

Don't Leave it to Chance: Problem Gambling Facts for Women

See here for the pamphlet we created for women experiencing concerns with gambling. It is strength-based and female-specific, providing information about how and why women may gamble, the link between problem gambling and other complex needs, how to manage gambling urges, and helplines and resources. This pamphlet was produced within our Raising Awareness project.

Don't Leave it to Chance: Problem Gambling Facts for Youth thumb

Don't Leave it to Chance: Problem Gambling Facts for Youth

A pamphlet for youth was also developed in part with our Raising Awareness project. It takes a harm-reduction approach to gambling, but also aims to increase awareness among youth about gambling-related harms. It discusses the ways youth may gamble, how gambling works, why people gamble, how to spot when it's becoming a problem, how to play smart, and helplines and resources.

Webinar: Exploring the link between gambling and poverty

Watch this webinar, created by Gambling Research Exchange Ontario (GREO), for an introduction to Dr. Matheson's gambling and poverty research.

Joey's Story with Problem Gambling: A Whiteboard Video

An animated video developed for and informed by youth who have lived experience with trauma, poverty and gambling. It presents an engaging, illustrated narrative of the challenges associated with youth problem gambling, the recovery process, and resources.


New Directions

Dr. Matheson is the lead research partner on the following initiatives:

Good Shepherd Ministries poverty reduction fund project​

The Local Poverty Reduction Fund (LPRF) is a $50 million six-year initiative of the Ontario government to support innovative, community-driven projects that measurably improve the lives of people most affected by poverty. Good Shepherd Ministries has launched the Gambling Addictions Program, a pilot project that supports individuals who struggle with homelessness and problem gambling. In collaboration with Good Shepherd Ministries, Dr. Matheson and her team will evaluate the impact of this new intervention and find sustainable housing and other support for their clients. Click here to read the Toronto Star article about the pilot program's success. 

Optimizing support and service delivery for problem gambling among people with complex needs

The Ministry of Health and Long-Term Care Health System Impact Fund for Targeted Research on Problem Gambling aims to ensure that research is innovative and evidence-based to inform policies and decision-making. Dr. Matheson (lead), Dr. Sara Guilcher (co-lead) and their team at St. Michael's Hospital and the University of Toronto conducted four related projects that focus on problem gambling and poverty to improve experiences for clients and health practitioners. One component of this research involved a concept-mapping project to identify what health practitioners need in order to optimize service delivery for people with problem gambling and complex needs. The team also conducted a scoping review of self-management strategies, qualitative interviews with clients of three community partner organizations and co-developed a smartphone app in partnership with the Biomedical Zone. The app was piloted at some of our partner organizations.

Betting on housing: Women, problem gambling and homelessness

Research on problem gambling and homelessness is predominantly male focused. This study is the first in Canada to research problem gambling among women experiencing homelessness. Funded by the Social Science and Humanities Research Council, this study intends to uncover the kinds of experiences that can lead to problem gambling and homelessness in women, such as concurrent mental illness, substance use, immigration and interpersonal violence. Problem gambling NODS-CLiP screening and qualitative methods will be used to identify their needs as well as gaps in supports and services. The goal of this research is to inform new and existing problem gambling treatment services for women at municipal, provincial and federal levels.

Meet Our Team

  • Dr. Flora Matheson
  • Sarah Hamilton-Wright
  • Dr. Jessica Wiese
  • Alison Baxter
  • Parisa Dastoori
  • Kevin Wu
  • Guido Tacchini
  • Carrie Adams

We are a dynamic team with specializations and expertise in areas including:

  • problem gambling
  • poverty
  • homelessness
  • disability
  • multimorbidity
  • gender and youth studies
  • criminalization
  • mental health
  • substance use
  • health equity
  • qualitative methods
  • quantitative methods
  • World Café method
  • concept mapping
  • evaluation
  • scoping, narrative and systematic reviews
  • social determinants of health
  • knowledge translation
  • graphic design
  • film production.


Community Advisory Committee

Our relationships with community agencies make our research meaningful and useful. We work closely with our Community Advisory Committee (CAC) and people with experiences of poverty and problem gambling to ensure that our research and solutions are helpful in services and treatment plans.

To create this website, we reached out to the community for help. We thank the members of the CAC for their wisdom and thoughtful guidance to create a space that brings together knowledge on problem gambling and poverty.

Our community partners:

Jean Tweed logo
Good Shepherd Ministries logo
Youth Gambling Awareness Program logo
Fred Victor logo
COSTI logo
Gambling Research Exchange Ontario logo
Black Youth Helpline logo
Ontario Pharmacists logo
Public Health Ontario logo
Skylark logo

Published Highlights

Open access publications

  • Baxter, A., Salmon, C., Dufresne, K., Carasco-Lee, A. & Matheson, F.I. (2016). Gender differences in felt stigma and barriers to help-seeking for problem gambling. Addictive Behaviors Reports, 3, 1-8. doi: 10.1016/j.abrep.2015.10.001
  • Devotta, K., Woodhall-Melnik, J., Pedersen, C., Wendaferew, A., Dowbor, T.P., Guilcher, S.J., Hamilton-Wright, S., Ferentzy, P., Hwang, S.W. & Matheson, F.I. (2016). Enriching qualitative research by engaging peer interviewers: A case study. Qualitative Research, 16 (6), 661-680. doi: 10.1177/1468794115626244
  • Guilcher, S.J.T., Hamilton-Wright, S., Skinner, W., Woodhall-Melnik, J., Ferentzy, P., Wendaferew, A., Hwang, S.W. 
    & Matheson, F.I. (2016). "Talk with me": Perspectives on services for men with problem gambling and housing instability. BMC Health Services Research, 16, 340-353. doi: 10.1186/s12913-016-1583-3
  • Hamilton-Wright, S., Woodhall-Melnik, J., Guilcher, S.J., Schuler, A., Wendaferew, A., Hwang, S.W. & Matheson, F.I. (2016). Gambling in the landscape of adversity in youth: Reflections from men who live with poverty and homelessness. International Journal of Environmental Research and Public Health, 13 (9), 853-870. doi: 10.3390/ijerph13090854
  • Kryszajtys, D.T., Hahmann, T.E., Schuler, A., Hamilton-Wright, S., Ziegler, C.P. & Matheson, F.I. (2018). Problem gambling and delinquent behaviours among adolescents: A scoping review. Journal of Gambling Studies, 1-22. doi: 10.1007/s10899-018-9754-2
  • Schuler, A., Ferentzy, P., Turner, N.E., Skinner, W., McIsaac, K.E., Ziegler, C.P. & Matheson, F.I. (2016). Gamblers Anonymous as a recovery pathway: A scoping review. Journal of Gambling Studies, 32 (4), 1261-1278. doi: 10.1007/s10899-016-9596-8
  • Ferentzy, P., Skinner, W.J. & Matheson, F.I. (2013). Illicit drug use and problem gambling. ISRN Addiction, 2013, 1-11. doi: 10.1155/2013/342392
  • Matheson, F. I., Hamilton-Wright, S., Kryszajtys, D. T., Wiese, J. L., Cadel, L., Ziegler, C., Hwang, S. W., & Guilcher, S. J. T. (2019). The use of self-management for problem gambling: A scoping review. BMC Public Health, 19:445. doi:

Limited access publication (abstract available)

  • Matheson, F.I., Devotta, K., Wendaferew, A. & Pedersen, C. (2014). Prevalence of gambling problems among the clients of a Toronto homeless shelter. Journal of Gambling Studies, 30 (2), 537-546. doi: 10.1007/s108​99-014-9452-7

Plain-language summaries


Flora ​Matheson, PhD
Scientist II
MAP Centre for Urban Health Solutions, St. Michael's Hospital

Michael Oliveira

Manager, Media & Digital Services, Strategic Communications
St. Michae​l's Hospital

Aklilu Wendaferew, MSW, RSW
Assistant Executive Director
Problem Gambling Addictions Program, Good Shepherd Ministries
Telephone: 416 869-3619 ext. 263​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​