Problem Gambling Research

Loot box spending in video games is linked to problem
gambling severity

Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior

Effect of transcranial direct current stimulation on decision making and cognitive flexibility in gambling disorder

A Comparison of Self-Reported Impulsivity in Gambling Disorder and Bipolar Disorder

Regional impacts of casino availability on gambling problems: Evidence from the Canadian Community Health Survey

Free online casino games linked with higher risks of gambling problems for young people

Cognitive Neuroscience Can Support Public Health Approaches to Minimise the Harm of "Losses Disguised as Wins" in Multi‐Line Slot Machines

Pharmacological insights into impulsive‐compulsive spectrum disorders associated with dopaminergic therapy

Post-traumatic stress and gambling related cognitions: Analyses in inpatient and online samples

Prevention and Treatment of Problem Gambling Among Older Adults: A Scoping Review (PDF)

Decision-making ability in psychosis: a systematic review and meta-analysis of the magnitude, specificity and correlates of impaired performance on the Iowa and Cambridge Gambling Tasks

Types of change strategies for limiting or reducing gambling behaviors and their perceived helpfulness: A factor analysis

Playing with your future: Who gambles in defined-contribution pension plans?

The psychology of in-play betting: a brief overview

An Analysis of Consumer Protection for Gamblers Across Different Online Gambling Operators in Ireland: A Descriptive Study

Traumatic brain injury as an independent risk factor for problem gambling: a matched case-control study

Women with compulsive buying or gambling disorder: Similar profiles for different behavioural addictions

The dishonest gambler: Low HEXACO honesty-humility and gambling severity in a community sample of gamblers

Looking into the One‐way Mirror: A Pilot Study on the Impact of Reflecting Teams on Family Members

Genetic and environmental influences on gambling disorder liability: a replication and combined analysis of two twin studies

Effects of Gambling Diagnostic Criteria Changes from DSM-IV to DSM-5 on Mental Disorder Comorbidity Across Younger, Middle-Aged, and Older Adults in a Nationally Representative Sample

Characteristics of Treatment Seeking Problem Gamblers with Adult ADHD

The importance of friends and family to recreational gambling, at-risk gambling, and problem gambling

A Selected Social History of the Stepping-Stone Drugs and Opiates

Twenty Years After the Iowa Gambling Task: Rationality, Emotion, and Decision-Making

Gender-related differences in addiction: a review of human studies

Where's the Bonus in Bonus Bets? Assessing Sports Bettors' Comprehension of their True Cost

Decision-Making Styles, Negative Affectivity, and Cognitive Distortions in Adolescent Gambling

The Effectiveness of the Game of Dice Task in Predicting At-Risk and Problem Gambling Among Adolescents: The Contribution of the Neural Networks

Reward-Related Decision-Making Among Individuals with Current and Past Disordered Gambling: Implications for its Role in the Maintenance of Problem Gambling Behaviour

Gambling Among Adolescents and Emerging Adults: A Cross-Cultural Study Between Portuguese and English Youth

eSports: Opportunities for Future Ergonomic Studies

The Psychometric Properties of the Online Gambling Symptom Assessment Scale (OGSAS)

Problematic Gaming and Subjective Well-Being: How Does Mindfulness Play a Role?

Effects of bet size and multi-line play on immersion and respiratory sinus arrhythmia during electronic gaming machine use

The Relationship Between Video Gaming, Gambling, and Problematic Levels of Video Gaming and Gambling

Suicidality among gambling helpline callers: A consideration of the role of financial stress and conflict

Can Positive Social Perception and Reduced Stigma be a Problem in Sports Betting? A Qualitative Focus Group Study with Spanish Sports Bettors Undergoing Treatment for Gambling Disorder

eSports, skins and loot boxes: Participants, practices and problematic behaviour associated with emergent forms of gambling

Responsible Gambling Research and Industry Funding Biases

The impact of an exercise program as a treatment for gambling disorder: A randomized controlled trial

Crime and Gambling Disorders: A Systematic Review

Christianity and Gambling: An Introduction

Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictiors of gambling disorder treament response

Role Reversal: The Influence of Slot Machine Gambling on Subsequent Alcohol Consumption

History of co-occurring disorders and current mental health status among homeless veterans

Social genomics of healthy and disordered internet gaming

The Personality Context of Adolescent Gambling: Better Explained by the Big Five or Sensation-seeking?

Fun and fair, and I don't care: The role of enjoyment, fairness and subjective norms on online gambling intentions



Gambling disorder and obsessive-compulsive personality disorder: A frequent but understudied comorbidity

Conceptualizing gambling disorder with the process model of emotion regulation

Using the Syndrome Model of Addiction: a Preliminary Consideration of Psychological States and Traits

Pathological Gambling in Parkinson's Disease: autonomic measures and impaired decision‐making

Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial

Anabolic-androgenic steroids alter decision making in a balanced rodent model of the Iowa gambling task

Prevalence, risk factors, and psychosocial adjustment of problematic gambling in adolescents: Results from two representative German samples

Gamblers seeking online help are active help-seekers: Time to support autonomy and competence

EEG correlates associated with the severity of gambling disorder and serum BDNF levels in patients with gambling disorder

Time Perspectives and Gambling in Adolescent Boys: Differential Effects of Present- and Future-Orientation

Are Video Games a Gateway to Gambling? A Longitudinal Study Based on a Representative Norwegian Sample

Impulsivity and Problem Gambling: Can the Anticipated Emotional Rewards Explain the Relationship?

Spanish adaptation of the Gambling Motives Questionnaire (GMQ): Validation in adult pathological gamblers and relationship with anxious-depressive symptomatology and perceived stress

Correlates of frequent gambling and gambling-related chasing behaviors in individuals with schizophrenia-spectrum disorders

Searching for Replicable Dopamine-Related Findings in Gambling Disorder

Online interventions for problem gamblers with and without co-occurring problem drinking: study protocol of a randomized controlled trial

A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health

Running Head: Traumatic Stress and Gambling Motives

Problem and Pathological Gambling in Schizophrenia: Exploring Links with Substance Use and Impulsivity

Social Explanations of Lottery Play: New Evidence Based on National Survey Data

Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review

A Revision of the Relationship between Gambling Disorder, Attention Deficit Hyperactivity Disorder, and Parkinson's Disease

Crossover Effects of Protective Behavioural Strategies for Drinking on Gambling Consequences Among College Gamblers With Alcohol or Drug Abuse

Self-guided Change: The most common form of long-term, maintained health behavior change

Adolescent Problem Video Gaming in Urban and Non-urban Regions

Daily Fantasy Sports Players: Gambling, Addiction, and Mental Health Problems

Differential Effects of Formal and Informal Gambling on Symptoms of Problem Gambling During Voluntary Self-Exclusion

Psychopathology of addiction: Can the SCL90-based five-dimensional structure differentiate Heroin Use Disorder from a non-substance-related addictive disorder such as Gambling Disorder?

Internet-Based Structural Characteristics of Sports Betting and Problem Gambling Severity: Is There a Relationship?

Academic Outcomes of Young Adults with a Childhood Diagnosis of ADHD

Clinical predictors of gaming abstinence in help-seeking adult problematic gamers

The Metacognitions about Gambling Questionnaire: Development and psychometric properties

Nonmotor Symptoms in Parkinson's Disease

Impulsivity in Patients with Parkinson's Disease

Psychological Vulnerability and Problem Gambling: The Mediational Role of Cognitive Distortions

An Exploratory Study on Internet Addiction, Somatic Symptoms and Emotional and Behavioral Functioning in School-Aged Adolescents

An Exploration of How Simulated Gambling Games May Promote Gambling with Money

The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple Versus Individual Therapy

Compulsivity-related neurocognitive performance deficits in gambling disorder: A systematic review and meta-analysis

A Latent Class Analysis of Gambling Activity Patterns in a Canadian University Sample of Emerging Adults: Socio-demographic, Motivational, and Mental Health Correlates

Comparative analysis of potential risk factors for at-risk gambling, problem gambling and gambling disorder among current gamblers - Results of the Austrian representative survey 2015

Problematic gaming behaviour and health-related outcomes: A systematic review and meta-analysis

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

Evaluation of a School-Based Gambling Prevention Program for Adolescents: Efficacy of Using the Theory of Planned Behaviour

Cognitive Dissonance, Personalized Feedback, and Online Gambling Behavior: An Exploratory Study Using Objective Tracking Data and Subjective Self-Report

Identifying the Relationship Between Mental Health Symptoms, Problem Behaviors and Gambling Among Adolescents

Effectiveness of two web-based cognitive bias modification interventions targeting approach and attentional bias in gambling problems: study protocol for a pilot randomised controlled trial

Comparing the Professionalization of Pro Gamblers and Pro Video Game Players

Gambling Among the Military and Veterans

Beyond stereotypes of adolescent risk taking: Placing the adolescent brain in developmental context

Dimensions of Emotional Intelligence and Online Gaming Addiction in Adolescence: The Indirect Effects of Two Facets of Perceived Stress

Betting, Forex Trading, and Fantasy Gaming Sponsorships-a Responsible Marketing Inquiry into the 'Gamblification' of English Football

The Economic and Social Impact of the Gaming Industry During Economic Downturns

Internet gaming disorder: A sign of the times, or time for our attention?

DSM-5 diagnosis of Internet Gaming Disorder: Some ways forward in overcoming issues and concerns in the gaming studies field: Response to the commentaries

Alterations in functional brain networks associated with loss-chasing in gambling disorder and cocaine-use disorder

A Systematic Review of Treatments for Problem Gambling

Episodic and Binge Gambling: An Exploration and Preliminary Quantitative Study

Effects of alcohol, initial gambling outcomes, impulsivity, and gambling cognitions on gambling behavior using a video poker task.

Gambling disorder: an integrative review of animal and human studies

Psychological Vulnerability and Gambling in Later Life

Gender Differences in the Presentation of Observable Risk Indicators of Problem Gambling

Incidence of Problem Gambling in Romania Brief Report

Recovery Agency and Informal Recovery Pathways from Gambling Problems

Treatment of gambling disorder patients with comorbid depression

Food Addiction in Gambling Disorder: Frequency and Clinical Outcomes

The Blurred Future of Adolescent Gamblers: Impulsivity, Time Horizon, and Emotional Distress

Self-report and behavioural measures of impulsivity as predictors of impulsive behaviour and psychopathology in male prisoners

Adolescent Gambling: An Update on Research Since 2010

Identifying Environmental and Social Factors Predisposing to Pathological Gambling Combining Standard Logistic Regression and Logic Learning Machine

Macau parents' perceptions of underage children's gambling involvement

Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients

Cyberpsychology, Behavior, and Social Networking

Traits and Biomarkers for Addiction Risk in Schizophrenia

Disorder or Socially Adapted Behavior? The Field Dependent Nature of Psychopathology and Some Implications for Intervention

Adaptive and Maladaptive Coping Strategies in Adult Pathological Gamblers and Their Mediating Role with Anxious-Depressive Symptomatology

Gender comparison of online and land-based gamblers from a nationally representative sample: Does gambling online pose elevated risk?

Psychiatric Measures of Gambling Problems in the General Population: A Reconsideration

Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers

The Benefits of Customized DNA Directed Nutrition to Balance the Brain Reward Circuitry and Reduce Addictive Behaviors

Risky Behaviors in Life: A Focus on Young People

Change Strategies and Associated Implementation Challenges: An Analysis of Online Counselling Sessions

Barriers to Treatment for Female Problem Gamblers: A UK Perspective

How to intervene on gambling and recreational use of cannabis: overly divergent recipes for related behaviours

Motivation, Internal and External

Exploring Social Attitudes to Suicide Using a Predicament Questionnaire

Comparison of impulsivity in non-problem, at-risk and problem gamblers

A Method for Classifying Pathological Gamblers According to "Enhancement", "Coping", and "Low Emotion Regulation" Subtypes

Gambling and Video Game Playing Among Youth

Prevalence Studies of Problem Gambling in the United States

Moderate-Risk and Problem Slot Machine Gamblers: A Typology of Gambling-Related Cognitions

Should voluntary self-exclusion by gamblers be used as a proxy measure for problem gambling?

The Role of Memory Associations in Excessive and Problem Gambling

Study of Vulnerability to Addiction With Regard to SelfEfficacy and Alexithymia in High School Students

Why Can't I Stop?

Development and Validation of the Gambling Pathways Questionnaire (GPQ)

President Trump and the Future of Legal Gaming

Baseball's Best Bet: A Call for the Legalization of Baseball Gambling in the United States

The influence of juvenile preference for online social interaction on problematic Internet use: The moderating effect of sibling condition and the moderated moderating effect of age cohort

The need for a behavioural analysis of behavioural addictions

Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers

The unique roles of intrapersonal and social factors in adolescent smoking development.

Pathological gambling and impulsivity: Comparison of the different measures in the behavior inhibition tasks

Player Behavioral Tracking and Personalized Feedback in On- line Gambling: Implications for Prevention and Treatment of Problem Gambling

The Relationship Between Impulsivity And Problem Gambling In Adolescence

Tele-counselling for Problem Gambling: A Case Study

Sub-clinical Alcohol Consumption and Gambling Disorder

Beyond Recreational Gambling: a Psychological Perspective on Risk- and Problem Gambling

Smartphone-mediated communication vs. face-to-face interaction: Two routes to social support and problematic use of smartphone

Does the General Strain Theory Explain Gambling and Substance Use?

Patterns and Motives for Electronic Cigarette Use in a Sample of Community-Recruited Gamblers

Gambling machine annexes as enabling spaces for addictive engagement

A large-scale national study of gambling severity among immigrant and non-immigrant adolescents: The role of the family

Teacher Awareness and Attitudes Regarding Adolescent Risk Behaviours: a Sample of Finnish Middle and High School Teachers

Socioeconomic influence on adolescent problematic Internet use through school-related psychosocial factors and pattern of Internet use

Media use and Internet addiction in adult depression: A case-control study

Gambling Among Asian American College Students

Loss Aversion in Cocaine Users: Influence of Risk and Commodity Type

The Grinders: Making Meaning in the Online and Offline Lives of Internet Poker Players

Application of Research Domain Criteria to childhood and adolescent impulsive and addictive disorders: Implications for treatment

Sub-clinical Alcohol Consumption and Gambling Disorder

A Baseline Study of Past-Year Problem Gambling Prevalence Among Ohioans

Beyond Recreational Gambling: a Psychological Perspective on Risk- and Problem Gambling

Influence of Studying in Higher Educational Establishment on Students' Harmful Computer Habits

Addiction severity pattern associated with adult and childhood Attention Deficit Hyperactivity Disorder (ADHD) in patients with addictions

Therapist and Client Interactions in Motivational Interviewing for Social Anxiety Disorder

Personality disorders and pathological gambling

Brain behavioral systems, self-control and problematic mobile phone use: The moderating role of gender and history of use

Cue-Reactive Rationality, Visual Imagery and Volitional Control Predict Cue-Reactive Urge to Gamble in Poker-Machine Gambers

The Intersection of Obesity and the Longitudinal Course of Problem Gambling

Canadian Counselling Psychology Graduate Student Knowledge of Women Problem Gamblers

Prevalence of Problem Gambling Among Adolescents: A Comparison Across Modes of Access, Gambling Activities, and Levels of Severity

Understanding the Relationship Between Sports-Relevant Gambling and Being At-Risk for a Gambling Problem Among American Adolescents

Are Consumers More Willing to Invest in Luck During Recessions?

Neurobiology of Disordered Gambling

Factors Influencing Recognition of Motivation for Change in Pathological Gamblers

The Need for Knowledge Extraction: Understanding Harmful Gambling Behavior with Neural Networks

Problem gambling worldwide: An update and systematic review of empirical research (2000-2015)

The Longitudinal Relationships Between Psychiatric Disorders and Gambling Disorders

The Welfare Evaluation of Gambling Behavior: Evidence from Experiments

The Effectiveness of Group Acceptance and Commitment Therapy on Emotion Regulation in Methamphetamine-Dependent Individuals Undergoing Rehabilitation

2 "He Wants It All the Time, Doctor"

Problem Gambling and Financial Wellbeing: The Experience of Losing, Consuming, and Receiving Money

Neural Substrates of cue reactivity and craving in Gambling Disorder

Social Marketing Research and Cognitive Neuroscience

Where do Gambling and the Internet 'Addictions' Belong? The Status of 'Other' Addictions

Problematic alcohol use and problem gambling: Associations to structural and functional aspects of social ties in a Finnish population sample

"I Am Becoming More and More Like My Eldest Brother!": The Relationship Between Older Siblings, Adolescent Gambling Severity, and the Attenuating Role of Parents in a Large-Scale Nationally Representative Survey Study

Nudging and Manipulation for Health

Green tourism

Assisted Desistance: Crossroads Day Reporting Centre's Role in Re-Entry

Desire Thinking: A New Target for Treatment of Addictive Behaviors?

Measuring Risk in Adolescents before Harm for Prevention Not Treatment: A New Approach to Risk Assessment for Social Policy, and Prevention Applications.

Annotated Bibliography of Behavior Analytic Scholarship Outside of Analysis of Gambling Behavior: 2013-2015

Links to the past: Childhood maltreatment and gambling disorder

Asset Pricing with Revealed Utility

Initiation, influence, and impact: adolescents and parents discuss the marketing of gambling products during Australian sporting matches

Peripheral serotonin 1B receptor transcription predicts the effect of  acute tryptophan depletion on risky decision-making

Determinism, Probability, and Imprecision in Decision-Making

The International Handbook of Suicide Prevention

Legalized Gambling: Socio-Economic Impacts

Trait Mindfulness, Problem-Gambling Severity, Altered State of Awareness and Urge to Gamble in Poker-Machine Gamblers

Effects of a Comprehensive, Multiple Risky Behavior Prevention Program on High School Students(PDF)

Play the cards, roll the dice - the integration of casinos within Asian tourism destination development strategy

The Structural Features of Sports and Race Betting Inducements: Issues for Harm Minimisation and Consumer Protection

Confirmatory factor analysis of the Spanish version of the Gamblers' Beliefs Questionnaire in a sample of Argentinean gamblers

Group Treatment for Women Gamblers Using Web, Teleconference and Workbook: Effectiveness Pilot

Cognitive Behavioural Group Therapy for Problem Gamblers who Gamble over the Internet: A Controlled Study

The Efficacy of Individual Community Reinforcement and Family Training (CRAFT) for Concerned Significant Others of Problem Gamblers

Epistemophily-epistemopathy: use of the interent between normality and disease

Evaluation of the Psychometric Properties of SOGS-RA in the Polish Version

An Animal Model of Human Gambling

The Case for Using Personally Relevant and Emotionally Stimulating Gambling Messages as a Gambling Harm-Minimisation Strategy

Predictors of Problem Gambling in the U.S.

Improved Outcomes Following a Single Session Web-Based Intervention for Problem Gambling

The role of social and cognitive factors in individual gambling: An empirical study on college students

Big five personality and adolescent Internet addiction: The mediating role of coping style

Pharmacotherapy and group cognitive behavioral therapy enhance follow-up treatment duration in gambling disorder patients

Unpacking the public stigma of problem gambling: The process of stigma creation and predictors of social distancing

The world of gambling: the National Gambling Experiences series

And the Wisdom to Know the Difference

Reinforcer pathologies: Predicting alcohol related problems in college drinking men and women

Trajectories of abstinence-induced Internet gaming withdrawal symptoms: A prospective pilot study

Is Endorsing Gambling as an Escape More a Trait or a State?

Thoughts and acts of self-harm, and suicidal ideation, in online gamblers

Gambling among adolescents with and without hearing loss

Adolescent gambling behaviour, a single latent construct and indicators of risk: findings from a national survey of New Zealand high school students


Adolescent Gambling-Oriented Attitudes Mediate the Relationship Between Perceived Parental Knowledge and Adolescent Gambling: Implications for Prevention

Online interventions for problem gamblers with and without co-occurring mental health symptoms: Protocol for a randomized controlled trial

Relationships Between Problem-Gambling Severity and Psychopathology as Moderated by Income

The Relationship Between Gambling Fallacies and Problem Gambling

Chronic D2/3 agonist ropinirole treatment increases preference for uncertainty in rats regardless of baseline choice patterns (Parkinson's)

Understanding factors associated with problem gambling in a clinical sample

The agranular and granular insula differentially contribute to gambling-like behavior on a rat slot machine task: effects of inactivation and local infusion of a dopamine D4 agonist on reward expectancy

Correlates of Problem Gambling: A Bibliography

Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies

A Randomized Controlled Trial of Brief Interventions for Problem Gambling in Substance Abuse Treatment Patients.

Altered resting-state neural activity and changes following a craving behavioral intervention for Internet gaming disorder

A Review of Advertising in the 21st Century

Gambling and football: Epidemiological research on gambling participation and problem gambling among adult football players in Iceland

Prevalence of Adolescent Problem Gambling: A Systematic Review of Recent Research

Adolescent Gambling and Problem Gambling: Prevalence, Current Issues, and Concerns

An Update on Gender Differences in the Characteristics Associated with Problem Gambling: a Systematic Review

What did you expect? Ethnic differences in gambling expectancies

Investigating Veterans' Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling

Alcohol use and suicidal ideation among gamblers

Problem gambling and the five-factor model of personality: A large population-based study.

Early action: Smoking and gambling among high school students

Gambling Disorder and Women: Does Gender Make a Difference?

Stimulant use and gambling among college students

Screening for Gambling Problems: Have the Conversation

Screening for Gambling Disorder among student athletes

Problem gambling has more to do with how you gamble than where you do it.

A qualitative analysis of the effects of a comorbid disordered gambling diagnosis with schizophrenia.

The tipping point in addion

"Parkinson's Drug Sparks Gambling Fever!" Evaluating the scientific evidence that Mirapex causes Pathological Gambling

Treating the Source, the Symptoms, or the Correlates? Bupropion in the Treatment of Pathological Gambling

A Longitudinal Study of the Temporal
Relation Between Problem Gambling
and Mental and Substance Use
Disorders Among Young Adults

A Longitudinal Study of the Temporal Relation Between Problem Gambling and Mental and Substance Use Disorders Among Young Adults

Investigating Possible Reciprocal Relations Between Depressive and Problem Gambling Symptoms in Emerging Adults

Personality and Other Factors Associated with the Gambling Addiction

Gambling addiction and the evolution of the" near miss".

Chronic Dopamimetic Drug Addiction and Pathologic Gambling in Patients with Parkinson's Disease - Presentation of Four Cases

Casino gambling increases heart rate and salivary cortisol in regular gamblers

Pathological Gambling and Depression

Brain Imaging Studies in Pathological Gambling

Potential pathways to problem gambling: The relationships among life stress, gambling motives, and gambling behavior

Mixed Emotions to Near-Miss Outcomes: A Psychophysiological Study with Facial Electromyography

Bipolar Disorder and Gambling Addiction

Steps to Reducing Underage Access to Lottery Products: Synar Compliance and Suggestions

Impact of ADHD symptoms on clinical and cognitive aspects of problem gambling

Treatment of Patients With Multiple Addictions

Drinking stopping thinking: Alcohol and gambling fallacies

Gambling Problems, Relationships and Social Networks. Part 1: Social Networks: Good, Bad or Ugly

Musical Explorations of Problem Gambling

Adolescent Gambling in the Transition Years:A Special 3- Part WAGER

Youth Gambling Prevention: Can Public Service Announcements Featuring Celebrity Spokespersons be Effective?

HIV Risk Among Pathological and Non-Pathological Gambling Drug Users Part I - Adults

Biology, Addiction, and Gambling: What's the Matter with Kids Today?

Biology, Addiction, and Gambling: Cocaine Abstinence and Gambling

Do the Effects Hold?: Brief Gambling Treatment - Beyond the 12-Month Follow-up

Youth Gambling: A public health perspective