Introduction

With a population of 2.3 million people as of 2016, Chinese immigrants are one of the oldest and largest immigrant groups in the U.S. (Zong and Batalova 2017). Their unique experiences as an immigrant group has led to a growing body of literature on their circumstances and needs. The majority of this literature has focused on working-aged Chinese immigrants, while the experiences of older Chinese immigrants remain understudied (Guo et al. 2016). Older Chinese immigrants face problems such as limited English proficiency, limited access to social services, and social isolation (Dong and Chang 2017; Liu et al. 2017). Additionally, personal and media accounts have suggested that Chinese communities engage in high rates of gambling, which is reflected in the fact that casinos are specifically targeting Chinese communities through advertisements and promotions (Osman 2018; Storey 2018). These stories paint a picture of a community in peril. However, little is actually known about older Chinese immigrants’ experiences with gambling, particularly in the U.S.

Gambling and Gaming in Chinese Culture

Gambling in Chinese communities dates back to ancient China, despite its having been prohibited throughout its history (Wu and Lau 2015). Perhaps to circumvent the illegality of gambling large amounts of money, many Chinese turned towards what was commonly referred to as “gaming.” Wu and Lau (2015) define “gaming” as betting small amounts for entertainment and not for monetary gains. While gambling and the desire to win money was undesirable, “gaming” was encouraged both in the greater society and within families (Wu and Lau 2015). Over time, though, the line between “gambling” and “gaming” has become blurred. The expansion of western gambling industries into Macau, such as casinos, has increased opportunities for the Chinese from mainland China and Hong Kong to participate in different types of gambling through casino tourism (Tse et al. 2010). Gambling is still considered illegal in China but it seems to be quite popular, though it is not referred to as “gambling,” but rather as “gaming” (Tse et al. 2010).

Chinese culture places an emphasis on fate, destiny, and luck, which may be associated with gambling behaviors (Papineau 2005; Subramaniam and Chong 2017). With a small number of older adult gamblers in Singapore, the majority of whom identified as Chinese, Subramaniam et al. (2017) found that the illusion of control among gamblers played a central role in their perception of gambling. The illusion of control refers to an individual’s belief that they can control gambling outcomes either actively or passively, via skill or luck, respectively. These older adult gamblers discussed the perception of gambling as a skill, alongside the concept of luck. Those who believed that skill played a role in gambling would practice honing their skills, while the concept of luck allowed them to further explain their wins. Losses were then attributed to being in an unlucky phase or around an unlucky person. It has been suggested that cognitive distortion, including the illusion of control, is associated with increased gambling (Toneatto et al. 1997; Wong and Austin 2008).

Gambling Among Chinese Immigrants

A number of gambling studies on Chinese populations have been conducted abroad, including in Singapore (Subramaniam et al. 2017), Hong Kong (Ohtsuka and Chan 2014), Macao (Fong and Ozorio 2005), Australia (Ohtsuka 2013; Blaszczynski et al. 1998), New Zealand (Tse et al. 2012), and Canada (Lai 2006). These studies have looked at prevalence rates, along with participants’ views on gambling. Among older Chinese immigrants in Canada, Lai (2006) found that 26.6% of study participants reported having gambled in the previous 12 months. In a study of senior gamblers in Hong Kong, 16.67% of participants were identified as pathological gamblers (Ohtsuka and Chan 2014). In Macao, where casinos are one of the main tourist attractions, 67.9% of study participants had engaged in some form of gambling within the last year, with 20% of the participants going to casinos. However, Blaszczynski et al. (1998) found that 60% of a Chinese speaking community in Australia reported never having gambled before, though they experienced a higher rate of pathological gamblers within their group than the general population. Additionally, in a separate study in Australia, older Chinese gamblers indicated that they only spent small amounts of money while gambling and were, therefore, unlikely to develop gambling problems (Ohtsuka 2013). Although these studies provided useful groundwork on gambling among Chinese immigrants, they do not contextualize their gambling behaviors.

In the U.S., little is known about the gambling habits and perceptions of older Chinese immigrants. In a study on community-dwelling older Chinese in Chicago, Chen and Dong (2015) found that 14.8% of participants had engaged in gambling in the past year and, of those, 13.9% reported a risk of problem gambling. They also found that the longer an immigrant had lived in the U.S., the more likely they were to participate in gambling. Interestingly, older adults in their study who gambled reported a better health status, which contradicts previous studies on gambling and health. In a study conducted in Singapore using a secondary analysis, Subramaniam et al. (2015) found that gamblers over 60 years were 3.2 times more likely to have diabetes and 4.9 times more likely to have hypertension, compared to gamblers between 18 and 59 years old.

It has been suggested that easy access to casino bus tours, heavily marketed towards Asian immigrants, are partially responsible for increased gambling among immigrant communities (Yang 2014). These buses are readily available shuttling groups from ethnic enclaves, like Chinatowns, to surrounding casinos (Singer 2013). Proximity to gambling venues has been linked to higher rates of gambling participation and risk for problem gambling (Welte et al. 2016; Pearce et al. 2008). The convenience and accessibility of casino bus tours has played an integral part in peoples’ decision and ability to visit casinos (van der Maas et al. 2017). Among Chinese immigrants, going to a casino is one of the most popular gambling activities (Chen and Dong 2015; Tang et al. 2007).

There is a general concern about the well-being of the gamblers and risks associated with heavy gambling in Chinese communities (Liao and NICOS Chinese Health Coalition n.d.; Sobrun-Maharaj et al. 2012). Though it is important to be able to address problem gambling within this community, it can also be detrimental to inappropriately stereotype any community group as problem gamblers. Although there is a growing body of literature on gambling among older Chinese immigrants abroad, the knowledge about the community in the U.S. is still limited. To our knowledge, there have not been any previous qualitative studies seeking to explore the perceptions and experiences of gambling among older Chinese immigrants in the U.S.

Purpose of Study

The purpose of this study is two-fold: (1) to explore the cultural meanings and definitions of gambling and problem gambling among older Chinese immigrants, and (2) to explore older Chinese immigrants’ own gambling behaviors.

Methods

Participants

Participants were recruited for this study through a senior center in New York City that provides multiple services to older Chinese immigrants. Flyers advertising the study were posted at the center, and staff members assisted in recruiting those they knew to engage in playing mahjong. In order to be part of this study, participants must be (1) self-identified as Chinese; (2) able to speak Cantonese or Mandarin fluently; (3) over 65 years old; and (4) self-identified as having gambled within the past 12 months. Gambling was defined as “betting money while playing any games.”

Twenty-five participants were interviewed, with ages ranging from 65 to 89 years old and a mean age of 72.4. Fourteen participants were male and eleven were female. The participants emigrated from five different areas, including Guangdong, Shanghai, Hong Kong, Taiwan, and Indonesia. Demographic characteristics of the participants are presented in Table 1.

Table 1 Participant demographics and gambling types (N = 25)
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Procedure

One bilingual (English–Mandarin) and one trilingual (English–Mandarin–Cantonese) Master of Social Work graduate student conducted semi-structured interviews based on an interview protocol. Interviews generally lasted 50 min and occurred in a private room at the senior center. Informed consent was obtained at the start of each session and each interview was digitally recorded. At the end of the interview, participants were given a $20 gift card for a local supermarket to compensate them for their time. This study was approved by the university Institutional Review Board (IRB#00003128).

The interview protocol, was divided into two categories: the first part asked participants about their own behaviors, while the second part asked about their views on the behaviors of others in general. Table 2 shows the basic interview questions.

Table 2 Interview questions
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Data Analysis

In order to prepare the qualitative data for analysis, all recordings were transcribed verbatim by one of four bilingual research assistants and verified by another. After transcriptions were completed and verified, they were translated by one of the research assistants and verified by another research assistant. Discrepancies between translations were discussed with the second author and a decision was made. Data for this study was analyzed thematically to gather a descriptive understanding of older Chinese immigrants’ perspectives on gambling. Thematic analysis can unearth meanings and the experiences of participants, while examining these experiences through a broader social and historical context (Braun and Clarke 2006). In addition to the 6 phases of thematic analysis described by Braun and Clarke (2006), a constant comparative method was used for coding and categorizing throughout the study. The constant comparative method requires researchers to compare transcripts while identifying similarities and differences among available data (Boeije 2002).

During the initial coding process, the authors separately analyzed one transcript before coming together to meet and discuss coding. The first author also developed a summary of the transcript that included key quotes from the interview as well as a profile of the interviewee. After the analysis meetings, which involved discussing the separately generated codes, the first author revised the transcript summaries appropriately. After a month of analyzing one transcript at a time, the authors were confident with the intercoder reliability and increased the analysis to 2–3 transcripts at a time. Subsequent transcripts were read and coded with the previous analysis of interviews in mind. Once all transcripts were coded, the authors grouped codes together to create potential themes and gathered transcript data that supported the potential themes. A list of major themes was created after the final analysis of all the potential themes and supporting data.

Findings

This study provided insights into older Chinese immigrants’ perceptions of gambling and their own gambling behaviors. In-depth analysis of interviews revealed that the participants had strong beliefs about how gambling was defined and that, ultimately, their own behaviors did not fall into what they considered to be gambling. In defining gambling, three themes were identified: differentiating between “gambling” and “playing,” equating “gambling” with “problem gambling,” and believing that “gambling” ultimately leads to loss.

Defining Gambling

“Gambling” Versus “Playing”

Although this study defined “gambling” as playing games for money, it was clear that participants defined “gambling” differently. For them, there was an inherent difference between gamblers and players, the latter describing their own behavior. The older Chinese immigrants in this study spoke about playing games but believed that their behaviors were a form of entertainment, similar to going to a movie or going on a trip, as opposed to gambling. Often, the money they spent playing at casinos was seen in the same way as paying for entertainment or food.

I treat it, I treat it as a kind of entertainment. It’s not officially gambling. Me, this, it’s not called officially gambling. If [you] calculate it, it’s not officially gambling. Some people lose tens of dollars [and] become loud and noisy. I lose tens of dollars, I don’t see it as a thing. But, I…er … The best is winning tens of dollars. Not greedy. (M, aged 73)

I treat it as eating, eating a meal and that’s it. (I) treat it as drinking tea. We are neither going frequently, nor (going) on daily basis. Ha, that is, only going once or twice a month, nothing more. (It) is not a very large problem. Right? That is to kill some time. (F, aged 71)

“Real Gambling” is “Problem Gambling”

Furthering their belief that there was a difference between gambling and playing was how they described “real gambling.” In their discussion of real gambling, they spoke about extremes that would occur when one engages in gambling too much. A real gambler was described in the following ways:

For somebody who likes gambling, they don’t even think about eating, they go gambling. (F, aged 71)

He loses it all every week. He always borrows dozens of dollars to gamble. He does not care whether it’s win or lose. He has to gamble until he’s satisfied. After he loses all his money, not even a penny is left behind, then he’ll leave the table. He won’t leave after winning one or two thousand dollars either. He is addicted to it. That’s almost a disorder. (M, aged 68)

Nearly all of the participants indicated that a person who has gone so far as to be addicted to gambling is someone who could no longer be helped. In addition to describing gamblers through extremes, gambling was often also compared to drug and alcohol addiction:

This is same as like smoking marijuana, smoking cigarette, and taking drugs, there is no way to control it. When the blood rushes up to the brain, “wow,” you cannot control it yourself, you don’t know what happened, it’s really difficult. (M, aged 68)

Ultimately, the older Chinese immigrants believed that real gambling was a form of addiction, similar to substance abuse, and that all were too difficult to control or to address. That is, for them, real gambling was problem gambling because gamblers continued to gamble regardless of the negative consequences.

“You Lose in Gambling”

The most-described negative consequence of gambling was loss. Gamblers were described as having lost money, homes, businesses, and even family and friends. Most participants shared their belief that gambling was ultimately unwinnable, and that those who gambled would end up losing their money. One participant explained the origin of the Chinese phrase for a slot machine, which translates to “tiger machine”:

Of course, that slot machine tells you clearly that it is a “tiger machine”! You keep feeding, keep feeding, no matter the amount you feed, it doesn’t get full, right! (M, aged 66)

The financial loss caused by gambling would extend to personal relationships, because of extra stress due either to financial problems or to gamblers constantly asking to borrow money. The belief was best summed up by one individual who stated, “after gambling, families lost peace, families became messy” (M, aged 89). This disruption among families was also explained through domestic violence:

After being addicted to gambling, he would not be able to do any other things. You would not care about your family (if) you were the wife. Men would gamble and lose all the money they have earned, and ask their wives for money, if the wife doesn’t have money (for them), (they) would hit their wives. (F, aged 79)

Motivation for Gambling Behaviors

Although participants had negative perceptions of gambling in general, they often spoke about how they used gambling in a favorable manner. The older Chinese immigrants in this study described four major reasons for their own gambling: as a coping strategy, as a form of socialization, as a way to improve health, and as a way to prove their luck or skill.

Coping Strategy

As a group that was mostly retired, the participants indicated that gambling was helpful for occupying their time and their minds with something to do. Many of the older Chinese immigrants spoke about their daily routine, which did not vary. The redundancy of a daily routine provided little opportunity for mental stimulation, which they sought through playing games. Gambling provided an opportunity for them to experience an uncertainty or newness that was different from their usual daily experiences. Losing interest in gambling was actually seen as an indication that someone had lost interest in their regular life:

But I can also say, for seniors, it is a good thing. Just treat it as passing the days, it is quite nice. Why is that? Because then he has some… interest. That is, turns out there is a purpose of living. It is good that I saw many seniors going to casinos like this… They played for many years. Once they stop going, they are done. That is, they lose that vitality. It is almost the end, the end of that lifespan. Many are like this. In the end, there is no interest at all because he lost all of the spirits already. (M, 72)

When reflecting on their previous gambling experiences, participants spoke about how they gambled to help reduce stress in their lives. One participant explained that gambling could help when adjusting to a new environment and culture, including limited English proficiency:

Because he wants to gamble… it has an excitement… Everyone doesn’t understand English or understand very little. Basically, can’t assimilate to the American society. He’s also bored. Eating, working, eating, working. It’s boring. Bored, and then he will go gambling. He wants to pursue that excitement. (M, aged 67)

In the immediate years after immigration, gambling helped keep participants’ minds off of all the changes, new experiences, and challenges they were going through as immigrants. Another participant discussed his immigration process and how he needed to find a way to relax from the stress of the process, which he found by going to Atlantic City with his friends. He explained:

You can forget all your stuffiness, a lot of your frustrations. Maybe temporarily forget about it. Just like I don’t have to worry about today. It diverts attention. It’s troublesome. (M, aged 79)

Additionally, gambling was associated with a sense of excitement that helped bring out a different feeling among the participants. Casinos were described as loud, bright, and infatuating. Participants were drawn to the excitement that casinos and gambling fostered in them. Specifically, there was a belief that gambling had an effect on their nerves:

Just wanted to excite my nerve, back then, winning and losing do not mean anything to me, I viewed money as unimportant, I just like to play. (M, aged 68)

Whereas that participant wanted the excitement of gambling, another spoke about how gambling helped him feel calmer:

The benefit is it anesthetize the nerves. That is, forget about the grass and wood (An idiom indicating that attention is really focused, to the point where the person forgets/ignores everything around him.) when (he) gambles. (M, aged 71)

Socialization

Older Chinese immigrants also described how they would gamble to help them socialize with friends and family. A number of participants stated that they only go to casinos with family or friends but would not go by themselves. It was friends who first brought them to casinos in the U.S. Trips to the casinos would turn into regular activities for them to get together. For some, it would be the only time they could see friends, as their work schedules limited their free time. Mahjong, especially, was more than just a game for them. It helped them to socialize, but it also served as a way to maintain cultural connections. One woman describes playing with her friends:

Our mahjong is pretty small. It’s for everyone to kill time and then improving our relationship; hang out/play in here happily. Then, about 2 dollars is the baseline. So, after having meal, play until 3 or 4 pm, then go home. (F, aged 67)

Social networking or developing a meaningful relationship had become more challenging than what they had previously been used to. A 71-year-old male participant compared the ease of socializing in China compared to in the U.S., post-migration:

Some people are actually trying (their) luck, like this…… Many people said… That is, the relationship here is unlike those relationships in mainland China. In mainland China, our friends, everyone eats and chats daily, either you come to my place, or I go to your place. This type of interaction is literally cut off. There is no this interaction. (M, aged 71)

For the most part, participants described gambling as a group activity and something that they could do with friends. Only two of the participants stated that they went to casinos alone. The purpose of their trip to casino was specifically to make money by selling the coupons provided by bus companies. These two differed from other participants as they also indicated that they had a more troubled history with gambling and were financially unstable. Their trips to the casino were not to play or for socialization, but through necessity.

Health Benefits

The older Chinese immigrants also brought up different ways that gambling could help them exercise their minds and bodies. There was a common belief that playing mahjong was a good way to prevent Alzheimer’s. One older woman shared:

Yes, sometimes, in the senior center, we play a little bit with mahjong to amuse and train the brain. Because you need the brain to play mahjong, then you won’t get Alzheimer’s Disease. (F, aged 70)

In addition to keeping their brains active, playing mahjong gave them the opportunity to exercise their hands. Most of the older immigrants emphasized living a healthy lifestyle, which included getting regular exercise, such as practicing Tai Chi in the park or simply making sure they stayed active. Even a bit of activity gained through mahjong was better than nothing. For example, speaking about mahjong, one participant explained, “so perhaps you use the brain a little bit, so move a little bit the hands and feet, like this. So there are some, some hobbies” (F, aged 79). Maintaining their mental and physical health was necessary so that their health would not deteriorate, especially as they grew older.

My view is that, playing mahjong is an exercise, especially to elders, can exercise the brain, exercise the hands, just like doing exercises, doing sports. (M, aged 79)

Luck and Skill

The perception that gambling involved either luck or skill also played a role in older Chinese immigrants’ gambling behaviors. Participants differed in how they perceived gambling outcomes. Games were seen as an outcome of either luck or skill. Some believed that they had more gambling skills than others, which made them more confident and led to more and heavier gambling behaviors. Those who believed that gambling was the result of skill justified their behavior as a way of proving their skills. One of the participants, who had a history of gambling and financial problems, explained:

It’s easy for me to win tens of dollars. I can do that. But, the bad thing is, I’ll feel like I’m the king of gambling when I win. I’ll gamble once, twice more. Then I’d lose it all… It’s very meaningful, it’s very superior. You won’t always feel like a useless object. ‘This time it’s not useless, this time it’s the most powerful,’ like that. There’s a feeling of superiority. (M, aged 68)

Other participants also spoke about how they were not good at other things but, for whatever reason, they were skilled in gambling; usually in card games. One participant even stated that he was so skillful that he would offer to play for others at the casino because he did not like to see others lose. Winning through skill was described as “a sense of satisfaction… There’s a feeling of superiority” (M, aged 68). Another participant noted that it was similar to a skill competition with the dealer:

You are the dealer, and I played with you. I won. Normally speaking, the dealer’s ability is sure to be higher than ours. But, if I win money, I win him. Then, it’s happy. (M, aged 79)

For these participants, their motivation for gambling was to prove that they were better than other players or dealers. On the other hand, some participants rationalized their wins or losses through luck or fate:

Buying lottery ticket is basically, is a luck. If you are lucky, you win. If your luck is bad, however much money you buy or spend is useless. If your luck is good, you will win buying one ticket. (M, aged 67)

Gambling is your fate. It is not up to your cleverness… Sometimes, he wins and wants to win all from other. But sometimes you cannot win. (M, aged 72)

Discussion

The findings from this study provide a deeper understanding of the gambling experiences of older Chinese immigrants. The qualitative interviews allowed participants to detail their perceptions of their own gambling behaviors as well as explore greater beliefs about gambling in general. As we sought to gather more knowledge about older Chinese immigrants’ gambling perceptions, we found that although they participated in various gambling activities, such as playing mahjong, going to the casino, and playing the lotto, most did not view their own behavior as gambling.

Unsurprisingly, going to casinos was a common activity among participants, similar to the older Chinese adults in other studies (Chen and Dong 2015). One possible reason that going to casinos was so common could be the accessibility of casinos to New York City, and the availability of casino bus tours. Participants indicated that bus tours would often employ Chinese speakers and advertise in Chinese newspapers to gain greater clientele.

Older Chinese adults in our study often engaged in cognitive distortion to justify their gambling behaviors. Similarly, Toneatto et al. (1997) found that heavy gamblers believed that they had the ability to either predict or control gambling outcomes. Subramaniam et al. (2017) identified the concept of the illusion of control as the belief that gamblers can control their winning either through skill or by an external force—such as luck, according to older Chinese adults in Singapore. Previous research mirrors our finding that individuals believed that their ability to win was dependent either on their own skill or on whether or not they were lucky at that time. More often than not, those who viewed gambling as involving skill were more likely to engage in gambling behaviors. In our study, those who believed that they were more skilled at gambling used it as a way to prove themselves.

Our study highlighted the ways in which the older Chinese participants differentiated their gambling behaviors from what they considered “real gambling.” They equated “real gambling” with problem gambling, which they saw as alarming and as affecting sensible behavior. This may be due to the cultural stigma attached to the word “gambling.” To be able to continue their gambling behaviors, they had to convince themselves that what they were doing was not gambling. This supports the argument by Wu and Lau (2015) that there is a distinction among Chinese between “gambling” and “gaming” that is rooted in Chinese history.

Interestingly, the older Chinese immigrants in our study believed that their gambling behaviors were healthy behaviors. They spoke about gambling to improve their cognitive functioning and to ensure that they were staying physically and mentally active. For participants in this study, gambling was not about the money or the winnings, but rather, being able to maintain interest in activities that they once enjoyed. Losing interest in gambling, therefore, meant that they were succumbing to either physical or mental health problems commonly associated with aging. The interpretation of gambling as a form of mental and physical exercise may indicate the great need for alternative opportunities to engage in healthy behaviors for older Chinese immigrants living in urban areas.

The findings from this study highlight the need for increased education around gambling in older Chinese communities. Participants believed that there was no help for those who engaged in “real gambling.” For them, gambling was associated with extreme loss, which included family, friends, and finances. They described gamblers as lost and unable to move forward in life. This may prevent them from seeking services for problem gambling behaviors either for themselves or for family and friends. Fong and Tsuang (2007) suggested that a lack of recognition of problems is a key barrier to treatment. It is, therefore, critical for those most connected with older Chinese immigrants to be able to provide needed education and engagement around problem gambling.

Limitations

This study is not without its limitations. First, it employed a convenience sample to recruit participants through the senior center. Results for this study, like other qualitative studies, cannot be generalized to the wider older Chinese immigrant community outside of New York City. Second, self-selection bias can influence findings. Those who chose to participate may have perceptions and experiences with gambling that differ from those who did not choose to participate. Third, gambling is a culturally sensitive topic. Thus, some participants may have been inhibited in their responses, particularly about their own gambling experiences.

Implications

The findings of this study provide insights on the way that older Chinese immigrants identify gambling and their motivation for gambling. These findings suggest that vocabulary plays an important role when working with older Chinese. Service providers and researchers should be aware of the terms they use when discussing gambling and gambling behaviors, since gambling is instinctively stigmatized and associated with negative outcomes. The discussion will need to be reframed in terms that make sense to older Chinese immigrants, such as asking them about the games that they play or asking about common behaviors like going to the casino or playing mahjong.

Furthermore, increasing education and outreach around treatment for problem gambling can improve the willingness to discuss gambling behaviors. The older Chinese immigrants in this study believed that problem gambling was untreatable and were unaware of treatment programs, even though there was one available through the senior center they attended. Education around examples of those who were able to manage their behaviors should be promoted to counter common anecdotal stories of individuals who have lost everything due to gambling. For example, Liu et al. (2017) discuss the importance of “Bridge People” to address service barriers experienced by older Chinese. “Bridge People” are those who older Chinese trust and who can assist them in obtaining services. They can be family and friends or service providers. Given the importance family plays in Chinese culture, education on problem gambling and treatment should not only be provided to older Chinese but also to their families so that they can support access to care and services.

Finally, service providers may use games to improve older Chinese immigrants’ conditions through increased socialization and physical activity. Gambling was seen through a positive lens when they spoke about how it reduced social isolation and provided an opportunity to improve their health. These positive associations should not be neglected. Instead, they should be used to identify potential programs.