In total, more than 60 stakeholders contributed to the development of the maps through the following process: We recruited 53 people who were working to reduce inequalities from gambling and alcohol harms in England. These stakeholders worked in national and local government, and in the community and voluntary sectors, in different geographical regions of England. The stakeholders worked alongside our multidisciplinary research team, which comprised researchers with expertise in alcohol policy, gambling policy, food policy, and community empowerment. We aimed to create a collaborative learning environment for the group. We called this group the National Learning Partnership (NLP). We ran a suite of activities with the stakeholder partnership including one-to-one meetings and workshops. Through these activities the stakeholder partnership: shaped the focus of the project on gambling and alcohol supported a review of the literature identified two locations for ‘field sites’ (Derby and Swindon) designed mapping workshops (as a data generation method).

Two local authority areas (‘field sites’) were involved in the development of the maps - Derby and Swindon. These two sites had different: geographic locations population demographics levels of inequality political and social histories priorities for public health work.

In each field site we conducted interviews with people working in roles related to health, the economy and/or the night-time economy. This included the police, local government workers, health workers and local business owners. We also looked at a selection of policy documents about the night-time economy written by local councils and the police. Data from these documents and interviews improved the researchers’ understanding of the local context (e.g. types of gambling and alcohol venues) and helped to establish the scope for the maps (e.g. local government boundaries).

We held face-to-face workshops with 10-12 participants in each of our field sites. Participants included those involved in licensing, planning, health, policing, and the community and voluntary sectors. One resident from each field site also took part in the workshops. During the workshops participants were asked to complete the following activities: On separate post-it notes, write down responses to the question ‘What is happening in your town’s/city's night-time economy to influence worse health in some places?’. Participants were instructed to create statements to specify who is doing what in the night-time economy (e.g. police concentrating resources in the city centre). Categorise the statements you have written down according to McCartney’s power framework. Researchers explained each source of power in McCartney’s framework and participants were asked to categorise their statements accordingly. Read and review each others’ statements. This was guided by questions including: Which things are missing? Which things might you re-label or re-categorise? Which things are irrelevant to Derby/Swindon?. As a group, move statements around and draw lines between statements that you think are connected. As a group, add, remove and rename statements and their connections.

We used the information gathered from the workshops in each field site to further develop the maps. We: reworded some statements merged some statements added connections between statements. We retained much of the language used by participants so that the maps reflected local perspectives. We then grouped the statements into themes, which we described as ‘spaces’ in which power was used in the night-time economy (in accordance with McCartney’s power framework).

We emailed the maps to our stakeholder partnership and workshop participants and we asked for their feedback. We also ran a series of workshops with the original workshop participants to: help them access and understand the maps discuss how the maps might be used in practice get feedback on how we present the maps on a website discuss how we could trial the maps with residents and/or their colleagues. Further information about the development of the map can be found in our paper (in review).

We created the maps in two contrasting locations – Derby and Swindon. We chose these locations as they have different: populations levels of inequality political and social histories public health priorities. By choosing two contrasting locations, we aimed to make our findings relevant to a range of different local areas in England. Derby is an ethnically diverse university city with stark inequalities in health, located in the midlands. In contrast, Swindon is a more affluent town in the south of England, which has pockets of deprivation. At the time of the fieldwork, Derby City Council focussed much of their public health work on gambling, while Swindon Borough Council was more focussed on safety in the night-time economy. This table shows demographic information for Derby and Swindon: Data sources: ¹ Office for National Statistics Census 2021 ² Office for Health Improvement and Disparities, Segment Tool 2020-2021 data

We used two different frameworks to help us organise our ideas. The first framework that we used was from a research study by Waitt et al (2023). We adapted this framework and called it ‘the literature framework’. The second framework that we used was from a research article by McCartney et al (2020). We adapted this framework and called it ‘the McCartney framework’. We decided that the McCartney framework was the most useful framework to help identify opportunities to address unequal harms from gambling and alcohol. We therefore used the McCartney framework instead of the literature framework to help us organise our ideas on the maps. Although we used the McCartney framework to help us organise our ideas, the maps can be adapted if you want to use a different power framework to organise your own ideas. This website provides an open-source tool for creating your own systems maps.

We worked with the stakeholder partnership to identify and review other published research that explains unequal harms from gambling and alcohol. We found a review of explanations for unequal harms from alcohol written by Boyd et al (2021). We also found 52 research papers that explain unequal harms from gambling. During our review of the research, we discovered a framework that helped us to make sense of the range of explanations we had found. This framework was developed by Waitt et al (2023). We decided to adapt Waitt et al’s framework to make it more suitable for our purpose. We called this framework ‘the literature framework’. This figure shows our literature framework adapted from Waitt et al’s (2023) conceptual framework for the relational geography of gambling harm. Our literature framework integrates explanations for unequal harms from gambling into three categories: 1. Identity and expectations. This category includes people’s everyday routines and expectations based on factors like gender, class, age, and ability. It describes how people orient themselves within a space. This affects the meaning of gambling practices. Identity and expectations are thought to influence risky or problem gambling and people’s ability to deal with the consequences of gambling. They are also thought to influence alcohol use. Research studies identified differences in people’s: exposure to stress and ability to deal with gambling harms use of gambling as a coping mechanism rejection of a society in which people feel marginalised. For example: ‘harmful gambling as a result of using gambling as a source of social identity’ and ‘harmful gambling when using gambling as a means to generate income’. 2. Immersion in gambling atmospheres. This category describes places in terms of the environment that’s created by different combinations of people and material things (e.g. buildings, infrastructure, lighting, advertising). In combination with the category ‘identity and expectations’, it helps us think about the ways in which people with different experiences respond differently to different environments. Research studies have found: that betting is encouraged and facilitated in sports bars by the layout of the premises e.g. lighting, music, proximity of betting machines to the entrance (Pennay et al, 2021). that betting shops, pubs and off-licences are located near each other in some disadvantaged communities e.g. the East End of Glasgow (Reith and Dobbie, 2012). For example: ‘gambling as part of other common routines of living in a place’ and ‘knowing how to behave in a venue/the rules of the game’. 3. Collective power and influence over practices and environments. This category encompasses the level of collective control that communities have to influence their local environments and their capability to influence public discourse. Public discourse often stigmatises disadvantaged areas and blames individuals for gambling and alcohol harms. For example: ‘ability to influence decision making in relation to localities’ and ‘capability to influence public discourse’. The literature framework suggests that unequal harms from gambling exist because of how: power, status and resources are distributed in society products and advertising are concentrated in disadvantaged places, leading to greater exposure and normalisation of gambling gambling harm is constructed as a problem faced by individuals. Consequently, solutions do not typically involve community-level changes to reduce gambling harm.

This project applies McCartney’s (2020) place-based power framework. We used McCartney’s framework as it is a useful tool to help identify opportunities to address unequal harms from gambling and alcohol. McCartney’s framework defines power as the essential resource in maintaining, increasing or reducing health inequalities. The framework recognises that power does not come from one source but that different groups exert power in different ways and at different times. The framework defines the most important sources, spaces, positions and forms of power influencing place-based inequalities in high-income Western settings, particularly the UK. Sources of power are the material and social resources from which people derive power. The different sources of power are: Economic Knowledge Culture and belief Collective organisations (e.g. community and voluntary groups) State Positional (e.g. social hierarchies relating to gender). Spaces of power are the social fields in which people use sources of power. For example: Safety, crime, policing and anti-social behaviour: The allocation of policing resources was identified as a space where power is used to influence harms from the night-time economy Gambling and alcohol: The provision of gambling and alcohol amenities was identified as a space where power is used in a way that influences harms from the night-time economy Governance, funding and vision: The management of and influence over the city’s image, reputation and identity was identified as a space where power is being used to impact harms from the night-time economy. Positions of power are the social positions people occupy to use power. For example: Business owners Police leaders Advertising company executives. Forms of power are the actions people take within particular social fields to use power. One example is: gambling venues targeting the most vulnerable and deprived. This table shows an example (based on the Swindon map) of how we adapted McCartney’s framework to help organise our ideas on the maps: