BMJ 2002;324:979 ( 20 April )

Letters

If only lottery winnings were randomly assigned

The first 150 words of the full text of this article appear below.

EDITOR---The causal effect of income on health has important policy implications, and yet its identification is dogged by the problem of income not being randomly assigned. Researchers continue to ignore this, including Rodgers in his editorial,1 but the idea that the problem can be overcome by exploiting lottery winnings as a "natural experiment"2 is superficial because winners are not randomly selected from the population since playing is not a random event.

Although playing is popular, it is far from universal. The probability of winning is directly proportional to the number of tickets bought, so winners, on average, will be disproportionately heavy players.

Survey evidence suggests that players and non-players differ systematically in terms of their observable characteristics such as age, education, and sex.3 Indeed, expenditure survey data show that, compared with non-players, players insure less, smoke more, work less, have more modest pension provision, are more likely to . . . [Full text of this article]
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Relevant Article

Income, health, and the National Lottery
Anthony Rodgers
BMJ 2001 323: 1438-1439. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Gambling is a health issue
Mark D. Griffiths
bmj.com, 19 Apr 2002 [Full text]
The National Lottery could provide a unique and important randomised trial
Anthony Rodgers, et al.
bmj.com, 7 Jun 2002 [Full text]
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