title: An analysis of the accessibility of video lottery terminals: the case of Montréal.
abstract: BACKGROUND
  Researchers and public health officials in Canada, the United States and Australia have for some time noted broader geographic accessibility to gambling establishments, above all in socioeconomically underprivileged communities. This increase in availability could lead to more and more gambling problems. This article focuses, in an ecological perspective, in particular on a spatial analysis of the geographic accessibility of sites possessing a VLT permit in the Montréal area, i.e. Montréal Island, the South Shore and Laval, from the standpoint of the development of an indicator of the vulnerability (socioeconomic components and demographic components) to gambling of populations at the level of certain neighbourhood units (dissemination areas). With the recent development of geographic information systems (GIS), it is now possible to ascertain accessibility to services much more accurately, for example by taking into account the configuration of the road network.
  
  
  RESULTS
  The findings of our analysis reveal widespread geographic accessibility to sites possessing a VLT permit in the downtown area and in pericentral districts. In some neighbourhood units, a site possessing a VLT permit may be within a three-minute walk. In the region studied overall, average walking time to a VLT site is nine minutes. Access to this type of service on foot is usually limited in the outskirts. However, a number of groups of sites possessing VLT permits are found along certain axial highways. According to local spatial self-correlation analyses, the findings suggest a significant link between walking accessibility to sites possessing VLT permits and the vulnerability of the communities. In a number of neighbourhood units with ready access to VLT's the populations display high vulnerability.
  
  
  CONCLUSIONS
  These findings reveal that accessibility to sites possessing a VLT permit is often linked to the vulnerability (socioeconomic and demographic components) of communities. Reliance in our analyses on neighbourhood units with fairly small areas enabled us to emphasize the rectilinear dimension of the spatial distribution of sites possessing VLT permits. This is a significant link that public health officials must consider when elaborating programs to combat pathological gambling.
authors.affiliation: Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal, Université de Montréal, 1301, rue Sherbrooke Est, Montréal, Canada. eric.robitaille@umontreal.ca
authors.forename: Eric
authors.initials: E
authors.lastname: Robitaille
authors.forename: Patrick
authors.initials: P
authors.lastname: Herjean
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D003132:Commerce / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government; D005715:Gambling / Q000523:psychology*; D040362:Geographic Information Systems; D005843:Geography; D006801:Humans; D008297:Male; D011204:Poverty Areas; D011640:Public Policy; D011792:Quebec / Q000453:epidemiology; D012111:Residence Characteristics / Q000145:classification*; D012307:Risk Factors; D012737:Sex Factors; D012931:Social Environment; D014504:Urban Health; D018910:Video Games / Q000191:economics / Q000523:psychology / Q000600:supply & distribution*; D035862:Vulnerable Populations / Q000523:psychology*