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Poverty is a social determinant of childhood obesity. Investigators assessed whether increased income from new American Indian casinos reduced the risk for obesity in children aged 7 to 18 years in 117 school districts in California between 2001 and 2012. They evaluated economic and obesity measures in 57 districts before and after they opened or expanded casinos, 24 districts with casinos that did not expand, and 36 districts without casinos.
Among the 57 districts with new or expanded casinos, the mean increase in slot machines was 13 per capita. Overall, each slot machine per capita gained was associated with an increase in average per capita annual income of $541 and a 0.6% decrease in the percentage of American Indians living in poverty…