Public Health Trust Fund

Public Health Trust Fund (PHTF) was established to allocate significant resources to research, prevention, intervention, treatment, and recovery support services in order to mitigate the harmful effects of problem gambling and related issues.

The Expanded Gaming Act of 2011 (Chapter 194) allows for up to three destination resort casinos and one slot parlor across three regions (Regions A, B, and C) in Massachusetts. It also allocates significant resources to a Public Health Trust Fund (PHTF) to mitigate the harms associated with gambling through research, prevention, intervention, treatment, and recovery support services.

The Public Health Trust Fund is overseen by the Executive Office of Health and Human Services (EOHHS) and a strategic plan was adopted in 2016, which is implemented primarily by the Massachusetts Department of Public Health (MDPH) Office of Problem Gambling Services (OPGS) ( and the Massachusetts Gaming Commission (MGC) ( OPGS provides relevant public health programs and services and MGC conducts relevant research and responsible gaming activities.

Problem gambling is a public health issue. The PHTF, under EOHHS, has led to an extensive public health response to gambling in the Commonwealth. This approach creates a public health infrastructure where professionals are in place to navigate the complexities of problem gambling and reduce gambling-related harms.

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Why a public health approach?

Problem gambling is governed by a complex set of interrelating factors, causes, and determinants ranging from biology and family history to social norms and existing statutes. Research indicates that gambling is interrelated with various health issues and disproportionately impacts individuals with mental health disorders, substance misuse disorders, and communities of color. Historically, community-level experiences of gambling and communities of color are often not the focus of problem gambling services and efforts. Preliminary research indicates that ethnic and racial minorities have higher rates of gambling problems than the adult general population.

Office of Problem Gambling Services (OPGS)

MDPH promotes the health and well-being of MA residents by ensuring access to high-quality healthcare services, and by focusing on prevention, wellness, and health equity for all people. Within MDPH, OPGS leads a public health response to problem gambling, guided by evidence and community voice. OPGS is committed to promoting equity and has conducted series of community engagement activities, including an Annual Stakeholder Listening Session (SLS). The purpose of the SLS (PDF | Doc) is to engage community members within the casino’s host community to inform problem gambling services. Since 2016, OPGS has engaged more than 2,000 community members and has over 40 community partners. This engagement informs the Office’s 26 initiatives.

Equity, Engagement, and Empowerment: A Path Forward to Mitigate Harm

Since 2016, OPGS has implemented a social-ecological method to carry out a public health and nationally leading response to problem gambling. A social-ecological method is a comprehensive approach that is rooted in the principles of public health and incorporates the individual, family, and community to mitigate harms associated with gambling. In contrast to programs, policies, and practices focused only on the individual, this approach actively: (1) engages individuals at different levels of risk, (2) considers the social and environmental context in which individuals live and thrive, and (3) adheres to principles of cultural competence.

Business plan graphic: Community Engagement and Assessment, Programs and Services, Workforce Training and Supports, Public Awareness, Technical Assistance and Evaluation

Additional Resources

Partnership and collaboration

A cornerstone of public health is working in partnership and collaboration. In addition of working in partnership with over 40 community-based organizations, OPGS provides public health expertise to the Mass Gaming Commission and the Mass State Lottery. Past collaborations have included:

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