For some, March conjures thoughts of spring weather, longer days and resort vacations.
For the rest of us, it's all about 65 college basketball teams, online gambling sites and the right wager.
But research on gamblers and their health problems may make you think twice before placing a bet this year.
A groundbreaking study found that people who gamble at least five times a year have more health problems than those who roll the dice less frequently.
"If you gamble it increases your risk of having some conditions," says Nancy Petry, a psychologist, professor of psychiatry at the University of Connecticut Health Center and study co-author. "But the important thing is the more you gamble, the worse [it gets]."
Adding up the risks
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions, a study of 43,000 Americans, researchers found that more than a quarter of participants gambled five or more times a year, including everything from playing cards for money to buying lottery tickets and betting on sports games.
Of them, the study identified close to 1 percent of the group as problem gamblers, people who developed mild to moderate issues as a result of the habit. Less than half percent were classified as pathological gamblers, a progressive and devastating disease characterized by a preoccupation with gambling, loss of control and continued gambling despite the impact on a person's work and social life.
After accounting for demographic factors such as age, gender, ethnicity and income, all of which might have affected the health of the respondents, the study still found that people who gambled five or more times a year had higher rates of hypertension, obesity and alcoholism. They also were more likely to smoke and to have been to the emergency room in the past year.
Even worse, problem and pathological gamblers also had higher incidences of angina and cirrhosis of the liver.
Before you make a doctor's appointment, however, it's important to note that the data doesn't explain whether gambling may cause these problems or people with these kinds of conditions tend to be gamblers. Placing a bet doesn't require a lot of physical activity and casinos in particular make it easy for people who are in ill-health or have disabilities to visit, says Petry.
"The more you're gambling," she says, "the less likely it is you're doing other healthy things."
Keith Whyte, executive director of the National Council on Problem Gambling, says for people in chronic pain, especially problem gamblers, making a wager can be like a narcotic — a form of escapism or way of coping with physical ailments. He points out that many problem gamblers are already being treated in the health care system, but their gambling problems often go undiagnosed.
But Whyte says people planning to place money on a game this month need to know they're getting involved in a potentially risky activity, in terms of their wallets and physical well-being.
"Americans are a nation of risk takers — gambling is extremely popular," he says. "We're hoping to raise awareness that it may be a health risk as well."