The impacts of the introduction of casino gambling in Plainville, MA and surrounding communities are of interest in developing informed policy. Problem gambling is a public health issue as associated harms include physical and mental illness, impaired relationships with one’s close social network, impacts on school or work, financial difficulties and illegal behavior. The results of surveys prior to and after the introduction of the casino were used to evaluate potential differences in the prevalence of at-risk and problem gambling, associations amongst health and gambling behavior covariates with at-risk and problem gambling status by year, and changes of covariate relationships with at-risk and problem gambling between years (2014 Total n = 1,090; 2016 Total n = 999; Total N = 2,089). No change in prevalence of at-risk and problem gambling was observed. A borderline significant higher rate in casino gambling between survey years was observed for at-risk and problem gamblers. Future research should aim to explore the influence of gambling availability on vulnerable subgroups of the population to create fully informed policy.