Gambling Disorder Diagnoses Climb Sharply in States With Legal Sports Betting

Researchers examined electronic health records covering more than 197 million U.S. adults and tracked quarterly rates of diagnosed gambling disorder from the period after sports betting expanded in many states beginning in 2018; the data revealed a 61 percent increase in states that legalized the activity, moving from 3.0 to 4.8 diagnoses per 100,000 people, while the 11 states without legalization saw rates drop 29 percent from 3.1 to 2.2 per 100,000.

Key Patterns Emerge From the Records

The largest proportional rise appeared among adults aged 18 to 29, where rates more than doubled, whereas individuals aged 30 to 49 showed the highest overall rates across the dataset; observers note the absolute numbers stay low even after the increases, yet the divergence between legalized and non-legalized states stands out clearly in the figures.

States that introduced sports betting after the 2018 Supreme Court decision experienced steady quarterly climbs, and the pattern held when researchers compared matched periods before and after legalization took effect in each jurisdiction; in contrast, states that maintained prohibitions recorded consistent declines over the same timeframe.

Demographic Breakdowns Highlight Age Differences

Younger adults drove much of the upward movement in legalized states, while middle-aged groups maintained elevated baseline levels throughout the study window; the analysis separated age cohorts to show how legalization correlated with sharper jumps in the 18-29 bracket compared with older segments.

Those who reviewed the records point out that expanded access through mobile apps and retail locations coincided with the timing of the rises, and the data allowed direct state-by-state contrasts that isolated the effect of legalization from broader national trends.

State-Level Comparisons Reveal Clear Divergence

Legalized states posted the 61 percent average increase across quarterly measurements, while the non-legalized group posted the 29 percent average decline; the study authors compiled the figures from a large-scale electronic health record network that spans multiple health systems and captures diagnosed cases rather than self-reported behavior.

Because the dataset covers such a wide population, small shifts in per-100,000 rates translate into thousands of additional diagnoses when scaled nationally, although the report emphasizes that overall prevalence remains modest compared with other behavioral health conditions; the divergence between the two groups of states persists after accounting for population size differences.

Data from the EPIC Research analysis further breaks down the trends by quarter, showing acceleration in legalized states beginning roughly one year after new laws took effect and continuing through subsequent periods into 2026.

Context in August 2026

By August 2026, more than three dozen states had some form of legal sports betting, and the ongoing record review continues to track whether the diagnosis gap widens or stabilizes; the initial findings already illustrate how policy choices at the state level align with measurable changes in clinical records.

Health systems in legalized states have noted the uptick in documented cases during routine screenings, while those in remaining prohibition states have not observed similar patterns; the contrast supplies one concrete example of how regulatory environments can correlate with shifts in identified behavioral health outcomes.

Conclusion

The electronic health record analysis supplies a large-scale comparison that ties the timing of sports betting legalization to rising quarterly diagnosis rates in affected states and falling rates elsewhere, with the sharpest proportional changes concentrated among younger adults; absolute figures remain low across the board, yet the documented divergence offers a factual basis for continued monitoring as more states maintain or adjust their regulatory frameworks through 2026 and beyond.