Electronic Health Records Analysis Links Sports Betting Expansion to Rising Gambling Disorder Diagnoses

Researchers examined electronic health records covering nearly 200 million patients across the United States and identified a clear divergence in gambling disorder diagnosis rates that coincides with the spread of legal sports betting. The quarterly rate in states where sports betting became legal climbed from 3.0 per 100,000 patients in the first quarter of 2018 to 4.8 per 100,000 in the first quarter of 2026, while the corresponding rate in states without legalized sports betting declined from 3.1 to 2.2 per 100,000 over the same span. That pattern represents roughly a 61 percent increase in the states that authorized the activity.

The analysis draws on a large-scale review of de-identified records compiled through a major health data platform, and it isolates the period after widespread legalization began following the 2018 Supreme Court decision that struck down the federal ban on sports betting. Observers note that the timing aligns closely with state-level policy changes that opened retail and online wagering markets in dozens of jurisdictions.

Demographic Patterns in the Data

Figures reveal the steepest increases occurred among young men, a group that also accounts for a disproportionate share of sports betting participation in states where the activity operates legally. The records show elevated diagnosis rates in this cohort compared with other age and gender categories, although the overall numbers remain relatively low in absolute terms. Parallel upward trends appear in connection with online prediction markets that allow users to wager on event outcomes outside traditional sportsbooks.

Those who've studied the dataset point out that the divergence between regulated and unregulated states persists even after accounting for differences in population size and baseline healthcare utilization. The analysis does not establish direct causation, yet the consistent directional split between the two groups of states supplies a measurable signal for further investigation.

Scope and Methodology Behind the Findings

Data collection spanned multiple years and incorporated records from both commercial and government-sponsored insurance plans, which allowed researchers to track diagnosis codes over successive calendar quarters. The study window begins before most states had authorized sports betting and extends through the first quarter of 2026, providing a before-and-after view in jurisdictions that changed their laws during the interval. Analysts applied standard statistical adjustments to control for changes in overall medical visits and diagnostic practices that might otherwise distort the results.

By June 2026, the cumulative dataset had grown large enough for quarterly updates to be released on a rolling basis, and the most recent release continues to show the same state-level contrast. The platform aggregates information from thousands of healthcare providers, which reduces the likelihood that regional reporting differences alone explain the observed gap.

Additional Factors Under Examination

Researchers also examined whether increased visibility of betting through advertising and mobile apps might contribute to higher rates of clinical recognition. The records indicate that states with legal markets experienced growth in both in-person and digital wagering options during the study period, while states without such markets showed no comparable expansion. Some analysts suggest that greater public awareness of gambling-related harms could lead clinicians to screen more frequently, although the data do not isolate that variable from actual incidence changes.

Prediction markets operating on digital platforms receive mention in the report as a parallel development that expanded during the same years. These platforms allow participants to trade contracts on a wide range of events, and several states have seen regulatory attention directed toward their operations. The health-record analysis notes that diagnosis upticks sometimes coincide with periods of heightened activity on those platforms, yet the primary split remains between states that permit conventional sports betting and those that do not.

Broader Context for Public Health Tracking

Public health agencies in multiple states have begun incorporating gambling disorder screening questions into routine behavioral health assessments, which may affect future diagnosis counts. The electronic health record review provides one benchmark against which later measurements can be compared. Because the dataset covers a substantial fraction of the U.S. population, it supplies a national-scale reference point rather than a localized sample.

State regulatory bodies continue to monitor revenue figures and licensing activity, yet the health-record analysis supplies an independent metric focused on clinical outcomes. The divergence documented in the study offers policymakers one data point when evaluating the effects of legalization decisions made since 2018.

Conclusion

The analysis of nearly 200 million patient records documents a 61 percent rise in diagnosed gambling disorder rates in states that legalized sports betting between early 2018 and early 2026, while rates fell in states that maintained prohibitions. The sharpest increases appear among young men, and similar directional trends coincide with growth in online prediction markets. The findings rest on standardized diagnosis codes tracked across a large, multi-year dataset and supply an objective measure for ongoing evaluation of policy impacts.