Electronic Health Records Track Gambling Disorder Rate Changes After Sports Betting Expansion
Written by Devon Franke · Aug 26, 2026
Electronic Health Records Track Gambling Disorder Rate Changes After Sports Betting Expansion
Researchers examined electronic health records covering more than 197 million U.S. adults and identified a clear pattern in quarterly rates of diagnosed gambling disorder, and those patterns aligned with state decisions on sports betting legalization since 2018. In states that permitted sports betting the rates climbed 61 percent from 3.0 to 4.8 per 100,000 people, whereas in the 11 states that maintained prohibitions the same rates dropped 29 percent from 3.1 to 2.2 per 100,000. The study, released through EPIC Research, draws directly from large-scale clinical data rather than survey responses, and the divergence appears tied to expanded access rather than broader national trends.
Study Design and Data Sources
Analysts pulled quarterly diagnosis figures from electronic health records spanning multiple years and multiple geographic regions, then grouped results according to each state's legal status on sports betting. Because the dataset exceeds 197 million adults, even modest proportional shifts translate into thousands of additional clinical encounters, adn the methodology allows direct comparison before and after legalization dates in each jurisdiction. Observers note that absolute rates stay low across the entire population, yet the proportional gap between legal and non-legal states widened steadily after 2018.
Age-Specific Patterns in Diagnosis Rates
The largest proportional increase occurred among adults aged 18 to 29, where rates more than doubled following legalization, while overall rates remained highest among those aged 30 to 49. Data indicates younger adults experienced the steepest climb in newly recorded diagnoses, and the pattern holds across multiple quarters after sports betting became available through mobile apps and retail locations. Researchers tracked these age bands separately to isolate whether legalization effects concentrated in particular demographic groups, and the results show consistent elevation in the younger cohort alongside sustained elevation in the middle-adult range.
State-by-State Comparisons
States that introduced sports betting saw quarterly diagnosis rates move upward in lockstep with the rollout of legal markets, while the 11 states that kept prohibitions recorded a steady decline over the same period. The contrast becomes visible when quarterly figures are plotted on the same timeline, and the separation begins to appear shortly after the first legal wagers were accepted in newly permissive jurisdictions. Because the analysis covers the full post-2018 window, it captures both early-adopter states and those that legalized later, and the upward trajectory remains evident in each group that changed its statutes.
Context Around Absolute Versus Relative Changes
Although the absolute number of diagnoses per 100,000 adults remains small, the 61 percent rise in permissive states stands in direct opposition to the 29 percent decline recorded elsewhere, and that divergence points to a measurable association with legalization. The report emphasizes that baseline prevalence sits at low levels nationwide, yet the direction and magnitude of change differ sharply based on policy environment. Those who reviewed the figures note that the clinical data do not capture undiagnosed cases, so the recorded rates represent only individuals who sought or received formal medical attention.
Access and Diagnosis Timing
Expanded access through smartphones and widespread advertising coincided with the observed uptick in states that legalized, and the timing of new diagnoses clusters after those markets opened. The analysis does not isolate causation from correlation, yet the geographic split between rising and falling rates aligns closely with the presence or absence of legal sports betting platforms. Data shows the trend persisted across multiple quarters, and similar patterns emerged whether legalization occurred early or later in the study window.
Conclusion
The electronic health record review supplies one of the largest population-level comparisons available on this topic, and it documents a sustained increase in diagnosed gambling disorder rates in states that legalized sports betting alongside a decrease in states that did not. Age breakdowns reveal the sharpest proportional rise among adults 18 to 29, with the highest overall rates concentrated in the 30 to 49 group. Observers continue to track these figures as more states evaluate regulatory frameworks, and the published report supplies the underlying quarterly data for further examination.