Electronic Health Data Links Sports Betting Expansion to Gambling Disorder Diagnoses

Electronic health records from more than 197 million U.S. adults reveal a sharp increase in gambling disorder diagnoses in the 39 states that legalized sports betting since 2018, according to commentary published in Sports Business Journal on June 26, 2026. Researchers tracked data from the first quarter of 2018 through the first quarter of 2026 and found diagnoses climbed from 3.0 to 4.8 per 100,000 patients, which represents roughly a 61 percent rise.

The analysis examined patterns across different age groups and compared outcomes between states with and without legalized sports betting. Observers note the absolute rates stayed low overall, yet the proportional change stood out in states where expanded access and advertising accompanied legalization.

Study Scope and Methodology

Data came from electronic health records compiled across a broad patient population, allowing researchers to measure diagnosis rates before and after policy changes took effect in individual states. The 39 states that introduced sports betting during this period showed consistent upward movement in recorded cases, while the 11 states that maintained prohibitions recorded a decline from 3.1 to 2.2 per 100,000 patients, or about 29 percent.

Because the study relied on existing medical records rather than new surveys, it captured only those individuals who sought clinical attention. This approach provides a conservative view of prevalence yet still documents a clear divergence tied to legalization timelines.

Age and Gender Patterns

The largest proportional increase appeared among adults aged 18 to 29, where rates more than doubled. Within this group, males accounted for a disproportionate share of the additional diagnoses. Researchers observed smaller but still notable rises in older cohorts, suggesting the trend extended beyond young adults even if the magnitude differed.

These demographic details emerged from the same electronic health record dataset, which allowed breakdowns by both age and sex. The patterns align with broader observations that younger populations often encounter new betting platforms first, though the data does not isolate specific causal pathways.

State-by-State Comparisons

States that kept sports betting illegal experienced the opposite movement in diagnosis rates. The 29 percent drop in those 11 jurisdictions stands in contrast to the 61 percent increase recorded where legalization occurred. This divergence appears across multiple quarters and persists after controlling for population size within the sampled records.

Because the study spans eight years, it captures both early-adopter states and those that legalized later in the period. The cumulative effect across all 39 states produces the overall national figure, while non-legal states provide a natural comparison group.

Access, Advertising, and Recorded Diagnoses

The commentary in Sports Business Journal points to expanded access and increased advertising as factors associated with the rise in diagnoses. Electronic health records cannot directly measure exposure to marketing, yet the timing of increases corresponds with periods when sports betting became widely available through mobile apps and retail locations in newly legalized states.

One report summarizing the same underlying data notes that the absolute number of diagnoses remains small relative to the total patient population. At the same time, the proportional change supplies a measurable signal that health systems and policymakers can track as markets continue to evolve through the second half of 2026.

Broader Context for 2026

By August 2026, most of the 39 states will have operated legal sports betting markets for multiple years, allowing continued monitoring of diagnosis trends in the same electronic health record systems. The original analysis stops at the first quarter of 2026, yet the methodology supports updates that could reveal whether the rate of increase stabilizes, accelerates, or begins to moderate.

Public health researchers have already begun comparing these figures against other behavioral health indicators collected in the same datasets. Such comparisons help isolate whether gambling disorder diagnoses move independently or alongside changes in related conditions.

Conclusion

The electronic health record analysis provides one of the largest-scale looks at gambling disorder diagnoses before and after sports betting legalization. With 197 million adults represented and clear differences between legal and non-legal states, the data offers a factual baseline for ongoing observation as markets operate through the remainder of 2026 and beyond. The patterns in young adult males and the contrasting decline in states without legalization supply concrete points for further examination using the same record systems.