Gambling Disorder Diagnoses Increase Following Sports Betting Legalization in Multiple States

A recent analysis of electronic health records reveals that diagnoses of gambling disorders climbed more than 60 percent in U.S. states that legalized sports betting after the 2018 Supreme Court decision while rates declined in states that maintained prohibitions and the sharpest increases appeared among men between the ages of 18 and 29 according to data covering the period through June 2026.

Researchers examined records maintained by Epic Systems and tracked diagnosis rates per 100,000 patients across states that introduced legal sports betting markets compared with those that did not and the figures show a clear divergence after legalization took hold in various jurisdictions.

Key Figures From the Analysis

The rate of gambling disorder diagnoses moved from 3.0 per 100,000 patients in 2018 to 4.8 per 100,000 patients by 2026 in states that legalized sports betting and that change represents an increase exceeding 60 percent while non-legalizing states recorded a decrease in the same metric over the identical timeframe.

Data drawn from millions of patient encounters allowed observers to isolate the impact of legalization because the records captured both new diagnoses and ongoing treatment patterns and the study period began immediately after the Supreme Court struck down the federal ban on sports betting which opened the door for state-level regulation.

Demographic Patterns Observed

Men aged 18 to 29 experienced the largest relative rise in diagnoses and this group showed elevated rates that outpaced other age brackets and gender categories in every state that permitted legal sports wagering platforms during the eight-year window.

Younger adults in general demonstrated higher sensitivity to the availability of legal betting options which aligns with patterns noted in earlier public health studies although the current analysis provides the first large-scale comparison using consistent electronic health record data across multiple states.

State-Level Comparisons

States that moved forward with legalization saw consistent upward trends in diagnoses whereas neighboring states that kept restrictions in place experienced stable or falling rates and this contrast held even after researchers adjusted for differences in population size and healthcare access.

The analysis covered jurisdictions that launched retail sportsbooks as well as those that added mobile betting applications and the increases appeared regardless of whether the market opened with limited or expansive product offerings.

Context Around the 2018 Ruling

The Supreme Court decision in May 2018 removed the longstanding federal prohibition and allowed states to create their own regulatory frameworks and within months several states began issuing licenses while others waited years before following suit and this staggered rollout created natural comparison groups for the later study.

Electronic health records from Epic Systems captured patient visits across primary care, specialty clinics, and emergency departments which gave researchers a broad view of how often clinicians recorded gambling disorder diagnoses before and after markets opened.

Implications for Public Health Tracking

Public health officials now have a clearer baseline for monitoring gambling-related conditions because the study demonstrates measurable shifts tied directly to policy changes and future analyses can build on these figures to evaluate the effectiveness of responsible gambling measures that states have implemented alongside legalization.

Because the data source remains active, ongoing surveillance can continue to track whether the upward trajectory in legal states stabilizes, reverses, or continues and non-legal states provide an ongoing control group for comparison.

Conclusion

The analysis released in late June 2026 supplies concrete evidence that legalization correlates with higher diagnosis rates of gambling disorders while states without legal markets show the opposite movement and the concentration of increases among young men points to a specific population that may require targeted outreach.

Those who review the full report will find detailed methodology and state-by-state breakdowns that support the headline findings and additional research can now examine how different regulatory approaches affect these trends over time.