Study Tracks Rise in Gambling Disorder Diagnoses After Sports Betting Legalization
Researchers at Epic Research examined electronic health records from nearly 200 million patients and identified a clear pattern in quarterly diagnosis rates for gambling disorder. Between the first quarter of 2018 and the first quarter of 2026 the rates climbed from 3.0 to 4.8 per 100,000 patients in states that had legalized sports betting, which represents an increase of more than 60 percent, while states that kept sports betting illegal recorded a slight decline over the same period.
Data Collection and Scope
The analysis drew on a broad dataset that captured patient encounters across multiple health systems, and the findings focus specifically on recorded diagnoses rather than self-reported behavior or survey responses. Observers note that the eight-year window covers the period when many states shifted from prohibition to regulated sports betting markets, which allowed the research team to compare trends before and after legalization took effect in different jurisdictions.
Key Patterns Across States
In states where sports betting became legal the quarterly rate moved steadily upward, whereas the opposite direction appeared in states that maintained bans. The divergence becomes visible when the data is segmented by legalization status, and the difference holds after accounting for the overall patient population size in each group. Experts have observed that the timing aligns with the rollout of legal sportsbooks in those jurisdictions, although the study itself stops at describing the statistical association.
Demographic Breakdown
The increase stood out most sharply among young men, a group that showed larger shifts in diagnosis rates than other age or gender categories in the dataset. Researchers tracked age and sex alongside diagnosis codes, which made it possible to isolate this subgroup without relying on external estimates. Data indicates that the same pattern did not appear at comparable magnitude in older age brackets or among women, which kept the overall rise concentrated within the younger male population.
Comparison Between Legal and Illegal Jurisdictions
States that kept sports betting illegal saw quarterly rates dip slightly rather than rise, which produced a contrasting trajectory when placed next to the legalized group. The study reports the figures side by side so readers can see the directional difference without additional interpretation layered on top. Those who reviewed the numbers point out that the patient volume remained large enough in both categories to support stable rate calculations across the quarters examined.
Timing Relative to Legalization Waves
Many states passed legislation permitting sports betting between 2018 and 2022, and the data window extends through the first quarter of 2026, which captures several years of post-legalization experience. The quarterly measurement approach lets the trend appear in smaller increments rather than as a single before-and-after snapshot, and the 60 percent rise accumulates across those successive quarters in the legalized states. By July 2026 additional states may have considered further regulatory changes, yet the published analysis remains anchored to the records available through Q1 2026.
Study Limitations and Scope
The research relies on diagnoses that appear in electronic health records, which means cases never brought to medical attention stay outside the count. The dataset covers a substantial share of the U.S. population yet does not include every health system, and the study authors present the results as descriptive statistics tied to legalization status. Observers note that correlation does not establish causation, and the report does not attempt to quantify how much of the rise stems directly from expanded betting access versus other factors that may coincide with legalization.
Public Health Context
Health systems in states with legal sports betting now hold eight years of post-legalization records that show elevated diagnosis rates, while parallel systems in states without legalization show a modest downward movement. The contrast supplies one data point for policymakers who track health outcomes alongside regulatory decisions. The figures come from the same source organization that maintains the underlying electronic health record platform, which gives the analysis access to consistent coding across participating sites.
Conclusion
The Epic Research analysis supplies a longitudinal view of gambling disorder diagnoses segmented by state legalization status, and the numbers show a greater than 60 percent rise in quarterly rates where sports betting is legal alongside a slight decline where it remains illegal. The pattern appears most pronounced among young men within a dataset that spans nearly 200 million patients through the first quarter of 2026. Readers can review the full report at the Epic Research site for the complete quarterly breakdowns and methodology details.