Electronic Health Records Track Rising Gambling Disorder Rates Alongside Sports Betting Expansion

Researchers examined electronic health records covering nearly 200 million patients and identified clear differences in gambling disorder diagnoses between states that legalized sports betting and those that did not. The quarterly rate in states with legal sports betting climbed from 3.0 per 100,000 patients in the first quarter of 2018 to 4.8 per 100,000 by the first quarter of 2026, while rates in states without such legalization dropped from 3.1 to 2.2 over the same span.

Data from the analysis points to the largest increases among young men, with additional patterns emerging that researchers connect to the growth of online prediction markets. The study period spans the years when multiple states enacted sports betting laws following the 2018 Supreme Court decision that cleared the way for broader legalization.

Study Scope and Methodology

Analysts pulled records from a large network of health systems and calculated quarterly diagnosis rates per 100,000 patients to allow direct comparison across regions with different legal environments. This approach captured changes before and after legalization took effect in participating states, creating a natural contrast with areas that maintained prohibitions. Observers note the dataset size reduces the chance that random fluctuations drove the observed shifts, while the consistent measurement window supports tracking of longer-term trends.

States that introduced legal sports betting showed steady upward movement in diagnoses starting around the time new wagering options became available to residents. In contrast, states that kept sports betting illegal recorded declines across the eight-year window. The divergence appears most pronounced after 2022 when additional states expanded access through mobile platforms and retail locations.

Demographic Patterns in the Data

Figures reveal the steepest climbs occurred in the 18-to-34 age group, particularly among males. Researchers tracked diagnosis codes tied to gambling disorder and found these cohorts accounted for a disproportionate share of the overall increase in legalized states. Parallel movements showed up in records that also referenced online prediction market activity, though the study stops short of establishing direct causation.

Health systems in states with earlier legalization dates contributed more records to the rising totals, while later-adopting states displayed similar trajectories once betting became available. The patterns hold after adjusting for population size and the number of patients seen each quarter, suggesting the changes track with the introduction of legal markets rather than broader shifts in healthcare utilization.

Links to Online Prediction Markets

Alongside the main findings, the analysis flagged rising mentions of prediction market participation in patient records from both legalized and non-legalized states. Researchers observed that these references increased in tandem with sports betting expansion, though the rate of change remained higher where sports wagering itself had become legal. The overlap points to overlapping user bases and shared promotional channels that draw attention to multiple forms of chance-based activity.

Records from June 2026 continue to reflect the same directional trends established earlier in the year, with no reversal visible in preliminary quarterly updates. This continuity suggests the patterns identified through Q1 2026 have not yet plateaued in the most recent data available to analysts.

Broader Context of Legal Changes

Multiple states passed legislation authorizing sports betting between 2018 and 2025, creating staggered rollout dates that researchers used to compare early and late adopters. The staggered timing allowed the study team to examine whether diagnosis rates accelerated after each new market opened. Results showed consistent acceleration in the year following legalization in each adopting state, while non-adopting states maintained downward trajectories.

Electronic health record systems captured both new and existing diagnoses, enabling separation of incident cases from ongoing treatment. The increase in legalized states appeared driven more by new identifications than by re-diagnoses of previously known cases, according to breakdowns supplied in the report. This distinction matters because it indicates fresh presentations rather than simply more frequent coding of existing conditions.

Conclusion

The analysis supplies one of the largest-scale examinations to date of how state-level policy shifts coincide with changes in clinical records. By contrasting nearly 200 million patient records across legal environments, the work documents a 61 percent rise in states that legalized sports betting against a decline in states that did not. Young men show the sharpest movement, while references to online prediction markets appear alongside the primary trends. Continued monitoring through mid-2026 indicates the patterns remain in place as additional quarters of data accumulate.