Analysis of Electronic Health Records Links Sports Betting Legalization to Increased Gambling Disorder Diagnoses

Epic Research conducted an analysis of U.S. electronic health records that examined quarterly rates of diagnosed gambling disorder across states with differing sports betting laws, and the results showed a notable increase in areas where such betting became legal. The study tracked data from Q1 2018 through Q1 2026, covering nearly 200 million patients, while rates climbed more than 60 percent in jurisdictions that permitted sports betting yet declined slightly where it stayed illegal. Observers note that the patterns emerged consistently across the dataset, with the rise concentrated particularly among young men. The quarterly rate moved from 3.0 to 4.8 diagnoses per 100,000 patients in states that legalized sports betting during this period, according to the figures compiled by Epic Research. In contrast, states that maintained prohibitions saw a modest drop in the same metric over the same eight-year span. Those who've studied this know the data set spans a large population base, which allowed researchers to identify trends that might otherwise remain hidden in smaller samples. The analysis drew from electronic health records maintained across multiple health systems, providing a broad view of diagnosis patterns as sports betting expanded following the 2018 Supreme Court decision that cleared the way for state-level legalization.

Scope of the Patient Data Reviewed

Data collection encompassed records from nearly 200 million individuals, which researchers at Epic Research used to calculate diagnosis rates on a quarterly basis. This approach captured changes over time while accounting for variations in state policies on sports betting. Figures reveal that the upward trend in legal states began shortly after legalization measures took effect in various jurisdictions, and it continued through the first quarter of 2026. By July 2026, analysts had compiled the full picture showing sustained growth in diagnoses tied to those policy shifts, whereas illegal states experienced the opposite movement in rates.

The study focused solely on diagnosed cases recorded in electronic health records rather than self-reported behaviors, which means the numbers reflect clinical identifications made by healthcare providers. Researchers discovered that the increase aligned closely with the rollout of legal sports betting platforms in affected states, although the analysis stopped short of establishing direct causation. Those who've examined similar health record studies often find that large sample sizes like this one help isolate regional differences that smaller efforts might overlook.

Demographic Patterns Within the Results

The rise appeared especially pronounced among young men, a group that showed higher rates of new diagnoses compared with other demographics tracked in the dataset. In states where sports betting operates legally, quarterly figures for this subgroup climbed alongside the overall increase from 3.0 to 4.8 per 100,000 patients. Data indicates that young men in illegal states did not experience a comparable uptick, and in some cases their rates followed the slight overall decline observed across those jurisdictions.

People often find that age and gender breakdowns provide additional context for understanding how policy changes intersect with health outcomes. The Epic Research analysis separated the data by these categories, revealing that the 60 percent jump concentrated in younger male patients within legal states. Observers note that this pattern held steady across the eight-year window examined, from early 2018 when the first states began allowing sports betting through the first quarter of 2026.

State-by-State Policy Comparisons

States that legalized sports betting recorded consistent quarterly increases in diagnosed gambling disorder, while those maintaining bans saw rates edge downward. The contrast between these two groups of states forms the core finding of the analysis, with the legal group showing the jump from 3.0 to 4.8 diagnoses per 100,000 patients. Researchers compiled the statistics by aggregating records from participating health systems nationwide, which allowed direct comparison based on each state's regulatory status at different points during the study period.

Turns out the timing of legalization in individual states correlated with when diagnosis rates began their climb in those areas. The data set included enough geographic diversity to track multiple waves of legalization that occurred after 2018, and the patterns repeated across those locations. In states that kept sports betting illegal, the slight decline in rates continued without interruption through Q1 2026. Epic Research presented these comparisons in the published analysis, which drew attention to the divergence between the two policy environments.

Timeline of Observed Changes

Between the first quarter of 2018 and the first quarter of 2026, teh quarterly diagnosis rate in legal states rose steadily, reaching the reported 60 percent increase by the end of the measurement window. The study captured data points at regular intervals, which showed the acceleration happening in tandem with expanding access to legal sports betting options. By July 2026, the full set of quarterly figures had been reviewed, confirming that the trend persisted through the most recent complete quarter included in the records.

The analysis accounted for the gradual rollout of legalization across different states, grouping locations according to when sports betting became permitted. This method highlighted how rates responded in real time to policy adjustments, with legal states experiencing the documented uptick while illegal states maintained or slightly reduced their baseline levels. Data shows the overall patient population of nearly 200 million provided sufficient statistical power to detect these shifts reliably across regions.

Conclusion

The Epic Research analysis of electronic health records documents a clear divergence in gambling disorder diagnosis rates based on sports betting legality, with legal states seeing more than a 60 percent rise from 3.0 to 4.8 per 100,000 patients between Q1 2018 and Q1 2026. The increase stood out most sharply among young men, while rates in states where betting remained illegal declined modestly over the same span. Covering records from nearly 200 million patients, the study supplies a detailed view of how these diagnosis patterns evolved alongside changes in state policies. As of July 2026, the compiled data continues to inform discussions around the health record trends observed in this specific examination.