Epic Research Tracks Sharp Increase in Gambling Disorder Diagnoses Across Legalized Sports Betting States

Epic Research analyzed Cosmos medical data to examine quarterly diagnosis rates for gambling disorder among adult patients, and the figures show a clear 61 percent rise in states that have legalized sports betting. The rate moved from 3.0 diagnoses per 100,000 patients in the first quarter of 2018 to 4.8 per 100,000 by the first quarter of 2026. Observers note that this increase occurred while rates in states without legalized sports betting fell to 2.2 per 100,000 over the same period. The study examined data from multiple states that introduced sports betting at different times, yet the upward trend appeared consistent rather than clustered around individual legalization dates. Researchers tracked adult patient records across the full eight-year span, allowing direct comparison between jurisdictions with and without expanded betting access.

Study Methodology and Data Scope

Cosmos medical data provided the foundation for the dual-team analysis, drawing from electronic health records that capture diagnosed conditions across participating health systems. Epic Research focused exclusively on adult patients who received a gambling disorder diagnosis during the measured quarters. The approach allowed the team to calculate rates per 100,000 patients while controlling for population differences between states.

Data collection covered Q1 2018 through Q1 2026, creating a timeline that begins before widespread sports betting legalization and extends well after most states had implemented their frameworks. The parallel movement across legalized states suggests the change coincided with the broader availability of sports betting rather than any single regulatory event.

Comparison Between Legalized and Non-Legalized States

States that legalized sports betting recorded the 61 percent increase, while non-legalized states experienced a decline to 2.2 diagnoses per 100,000. This divergence widened steadily after 2018, with legalized states showing consistent quarterly gains and non-legalized states showing reductions. The contrast holds even when researchers accounted for differences in overall healthcare utilization rates between the two groups of states.

Those who've reviewed the findings point out that the pattern does not align with staggered legalization timelines. Instead the rise appears broadly parallel, indicating a shared factor across the legalized group. The data does not establish causation, yet it documents a measurable difference that emerged alongside expanded sports betting access.

Patterns Observed Across Multiple Jurisdictions

Researchers examined whether spikes occurred immediately after each state's legalization date, but the results showed no such clustering. Rates rose gradually and uniformly across the group of legalized states, suggesting the effect may relate to cumulative exposure rather than isolated policy changes. The same dataset revealed that non-legalized states maintained lower and declining rates throughout the study window.

Healthcare systems in both categories contributed records to Cosmos, which supports the reliability of the comparison. The study authors note that diagnosis rates reflect only those cases identified and recorded by medical providers, so the figures represent diagnosed instances rather than total prevalence.

Context in Mid-2026

By July 2026 the eight-year dataset had captured several years of post-legalization experience in most states that chose to expand sports betting. The steady divergence between the two groups of states continued through the most recent quarter examined. Public health officials and medical researchers now have access to these longitudinal figures when assessing the relationship between betting availability and disorder diagnoses.

Conclusion

The Epic Research analysis of Cosmos data documents a 61 percent increase in diagnosed gambling disorder rates in states that legalized sports betting, reaching 4.8 per 100,000 by Q1 2026, while rates in non-legalized states declined to 2.2 per 100,000. The trend appeared consistent across legalized states and did not cluster around individual legalization dates. The full report provides additional detail on methodology and state-level breakdowns for those seeking further examination of the figures.