The Health Divide: The explosion of sports betting is fueling a new public health crisis
Author(s)
Image
(Getty Images)
Published on
January 5, 2026
Every moment in sports has become a wager, and not just on who will win the Super Bowl or how many strikeouts a pitcher will throw. With a quick tap on your phone, you can bet on what color Gatorade will drench a winning coach, whether a player will propose to his girlfriend on the field, and more.
The collision of legalized sports betting, smartphones and celebrity culture is quietly creating a public health crisis we’ve barely begun to understand.
But the signs are everywhere. From 2018, when New Jersey legalized sports betting, to September 2024, calls to the hotline run by the state’s Council on Compulsive Gambling nearly quadrupled. In the months following the legalization of sports betting in Connecticut, calls to that state’s hotline quadrupled.
And a survey in Maryland found that in the 20 months after online sports betting launched in that state, the rate of persistent problematic gambling among adults jumped 42%, from 4% to 5.7%. Two-thirds of those who reported troubling behaviors — running up big debts, for example, or lying to loved ones to hide losses — were men, according to the survey by the Maryland Center of Excellence on Problem Gambling at the University of Maryland School of Medicine.
“Yeah, it’s a pretty significant increase,” said Dr. Christopher Welsh, the Center’s medical director. “And this was looking only at 18 and older. So we’re not even looking at teenagers, and we know there’s an issue.”
Some 22% of all Americans, and 48% of men ages 18 to 49, have an account with at least one online sportsbook. It’s not surprising, then, that young men are most susceptible to the compulsive and self-destructive behaviors that sports betting can lead to. The Maryland survey found the rate of problematic sports gambling was highest among white men, while the rate of problematic gambling more generally was three times higher among Black adults than white adults.
Other research has found that sports betting is most common among Black adults. Although the activity is generally prohibited for anyone under 21, a 2023 national survey of 18- to 22-year-olds found that 68% Black respondents had engaged in sports betting, compared with 63% of Hispanic, 55% of Asian, and 54% of white respondents. And the Black young adults were twice as likely as bettors overall to make big wagers.
The finding is consistent with years of research pointing to higher rates of gambling disorders in communities of color. Dice, lottery tickets and horse-race betting were popular in low-income communities well before our phones turned into casinos and tethers to sportsbooks, Welsh said. “The person doesn’t even see it as gambling. It’s a way to try and make money.”
This longstanding pattern begs two questions: How will the new normalization and ease of gambling affect the most vulnerable communities? And why didn’t gambling disorders get more attention — and funding — until it mushroomed as a problem among white men in recent years?
The explosion of sports betting started with a 2018 Supreme Court decision that overturned a federal law that effectively banned the activity in all but a few states. Now, 38 states plus D.C. and Puerto Rico offer legal sports betting for adults and 30 states allow it online.
There are dozens of betting apps, with relentless push notifications to place a wager. Sports leagues, broadcasters, and colleges have lucrative partnerships with sportsbooks, which advertise heavily during games watched by millions of people of all ages. Last year alone, Americans legally wagered a staggering $148 billion on sports.
Wagers are common even in states that haven’t legalized sports betting. A survey last year found that nearly a half-million Californians reported symptoms of problem gambling, even though online casinos and sports betting remain illegal there. It’s not hard to skirt restrictions. One way is by using a “prediction market” app, which is not a betting app per se, but a tool — legal in every state — that allows a user to invest in the outcome of a game.
Amid the betting frenzy, it’s not surprising that high-profile scandals are mounting. In October, several current and former National Basketball Association players and a coach were arrested in illegal betting schemes. In November, two Cleveland Guardians pitchers were indicted for allegedly rigging individual pitches to provide huge payoffs on prop bets — bets that depend on pitch characteristics rather than who wins or loses the game.
Also in November, the NCAA announced that six former men’s basketball players at three colleges took part in schemes that included throwing games and funneling information to known bettors. Now, match-fixing concerns even extend to table tennis and surfing.
While the scandals make headlines, the growing toll on health and well-being is a story ripe for coverage.
A study published in mid-November found that legalized sports betting is associated with a measurable rise in crime, especially assaults, on game days. The increase is sharpest when games are close, and stressful for fans.
And researchers in California have documented the financial consequences: Legalizing sports betting is followed by a significant increase in bankruptcies, debts sent to collections, and delinquent car loans and credit cards.
There are ample opportunities for more reporting here. What’s the impact of sports betting in your community? How prevalent is it among teens? How does betting contribute to health disparities or affect public safety?
What essentials are low-income families forced to do without when gambling losses mount? What resources are available when gambling becomes ruinous, and who can afford them?
Problem gambling was not even recognized as an addiction by the American Psychiatric Association until 2013, long after drug and alcohol addictions were widely accepted as public health issues. The federal government has provided little funding for research or treatment of gambling addiction.
Like alcohol, gambling plays a complicated, contradictory role in society. It can be fun and social, yet it has the potential to destroy lives. A Siena poll last year of 3,047 Americans captured this paradox.
Half the respondents agreed that online sports betting should be legal in every state. But nearly two-thirds agreed that online sports betting will create compulsive gamblers whose addiction will cause pain to them and their families. A poll released last month reported that 36% of Americans view the growing number of states allowing people to place bets on sports as a “bad thing."
It’s encouraging to see public awareness of the risks. But that’s not enough when an entire sports and gambling ecosystem operates with virtually no federal guardrails, and a generation is growing up with casinos on their phones. Two new bills in Congress aim to create some protections.
The Supporting Affordability and Fairness with Every Bet (SAFE Bet) Act would create nationwide consumer protections and standards for mobile sports gambling, including prohibitions on sportsbook marketing during live sporting events, and bans on the use of artificial intelligence to track a player’s habits or offer individualized promotions.
The Gambling Addiction Recovery, Investment, and Treatment (GRIT) Act would use federal sports excise tax revenue to fund programs to combat gambling addiction.
It’s not surprising that the bills face stiff opposition from the industry. Nor is it surprising that some states don’t want Congress to act. While they argue that gambling regulation is their job, not the federal government’s, the issue isn’t simply about states’ rights.
Collectively, states are raking in hundreds of millions of dollars in tax revenues from sports betting. (Check out the Journalist’s Resource for a state-by-state breakdown.) The prospect of new revenue persuaded many legislators and governors to allow sports betting in the first place, and states don’t want to lose the payoff — no matter the cost to public health.