Researchers analyzed millions of electronic health records and found a major difference between states that greenlit sports gambling and those that didn’t.

Diagnoses of gambling disorder rose more than 60% since 2018 in states that have legalized sports betting, with the biggest increase among young men, according to a new study of electronic health records across the U.S.

Gambling disorder is a recognized mental health condition in which patients often cannot stop gambling, despite the growing distress and harm they experience.

Sports betting has exploded across the U.S. following a landmark Supreme Court ruling that paved the way for states to legalize online sportsbooks in 2018. Experts say the findings offer more evidence of potential fallout from the decision — at a time when more online betting sites, like prediction markets, are taking off.