Ontario’s Online Gambling Boom Triggers Emergency Room Surge
Online sports betting has surged in popularity, but new research highlights its darker side. A study from ICES, a Canadian healthcare research institute, reveals a sharp rise in gambling-related emergency room visits after Ontario expanded its online gambling market. Canada legalized single-event sports betting in August 2021, setting the stage for Ontario’s move in April 2022 to allow private companies to operate regulated online gambling sites.
The study, published in the American Journal of Preventive Medicine, analyzed 14 years of emergency department data in Ontario. This period saw a significant shift in the accessibility and marketing of online gambling, particularly targeting younger demographics.
Emergency Visits Spike
Gambling-related emergency care more than doubled following the market changes. The increase was most pronounced among younger men. By the end of the study, the number of gambling-related ER visits was 154% higher than expected among males aged 10-29 and 116% higher among males aged 30-44. During the study period, 757 people made a total of 952 ER visits where a gambling disorder was recorded as either the primary reason or a contributing factor. Nearly three-quarters of these visits were by males, showing the gender disparity in gambling-related harm.
The study found no corresponding change in gambling-related emergency visits among females. More than 70% of these visits involved another mental health condition or heavy substance use, while nearly one-third resulted in hospital admission. These findings suggest that at least some of the people arriving at emergency departments were dealing with gambling problems alongside other significant health or substance-use concerns.
Beyond Financial Losses
The findings suggest that online gambling’s impact extends beyond financial losses. The concentration of the increase among younger males is particularly concerning given the rapid growth and promotion of online sports betting, which target this demographic. “The consequences of rising gambling involve not just harm to people who are gambling but wider effects on families and communities,” said a public health doctoral student at the University of Toronto’s Dalla Lana School of Public Health in a press release.
The study also highlights the potential underreporting of gambling disorders. People with gambling disorders often do not seek formal treatment, in part because of stigma. Some may wait until gambling has contributed to serious financial, social, or health consequences before seeking help. Emergency department visits, therefore, likely represent only the most severe cases.
A Growing Market
Ontario’s online gambling market has expanded significantly, with 83 gaming and betting sites operated by 43 private companies. In 2024, Ontarians wagered $82.7 billion Canadian dollars through 2.6 million player accounts. This rapid growth reflects the increasing normalization of online gambling as a mainstream activity, but it also raises concerns about the associated risks.
The study does not establish that the expansion of online gambling directly caused the increase in emergency department visits. That distinction is consequential because other factors could potentially have contributed to the increase.
A Public Health Concern
The research shows the need for a subtle approach to online gambling. As the industry grows, so does the potential for harm, particularly among vulnerable populations. It calls for a balanced perspective that acknowledges both the entertainment value of gambling and its potential risks.
