BOSTON – Not enough attention is being paid to the social and public health consequences of legalizing sports betting, particularly the ability to place wagers online or through mobile applications, expanded gambling opponents and public health advocates have told the lawmakers considering making another form of gambling available in the Bay State.

Throughout two days of hearings this week to consider making sports betting legal, the Economic Development and Emerging Technologies Committee heard mostly from sports betting supporters who wanted to highlight why their preferred regulatory scheme is best. But at least two people, one of whom was invited by the committee to testify Tuesday, urged lawmakers to think long and hard before approving sports wagering.

"I feel like through this process right now the public health aspects of this issue are getting short shrift," Mark Gottlieb, executive director of the Public Health Advocacy Institute at Northeastern University School of Law, told the committee Wednesday morning during the hearing open for the general public to share their thoughts. "We view state-sponsored sports gambling not really as a revenue generator for the commonwealth, not as a means to bolster casino traffic or as a way to help support internet gambling companies like Massachusetts' DraftKings, nor do we apply any religious or moral notions to our perspective, but we see state-sponsored gambling first and foremost as a public health issue."

Over the two days, supporters of sports betting including lawmakers, members of the governor's administration and industry officials touted legal sports betting as a way to combat a thriving illegal betting market, generate somewhere in the neighborhood of $35 million in annual revenue for the state and help the state's casinos compete with other entertainment options for foot traffic.

But Gottlieb and Les Bernal, national director of Stop Predatory Gambling, said lawmakers need to also consider the costs that could accompany another expansion of legal gaming, like exacerbating income inequality, contributing to greater health care costs and bilking bettors out of their savings.

"Last year alone, the American people lost $118 billion of personal wealth to government-sanctioned gambling. Over the next eight years, the American people are on a collision course to lose more than $1 trillion of their personal wealth to government-sanctioned gambling," Bernal, a former chief of staff for former state Sen. Susan Tucker, said. He added, "If you bring in sports gambling, particularly online, you're going to make these financial losses to citizens even worse."

Bernal was invited by the committee to testify during Tuesday's invite-only hearing alongside Marlene Warner, the head of the Massachusetts Council on Compulsive Gambling.

Gottlieb said state-sponsored gambling "acts as a regressive tax on lower-income populations," that Massachusetts sports bettors tend to have higher rates of problem gambling, and that Massachusetts bettors who wager online have even higher rates of problem gambling. He said he did not testify Wednesday in hopes of eliminating all state-sponsored gambling, but rather "in hopes that we can mitigate its public health impact on vulnerable populations in Massachusetts."

"We already know that Massachusetts sports gamblers have higher rates of problem gambling than non-sports gamblers in Massachusetts ... making sports gambling for all practical purposes universal and constantly available puts vulnerable subpopulations at an especially higher risk," he said. "Limiting sports gambling to on-site wagering, on the other hand, might help mitigate some of the public health impacts."

Bernal also highlighted online and mobile betting as being particularly problematic. "These addicted online gamblers are the main source of profits in the business. You don't have a revenue model in sports gambling without the out-of-control gambler," he said.

Committee co-chair Rep. Ann-Margaret Ferrante asked Gottlieb on Wednesday about the notion that legalizing sports betting would bring an activity that is already occurring illegally out of the shadows and would allow the state to build consumer protections around betting.

While that may be true and may be a benefit to people who are already problem gamblers, he said he is concerned that legalization would simply draw more people into gambling.

"There is an illegal sports gambling market, there is no doubt about it and it is already taking a toll," Gottlieb said. "But having the commonwealth really embrace sports betting this way and market it in a number of venues, although it may be a safer environment for those gamblers, you're just really growing that market and there will be more people involved."

Of particular concern, Gottlieb said, is that having the state get behind sports betting could normalize gambling for young people. He said lawmakers need to give more attention to the long-term consequences of another gaming expansion rather than focusing on the short-term benefits.

"For the government to say, 'this is OK and this is going to make everybody better, stronger economically,' there is a cost to it and I think there is a public health cost that has real economic consequences down the road," he said. "You're going to have a boost in revenue, in tax revenue and in these businesses you're getting a cut of, but there's going to be health care costs, there's going to be social costs, there's going to be loss of productivity perhaps down the road that should be considered."