Availability of medical cannabis services by racial, social, and geographic characteristics of neighborhoods in New York: a cross-sectional study

Abstract

Background Within the United States (US), because racial/ethnic disparities in cannabis arrests continue, and cannabis legalization is expanding, understanding disparities in availability of legal cannabis services is important. Few studies report mixed findings regarding disparities in availability of legal cannabis services; none examined New York. We examined disparities in availability of medical cannabis services in New York. We hypothesized that New York census tracts with few Black or Hispanic residents, high incomes, high education levels, and greater urbanicity would have more medical cannabis services. Methods In this cross-sectional study, we used data from the 2018 US Census Bureau 5-year American Community Survey and New York Medical Marijuana Program. Main exposures were census tract characteristics, including urban–rural classification, percentage of Black and Hispanic residents, percentage of residents with bachelor’s degrees or higher, and median household income. Main outcomes were presence of at least one medical cannabis certifying provider and dispensary in each census tract. To compare census tracts’ characteristics with (vs. without) certifying providers and dispensaries, we used chi-square tests and t-tests. To examine characteristics independently associated with (vs. without) certifying providers, we used multivariable logistic regression. Results Of 4858 New York census tracts, 1073 (22.1%) had medical cannabis certifying providers and 37 (0.8%) had dispensaries. Compared to urban census tracts, suburban census tracts were 62% less likely to have at least one certifying provider (aOR = 0.38; 95% CI = 0.25–0.57). For every 10% increase in the proportion of Black residents, a census tract was 5% less likely to have at least one certifying provider (aOR = 0.95; 95% CI = 0.92–0.99). For every 10% increase in the proportion of residents with bachelor’s degrees or higher, a census tract was 30% more likely to have at least one certifying provider (aOR = 1.30; 95% CI = 1.21–1.38). Census tracts with (vs. without) dispensaries were more likely to have a higher percentage of residents with bachelor’s degrees or higher (43.7% vs. 34.1%, p < 0.005). Conclusions In New York, medical cannabis services are least available in neighborhoods with Black residents and most available in urban neighborhoods with highly educated residents. Benefits of legal cannabis must be shared by communities disproportionately harmed by illegal cannabis.

“It doesn’t make any sense to even try”: the disruptive impact of COVID-19’s first wave on people with chronic pain using medical cannabis in New York

“…While previous studies pointed to cost as a significant challenge to certified patients prior to the pandemic (Zeng et al 2021 ; Zhu et al 2021 ), this burden was worsened due to newly added delivery costs and to financial vulnerability that participants experienced during the pandemic. In addition, the pandemic exacerbated disparities in access to medical cannabis services which previous studies identified in NY before the pandemic (Cunningham et al 2022 ).…”

“…In NY as in other states, medical cannabis products are not covered by insurance and patients must pay for them with cash rather than credit or debit cards (New York City Department of Health and Mental Hygiene 2022 ). Certifying providers in NY are less likely to be located in areas with Black residents than in areas with other racial and ethnic compositions, and medical cannabis dispensaries are more highly concentrated in highly educated neighborhoods than in neighborhoods with less educated population (Cunningham et al 2022 ).…”

Toward reducing racialized pain care disparities: Approaching cannabis research and access through the lens of equity and inclusion

“…Last, cannabisrelated tax revenue will be used to invest in communities most impacted by the war on drugs through social and economic equity programs implemented by local governments and community organizations. 47…”

“…45,46 For example, in 2021, New York state passed the Marijuana Regulation and Taxation Act, which includes three components designed to benefit communities that have been disproportionately affected by cannabis laws. 47 First, individuals convicted of a cannabis-related offense will have their convictions expunged. Second, the New York law stipulates that communities that have been disproportionately affected will have access to economic opportunities created by the law (e.g., cannabis licenses).…”

“…Given this prejudiced history, several recently passed state laws to legalize cannabis have explicitly addressed the issue as one of social justice 45,46 . For example, in 2021, New York state passed the Marijuana Regulation and Taxation Act, which includes three components designed to benefit communities that have been disproportionately affected by cannabis laws 47 . First, individuals convicted of a cannabis‐related offense will have their convictions expunged.…”