Despite the role drug-war cannabis criminalization played in destroying community and individual lives, medical cannabis care still has yet to reach many of these same communities. A study across New York state shows areas with larger black populations have a lower likelihood of containing a medical dispensary than other areas.
Many predominantly Black/Latinx communities not only lack a medical dispensary but are not even remotely close to one. All medical dispensaries in Rochester and Syracuse, for example, are in predominantly or overwhelmingly white ZIP codes. Buffalo has one medical dispensary in a predominantly Black community, which is still inadequate.
Following the same “rational” economics as other physicians and medical offices, medical cannabis facilities seem to stray away from medically underserved areas in pursuit of sustainable, profitable demand.
Even if facilities are located near or in Black/Latinx communities, this is not a sufficient measure of access to medical cannabis prescribing professionals. Based on the locations of prescribing professionals in New York City, Buffalo, Rochester, and Syracuse, white residents are consistently favored.
The New York City ZIP code with by far the most medical cannabis practitioners (56 located in 10016 alone) is largely white, with incredibly small percentages of Latinx and Black residents. In the Bronx, despite the density of non-white residents in the borough, the ZIP code with the most medical cannabis practitioners is predominantly white.
Based on analysis of Census data for the cities listed above, larger percentages of Black residents correspond to a lower number of medical cannabis practitioners, even if the area population and median income are the same. While some minority-majority zip codes possess higher numbers of medical cannabis practitioners, at most they have roughly half of the medical cannabis practitioners in similarly sized majority white areas.
This phenomenon goes beyond mere economic decision making and exemplifies the structural racism underlying medical cannabis access.
Access to medical cannabis is a persistent facet of broader health care inequality, and it must be recognized that it cannot be separated from the histories of overly carceral social interventions that have driven intergenerational deprivation. As New York’s cannabis program expands, it is imperative that policymakers find ways to target and empower those communities impacted severely by racist policies.
Identifying the social vulnerabilities generated and maintained under drug-war policies provides some explanation for inequitable access to health care. Financial stability, housing security, educational opportunity, and community resiliency, all of which contribute to and impact one another, also directly impact access to general care.
As it relates to medical cannabis more specifically, accessibility is worsened by the generational eschewing of cannabis as medicine.
Racist Roots Persist
Surveys of medical cannabis patients attest to the significant medical and therapeutic benefits of cannabis in treating a variety of ailments. Despite compelling anecdotal evidence for the use of medical cannabis, medical literature still points to limited or insufficient evidence for cannabis’ medicinal or therapeutic uses. The disconnect between the relief experienced by individuals and what benefits academics and researchers have proven is a byproduct of not only drug-war policies, but over a century of cannabis stigmatization.
Pharmacies sold cannabis-derived medicines from the 1800s until the early 20th century, and most government officials and regulators at the time saw no issue with cannabis. The rise of anti-cannabis sentiment started after the Mexican immigrant population increased after 1910. By adopting the anti-cannabis sentiment already present in Mexico, anti-Mexican factions in the U.S. were able to portray cannabis, and those who used it, as a threat to society and its values.
The racism underlying anti-cannabis sentiment eventually included immigrants from India and the Caribbean, as the country continued to undergo demographic, and therefore political, changes. Overtime, cannabis became imbued with the racist, classist, and patriarchal currents of the late 19th and early 20th centuries, and anti-cannabis sentiment was reaffirmed with Prohibition-era ethics.
After a generation of social and legal nonacceptance, and lacking the legitimacy of serious medical inquiry, cannabis patients attest to a persistent stigmatization. Because cannabis use is connected to other socially stigmatized backgrounds, such as poverty or disabilities, and stigmatized ailments, such as HIV/AIDS and mental illness, many patients are subjected to a critical eye for seeking otherwise legitimate medical care.
Additionally, with the conflation of cannabis use with criminality as a result of War on Drugs’ policing, many patients bear underserved social scrutiny for utilizing effective medicine.
Righting the Wrongs
Pursuits of equitable cannabis access must wrestle with the bigotry, classism, nativism, pseudo-scientific appeals, and political contexts which gave rise to past cannabis prohibitions, and labeled medicine as an illicit drug. By dispelling these views, policymakers and community leaders can empower patients to access the care they need.
New York’s Office of Cannabis Management must ensure equitable distribution of medical cannabis facilities, and ensure their services and benefits reach impacted communities.
As the medical market expands, many community partners are worried that profit would take precedence over community. In redressing the inequities produced by the War on Drugs and the stigmatization of cannabis, community should ultimately come first.
Dr. Torian Easterling is senior vice president for population and community health and chief strategic and innovation officer at One Brooklyn Health and founding partner of Black Star Wellness. Dr. Easterling previously served as the first deputy commissioner and chief equity officer at the city Department of Health and Mental Hygiene.