A new and illuminating study has shed light on the troublingly disproportionate presence of recreational (nonmedical) cannabis retailers in socioeconomically disadvantaged neighbourhoods and areas with higher proportions of Black and Hispanic residents across 18 states in the United States that have legalised adult-use cannabis. The research, published in the American Journal of Preventive Medicine by Elsevier, provides crucial data for policymakers and public health officials, calling for strategies that prioritise equitable distribution of cannabis retailers. This is particularly relevant in an era when cannabis consumption is growing and the legal market continues to expand across the country.
The researchers conducted a detailed analysis using 2023 data from state agencies, which included 5,586 licensed recreational cannabis retailers across the 18 states that legalised recreational cannabis between 2012 and 2022. These states are Alaska, Arizona, California, Colorado, Connecticut, Illinois, Maine, Massachusetts, Michigan, Missouri, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington. To assess the correlation between neighbourhood deprivation and cannabis retailer concentration, the team employed multilevel logistic regression and negative binomial Poisson regression models, using geocoded retailer address data and census tract-level deprivation indices.
Dr Lindsay L. Kephart, the lead author and a researcher in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health, emphasised the stark disparity revealed by the findings. She explained that although cannabis retailers were present in just over 10% of census tracts within these legalised states, the most socioeconomically disadvantaged areas were consistently more likely to host them. In particular, neighbourhoods with high concentrations of low-income Black residents had 2.53 times the number of cannabis retailers compared to high-income, predominantly White neighbourhoods. For low-income Hispanic communities, this figure rose to 2.67 times. This pattern persisted across various definitions of neighbourhood disadvantage and was robust across all 18 states studied, regardless of their regional location or the specific timing of cannabis legalisation.
This distribution of cannabis retailers mirrors long-standing patterns observed with other legal substances, such as tobacco and alcohol. Historically, retailers of these products have often been situated in lower-income communities and communities of colour, reflecting systemic and structural factors that shape urban development and commercial zoning. Dr Kephart noted that this clustering may not always result from deliberate targeting but is frequently the outcome of structural inequalities, including zoning and land use policies that have historically placed undesirable commercial enterprises in less privileged neighbourhoods. She pointed to the influence of Not-In-My-Backyard (NIMBY) policies, which often divert cannabis retailers away from more affluent communities.
A particularly intriguing aspect of the study was a sensitivity analysis, which suggested that racial disadvantage alone—absent income considerations—did not significantly predict cannabis retailer density. This implies that socioeconomic factors may exert a more substantial influence than race. However, Dr Kephart cautioned that the intersection of race and income remains vital, as neighbourhoods with high proportions of low-income residents of colour experienced the highest densities of cannabis retailers. This highlights the need for policies that acknowledge the multifaceted nature of disadvantage, incorporating race and income in their analyses and interventions.
The broader implications of these findings are significant. Cannabis is currently one of the most widely consumed substances in the United States, with nearly 19% of those aged 12 or older reporting use in the past year. As of November 2024, 24 states have legalised recreational cannabis sales, raising concerns about how this evolving industry may differentially impact communities. Dr Kephart argued that the high density of cannabis retailers in disadvantaged neighbourhoods could exacerbate substance use disparities by increasing accessibility, lowering perceived health risks, and introducing novel products that may particularly appeal to young people. These factors, in turn, could have long-term implications for public health and community well-being.
Conversely, it is essential to acknowledge that the presence of legal cannabis retailers may also have some potential benefits, particularly in areas where illicit cannabis markets have historically flourished. Dr Kephart observed that a regulated and taxed supply of cannabis may help reduce the demand for illegal products, increase safety by ensuring product quality, and generate tax revenues that can be reinvested in local communities. Indeed, existing research suggests that recreational cannabis legalisation is associated with rising home values, especially in early-adopting states like Colorado and Washington. Although the precise causes are not yet fully understood, they may include economic development linked to the cannabis industry and broader social and policy changes that make neighbourhoods more attractive to homebuyers.
In closing, Dr Kephart stressed the importance of grounding cannabis policy in rigorous, evidence-based research. Such research can provide communities with the tools to make informed decisions about where cannabis retailers should be located, ensuring a balance between consumer access for adults and the minimisation of harm to vulnerable populations, particularly youth. Local policies such as zoning regulations or caps on the number of cannabis retailers in specific neighbourhoods may be instrumental in achieving this balance, helping to mitigate potential harms while supporting safe, legal access for those who choose to use cannabis.
More information: Lindsay L. Kephart et al, The Unequal Geography of Recreational Cannabis Retailers in the U.S., American Journal of Preventive Medicine. DOI: 10.1016/j.amepre.2025.107643
Journal information: American Journal of Preventive Medicine Provided by Elsevier
