Proximity to Cannabis Retailers and Recent Cannabis Use among a Diverse Sample of California Adolescents.

Background: As of May 2023, 23 states and Washington, DC have legalized the sale of cannabis for adults aged 21+, and 38 states, three territories, and D.C. have legalized medical cannabis. Exposure to cannabis retailers could increase adolescent cannabis use. Few studies have examined the impact of residential proximity to cannabis retailers on adolescent cannabis use, and previous findings are inconsistent. Methods: This study examined associations between proximity to cannabis retailers and past 30-day cannabis use. Data were from Project Cal Teens, a statewide survey of California adolescents regarding cannabis-related opinions/behaviors (N = 1406, mean age = 15.5 years, 48% female, 38% Hispanic/Latinx, 33% White, 15% Asian/Pacific Islander, 10% Black/African American, 5% Other/Multiracial). Participants were recruited via schools/social media in 2018-2020. Results: For every additional 5 driving miles to the nearest cannabis retailer, the risk of past 30-day cannabis use was reduced by 3.6% [IRR: 0.964; 95% CI: 0.935-0.994]. For every additional 5 miles from a licensed retailer, the risk of past 30-day cannabis use was reduced by 4.3% [IRR: 0.957; 95% CI: 0.926-0.989]. Interaction analyses revealed that among Hispanic/Latinx students, every 5 miles from a licensed retailer was associated with an 11.9% reduction in the risk of past 30-day cannabis use [IRR: 0.881; 95% CI: 0.820-0.945]. Conclusions: As the number of cannabis retailers in the U.S. increases with the continued legalization of adult cannabis use, research examining the effects of these policies on underage use is crucial. Interventions could include enforcement of zoning laws in/near residential areas to reduce accessibility of adolescents to cannabis retailers.

Financial status and travel time to driving schools as barriers to obtaining a young driver license in a state with comprehensive young driver licensing policy.

The highest lifetime risk for a motor vehicle crash is immediately after the point of licensure, with teen drivers most at risk. Comprehensive teen driver licensing policies that require completion of driver education and behind-the-wheel training along with Graduated Driver Licensing (GDL) are associated with lower young driver crash rates early in licensure. We hypothesize that lack of financial resources and travel time to driving schools reduce the likelihood for teens to complete driver training and gain a young driver's license before age 18. We utilize licensing data from the Ohio Bureau of Motor Vehicles on over 35,000 applicants between 15.5 and 25 years old collected between 2017 and 2019. This dataset of driving schools is maintained by the Ohio Department of Public Safety and is linked with Census tract-level socioeconomic data from the U.S. Census. Using logit models, we estimate the completion of driver training and license obtainment among young drivers in the Columbus, Ohio metro area. We find that young drivers in lower-income Census tracts have a lower likelihood to complete driver training and get licensed before age 18. As travel time to driving schools increases, teens in wealthier Census tracts are more likely to forgo driver training and licensure than teens in lower-income Census tracts. For jurisdictions aspiring to improve safe driving for young drivers, our findings help shape recommendations on policies to enhance access to driver training and licensure especially among teens living in lower-income Census tracts.

Identifying community-level disparities in access to driver education and training: Toward a definition of driver training deserts.

OBJECTIVE: Obtaining a license may be challenging for teens due to access to driving instruction; in some states, behind-the-wheel (BTW) instruction is required to secure a license before age 18. We investigate spatial accessibility to BTW centers, and how this geographic distribution intersects with metrics of social disparity at the metropolitan level, toward identifying Driver Training Deserts (DTDs): geographic areas of disconnection to driver training. METHODS: For the Columbus OH region, we collect socioeconomic variables at the Census tract unit of analysis and geocoded locations of public and private BTW training centers and estimate travel time to the nearest BTW training center. We define travel time as either the mean or the maximum travel time to BTW centers across all 1 km × 1 km grid cells within a Census tract. We employ spatial statistical approaches, including homogeneous/inhomogeneous K functions, to determine whether BTW training centers are clustered. Next, we define DTDs as Census tracts with a poverty rate and travel time to BTW centers larger than the 75th percentile values across the region. RESULTS: BTW training centers are spatially clustered across the region; the magnitude of this clustering is so great that BTW centers exhibit statistically significant patterns of clustering, even when considering the underlying spatial distribution of socio-economic characteristics. We find that 11-27 Census tracts are identified as DTDs depending on the definition of travel time. DTDs contain a disproportionate percent of the high poverty population (8.7-23.5%) and, depending on the definition of travel time, a disproportionately large African American population. CONCLUSIONS: Methodologically, defining DTDs necessitates a fine-grained spatial approach as suburban and rural Census tracts tend to be large and thus can be poorly represented by travel times averaged over the Census tract. Defining DTDs as a measure of individual-specific variables - income and impedance - allows DTDs to be addressed with policy interventions. The findings motivate future research correlating DTDs with licensure rates, enrollment in driver training, and safe driving outcomes to understand if DTDs can help explain health equity outcomes related to young driver safety.

Locations of licensed and unlicensed cannabis retailers in California: A threat to health equity?

This study examined whether unlicensed and licensed cannabis retailers in California are disproportionately located in neighborhoods with minority populations or populations living below the Federal Poverty Level. We mapped the locations of licensed and unlicensed cannabis retailers in California in October 2018, combining advertisements from cannabis websites with licensing data. Demographic characteristics of neighborhoods with and without licensed and/or unlicensed cannabis retailers were compared. We identified 1110 cannabis retailers in California (448 licensed and 662 unlicensed). Relative to neighborhoods without retailers, neighborhoods with retailers had higher proportions of Hispanics, African Americans, and residents living below the poverty level. Compared with neighborhoods with only licensed retailers, neighborhoods with only unlicensed retailers had higher proportions of Hispanics and African Americans, and lower proportions of non-Hispanic whites. Neighborhoods with both licensed and unlicensed retailers had higher proportions of African Americans, Asian Americans, and people living in poverty, relative to neighborhoods with only licensed retailers. Unlicensed retailers were disproportionately located in unincorporated areas and jurisdictions that allow cannabis retailers. Minority populations in California are disproportionately exposed to unlicensed cannabis retailers, potentially exacerbating health disparities by selling unregulated products or selling to minors.