Abstract
PURPOSE: Over 75% of Americans have legal access to medical cannabis, though physical access is not uniform and can be difficult for rural residents. Additionally, substantial stigma remains in using medical cannabis, particularly within the health care system. This article argues that rural Americans may be particularly affected by such stigma and may thus be more likely to not report cannabis use to health care providers. METHODS: Data were obtained from 1,045 adult Pennsylvanians using a self-administered web panel omnibus survey. Rurality was determined by overlaying Zip Code Tabulation Areas with urban areas, as defined by the U.S. Census Bureau. Primary outcomes were prior use of cannabidiol (CBD) or marijuana and reporting of such use to medical professionals. Covariates utilized in logistic regressions included rurality, gender, age, race/ethnicity, political affiliation, political ideology, and veteran status. FINDINGS: Living in an urban area was positively associated with disclosure of marijuana use to health care providers as compared to those in rural areas, although there were no differences found in CBD disclosure. CONCLUSIONS: Stigma surrounding marijuana usage may have a disproportionate impact on health outcomes for rural residents who use marijuana. Nonreporting prevents effective holistic medical care and can result in negative drug interactions and other side effects.