CHEM Manifesto

A Pathway to Healing through Cannabis Health Equity

Reframing Equity

Social equity. What is it? In the cannabis industry it has become a rallying cry against the ongoing missteps in policy reform and cannabis regulation around reconciling the direct and disproportionate impact of cannabis criminalization on the wellbeing of Black, Indigenous, and Latinx people. The missteps occur because “social equity" is poorly and inconsistently defined throughout the cannabis industry, and fails to consider the totality of what creates and ensures equity across a diverse population, and why this is important. 

In order to "get equity right," we must develop a comprehensive and shared understanding of what exactly equity is, what it must holistically do, and what roles we all must play to achieve it.

Equity is perhaps best explained through its intersection with ecology, or the state of the relationship between people and our ecosystems. 

Equity is a spectrum that ranges from inequity to total equity and is ultimately both a determinant and reflection of the health of an individual, their community, and our society as a whole. And our health—good or poor—is a malleable state of being that is continually influenced by the ecosystems within which we all live. As such, well-being is dependent upon living in a healthy ecosystem.

Healthy ecosystems depend upon optimizing four determinants of wellbeing—economic, environmental, human, and social determinants—and require continual attention and investment to maintain them. Total equity requires intentional distribution of resources  and investment across all determinants of wellbeing within an ecosystem such that it creates healthy people, healthy communities, and a healthy society. 

Total equity is better known as health equity, and it should achieve wellbeing for all people. 

The 4 Pillars of Health Equity

Another helpful way to describe health equity is as the sum of 4 categorical pillars:

  • Economic Equity: 1) The impartial assurance of access to economic resources such as income, savings, assets, and capital. 2) Possessing personal and collective agency over the flow of economic resources through a household or community.

  • Environmental Equity: The impartial assurance of access to and maintenance of 1) clean air, water, land, and soil, 2) clean and safe indoor spaces, 3) clean, natural, and safe outdoor spaces, and 4) clean, safe, and consistent housing options.

  • Human Equity: 1) The impartial optimization of an individual’s knowledge, skills, ability, capability, adaptability, and empathy. 2) The impartial optimization of an individual’s physical, mental, and spiritual fitness.

  • Social Equity: Fairness in policy and in the distribution of social resources and services to ensure that policy and social infrastructures facilitate 1) the impartial and continual maintenance of economic, environmental, and human equity, and 2) the social participation, cooperation, trust, cohesion, protection, and productivity of all people.

Healthy ecosystems are the result of the equitable capitalization of each determinant of wellbeing through which prosperity can be monitored, measured, scaled, and assured.

Cannabis Health Equity

Through decades-long selective enforcement of prohibition laws, Black, Indigenous, Latinx and other marginalized communities have been denied health equity—the equitable access to wellbeing. Because lawmakers crafted the cannabis policies that harmed these communities, it is incumbent on them to reform cannabis laws to repair and heal those same communities. However, policy makers aren’t solely responsible. It is imperative that we all participate in and support equitable regulatory frameworks.

Notwithstanding human folly, cannabis makes this easy. There is an opportunity to leverage cannabis policy, the cannabis economy, and the evidence-backed agricultural, industrial, medical, and nutritional uses of cannabis to address many of the medical and socio-ecological problems plaguing our targeted communities as a direct result of the systemic disinvestment in our determinants of wellbeing. This is Cannabis Health Equity.

Health equity won't be achieved  if the policies, regulations, and practices that govern the cannabis industry aren't health equity-centered. And ironically, the greatest threat is the ongoing failure of our legislators, regulators, and industry operators to recognize that the policies, rules, and practices they craft—not the programs they create—are the real social equity vehicles to reach the health equity as a destination.

We invite you to join our movement as we advocate for real cannabis education and the demonstration of the potential of cannabis to heal our economies, our environments, and ourselves. ​


Dr. Rachel Knox, MD, MBA

Co-founder and President, Cannabis Health Equity Movement™

Chair, CHEM Allyance