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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 185 Introduced in House (IH)]

<DOC>

118th CONGRESS
  1st Session
H. RES. 185

                Declaring racism a public health crisis.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           February 28, 2023

   Mrs. Hayes (for herself and Mr. Cardenas) submitted the following 
resolution; which was referred to the Committee on Energy and Commerce, 
 and in addition to the Committee on the Judiciary, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                               RESOLUTION

 
                Declaring racism a public health crisis.

Whereas since the Nation's founding, the United States has had a longstanding 
        history and legacy of racism, mistreatment, and discrimination against 
        African Americans, Latinos, Native Americans, and other people of color;
Whereas the United States ratified over 350 treaties with sovereign indigenous 
        communities, has broken the promises made in such treaties, and has 
        historically failed to carry out its trust responsibilities to Native 
        Americans, including American Indians, Alaska Natives, and Native 
        Hawaiians, as made evident by the chronic and pervasive underfunding of 
        the Indian Health Service and Tribal, Urban Indian, and Native Hawaiian 
        health care, the vast health and socioeconomic disparities faced by 
        Native American people, and the inaccessibility of many Federal public 
        health and social programs in Native American communities;
Whereas people of Mexican and Puerto Rican descent, who became Americans through 
        conquest, were subject to, but never full members of the polity of the 
        United States and experienced widespread discrimination in employment, 
        housing, education, and health care;
Whereas the immoral paradox of slavery and freedom is an indelible wrong traced 
        throughout the Nation's history, as African Americans lived under the 
        oppressive institution of slavery from 1619 through 1865, endured the 
        practices and laws of segregation during the Jim Crow era, and continue 
        to face the ramifications of systemic racism through unjust and 
        discriminatory structures and policies;
Whereas before the enactment of the Medicare Program, the United States health 
        care system was highly segregated, and, as late as the mid-1960s, 
        hospitals, clinics, and doctors' offices throughout Northern and 
        Southern States complied with Jim Crow laws and were completely 
        segregated by race--leaving Black communities with little to no access 
        to health care services;
Whereas between 1956 and 1967, the National Association for the Advancement of 
        Colored People (NAACP) Legal Defense and Educational Fund litigated a 
        series of court cases to eliminate discrimination in hospitals and 
        professional associations;
Whereas the landmark case Simkins v. Moses H. Cone Memorial Hospital, 323 F.2d 
        959 (1963), challenged the Federal Government's use of public funds to 
        expand, support, and sustain segregated hospital care, and provided 
        justification for title VI of the 1964 Civil Rights Act and the Medicare 
        hospital certification program--establishing Medicare hospital racial 
        integration guidelines that applied to every hospital that participated 
        in the Federal program;
Whereas, in 1967, President Lyndon B. Johnson established the National Advisory 
        Commission on Civil Disorders, which concluded that White racism is 
        responsible for the pervasive discrimination and segregation in 
        employment, education, and housing, resulting in deepened racial 
        division and continued exclusion of Black communities from the benefits 
        of economic progress;
Whereas language minorities, including Latinos, Asian Americans, and Pacific 
        Islanders, were not assured nondiscriminatory access to federally funded 
        services, including health services, until the signing of Executive 
        Order 13166 in 2000;
Whereas the Patient Protection and Affordable Care Act (Public Law 111-148) 
        included provisions to expand the Medicaid program and--for the first 
        time in the United States--established a Federal prohibition against 
        discrimination on the basis of race, color, national origin, sex, age, 
        or disability in certain health programs, building on other Federal 
        civil rights laws;
Whereas the Patient Protection and Affordable Care Act required reporting to 
        Congress on health disparities based on race, color, national origin, 
        sex, age, or disability;
Whereas several Federal programs have been established to address some, but not 
        all, of the health outcomes that are disproportionately experienced by 
        communities of color, including sickle cell disease, tuberculosis, 
        infant mortality, and HIV/AIDS;
Whereas the National Center for Chronic Disease Prevention and Health Promotion 
        works to raise awareness of health disparities faced by minority 
        populations in the United States, such as Native Americans, Asian 
        Americans, Black Americans, and Latino Americans, aiming to reduce risk 
        factors for groups affected by such health disparities;
Whereas the United States health care system and other economic and social 
        structures remain fraught with racism and racial, ethnic, sex (including 
        sexual orientation and gender identity), and class biases that lead to 
        health inequity and health disparities;
Whereas life expectancy rates for Black and Native American people in the United 
        States are significantly lower than those of White people in the United 
        States;
Whereas disparities in health outcomes are exacerbated for LGBTQIA+ people of 
        color;
Whereas disparities in health outcomes are worsened for people of color with 
        disabilities due to bias and inequitable access to health care;
Whereas several States with higher percentages of Black, Latino, and Native 
        American populations have not expanded their Medicaid programs pursuant 
        to subclause (VIII) of section 1902(a)(10)(A)(i) of the Social Security 
        Act (42 U.S.C. 1396a(a)(10)(A)(i))--continuing to disenfranchise 
        minority communities from access to health care;
Whereas 16 States have failed to take advantage of the Federal option to expand 
        access to the Medicaid program under title XIX of the Social Security 
        Act (42 U.S.C. 1396 et seq.) and the Children's Health Insurance Program 
        under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) to 
        lawfully residing immigrant children within the first 5 years of lawful 
        status, and 26 States have failed to do so for similarly situated 
        pregnant women;
Whereas between 2016 and 2018, the child uninsured rate increased from 4.7 
        percent to 5.2 percent and the Latino child uninsured rate increased 
        from 7.7 percent to 8.1 percent, and children of color are far more 
        likely to be uninsured than White children;
Whereas a climate of fear and confusion for immigrant families due to the public 
        charge rule discourages such families from enrolling eligible children 
        in the Medicaid program and the Children's Health Insurance Program;
Whereas Pacific Islanders from the Freely Associated States experience unique 
        health disparities resulting from United States nuclear weapons tests on 
        their home islands, but such people have been categorically denied 
        access to Medicaid and other Federal health benefits;
Whereas the United States has historically facilitated outsider status toward 
        Asian Americans and Pacific Islanders, such as the authorization of the 
        internment of Japanese Americans during World War II, which resulted in 
        profound economic, social, and psychological burdens for the people 
        impacted;
Whereas the history and persistence of racist and nonscientific medical beliefs 
        are associated with ongoing racial disparities in treatment and health 
        outcomes;
Whereas implicit racial and ethnic biases within the health care system have an 
        impact on the quality of care experienced by communities of color, such 
        as the undertreatment of pain in Black patients;
Whereas the historical context of unethical practices and abuses experienced by 
        Black patients and research participants, such as the Tuskegee Syphilis 
        Study, serve as symbols of the Black community's mistrust of the medical 
        system;
Whereas women of color continue to face attacks, documented throughout history, 
        on their prenatal, maternal, and reproductive health and rights;
Whereas enslaved Black women were forced to endure egregiously unethical and 
        cruel treatment, as subjects of insidious medical experiments, to 
        advance modern gynecology;
Whereas through the late 1960s and early 1980s, physicians routinely sterilized 
        people of color, performing excessive and medically unnecessary 
        procedures on patients of color without their informed consent;
Whereas Black and Native American women are 2 to 4 times more likely than White 
        women to suffer severe maternal morbidity or die of pregnancy-related 
        complications, and implicit racial biases and lower quality care are 
        contributing factors to the health care disparities that lead to these 
        outcomes;
Whereas Black and Native American infants are twice as likely to die as White 
        infants, and the Black infant mortality rate in the United States is 
        higher than in 97 countries worldwide;
Whereas researchers have developed the analytical framework of ``weathering'' to 
        describe how the constant stress of racism leads to poor health outcomes 
        for Black Americans;
Whereas the daily experience of racism is associated with stress, depression, 
        and anxiety, and may cause physiological reactivity or contribute to 
        chronic health conditions;
Whereas racism is linked to mental health challenges for children and 
        adolescents;
Whereas children of color are overrepresented in the United States child welfare 
        system, and up to 80 percent of children in foster care enter State 
        custody with significant mental health challenges;
Whereas disparities in educational access and attainment, along with racism 
        experienced in the educational setting, affect the trajectory of 
        academic achievement for children and adolescents, and ultimately impact 
        health and racial inequities in school discipline, which has long-term 
        consequences for children;
Whereas racism and segregation in the United States contribute to poor health 
        outcomes by segregating Black, Latino, and Native-American communities 
        from opportunity;
Whereas, for decades, discriminatory housing practices, such as redlining, 
        systemically excluded people of color from housing, robbing them of 
        capital in the form of low-cost, stable mortgages and opportunities to 
        build wealth, and the Federal Government used its financial power to 
        segregate renters in newly built public housing;
Whereas environmental injustices, such as proximity and exposure to toxic waste 
        or hazardous air pollutants, continue to harm the health of communities 
        of color, low-income communities, and indigenous communities around the 
        Nation;
Whereas social inequities such as differing access to quality health care, 
        healthy food and safe drinking water, safe neighborhoods, education, job 
        security, and reliable transportation affect health risks and outcomes;
Whereas during the COVID-19 pandemic, the effects of racism and discrimination 
        are seen in COVID-19 infection, hospitalization, and mortality rates--
        disproportionately high among Black, Latino, and Native-American 
        populations compared to the overall population--exacerbating health 
        disparities and highlighting barriers to care for Black, Latino, and 
        Native American patients across the United States;
Whereas because of racial and ethnic disparities, people of color are more 
        likely to have preexisting, preventable, and chronic conditions, which 
        lead to higher COVID-19 morbidity and mortality rates;
Whereas people of color are overrepresented in the number of people in the 
        United States living under poor air quality conditions, which can 
        increase the likelihood of COVID- 19 morbidity and mortality;
Whereas the COVID-19 pandemic has worsened barriers for Black, Latino, and 
        Native-American households that suffer from disproportionately higher 
        rates of food insecurity;
Whereas Black and Latino workers make up a disproportionate number of frontline 
        workers, are less likely to receive paid sick leave or have the ability 
        to work from home, and have been excluded from many forms of relief 
        readily available to other groups;
Whereas people of color are disproportionately impacted by the criminal justice 
        and immigration enforcement systems and face a higher risk of 
        contracting COVID-19 within prison populations and detention centers due 
        to the over-incarceration of people of color;
Whereas during the COVID-19 pandemic, an increased use of anti-Asian rhetoric 
        has resulted in Asian Americans being harassed, assaulted, and 
        scapegoated for the pandemic;
Whereas communities of color continue to bear the burdens of inequitable social, 
        economic, and criminal justice policies, practices, and investments that 
        cause deep disparities, hurt, harm, danger, and mistrust;
Whereas over 40 percent of Latinos report being discriminated against or 
        harassed because of their race;
Whereas approximately 24 percent of the Latino population in the United States 
        identifies as ``Afro-Latino'' and is thus potentially subject to both 
        race and national origin discrimination;
Whereas a public health issue is defined as meeting the following 4 criteria--

    (1) the condition affects many people, is seen as a threat to the 
public, and is continuing to increase;

    (2) the condition is distributed unfairly;

    (3) preventive measures could reduce the effects of the condition; and

    (4) those preventive measures are not yet in place;

Whereas racism meets the criteria of a public health crisis, and public health 
        experts agree;
Whereas a Federal public health crisis declaration would define racism as a 
        pervasive health issue and alerts the Nation to the need to enact 
        immediate and effective cross-governmental efforts to address the root 
        causes of institutional racism and their downstream impacts; and
Whereas such declaration requires the response of the Government to engage 
        significant resources to empower those communities that are impacted: 
        Now, therefore, be it
    Resolved, That the House of Representatives--
            (1) supports the resolutions drafted, introduced, and 
        adopted by cities and localities across the Nation declaring 
        racism a public health crisis;
            (2) declares racism a public health crisis in the United 
        States;
            (3) commits to--
                    (A) establishing a nationwide strategy to address 
                health disparities and inequity across all sectors in 
                the United States;
                    (B) dismantling systemic practices and policies 
                that perpetuate racism in the United States;
                    (C) advancing reforms to address years of 
                neglectful and apathetic policies that have led to poor 
                health outcomes for communities of color in the United 
                States; and
                    (D) promoting efforts to address the social 
                determinants of health--especially for Black, Latino, 
                and Native-American people, and other people of color 
                in the United States; and
            (4) charges the Nation with moving forward with urgency to 
        ensure that the United States stands firmly in honoring its 
        moral purpose of advancing the self-evident truths that all 
        people are created equal, that they are endowed with certain 
        unalienable rights, and that among these are life, liberty, and 
        the pursuit of happiness.
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