II 

116TH CONGRESS 

2D SESSION S. 4533 

To amend the Public Health Service Act to provide for public health research 

and investment into understanding and eliminating structural racism 

and police violence. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 8, 2020 

Ms. WARREN (for herself, Ms. HIRONO, Mr. MARKEY, Mr. MERKLEY, and Ms. 

SMITH) introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to provide for 

public health research and investment into understanding 

and eliminating structural racism and police violence. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Anti-Racism in Public 

5 Health Act of 2020’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) For centuries, structural racism, defined by 

9 the National Museum of African American History 


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1 and Culture as an ‘‘overarching system of racial bias 

2 across institutions and society’’, in the United States 

3 has negatively affected communities of color, espe4 cially Black, Latinx, Asian American, Pacific Is5 lander, and American Indian and Alaska Native peo6 ple, to expand and reinforce White supremacy. 

7 (2) Structural racism determines the conditions 

8 in which people are born, grow, work, live, and age 

9 and determine people’s access to quality housing, 

10 education, food, transportation, and political power, 

11 and other social determinants of health. 

12 (3) Structural racism serves as a major barrier 

13 to achieving health equity and eliminating racial and 

14 ethnic inequities in health outcomes that exist at 

15 alarming rates and are determined by a wider set of 

16 forces and systems. 

17 (4) Due to structural racism in the United 

18 States, people of color are more likely to suffer from 

19 chronic health conditions (such as heart disease, dia20 betes, asthma, hepatitis, and hypertension) and in21 fectious diseases (such as HIV/AIDS, and COVID– 

22 19) compared to their White counterparts. 

23 (5) Due to structural racism in maternal health 

24 care in the United States, Black and American In25 dian and Alaska Native infants are more than twice 


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1 as likely to die than White infants, Black women are 

2 3 to 4 times more likely to die from pregnancy-re3 lated causes than White women, and American In4 dian and Alaska Native women are 5 times more 

5 likely to die from pregnancy-related causes than 

6 White women. This trend persists even when adjust7 ing for income and education. 

8 (6) Due to structural racism in the United 

9 States, Non-Hispanic Black women have the highest 

10 rates for 22 of 25 severe morbidity indicators used 

11 by the Center for Disease Control and Prevention 

12 (CDC). 

13 (7) Due to structural racism in the United 

14 States, people of color comprise a disproportionate 

15 percentage of persons with disabilities in the United 

16 States. 

17 (8) Due to structural racism in the United 

18 States, Black men are up to three and a half times 

19 as likely to be killed by police as White men, and 1 

20 in every 1,000 Black men will die as a result of po21 lice violence. Policing has adverse effects on mental 

22 health in Black communities. 

23 (9) Due to the confluence of structural racism 

24 and factors such as gender, class, and sexual ori25 entation or gender identity, commonly referred to as 


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1 intersectionality, Black and Latinx transgender 

2 women are more likely to die due to violence and 

3 homicide than their White counterparts. 

4 (10) Due to structural racism, inequitable ac5 cess to quality health care and long-term services 

6 and supports also disproportionately burdens com7 munities of color; people of color and immigrants are 

8 less likely to be insured and are more likely to live 

9 in medically underserved areas. 

10 (11) Due to structural racism, older adults of 

11 color are also more likely to be admitted to nursing 

12 homes and assisted living facilities and to reside in 

13 those of poor quality, and when older adults of color 

14 do receive home and community based services, Med15 icaid spends less money on their services and they 

16 are more likely to be hospitalized than older White 

17 adults. 

18 (12) In addition, the Federal Government’s fail19 ure to honor the unique political status of American 

20 Indian and Alaska Native people, to respect the in21 herent sovereignty of Tribal Nations, and to uphold 

22 its trust and treaty obligations to Tribal Nations 

23 and American Indian and Alaska Native people, is 

24 an ongoing and unjust manifestation of centuries of 


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1 oppression, with the consequence of adverse health 

2 outcomes for Native peoples. 

3 (13) The COVID–19 pandemic has exposed the 

4 devastating impact of structural racism on the 

5 United States ability to ensure equitable health out6 comes for people of color, and made these commu7 nities more likely to suffer from severe outcomes due 

8 to the coronavirus infection. 

9 (14) Racial and ethnic inequity in public health 

10 is a result of systematic, personally mediated, and 

11 internalized racism and racist public and private 

12 policies and practices, and dismantling structural 

13 racism is integral to addressing public health. 

14 SEC. 3. DEFINITIONS. 

15 In this Act: 

16 (1) ANTIRACISM.—The term ‘‘antiracism’’ is a 

17 collection of antiracist policies that lead to racial eq18 uity, and are substantiated by antiracist ideas. 

19 (2) ANTIRACIST.—The term ‘‘antiracist’’ is any 

20 measure that produces or sustains racial equity be21 tween racial groups. 


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1 SEC. 4. PUBLIC HEALTH RESEARCH AND INVESTMENT IN 

2 DISMANTLING STRUCTURAL RACISM. 

3 Part B of title III of the Public Health Service Act 

4 (42 U.S.C. 243 et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘SEC. 320B. NATIONAL CENTER ON ANTIRACISM AND 

7 HEALTH. 

8 ‘‘(a) IN GENERAL.— 

9 ‘‘(1) NATIONAL CENTER.—There is established 

10 within the Centers for Disease Control and Preven11 tion a center to be known as the ‘National Center 

12 on Antiracism and Health’ (referred to in this sec13 tion as the ‘Center’). The Director of the Centers for 

14 Disease Control and Prevention shall appoint a di15 rector to head the Center who has experience living 

16 in and working with racial and ethnic minority com17 munities. The Center shall promote public health 

18 by— 

19 ‘‘(A) declaring racism a public health crisis 

20 and naming racism as an historical and present 

21 threat to the physical and mental health and 

22 well-being of the United States and world; 

23 ‘‘(B) aiming to develop new knowledge in 

24 the science and practice of antiracism, including 

25 by identifying the mechanisms by which racism 


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1 operates in the provision of health care and in 

2 systems that impact health and well-being; 

3 ‘‘(C) transferring that knowledge into 

4 practice, including by developing interventions 

5 that dismantle the mechanisms of racism and 

6 replace such mechanisms with equitable struc7 tures, policies, practices, norms, and values so 

8 that a healthy society can be realized; and 

9 ‘‘(D) contributing to a national and global 

10 conversation regarding the impacts of racism on 

11 the health and well-being of the United States 

12 and world. 

13 ‘‘(2) GENERAL DUTIES.—The Secretary, acting 

14 through the Center, shall undertake activities to 

15 carry out the mission of the Center as described in 

16 paragraph (1), such as the following: 

17 ‘‘(A) Conduct research into, collect, ana18 lyze and make publicly available data on, and 

19 provide leadership and coordination for the 

20 science and practice of antiracism, the public 

21 health impacts of structural racism, and the ef22 fectiveness of intervention strategies to address 

23 these impacts. Topics of research and data col24 lection under this subparagraph may include 

25 identifying and understanding— 


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1 ‘‘(i) policies and practices that have a 

2 disparate impact on the health and well3 being of communities of color; 

4 ‘‘(ii) the public health impacts of im5 plicit racial bias, White supremacy, weath6 ering, xenophobia, discrimination, and 

7 prejudice; 

8 ‘‘(iii) the social determinants of health 

9 resulting from structural racism, including 

10 poverty, housing, employment, political 

11 participation, and environmental factors; 

12 and 

13 ‘‘(iv) the intersection of racism and 

14 other systems of oppression, including as 

15 related to age, sexual orientation, gender 

16 identity, and disability status. 

17 ‘‘(B) Award noncompetitive grants and co18 operative agreements to eligible public and non19 profit private entities, including State, local, 

20 territorial, and Tribal health agencies and orga21 nizations, for the research and collection, anal22 ysis, and reporting of data on the topics de23 scribed in subparagraph (A). 

24 ‘‘(C) Establish, through grants or coopera25 tive agreements, at least 3 regional centers of 


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1 excellence, located in racial and ethnic minority 

2 communities, in antiracism for the purpose of 

3 developing new knowledge in the science and 

4 practice of antiracism in health by researching, 

5 understanding, and identifying the mechanisms 

6 by which racism operates in the health space, 

7 racial and ethnic inequities in health care ac8 cess and outcomes, the history of successful 

9 antiracist movements in health, and other 

10 antiracist public health work. 

11 ‘‘(D) Establish a clearinghouse within the 

12 Centers for Disease Control and Prevention for 

13 the collection and storage of data generated 

14 under the programs implemented under this 

15 section for which there is not an otherwise ex16 isting surveillance system at the Centers for 

17 Disease Control and Prevention. Such data 

18 shall— 

19 ‘‘(i) be comprehensive and 

20 disaggregated, to the extent practicable, by 

21 including racial, ethnic, primary language, 

22 sex, gender identity, sexual orientation, 

23 age, socioeconomic status, and disability 

24 disparities; 

25 ‘‘(ii) be made publicly available; 


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1 ‘‘(iii) protect the privacy of individuals 

2 whose information is included in such data; 

3 and 

4 ‘‘(iv) comply with privacy protections 

5 under the regulations promulgated under 

6 section 264(c) of the Health Insurance 

7 Portability and Accountability Act of 1996. 

8 ‘‘(E) Provide information and education to 

9 the public on the public health impacts of struc10 tural racism and on antiracist public health 

11 interventions. 

12 ‘‘(F) Consult with other Centers and Na13 tional Institutes within the Centers for Disease 

14 Control and Prevention, including the Office of 

15 Minority Health and Health Equity and the 

16 Center for State, Tribal, Local, and Territorial 

17 Support, to ensure that scientific and pro18 grammatic activities initiated by the agency 

19 consider structural racism in their designs, 

20 conceptualizations, and executions, which shall 

21 include— 

22 ‘‘(i) putting measures of racism in 

23 population-based surveys; 

24 ‘‘(ii) establishing a Federal Advisory 

25 Committee on racism and health for the 


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1 Centers for Disease Control and Preven2 tion; 

3 ‘‘(iii) developing training programs, 

4 curricula, and seminars for the purposes of 

5 training public health professionals and re6 searchers around issues of race, racism, 

7 and antiracism; 

8 ‘‘(iv) providing standards and best 

9 practices for programming and grant re10 cipient compliance with Federal data col11 lection standards, including section 4302 

12 of the Patient Protection and Affordable 

13 Care Act; and 

14 ‘‘(v) establishing leadership and stake15 holder councils with experts and leaders in 

16 racism and public health disparities. 

17 ‘‘(G) Coordinate with the Indian Health 

18 Service and with the Centers for Disease Con19 trol and Prevention’s Tribal Advisory Com20 mittee to ensure meaningful Tribal consulta21 tion, the gathering of information from Tribal 

22 authorities, and respect for Tribal data sov23 ereignty. 


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1 ‘‘(H) Engage in government to government 

2 consultation with Indian Tribes and Tribal or3 ganizations. 

4 ‘‘(I) At least every 2 years, produce and 

5 publicly post on the Centers for Disease Control 

6 and Prevention’s website a report on antiracist 

7 activities completed by the Center, which may 

8 include newly identified antiracist public health 

9 practices. 

10 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

11 is authorized to be appropriated such sums as may be nec12 essary to carry out this section.’’. 

13 SEC. 5. PUBLIC HEALTH RESEARCH AND INVESTMENT IN 

14 POLICE VIOLENCE. 

15 (a) IN GENERAL.—The Secretary of Health and 

16 Human Services shall establish within the National Center 

17 for Injury Prevention and Control of the Centers for Dis18 ease Control and Prevention (referred to in this section 

19 as the ‘‘Center’’) a law enforcement violence prevention 

20 program. 

21 (b) GENERAL DUTIES.—In implementing the pro22 gram under subsection (a), the Center shall conduct re23 search into, and provide leadership and coordination for— 

24 (1) the understanding and promotion of knowl25 edge about the public health impacts of uses of force 


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1 by law enforcement, including police brutality and 

2 violence; 

3 (2) developing public health interventions and 

4 perspectives for eliminating deaths, injury, trauma, 

5 and negative mental health effects from police pres6 ence and interactions, including police brutality and 

7 violence; and 

8 (3) ensuring comprehensive data collection, 

9 analysis, and reporting regarding police violence and 

10 misconduct in consultation with the Department of 

11 Justice and independent researchers. 

12 (c) FUNCTIONS.—Under the program under sub13 section (a), the Center shall— 

14 (1) summarize and enhance the knowledge of 

15 the distribution, status, and characteristics of law 

16 enforcement-related death, trauma, and injury; 

17 (2) conduct research and prepare, with the as18 sistance of State public health departments— 

19 (A) statistics on law enforcement-related 

20 death, injury, and brutality; 

21 (B) studies of the factors, including legal, 

22 socioeconomic, discrimination, and other factors 

23 that correlate with or influence police brutality; 

24 (C) public information about uses of force 

25 by law enforcement, including police brutality 


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1 and violence, for the practical use of the public 

2 health community, including publications that 

3 synthesize information relevant to the national 

4 goal of understanding police violence and meth5 ods for its control; 

6 (D) information to identify socioeconomic 

7 groups, communities, and geographic areas in 

8 need of study, and a strategic plan for research 

9 necessary to comprehend the extent and nature 

10 of police uses of force by law enforcement, in11 cluding police brutality and violence, and deter12 mine what options exist to reduce or eradicate 

13 death and injury that result; and 

14 (E) best practices in police violence preven15 tion in other countries; 

16 (3) award grants, contracts, and cooperative 

17 agreements to provide for the conduct of epidemio18 logic research on uses of force by law enforcement, 

19 including police brutality and violence, by Federal, 

20 State, local, and private agencies, institutions, orga21 nizations, and individuals; 

22 (4) award grants, contracts, and cooperative 

23 agreements to community groups, independent re24 search organizations, academic institutions, and 

25 other entities to support, execute, or conduct reVerDate Sep 11 2014 01:42 Sep 09, 2020 Jkt 099200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S4533.IS S4533

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1 search on interventions to reduce or eliminate uses 

2 of force by law enforcement, including police bru3 tality and violence; 

4 (5) coordinate with the Department of Justice, 

5 and other Federal, State, and local agencies on the 

6 standardization of data collection, storage, and re7 trieval necessary to collect, evaluate, analyze, and 

8 disseminate information about the extent and nature 

9 of uses of force by law enforcement, including police 

10 brutality and violence, as well as options for the 

11 eradication of such practices; 

12 (6) submit an annual report to Congress on re13 search findings with recommendations to improve 

14 data collection and standardization and to disrupt 

15 processes in policing that preserve and reinforce rac16 ism and racial disparities in public health; 

17 (7) conduct primary research and explore uses 

18 of force by law enforcement, including police bru19 tality and violence, and options for its control; and 

20 (8) study alternatives to law enforcement re21 sponse as a method of reducing police violence. 

22 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

23 authorized to be appropriated, such sums as may be nec24 essary to carry out this section. 

Æ 


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