II 

118TH CONGRESS 

1ST SESSION S. 2899 

To amend the Public Health Service Act to include Middle Easterners and 

North Africans in the statutory definition of a ‘‘racial and ethnic minority 

group’’, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 21, 2023 

Mr. PADILLA 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 include Middle 

Easterners and North Africans in the statutory definition 

of a ‘‘racial and ethnic minority group’’, and for other 

purposes. 

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 ‘‘Health Equity and 

5 Middle Eastern and North African Community Inclusion 

6 Act of 2023’’ or the ‘‘Health Equity and MENA Commu7 nity Inclusion Act of 2023’’. 


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1 SEC. 2. DEFINITION. 

2 In this Act, the terms ‘‘Middle Eastern and North 

3 African’’ or ‘‘MENA’’, with respect to individuals or popu4 lations, includes individuals and populations who identify 

5 with or belong to one or more nationalities or ethnic 

6 groups originating in a country (or portion thereof) in the 

7 Middle Eastern and North African region (such as Leba8 nese, Iranians, Egyptians, Moroccans, Yemenis, 

9 Chaldeans, Imazighen, Kurds, Palestinians, and Yazidis). 

10 SEC. 3. FINDINGS. 

11 Congress finds the following: 

12 (1) Through the establishment of the Office of 

13 Minority Health (referred to in this section as the 

14 ‘‘OMH’’) in 1986, the Department of Health and 

15 Human Services has developed health policies and 

16 programs that eliminate health disparities and im17 prove the health of racial and ethnic minority popu18 lations. 

19 (2) Congress has funded the OMH to assure 

20 improved health status of racial and ethnic minori21 ties, and to develop measures to evaluate the effec22 tiveness of activities aimed at reducing health dis23 parities and supporting the local community. The ac24 tivities of the OMH have addressed health dispari25 ties, including with respect to physical activity and 

26 nutrition, clinical conditions, individual social needs, 


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1 and the social determinants of health for ‘‘racial and 

2 ethnic minority groups’’. 

3 (3) Before the amendments made by this Act, 

4 section 1707(g)(1) of the Public Health Service Act 

5 (42 U.S.C. 300u–6(g)(1)) defined the term ‘‘racial 

6 and ethnic minority group’’ (for whom the OMH 

7 works to improve health outcomes and eliminate 

8 health disparities) to exclude Middle Easterners and 

9 North Africans, and thereby prevented MENA popu10 lations from accessing critical resources intended to 

11 assist historically marginalized communities. 

12 (4) Independent researchers and private sector 

13 research initiatives have found significant health dis14 parities between MENA individuals and the non15 Hispanic White population, as well as significant 

16 overlap between the health outcomes and health con17 ditions of MENA individuals and those of other ra18 cial and ethnic minority groups. 

19 (5) Poor health outcomes are often connected to 

20 impoverishment in other aspects of life and are exac21 erbated by additional barriers to access high-quality 

22 health coverage, whether in terms of language, eligi23 bility, health literacy, or discrimination at the point24 of-service. 


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1 (6) A recent study published in the journal, 

2 Proceedings of the National Academy of Sciences, 

3 suggested that MENA individuals are not perceived 

4 as White and do not perceive themselves as White. 

5 (7) Research on the health outcomes and health 

6 conditions of MENA individuals is troubling and 

7 suggests that efforts must be made on the Federal 

8 level to disaggregate the demographic data of 

9 MENA individuals from the demographic data of in10 dividuals in the non-Hispanic White category and 

11 fully understand the social determinants of health 

12 for health disparities and outcomes experienced by 

13 MENA individuals. 

14 (8) Under the current Federal standards for 

15 data on race and ethnicity, demographic data on 

16 MENA individuals is aggregated into the same cat17 egory as demographic data on individuals of Euro18 pean ancestry, which limits the ability of the Federal 

19 Government to understand the factors that con20 tribute to health outcomes for MENA individuals. 

21 (9) The Federal standards for data on race and 

22 ethnicity effectively obscure the reality of minority 

23 health and health disparities by aggregating demo24 graphic health data on MENA individuals with that 

25 of Europeans. 


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1 (10) MENA individuals are not included among 

2 the groups for whom the OMH works to improve 

3 health outcomes and eliminate health disparities, 

4 which further limits the opportunity of MENA indi5 viduals to access programs designed to address their 

6 experiences and health conditions. 

7 (11) The OMH could better assess and elimi8 nate health disparities by conducting a comprehen9 sive study of the health of MENA individuals and 

10 recognizing MENA individuals as a racial and ethnic 

11 minority group. 

12 SEC. 4. INCLUSION OF MIDDLE EASTERNERS AND NORTH 

13 AFRICANS IN DEFINITION OF RACIAL AND 

14 ETHNIC MINORITY GROUPS. 

15 (a) IN GENERAL.—Section 1707(g)(1) of the Public 

16 Health Service Act (42 U.S.C. 300u–6(g)(1)) is amended 

17 by striking ‘‘Blacks; and Hispanics’’ and inserting 

18 ‘‘Blacks or African Americans; Hispanics; and Middle 

19 Easterners and North Africans’’. 

20 (b) SENSE OF CONGRESS.—It is the sense of Con21 gress that subsection (a) should be implemented so as to 

22 ensure that— 

23 (1) the definition of a ‘‘racial and ethnic minor24 ity group’’ in section 1707(g)(1) of the Public 

25 Health Service Act (42 U.S.C. 300u–6(g)(1)), as 


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1 amended by subsection (a), is applied in the imple2 mentation and execution of Federal programs and 

3 activities that reference such definition; and 

4 (2) no racial and ethnic minority group served 

5 by such programs and activities is negatively im6 pacted by the amendment made by subsection (a). 

7 (c) UNDEFINED REFERENCES.—Not later than 2 

8 years after the date of enactment of this Act, the Sec9 retary of Health and Human Services shall— 

10 (1) identify all regulations, guidance, orders, 

11 and documents of the Department of Health and 

12 Human Services for establishment or implementa13 tion of a health care or public health program, activ14 ity, or survey that— 

15 (A) use the term ‘‘racial and ethnic minor16 ity group’’ or similar terminology; and 

17 (B) do not define such term or termi18 nology; and 

19 (2) take such actions as may be necessary to 

20 clarify whether the definition of ‘‘racial and ethnic 

21 minority group’’ in section 1707(g)(1) of the Public 

22 Health Service Act (42 U.S.C. 300u–6(g)(1)), as 

23 amended by subsection (a), applies to such term or 

24 terminology. 


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1 (d) REPORT TO CONGRESS.—Not later than 2 years 

2 after the date of enactment of this Act, the Secretary of 

3 Health and Human Services shall submit a report to Con4 gress on the implementation of this section. 

5 SEC. 5. REPORT ON THE HEALTH OF THE MIDDLE EASTERN 

6 AND NORTH AFRICAN POPULATION. 

7 (a) STUDY REQUIRED.—The Secretary of Health and 

8 Human Services (referred to in this section as the ‘‘Sec9 retary’’) shall conduct or support a comprehensive study 

10 regarding the unique health patterns and outcomes of 

11 MENA populations. 

12 (b) REQUIREMENTS FOR STUDY.—The comprehen13 sive study under subsection (a) shall include an enumera14 tion of MENA populations across the United States, 

15 disaggregated by subpopulation, and with respect to each 

16 such population and subpopulation— 

17 (1) the rates of— 

18 (A) obesity, diabetes, sickle cell anemia, 

19 stroke, asthma, pneumonia, lung cancer, HIV/ 

20 AIDS, HPV, high cholesterol, high blood pres21 sure, chronic heart, lung, and kidney disease; 

22 (B) morbidity and mortality, including the 

23 rates of morbidity and mortality associated with 

24 the health conditions listed in subparagraph 

25 (A); 


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1 (C) mental health and substance use dis2 orders; and 

3 (D) domestic violence, dating violence, sex4 ual assault, sexual harassment, and stalking; 

5 (2) analysis of— 

6 (A) the rates described in paragraph (1); 

7 (B) the leading causes of pregnancy-associ8 ated morbidity and mortality; and 

9 (C) access to health care facilities and the 

10 associated outcomes of care; 

11 (3) analysis, enumeration, or quantification of 

12 any other health or health-related parameters the 

13 Secretary may deem necessary; and 

14 (4) analysis of the relationship between the 

15 health factors, outcomes, and conditions described in 

16 paragraphs (1) through (3) and the implementation 

17 of Federal health programs. 

18 (c) CONSULTATION.—The Secretary shall— 

19 (1) carry out this section in consultation, as ap20 propriate, with the Director of the Census Bureau, 

21 the Director of the Centers for Disease Control and 

22 Prevention, the Director of the National Institutes 

23 of Health, the Assistant Secretary for Mental Health 

24 and Substance Use, and other stakeholders (includ25 ing community-based organizations); and 


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1 (2) determine through such consultation the 

2 subpopulations to be used for purposes of 

3 disaggregation of data pursuant to subsection (b). 

4 (d) ONLINE PORTAL.—Upon conclusion of the com5 prehensive study under this section, the Secretary shall 

6 establish a public online portal to catalogue the results of 

7 the study, its underlying data, and information in the re8 port submitted pursuant to subsection (f). 

9 (e) REPORTING.— 

10 (1) INTERIM REPORT.—Not later than 2 years 

11 after the date of enactment of this Act, the Sec12 retary shall submit to Congress a report outlining 

13 the challenges associated with, and progress towards 

14 implementing health data collection for MENA pop15 ulations as a distinct category and the plan for com16 pleting a comprehensive study regarding the unique 

17 health patterns and outcomes of MENA populations. 

18 (2) FINAL REPORT.—Not later than 30 days 

19 after the conclusion of the comprehensive study 

20 under this section, the Secretary shall submit to 

21 Congress a report describing— 

22 (A) the results of the study conducted 

23 under this section; and 

24 (B) the rulemakings and other actions the 

25 agencies described in subsection (c)(1) can unVerDate Sep 11 2014 03:03 Sep 23, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2899.IS S2899

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1 dertake to more equitably include MENA indi2 viduals in their programs. 

3 (f) PRIVACY.—The Secretary shall not include any 

4 personally identifiable information on the online portal 

5 under subsection (e) or in the report under subsection (f). 

Æ 


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