I 

118TH CONGRESS 

1ST SESSION H. R. 6746 

To amend the Public Health Service Act to provide for a public awareness 

campaign with respect to iron deficiency. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 13, 2023 

Ms. CARAVEO (for herself, Ms. BUDZINSKI, Ms. SEWELL, Ms. CLARKE of New 

York, Ms. PETTERSEN, Mr. CARTER of Louisiana, Mr. GRIJALVA, Mr. 

DAVIS of North Carolina, and Mr. GARCI ́A of Illinois) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to provide for 

a public awareness campaign with respect to iron deficiency. 

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 ‘‘Iron Deficiency Edu5 cation and Awareness Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) Iron deficiency occurs when there are insuf9 ficient amounts of iron in the body. Without enough 

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1 iron, the body cannot produce sufficient amounts of 

2 hemoglobin, which is the protein that enables red 

3 blood cells to carry oxygen. 

4 (2) Menstrual bleeding and pregnancy are 

5 major reasons for lower levels of iron in the body. 

6 The symptoms of iron deficiency include fatigue, 

7 cold extremities, hair loss, cognitive issues, shortness 

8 of breath, headaches, and sleep disorders. 

9 (3) Iron deficiency often goes undiagnosed due 

10 to difficulty recognizing symptoms and lack of ur11 gency in diagnosing. When left untreated, the condi12 tion can progress to iron-deficiency anemia. This 

13 may increase the risk of developing organ complica14 tions, such as an abnormally fast heartbeat, or tach15 ycardia, and heart failure. 

16 (4) Among pregnant women, iron deficiency 

17 and iron-deficiency anemia has been linked to in18 creased maternal illness, premature birth and low 

19 birth weight among babies, and intrauterine growth 

20 restriction. 

21 (5) Approximately 35 percent of women of re22 productive age in the United States do not have a 

23 sufficient amount of iron in their bodies. Addition24 ally, nearly 40 percent of girls and young women 

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1 ages 12 to 21 are affected by iron deficiency, and 6 

2 percent are iron-deficient anemic. 

3 (6) Children under the age of two are at a high 

4 risk for iron deficiency. About 6 percent of children 

5 ages 1–2 have iron deficiency. 

6 (7) Eliminating barriers to awareness, edu7 cation, and screening will assist in preventing and 

8 treating iron deficiency, iron deficiency anemia, and 

9 related health issues among women and children 

10 under the age of two. 

11 SEC. 3. IRON DEFICIENCY AWARENESS CAMPAIGN. 

12 (a) IN GENERAL.—Section 317 of the Public Health 

13 Service Act (42 U.S.C. 247b) is amended by adding at 

14 the end the following: 

15 ‘‘(o) IRON DEFICIENCY PUBLIC AWARENESS CAM16 PAIGN.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall carry 

18 out a national campaign to— 

19 ‘‘(A) increase awareness of the importance 

20 of iron deficiency screening; 

21 ‘‘(B) combat misconceptions about iron de22 ficiency, including misconceptions in diagnosis 

23 and management of iron deficiency; 

24 ‘‘(C) increase awareness about missed di25 agnoses due to inadequate screening tests; and 

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1 ‘‘(D) increase iron deficiency screening 

2 among women and children under the age of 

3 two. 

4 ‘‘(2) CONSULTATION.—In carrying out the na5 tional campaign required by paragraph (1), the Sec6 retary shall consult with the National Academy of 

7 Medicine, health care providers, public health asso8 ciations, nonprofit organizations, State and local 

9 public health departments, and institutions of higher 

10 education to solicit advice on evidence-based infor11 mation for policy development and program develop12 ment, implementation, and evaluation. 

13 ‘‘(3) REQUIREMENTS.—The national campaign 

14 required by paragraph (1) shall— 

15 ‘‘(A) include the use of evidence-based 

16 media and public engagement; 

17 ‘‘(B) be carried out through competitive 

18 grants or cooperative agreements awarded to 1 

19 or more private, nonprofit entities with a his20 tory developing and implementing similar cam21 paigns; 

22 ‘‘(C) include the development of culturally 

23 and linguistically competent resources that shall 

24 be tailored for— 

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1 ‘‘(i) women who are pregnant, re2 cently gave birth, or are breastfeeding; 

3 ‘‘(ii) women who menstruate, espe4 cially if menstrual periods are heavy; 

5 ‘‘(iii) women who have undergone 

6 major surgery or physical trauma; 

7 ‘‘(iv) women with limited English pro8 ficiency; 

9 ‘‘(v) women with gastrointestinal dis10 eases, such as Celiac disease and inflam11 matory bowel diseases such as ulcerative 

12 colitis and Crohn’s disease; 

13 ‘‘(vi) women with peptic ulcer disease; 

14 ‘‘(vii) populations with a high preva15 lence of iron deficiency (such as Black and 

16 Hispanic women); 

17 ‘‘(viii) parents with children under the 

18 age of two; 

19 ‘‘(ix) rural communities; and 

20 ‘‘(x) such other communities as the 

21 Secretary determines appropriate; 

22 ‘‘(D) include the dissemination of iron defi23 ciency information and communication re24 sources to health care providers and health care 

25 facilities (including pediatricians, primary care 

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1 providers, community health centers, dentists, 

2 obstetricians, and gynecologists), State and 

3 local public health departments, elementary and 

4 secondary schools, child care centers, and col5 leges and universities; 

6 ‘‘(E) be complementary to, and coordi7 nated with, any other Federal efforts with re8 spect to iron deficiency awareness; 

9 ‘‘(F) include message testing to identify 

10 culturally competent and effective messages for 

11 behavioral change; and 

12 ‘‘(G) include the award of grants or coop13 erative agreements to State, local, and Tribal 

14 public health departments to engage with— 

15 ‘‘(i) communities specified in subpara16 graph (C); 

17 ‘‘(ii) local educational agencies; 

18 ‘‘(iii) health care providers; 

19 ‘‘(iv) community organizations; or 

20 ‘‘(v) other groups the Secretary deter21 mines are appropriate to develop and de22 liver effective strategies to decrease iron 

23 deficiency rates. 

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1 ‘‘(4) OPTIONS FOR DISSEMINATION OF INFOR2 MATION.—The national campaign required by para3 graph (1) may— 

4 ‘‘(A) include the use of— 

5 ‘‘(i) social media, television, radio, 

6 print, the internet, and other media; 

7 ‘‘(ii) in-person or virtual public com8 munications; and 

9 ‘‘(iii) recognized, trusted figures; 

10 ‘‘(B) be targeted to specific communities 

11 specified in paragraph (3)(C); and 

12 ‘‘(C) include the dissemination of informa13 tion highlighting— 

14 ‘‘(i) appropriate screening for iron de15 ficiency, including the recommended popu16 lations to be screened by age range or 

17 other criteria; 

18 ‘‘(ii) the prevalence of iron deficiency; 

19 ‘‘(iii) symptoms of iron deficiency; and 

20 ‘‘(iv) mechanisms of preventing and 

21 managing iron deficiency. 

22 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

23 There is authorized to be appropriated to carry out 

24 this subsection $7,000,000 for each of fiscal years 

25 2024 through 2028.’’. 

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1 (b) REPORT TO CONGRESS.— 

2 (1) IN GENERAL.—Not later than the end of 

3 fiscal year 2027, the Secretary of Health and 

4 Human Services shall submit to the Committee on 

5 Energy and Commerce of the House of Representa6 tives and the Committee on Health, Education, 

7 Labor, and Pensions of the Senate a report on the 

8 campaign under section 317(o) of the Public Health 

9 Service Act, as added by subsection (a). 

10 (2) QUALITATIVE ASSESSMENT.—The report 

11 under paragraph (1) shall include a qualitative as12 sessment of— 

13 (A) the overall campaign under section 

14 317(o) of the Public Health Service Act, as 

15 added by subsection (a); and 

16 (B) the impacts of the activities conducted 

17 through the campaign, including such impacts 

18 on iron deficiency, and iron deficiency anemia, 

19 among women and children under the age of 

20 two. 

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