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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 319 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  1st Session
S. RES. 319

                Declaring racism a public health crisis.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             July 27, 2023

   Mr. Brown (for himself, Mr. Booker, Mr. Padilla, Ms. Warren, Mr. 
Merkley, Mr. Markey, Ms. Smith, Mr. Whitehouse, Mr. Carper, Mr. Cardin, 
 Ms. Hirono, Mr. Blumenthal, Mr. Menendez, Ms. Baldwin, Mr. Wyden, Mr. 
    Reed, Ms. Stabenow, and Ms. Duckworth) submitted the following 
 resolution; which was referred to the Committee on Health, Education, 
                          Labor, and Pensions

_______________________________________________________________________

                               RESOLUTION

 
                Declaring racism a public health crisis.

Whereas a public health crisis is an issue--

    (1) that affects many people, is a threat to the public, and is 
ongoing;

    (2) that is unfairly distributed among different populations and 
disproportionately impacts health outcomes, access to health care, and life 
expectancy;

    (3) the effects of which could be reduced by preventive measures; and

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

Whereas public health experts agree that significant racial inequities exist in 
        the prevalence, severity, and mortality rates of various health 
        conditions in the United States;
Whereas examples of those inequities include--

    (1) life expectancies for Black and Native American people in the 
United States are significantly lower than those of White people in the 
United States;

    (2) 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;

    (3) Black and Native American infants are 2 to 3 times more likely to 
die than White infants;

    (4) the Black infant mortality rate in the United States is higher than 
the infant mortality rates recorded in 27 of the 36 democratic countries 
with market-based economies that are members of the Organization for 
Economic Co-operation and Development;

    (5) Hispanic women are 40 percent more likely to be diagnosed with and 
30 percent more likely to die from cervical cancer compared to non-Hispanic 
White women;

    (6) Asian Americans face health disparities in cancer and chronic 
diseases, and are the only population in the United States for which cancer 
is the leading cause of death;

    (7) Native Hawaiians and Pacific Islanders suffer from a number of poor 
health outcomes such as high rates of overweight status, obesity, 
hypertension, and asthma and cancer mortality;

    (8) Native Hawaiians suffer from coronary heart disease, stroke, heart 
failure, cancer, and diabetes at a rate 3 times greater than in other 
ethnic populations in Hawaii and become afflicted with those diseases a 
decade earlier in their lives compared with other ethnic populations; and

    (9) during the COVID-19 pandemic, Black, Hispanic or Latino, Asian 
American, Native Hawaiian or Pacific Islander, and Native American 
communities experienced disproportionately high rates of COVID-19 
infection, hospitalization, and mortality compared to the White population 
of the United States;

Whereas inequities in health outcomes are exacerbated for people of color who 
        are LGBTQIA+;
Whereas inequities in health outcomes are exacerbated for people of color who 
        have disabilities;
Whereas, historically, explanations for health inequities have focused on false 
        genetic science such as eugenics;
Whereas, historically, explanations for health inequities have focused on 
        incomplete social scientific analyses that narrowly focus on individual 
        behavior to highlight ostensible deficiencies within racial and ethnic 
        minority groups;
Whereas modern public health officials recognize the broader social context in 
        which health inequities emerge and acknowledge the impact of historical 
        and contemporary racism on health;
Whereas racism is recognized in modern public health discourse as one of many 
        social determinants of health, which--

    (1) are a broad range of nonmedical factors that can enhance or hinder 
quality of life and influence health outcomes;

    (2) are the conditions in which people are born, grow, work, live, and 
age, and include the wider set of forces and systems shaping the conditions 
of daily life;

    (3) include such factors as housing, employment, education, health 
care, food, transportation, social support, poverty, crime, violence, 
segregation, and environmental toxins;

    (4) are linked to a lack of opportunity and resources to protect, 
improve, and maintain health; and

    (5) taken together, create health inequities that stem from unfair and 
unjust systems, policies, and practices, and limit access to the 
opportunities and resources needed to live the healthiest life possible;

Whereas, since its founding, the United States has had a longstanding history 
        and legacy of racism, mistreatment, and discrimination that has 
        perpetuated health inequities for members of racial and ethnic minority 
        groups;
Whereas that history and legacy of racism, mistreatment, and discrimination 
        includes--

    (1) the immoral paradox of freedom and slavery, which is an atrocity 
that can be traced throughout the history of the United States, 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;

    (2) the failure of the United States to carry out the responsibilities 
and promises made in more than 350 treaties ratified with sovereign 
indigenous communities, including American Indians, Alaska Natives, and 
Native Hawaiians or Pacific Islanders, 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 
inequities faced by Native American people, and the inaccessibility of many 
Federal public health and social programs in Native American communities;

    (3) the enactment of immigration laws in the United States that 
scapegoated Asians, separated families, and branded Asians as perpetual 
outsiders, such as--

    G    (A) the enactment of the Act entitled ``An Act supplementary to 
the Acts in relation to immigration'', approved March 3, 1875 (commonly 
known as the ``Page Act of 1875'') (18 Stat. 477, chapter 141), which 
effectively prohibited the entry of East Asian women into the United 
States;

    G    (B) the Act entitled ``An Act to execute certain treaty 
stipulations relating to Chinese'', approved May 6, 1882 (commonly known as 
the ``Chinese Exclusion Act''; 22 Stat. 58, chapter 126), which banned 
thousands of Chinese-born laborers, who were essential in the completion of 
the transcontinental railroad and development of the West Coast of the 
United States; and

    G    (C) the Act entitled ``An Act to regulate the immigration of 
aliens to, and the residence of aliens in, the United States'', approved 
February 5, 1917 (commonly known as the ``Immigration Act of 1917'') (39 
Stat. 874, chapter 29), which barred all immigrants from the ``Asiatic 
zone'' and prevented the migration of individuals from South Asia, 
Southeast Asia, and East Asia; and

    (4) during the Great Depression Era, the deportation of approximately 
1,800,000 individuals based on their Mexican ethnic identity, although 
approximately 60 percent of the deported individuals were citizens of the 
United States, and the targeting of individuals of Mexican descent for 
``repatriation'' due to scapegoating efforts, which blamed those 
individuals for ``stealing'' jobs from ``real'' Americans;

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, causing deepened racial division and 
        the continued exclusion of Black communities from the benefits of 
        economic progress;
Whereas overt racism was embedded in the development of medical science and 
        medical training during the 18th, 19th, and 20th centuries, causing 
        disproportionate physical and psychological harm to members of racial 
        and ethnic minority groups, including--

    (1) the unethical practices and abuses experienced by Black patients 
and research participants, such as the Tuskegee Study of Untreated Syphilis 
in the Negro Male, which serve as the foundation for the mistrust the Black 
community has for the medical system; and

    (2) the egregiously unethical and cruel treatment of enslaved Black 
women who were forced to be the subject of insidious medical experiments to 
advance modern gynecology, including those perpetuated by the so-called 
``father of gynecology'', J. Marion Sims;

Whereas structural racism cemented historical racial and ethnic inequities in 
        access to resources and opportunities, contributing to worse health 
        outcomes;
Whereas examples of that structural racism include--

    (1) 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 the northern and 
southern United States complied with Jim Crow laws and were completely 
segregated by race, leaving Black communities with little to no access to 
health care services;

    (2) the landmark case Simkins v. Moses H. Cone Memorial Hospital, 323 
F.2d 959 (4th Cir. 1963), which challenged the use of public funds by the 
Federal Government to expand, support, and sustain segregated hospital care 
and provided justification for title VI of the Civil Rights Act of 1964 (42 
U.S.C. 2000d et seq.) and the Medicare hospital certification program by 
establishing Medicare hospital racial integration guidelines that applied 
to every hospital that participated in the Federal program;

    (3) Pacific Islanders from the Freely Associated States experience 
unique health inequities resulting from United States nuclear weapons tests 
on their home islands while they have been categorically denied access to 
Medicaid and other Federal health benefits;

    (4) language minorities, including Chinese-, Korean-, Vietnamese-, and 
Spanish-speaking Americans, were not assured nondiscriminatory access to 
federally funded services, including health services, until the signing of 
Executive Order 13166 (42 U.S.C. 2000d-1 note; relating to improving access 
to services for persons with limited English proficiency) in 2000;

    (5) the COVID-19 pandemic exacerbated economic, health, housing, and 
food security barriers for Black, Hispanic or Latino, Asian American, 
Native Hawaiian or Pacific Islander, and Native American households, which 
already suffer from disproportionately higher rates of food insecurity; and

    (6) members of the Black, Native American, Alaska Native, Asian 
American, Native Hawaiian or Pacific Islander, and Hispanic or Latino 
communities 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 members of those communities;

Whereas subtle or implicit racism in all sectors of the medical service 
        profession continues to cause disproportionate physical and 
        psychological harm to members of racial and ethnic minority groups;
Whereas examples of subtle or implicit racism in the medical service profession 
        include--

    (1) the history and persistence of racist and nonscientific medical 
beliefs, which are associated with ongoing racial inequities in treatment 
and health outcomes;

    (2) implicit racial and ethnic biases within the health care system, 
which have an explicit impact on the quality of care experienced by members 
of racial and ethnic minority groups, such as the undertreatment of pain in 
Black patients;

    (3) nearly \1/5\ of Hispanic or Latino Americans avoid medical care due 
to concern about being discriminated against or treated poorly;

    (4) the United States health care system and other economic and social 
structures remain fraught with biases based on race, ethnicity, sex 
(including sexual orientation and gender identity), and class that lead to 
health inequities;

    (5) women of color, including Black, Native American, Hispanic or 
Latina, Asian American, and Native Hawaiian or Pacific Islander women, have 
faced and continue to face attacks on their prenatal, maternal, and 
reproductive health and rights; and

    (6) physicians routinely, through the early 1980s, sterilized members 
of racial and ethnic minority groups, specifically American Indian and 
Alaska Native women (with \1/4\ of childbearing-age women sterilized by the 
Indian Health Service) and African American and Latina women, performing 
excessive and medically unnecessary procedures without their informed 
consent;

Whereas structural racism perpetuates racial and ethnic inequities in the social 
        determinants of health, which produces unintended negative health 
        outcomes for members of racial and ethnic minority groups;
Whereas examples of that structural racism include--

    (1) there are fewer pharmacies, medical practices, and hospitals in 
predominantly Black and Hispanic or Latino neighborhoods, compared to White 
or more diverse neighborhoods;

    (2) environmental hazards such as toxic waste facilities, garbage 
dumps, and other sources of airborne pollutants, are disproportionately 
located in predominantly Black, Hispanic or Latino, Asian American, Native 
Hawaiian or Pacific Islander, and low-income communities, resulting in poor 
air quality conditions, which can increase the likelihood of chronic 
respiratory illness and premature death from particle pollution;

    (3) employed Black adults are 10 percent less likely to have employer-
sponsored health insurance than employed White adults because of racial 
segregation in occupation sectors and the types of organizations in which 
they work, nearly \1/4\ of American Indians and Alaska Natives lack health 
insurance, and nonelderly Native Hawaiian or Pacific Islander adults and 
certain groups of nonelderly Asian American adults, including Korean, 
Vietnamese, and Cambodian adults, also have lower levels of insurance than 
White adults;

    (4) several States with higher percentages of Black, Hispanic or 
Latino, and Native American populations have not expanded their Medicaid 
programs, continuing to disenfranchise minority communities from access to 
health care as of the date of adoption of this resolution;

    (5) discriminatory housing practices, such as redlining, which have, 
for decades, systemically excluded members of racial and ethnic minority 
groups from housing by robbing them of capital in the form of low-cost, 
stable mortgages and opportunities to build wealth, and the use by the 
Federal Government of its financial power to segregate renters in public 
housing;

    (6) social inequities such as differing access to quality health care, 
healthy food and safe drinking water, safe neighborhoods, education, job 
security, and reliable transportation, which affect health risks and 
outcomes;

    (7) exclusionary disciplinary practices (such as detention and 
suspension) in primary education and even early education settings, which 
disproportionately affect children from racial and ethnic minority 
backgrounds, particularly Black children; and

    (8) that, as much as 60 percent of the health of a person in the United 
States can be determined by their ZIP Code;

Whereas structural racism perpetuates ongoing knowledge gaps in data, research, 
        and development, which produces unintended negative health outcomes for 
        members of racial and ethnic minority groups;
Whereas examples of that structural racism include--

    (1) most participants in clinical trials are White, so there is 
insufficient data to develop evidence-based recommendations for people from 
racial and ethnic minority groups;

    (2) medical research equipment and medical devices are typically 
developed by majority-White teams and thus can have racial blind spots 
unintentionally built into their design, rendering them less effective for 
people from racial and ethnic minority groups, such as--

    G    (A) electroencephalogram (EEG) electrodes used in neuroimaging 
research do not collect reliable data when used on scalps with thick, curly 
hair; and

    G    (B) pulse oximeters produce less accurate oxygen saturation 
readings when used on fingertips with darker skin;

    (3) a lack of images depicting darker skin in medical textbooks, 
literature, and journals contributes to higher rates of underdiagnosis or 
misdiagnosis in patients with darker skin; and

    (4) many health-related studies fail to include data on Native 
Americans, Asian Americans, and Native Hawaiians or Pacific Islanders, or 
do not disaggregate data among those groups, leading to their invisibility 
in health data and unjust resource allocation and policies;

Whereas racism produces unjust outcomes and treatment for members of racial and 
        ethnic minority groups, with such negative experiences serving as 
        stressors that over time have a negative impact on physical health 
        (leading, for example, to high blood pressure or hypertension) and 
        mental health (leading, for example, to anxiety or depression);
Whereas there is evidence that racial and ethnic minority groups continue to 
        face discrimination in the United States, examples of which include 
        that--

    (1) social scientists have documented racial microaggressions in 
contemporary United States society, including--

    G    (A) assumptions that members of racial and ethnic minority groups 
are not true Americans;

    G    (B) assumptions of lesser intelligence;

    G    (C) statements that convey color-blindness or denial of the 
importance of race;

    G    (D) assumptions of criminality or dangerousness;

    G    (E) denial of individual racism;

    G    (F) promotion of the myth of meritocracy;

    G    (G) assumptions that the cultural background and communication 
styles of an individual are pathological;

    G    (H) treatment as a second-class citizen; and

    G    (I) environmental messages of being unwelcome or devalued;

    (2) compared to White Americans, Black Americans are 5 times more 
likely to report experiencing discrimination when interacting with the 
police, Hispanic or Latino Americans and Native Americans are nearly 3 
times as likely, and Asian Americans and Native Hawaiians or Pacific 
Islanders are nearly twice as likely;

    (3) 42 percent of employees in the United States have experienced or 
witnessed racism in the workplace;

    (4) Muslims, South Asians, and Sikhs were unjustly targeted for 
profiling, surveillance, arrest, discrimination, harassment, assault, and 
murder after 9/11;

    (5) xenophobic rhetoric, including anti-immigrant rhetoric and the 
scapegoating of people of East Asian and Southeast Asian descent for the 
COVID-19 pandemic, resulted in a surge of hate against Asian Americans and 
Native Hawaiians or Pacific Islanders, including increased harassment, 
discrimination, bullying, vandalism, and assault;

    (6) nearly \1/2\ of Asian Americans and Native Hawaiians or Pacific 
Islanders throughout the United States have experienced discrimination or 
unfair treatment that may be illegal and the majority of victims of 
discrimination name race or related characteristics as the reason for the 
discrimination; and

    (7) more than 50 percent of Hispanic or Latino adults experience at 
least one form of discrimination due to their racial or ethnic heritage, 
such as being treated as if they were not smart, criticized for speaking 
Spanish, told to return to their country, called offensive names, or 
unfairly stopped by the police;

Whereas Black people in the United States experience overt and direct forms of 
        violence that, when not fatal, can cause severe physical or 
        psychological harm;
Whereas examples of such forms of violence include--

    (1) that Black people are confronted and threatened by armed citizens 
while performing everyday tasks, such as jogging in neighborhoods, driving, 
or playing in a park;

    (2) that Black people are 3 times more likely to be killed by police 
than White people, and police violence is the sixth leading cause of death 
for young Black men;

    (3) the killings of Tamir Rice, Ahmaud Arbery, Breonna Taylor, George 
Floyd, Elijah McClain, Jayland Walker, Jeenan Anderson, Timothy McCree 
Johnson, Jordan Neely, and countless other Black Americans by law 
enforcement;

    (4) that it took the United States 66 years after the senseless and 
brutal murder of 14-year-old Emmett Till to make lynching a Federal crime;

    (5) that, since 2015, mass shootings around the country, such as in 
Buffalo, New York, and Charleston, South Carolina, serve as reminders of 
the unresolved history of racism in the United States and highlight the 
threats Black people must take into consideration when going about their 
daily lives, both when outside their communities and within those 
communities; and

    (6) that the real threat of brutality and violence adversely impacts 
mental health among Black communities;

Whereas American Indians and Alaska Natives experience historical trauma, 
        systemic oppression, and cultural genocide that, even when not fatal, 
        can cause severe physical or psychological harm;
Whereas examples of such forms of violence include--

    (1) forced relocation, termination, and assimilation policies such as 
boarding schools that contributed to health disparities and legacies of 
trauma inflicted on indigenous people;

    (2) the United States Army attempting cultural genocide by instigating 
numerous massacres, including the mass execution of 38 Dakota men in 
Minnesota and the murder of 300 Lakota people at the Battle of Wounded 
Knee, to eradicate American Indians and Alaska Natives;

    (3) murder being the third leading cause of death for Native women and 
\4/5\ of Indigenous women experiencing violence in their lifetime;

    (4) since 2016, there have been 5,712 cases of missing and murdered 
indigenous women and people across the United States, including 506 cases 
in 71 urban cities and 153 cases missing from law enforcement databases, 
with those missing cases likely undercounting the actual number of cases 
due to the underreporting of cases within American Indian and Alaska Native 
communities;

    (5) the overall death rate from suicide among American Indians and 
Alaska Natives is 20 percent higher compared to non-Hispanic White 
populations; and

    (6) cycles of violence have overburdened indigenous communities to 
respond to levels of violence such as gender-based violence, human 
trafficking, suicide, and homicide with minimal resources;

Whereas Hispanics or Latinos, Asian Americans, and Native Hawaiians or Pacific 
        Islanders experience racially motivated kidnapping, murders, and mass 
        violence, such as shootings in Oak Creek, Wisconsin, El Paso and Allen, 
        Texas, Atlanta, Georgia, and Indianapolis, Indiana, that, even when not 
        fatal, can cause severe physical or psychological harm;
Whereas, throughout the history of the United States, members of racial and 
        ethnic minority groups have been at the forefront of civil rights 
        movements for essential freedoms, human rights, and equal protection for 
        marginalized groups and continue to fight for racial and economic 
        justice today;
Whereas racial inequities in health continue to persist because of historical 
        and contemporary racism;
Whereas public health experts agree that racism meets the criteria of a public 
        health crisis because--

    (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 the Centers for Disease Control and Prevention--

    (1) declared racism a serious threat to public health; and

    (2) acknowledged the need for additional research and investments to 
address that serious threat;

Whereas a Federal public health crisis declaration proclaims racism as a 
        pervasive health issue and alerts the people of the United States to the 
        need to enact immediate and effective cross-governmental efforts to 
        address the root causes of structural racism and the downstream impacts 
        of that racism; and
Whereas such a declaration requires the response of governments to engage 
        significant resources to empower the communities that are impacted: Now, 
        therefore, be it
    Resolved, That the Senate--
            (1) supports the resolutions drafted, introduced, and 
        adopted by cities and localities across the United States 
        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 inequities across all sectors in 
                society;
                    (B) dismantling systemic practices and policies 
                that perpetuate racism;
                    (C) advancing reforms to address years of 
                neglectful and apathetic policies that have led to poor 
                health outcomes for members of racial and ethnic 
                minority groups; and
                    (D) promoting efforts to address the social 
                determinants of health for all racial and ethnic 
                minority groups in the United States, and especially 
                for Black and Native American communities; and
            (4) places a charge on the people of the United States to 
        move 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.
                                 <all>
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