684 
graph (1) and submit to Congress a report con-
taining the results of such study. 
(b) NIH REPORT ON CERTAIN AUTHORITY OF NA-
TIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH 
DISPARITIES.—Not later than six months after the date 
of the enactment of this Act, and biennially thereafter, the 
Director of the National Institutes of Health, in collabora-
tion with the Director of the National Institute on Minor-
ity Health and Health Disparities, shall submit to Con-
gress a report that details and evaluates— 
(1) the steps taken during the applicable report 
period by the Director of the National Institutes of 
Health to enforce the expanded planning, coordina-
tion, review, and evaluation authority provided the 
National Institute on Minority Health and Health 
Disparities under section 464z–3(h) of the Public 
Health Service Act (42 U.S.C. 285(h)), as added by 
section 10334(c) of the Patient Protection and Af-
fordable Care Act, over all minority health and 
health disparity research that is conducted or sup-
ported by the Institutes and Centers at the National 
Institutes of Health; and 
(2) the outcomes of such steps. 
(c) GAO REPORT RELATED
TO RECIPIENTS
OF 
PPACA FUNDING.—Not later than one year after the 
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date of the enactment of this Act and biennially thereafter 
until 2024, the Comptroller General of the United States 
shall submit to Congress a report that identifies, with re-
spect to minority community-based organizations that ap-
plied during the applicable report period for Federal fund-
ing provided pursuant to the provisions of (and amend-
ments made by) the Patient Protection and Affordable 
Care Act for purposes of achieving health equity and elimi-
nating health disparities, the percentage of such organiza-
tions that were awarded such funding. 
(d) ANNUAL REPORT ON ACTIVITIES OF NATIONAL 
INSTITUTE ON MINORITY HEALTH AND HEALTH DIS-
PARITIES.—The Director of the National Institute on Mi-
nority Health and Health Disparities shall prepare an an-
nual report on the activities carried out or to be carried 
out by the Institute, and shall submit each such report 
to the Committee on Health, Education, Labor, and Pen-
sions of the Senate, the Committee on Energy and Com-
merce of the House of Representatives, the Secretary of 
Health and Human Services, and the Director of the Na-
tional Institutes of Health. With respect to the fiscal year 
involved, the report shall— 
(1) describe and evaluate the progress made in 
health disparities research conducted or supported 
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by institutes and centers of the National Institutes 
of Health; 
(2) summarize and analyze expenditures made 
for activities with respect to health disparities re-
search conducted or supported by the National Insti-
tutes of Health; 
(3) include a separate statement applying the 
requirements of paragraphs (1) and (2) specifically 
to minority health disparities research; and 
(4) contain such recommendations as the Direc-
tor of the Institute considers appropriate. 
TITLE X—ADDRESSING SOCIAL 
DETERMINANTS 
AND 
IM-
PROVING 
ENVIRONMENTAL 
JUSTICE 
SEC. 1001. DEFINITIONS. 
(a) DETERMINANTS OF HEALTH.—The term ‘‘deter-
minants of health’’— 
(1) refers to the range of personal, social, eco-
nomic, and environmental factors that influence 
health status; and 
(2) includes social determinants of health 
(which are sometimes referred to as ‘‘social and eco-
nomic determinants of health’’ or ‘‘socioeconomic de-
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terminants of health’’), environmental determinants 
of health, and personal determinants of health. 
(b) 
ENVIRONMENTAL
DETERMINANTS
OF 
HEALTH.—The term ‘‘environmental determinants of 
health’’ refers to the broad physical, psychological, social, 
and aesthetic environment. 
(c) PERSONAL DETERMINANTS OF HEALTH.—The 
term ‘‘personal determinants of health’’ refers to an indi-
vidual’s behavior, biology, and genetics. 
(d) SOCIAL DETERMINANTS OF HEALTH .—The term 
‘‘social determinants of health’’ refers to a subset of deter-
minants of the health of individuals and environments 
(such as communities, neighborhoods, and societies) that 
describe people’s social identity, describe the social and 
economic resources to which people have access, and de-
scribe the conditions in which people work, live, and play. 
SEC. 1002. FINDINGS. 
The Congress finds as follows: 
(1) There are more opportunities to improve 
health for everyone when we understand that health 
starts, first, not in a medical setting, but in our 
families, in our schools and workplaces, in our 
neighborhoods, and in the air we breathe and water 
we drink. 
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(2) The social determinants of health are the 
largest predictors of health outcomes. 
(3) Healthy People 2020 identifies health and 
health care quality as a function of not only access 
to health care, but also the social determinants of 
health, categorized into the following: neighborhoods 
and the built environment; social and community 
context; education; and economic stability. The fol-
lowing examples illustrate the nexus between the un-
equal distribution of the social determinants of 
health and health disparities: 
(A) The built environment influences resi-
dents’ level of physical activity. Neighborhoods 
with high levels of poverty are significantly less 
likely to have places where children can be 
physically active, such as parks, green spaces, 
and bike paths and lanes. Neighborhoods and 
communities can provide opportunities for phys-
ical activity and support active lifestyles 
through accessible and safe parks and open 
spaces and through land use policy, zoning, and 
healthy community design. 
(B) Emotional and physical health and 
well-being are directly impacted by perceived 
levels of safety, such as unlit streets at night. 
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