such as Medicaid and the State Children’s Health 
Insurance Program. 
(2) Language, cultural barriers, and lack of in-
formation may delay or block enrollment in public 
programs. 
(3) Community health workers are effective in 
significantly increasing health insurance coverage, 
screening, and medical follow-up visits among resi-
dents with limited access or underutilization of 
health care services. 
(4) A study published in the ‘‘Journal of the 
American Academy of Pediatrics’’ found that fami-
lies who interacted with community health workers 
are 8 times more likely to obtain health insurance 
for their children. Almost 96 percent of children who 
worked with community health workers obtained 
health insurance, and 78 percent were insured con-
tinuously. 
(5) Chronic diseases, defined as any condition 
that requires regular medical attention or medica-
tion, are the leading cause of death and disability for 
women in the United States across racial and ethnic 
groups. 
(6) According to the National Vital Statistics 
Report of 2001, the 5 leading causes of death 
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among Hispanic, American Indian, and African- 
American women are heart disease, cancer, diabetes, 
cerebrovascular disease, and unintentional injuries. 
(7) Unhealthy behaviors alone lead to more 
than 50 percent of premature deaths in the United 
States. 
(8) Poor diet, physical inactivity, tobacco use, 
and alcohol and drug abuse are the health risk be-
haviors that most often lead to disease, premature 
death, and disability, and are particularly prevalent 
among many groups of minority women. 
(9) Over 60 percent of Hispanic and African- 
American women are classified as overweight, and 
over 30 percent are classified as obese. Over 60 per-
cent of American Indian women are classified as 
obese. 
(10) American Indian women have the highest 
mortality rates related to alcohol and drug use of all 
women in the United States. 
(11) High poverty rates coupled with barriers 
to health preventive services and medical care con-
tribute to racial and ethnic disparities in health fac-
tors, including premature death, life expectancy, risk 
factors associated with major diseases, and the ex-
tent and severity of illnesses. 
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(12) There is increasing evidence that early life 
experiences are associated with adult chronic disease 
and that prevention and intervention services pro-
vided within the community and the home may less-
en the impact of chronic outcomes, while strength-
ening families and communities. 
(13) Community health workers, who are pri-
marily women, can be a critical component in con-
ducting health promotion and disease prevention ef-
forts in medically underserved populations. 
(14) Recognizing the difficult barriers con-
fronting medically underserved communities (pov-
erty, geographic isolation, language and cultural dif-
ferences, lack of transportation, low literacy, and 
lack of access to services), community health work-
ers are in a unique position to reduce preventable 
morbidity and mortality, improve the quality of life, 
and increase the utilization of available preventive 
health services for community members. 
SEC. 3. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS IN WOMEN. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
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