I
106TH CONGRESS
1ST SESSION
H. R. 2391
To establish a National Center for Research on Domestic Health Disparities.
IN THE HOUSE OF REPRESENTATIVES
JUNE 30, 1999
Mr. JACKSON of Illinois (for himself, Mr. NORWOOD, Mrs. CHRISTENSEN, Mr.
CLYBURN, Mr. RODRIGUEZ, Mr. UNDERWOOD, Mr. WU, Mr. SANDERS,
Mr. DEFAZIO, Mr. BONIOR, Mr. MENENDEZ, Mr. BROWN of Ohio, Mr.
STARK, Mr. ABERCROMBIE, Ms. MILLENDER-MCDONALD, Mr. THOMP-
SON of Mississippi, Mr. HILLIARD, Mr. FILNER, Mr. FALEOMAVAEGA,
Mrs. MEEK of Florida, Mr. SERRANO, Mr. HINCHEY, Mr. JEFFERSON,
Mr. FORD, Ms. MCKINNEY, Mrs. JONES of Ohio, Ms. LEE, Ms. PELOSI,
Ms. KILPATRICK, Mr. SCOTT, Ms. NORTON, Mr. CLAY, Mr. OWENS, Ms.
VELA´ZQUEZ, Mr. PAYNE, Mr. WYNN, Mr. RUSH, Mr. CUMMINGS, Mr.
DAVIS of Illinois, Mr. PASTOR, Mr. MEEKS of New York, Ms. JACKSON-
LEE of Texas, Ms. BROWN of Florida, Ms. WATERS, Ms. EDDIE BER-
NICE JOHNSON of Texas, Mr. ROMERO-BARCELO´, Mr. BISHOP, Ms. CAR-
SON, Mrs. CLAYTON, Mr. CONYERS, Mr. RANGEL, Mr. REYES, Mr. LEWIS
of Georgia, Mr. TOWNS, Mr. DIXON, Mr. FATTAH, Mr. WATT of North
Carolina, Mr. GONZALEZ, Mr. NADLER, Mr. BROWN of California, Mr.
MATSUI, 
Mr. 
LANTOS, 
Ms. 
KAPTUR, 
Mrs. 
NAPOLITANO, 
Ms.
SCHAKOWSKY, Mr. HASTINGS of Florida, Mr. FRANK of Massachusetts,
Mr. ORTIZ, Ms. WOOLSEY, Mrs. MINK of Hawaii, and Mr. BECERRA) in-
troduced the following bill; which was referred to the Committee on Com-
merce
A BILL
To establish a National Center for Research on Domestic
Health Disparities.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘National Center for
Research on Domestic Health Disparities Act’’.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) The United States ranks below most indus-
trialized nations in health status measured by lon-
gevity, sickness, and mortality.
(2) The United States ranks 24th among indus-
trialized nations in infant mortality.
(3) This poor rank in health status is attributed
in large measure to the lower health status of Amer-
ica’s minority populations.
(4) Many minority groups suffer disproportion-
ately from cancer. Disparities exist in both mortality
and incidence rates. For men and women combined,
African Americans have a cancer death rate about
35 percent higher than that for whites. Paralleling
the death rate, the incidence rate for lung cancer in
African American men is about 50 percent higher
than white men. Native Hawaiian men also have ele-
vated rates of lung cancer compared with white men.
Alaska Native men and women suffer from higher
rates of cancers of the colon and rectum than do
whites. Vietnamese women in the United States have
a cervical cancer incidence rate more than five times
greater than white women. Hispanic women also suf-
fer elevated rates of cervical cancer.
(5) Infant death rates among African Amer-
ican, American Indians and Alaska Natives, and
Hispanics were well above the national average. The
greatest disparity exists for African Americans. The
overall American Indian rate does not reflect the di-
versity among Indian communities, some of which
have infant mortality rates approaching twice the
national rate.
(6) SIDS accounts for approximately 10 per-
cent of all infant deaths in the first year of life. Mi-
nority populations are at greater risk for SIDS. In
addition to the greater risks among African Ameri-
cans, the rates are three to four times as high for
some American Indians and Alaska Native popu-
lations.
(7) Cardiovascular disease is the leading cause
of death for all racial and ethnic groups. Major dis-
parities exist among population groups, with a dis-
proportionate burden of death and disability from
cardiovascular disease in minority and low-income
populations. Stroke is the only leading cause of
death for which mortality is higher for Asian-Amer-
ican males than for white males.
(8) Racial and ethnic minorities have higher
rates of hypertension, tend to develop hypertension
at an earlier age, and are less likely to undergo
treatment to control their high blood pressure.
(9) Diabetes, the seventh leading cause of death
in the United States, is a serious public health prob-
lem affecting racial and ethnic communities. The
prevalence of diabetes in African Americans is ap-
proximately 70 percent higher than whites and the
prevalence in Hispanics is nearly double that of
whites. The prevalence rate of diabetes among
American Indians and Alaska Natives is more than
twice that for the total population and at least one
tribe, the Pimas of Arizona, have the highest known
prevalence of diabetes of any population in the
world.
(10) 
The 
human 
immunodeficiency 
virus
(‘‘HIV’’), which causes acquired immune deficiency
syndrome (‘‘AIDS’’), results in disproportionate suf-
fering in minority populations. Minority persons rep-
resent 25 percent of the total United States popu-
lation, but 54 percent of all cases of AIDS.
(11) More than 75 percent of AIDS cases re-
ported among women and children occur in minority
women and children.
Human Services, and Education, and Related Agencies
Appropriations Act, 1999 (as contained in section 101(f)
of Public Law 105–277) (112 Stat. 2681–387), is amend-
ed by adding at the end the following subpart:
‘‘Subpart 6—National Center for Research on Domestic
Health Disparities
‘‘SEC. 485E. (a) IN GENERAL.—The general purpose
of the National Center for Research on Domestic Health
Disparities (in this subpart referred to as the ‘Center’)
is the conduct and support of basic and clinical research,
training, the dissemination of health information, and
other programs with respect to minority health.
‘‘(b) COORDINATION OF ACTIVITIES.—
‘‘(1) IN GENERAL.—The Director of the Center
shall coordinate the activities of the Center with re-
lated activities of the other agencies of the National
Institutes of Health, including the national research
institutes.
‘‘(2) 
AGENCYWIDE
RECOMMENDATIONS
THROUGH COMPREHENSIVE PLAN.—The Director of
NIH, the Director of the Center, and the directors
of the national research institutes shall collaborate
for the purpose of developing, and periodically re-
viewing and as appropriate revising, a comprehensive
plan that provides recommendations for the conduct
and support by the National Institutes of Health of
the activities described in subsection (a) with respect
to minority health.
‘‘(3) CERTAIN
ACTIVITIES.—For purposes of
the comprehensive plan under paragraph (2), the Di-
rector of the Center shall—
‘‘(A) identify projects of research on mi-
nority health that should be conducted or sup-
ported by the Center and the other agencies of
the National Institutes of Health, including the
national research institutes;
‘‘(B) identify multidisciplinary research re-
lating to research on minority health that
should be so conducted or supported;
‘‘(C) promote coordination and collabora-
tion among entities conducting research identi-
fied under subparagraph (A) or (B);
‘‘(D) encourage the conduct of such re-
search by entities receiving funds from the na-
tional research institutes;
‘‘(E) recommend an agenda for conducting
and supporting such research; and
‘‘(F) promote the sufficient allocation of
the resources of the national research institutes
for conducting and supporting such research.
‘‘(c) CLINICAL RESEARCH EQUITY.—The Director of
the Center shall assist in the administration of section
492B with respect to the inclusion of members of minority
groups as subjects in clinical research.
‘‘(d) RESEARCH ENDOWMENTS.—The Director of the
Center may carry out a program to facilitate research on
minority health by providing for research endowments at
centers of excellence under section 736.
‘‘(e) ADVISORY COUNCIL.—The Secretary shall, in
accordance with section 406, establish an advisory council
to advise, assist, consult with, and make recommendations
to the Director of the Center on matters relating to the
activities described in subsection (a), and with respect to
such activities to carry out any other functions described
in section 406 for advisory councils under such section.
‘‘(f) BIENNIAL REPORT.—The Director of the Center
shall prepare biennial reports on the activities carried out
or to be carried out by the Center, and shall submit each
such report to the Director of NIH for inclusion in the
biennial report under section 403.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this subpart, there are authorized
to be appropriated $100,000,000 for fiscal year 2000, and
such sums as may be necessary for each of the fiscal years
2001 through 2004. Such authorization of appropriations
is in addition to other authorizations of appropriations
that are available for the conduct and support of research
on minority health by the national research institutes and
other agencies of the National Institutes of Health.’’.
(b) CONFORMING AMENDMENT.—Part A of title IV
of the Public Health Service Act (42 U.S.C. 281 et seq.)
is amended by striking section 404.
SEC. 4. EFFECTIVE DATE.
The amendments made by this Act take effect Octo-
ber 1, 1999, or upon the date of the enactment of this
Act, whichever occurs later.
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