IV 
117TH CONGRESS 
1ST SESSION 
H. RES. 344 
Declaring racism a public health crisis. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 22, 2021 
Mrs. HAYES (for herself and Mr. CA´RDENAS) submitted the following resolu-
tion; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on the Judiciary, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
RESOLUTION 
Declaring racism a public health crisis. 
Whereas since the Nation’s founding, the United States has 
had a longstanding history and legacy of racism, mis-
treatment, and discrimination against African Americans, 
Latinos, Native Americans, and other people of color; 
Whereas the United States ratified over 350 treaties with 
sovereign indigenous communities, has broken the prom-
ises made in such treaties, and has historically failed to 
carry out its trust responsibilities to Native Americans, 
including American Indians, Alaska Natives, and Native 
Hawaiians, 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 disparities faced by Native 
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American people, and the inaccessibility of many Federal 
public health and social programs in Native American 
communities; 
Whereas people of Mexican and Puerto Rican descent, who 
became Americans through conquest, were subject to, but 
never full members of the polity of the United States and 
experienced widespread discrimination in employment, 
housing, education, and health care; 
Whereas the immoral paradox of slavery and freedom is an 
indelible wrong traced throughout the Nation’s history, 
as African Americans lived under the oppressive institu-
tion 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; 
Whereas 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 doc-
tors’ offices throughout Northern and Southern States 
complied with Jim Crow laws and were completely seg-
regated by race—leaving Black communities with little to 
no access to health care services; 
Whereas between 1956 and 1967, the National Association 
for the Advancement of Colored People (NAACP) Legal 
Defense and Educational Fund litigated a series of court 
cases to eliminate discrimination in hospitals and profes-
sional associations; 
Whereas the landmark case Simkins v. Moses H. Cone Me-
morial Hospital, 323 F.2d 959 (1963), challenged the 
Federal Government’s use of public funds to expand, sup-
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port, and sustain segregated hospital care, and provided 
justification for title VI of the 1964 Civil Rights Act and 
the Medicare hospital certification program—establishing 
Medicare hospital racial integration guidelines that ap-
plied to every hospital that participated in the Federal 
program; 
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, resulting in deepened racial divi-
sion and continued exclusion of Black communities from 
the benefits of economic progress; 
Whereas language minorities, including Latinos, Asian Amer-
icans, and Pacific Islanders, were not assured non-
discriminatory access to federally funded services, includ-
ing health services, until the signing of Executive Order 
13166 in 2000; 
Whereas the Patient Protection and Affordable Care Act 
(Public Law 111–148) included provisions to expand the 
Medicaid program and—for the first time in the United 
States—established a Federal prohibition against dis-
crimination on the basis of race, color, national origin, 
sex, age, or disability in certain health programs, building 
on other Federal civil rights laws; 
Whereas the Patient Protection and Affordable Care Act re-
quired reporting to Congress on health disparities based 
on race, color, national origin, sex, age, or disability; 
Whereas several Federal programs have been established to 
address some, but not all, of the health outcomes that are 
disproportionately experienced by communities of color, 
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including sickle cell disease, tuberculosis, infant mor-
tality, and HIV/AIDS; 
Whereas the National Center for Chronic Disease Prevention 
and Health Promotion works to raise awareness of health 
disparities faced by minority populations in the United 
States, such as Native Americans, Asian Americans, 
Black Americans, and Latino Americans, aiming to re-
duce risk factors for groups affected by such health dis-
parities; 
Whereas the United States health care system and other eco-
nomic and social structures remain fraught with racism 
and racial, ethnic, sex (including sexual orientation and 
gender identity), and class biases that lead to health in-
equity and health disparities; 
Whereas life expectancy rates for Black and Native American 
people in the United States are significantly lower than 
those of White people in the United States; 
Whereas disparities in health outcomes are exacerbated for 
LGBTQIA+ people of color; 
Whereas disparities in health outcomes are worsened for peo-
ple of color with disabilities due to bias and inequitable 
access to health care; 
Whereas several States with higher percentages of Black, 
Latino, and Native American populations have not ex-
panded their Medicaid programs pursuant to subclause 
(VIII) of section 1902(a)(10)(A)(i) of the Social Security 
Act (42 U.S.C. 1396a(a)(10)(A)(i))—continuing to dis-
enfranchise minority communities from access to health 
care; 
Whereas 16 States have failed to take advantage of the Fed-
eral option to expand access to the Medicaid program 
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under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) and the Children’s Health Insurance Pro-
gram under title XXI of the Social Security Act (42 
U.S.C. 1397aa et seq.) to lawfully residing immigrant 
children within the first 5 years of lawful status, and 26 
States have failed to do so for similarly situated pregnant 
women; 
Whereas between 2016 and 2018, the child uninsured rate in-
creased from 4.7 percent to 5.2 percent and the Latino 
child uninsured rate increased from 7.7 percent to 8.1 
percent, and children of color are far more likely to be 
uninsured than White children; 
Whereas a climate of fear and confusion for immigrant fami-
lies due to the public charge rule discourages such fami-
lies from enrolling eligible children in the Medicaid pro-
gram and the Children’s Health Insurance Program; 
Whereas Pacific Islanders from the Freely Associated States 
experience unique health disparities resulting from 
United States nuclear weapons tests on their home is-
lands, but such people have been categorically denied ac-
cess to Medicaid and other Federal health benefits; 
Whereas the United States has historically facilitated out-
sider status toward Asian Americans and Pacific Island-
ers, such as the authorization of the internment of Japa-
nese Americans during World War II, which resulted in 
profound economic, social, and psychological burdens for 
the people impacted; 
Whereas the history and persistence of racist and nonsci-
entific medical beliefs are associated with ongoing racial 
disparities in treatment and health outcomes; 
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Whereas implicit racial and ethnic biases within the health 
care system have an impact on the quality of care experi-
enced by communities of color, such as the undertreat-
ment of pain in Black patients; 
Whereas the historical context of unethical practices and 
abuses experienced by Black patients and research par-
ticipants, such as the Tuskegee Syphilis Study, serve as 
symbols of the Black community’s mistrust of the med-
ical system; 
Whereas women of color continue to face attacks, docu-
mented throughout history, on their prenatal, maternal, 
and reproductive health and rights; 
Whereas enslaved Black women were forced to endure egre-
giously unethical and cruel treatment, as subjects of in-
sidious medical experiments, to advance modern gyne-
cology; 
Whereas through the late 1960s and early 1980s, physicians 
routinely sterilized people of color, performing excessive 
and medically unnecessary procedures on patients of 
color without their informed consent; 
Whereas 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, and 
implicit racial biases and lower quality care are contrib-
uting factors to the health care disparities that lead to 
these outcomes; 
Whereas Black and Native American infants are twice as 
likely to die as White infants, and the Black infant mor-
tality rate in the United States is higher than in 97 
countries worldwide; 
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Whereas researchers have developed the analytical framework 
of ‘‘weathering’’ to describe how the constant stress of 
racism leads to poor health outcomes for Black Ameri-
cans; 
Whereas the daily experience of racism is associated with 
stress, depression, and anxiety, and may cause physio-
logical reactivity or contribute to chronic health condi-
tions; 
Whereas racism is linked to mental health challenges for chil-
dren and adolescents; 
Whereas children of color are overrepresented in the United 
States child welfare system, and up to 80 percent of chil-
dren in foster care enter State custody with significant 
mental health challenges; 
Whereas disparities in educational access and attainment, 
along with racism experienced in the educational setting, 
affect the trajectory of academic achievement for children 
and adolescents, and ultimately impact health and racial 
inequities in school discipline, which has long-term con-
sequences for children; 
Whereas racism and segregation in the United States con-
tribute to poor health outcomes by segregating Black, 
Latino, and Native American communities from oppor-
tunity; 
Whereas, for decades, discriminatory housing practices, such 
as redlining, systemically excluded people of color from 
housing, robbing them of capital in the form of low-cost, 
stable mortgages and opportunities to build wealth, and 
the Federal Government used its financial power to seg-
regate renters in newly built public housing; 
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Whereas environmental injustices, such as proximity and ex-
posure to toxic waste or hazardous air pollutants, con-
tinue to harm the health of communities of color, low-in-
come communities, and indigenous communities around 
the Nation; 
Whereas social inequities such as differing access to quality 
health care, healthy food and safe drinking water, safe 
neighborhoods, education, job security, and reliable trans-
portation affect health risks and outcomes; 
Whereas during the COVID–19 pandemic, the effects of rac-
ism and discrimination are seen in COVID–19 infection, 
hospitalization, and mortality rates—disproportionately 
high among Black, Latino, and Native American popu-
lations compared to the overall population—exacerbating 
health disparities and highlighting barriers to care for 
Black, Latino, and Native American patients across the 
United States; 
Whereas because of racial and ethnic disparities, people of 
color are more likely to have preexisting, preventable, and 
chronic conditions, which lead to higher COVID–19 mor-
bidity and mortality rates; 
Whereas people of color are overrepresented in the number of 
people in the United States living under poor air quality 
conditions, which can increase the likelihood of COVID– 
19 morbidity and mortality; 
Whereas the COVID–19 pandemic has worsened barriers for 
Black, Latino, and Native American households that suf-
fer from disproportionately higher rates of food insecu-
rity; 
Whereas Black and Latino workers make up a dispropor-
tionate number of frontline workers, are less likely to re-
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ceive paid sick leave or have the ability to work from 
home, and have been excluded from many forms of relief 
readily available to other groups; 
Whereas people of color 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 people of color; 
Whereas during the COVID–19 pandemic, an increased use 
of anti-Asian rhetoric has resulted in Asian Americans 
being harassed, assaulted, and scapegoated for the pan-
demic; 
Whereas communities of color continue to bear the burdens 
of inequitable social, economic, and criminal justice poli-
cies, practices, and investments that cause deep dispari-
ties, hurt, harm, danger, and mistrust; 
Whereas over 40 percent of Latinos report being discrimi-
nated against or harassed because of their race; 
Whereas approximately 24 percent of the Latino population 
in the United States identifies as ‘‘Afro-Latino’’ and is 
thus potentially subject to both race and national origin 
discrimination; 
Whereas because of racism, Black people in the United 
States share a unique set of challenges and experiences 
that require heightened levels of awareness and risk while 
performing everyday tasks—such as jogging in neighbor-
hoods, ‘‘driving while Black’’, or playing in a park—that 
are not experienced by other populations; 
Whereas Black people in the United States are 3 times more 
likely to be killed by police than White people in the 
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United States, and police violence is the 6th leading 
cause of death for young Black men; 
Whereas the police brutality and violence experienced by 
Black people in the United States adversely impacts men-
tal health among Black communities; 
Whereas Black communities led the Nation in mourning the 
killings of Ahmaud Arbery, Breonna Taylor, George 
Floyd, Elijah McClain, and countless other Black Ameri-
cans—calling for justice and long-term changes to dis-
mantle systems of oppression; 
Whereas throughout our Nation’s history, people of color 
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 a public health issue is defined as meeting the fol-
lowing 4 criteria— 
(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 racism meets the criteria of a public health crisis, 
and public health experts agree; 
Whereas a Federal public health crisis declaration would de-
fine racism as a pervasive health issue and alerts the Na-
tion to the need to enact immediate and effective cross- 
governmental efforts to address the root causes of insti-
tutional racism and their downstream impacts; and 
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Whereas such declaration requires the response of the Gov-
ernment to engage significant resources to empower those 
communities that are impacted: Now, therefore, be it 
Resolved, That the House of Representatives— 
(1) supports the resolutions drafted, introduced, 
and adopted by cities and localities across the Na-
tion 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 inequity across 
all sectors in the United States; 
(B) dismantling systemic practices and 
policies that perpetuate racism in the United 
States; 
(C) advancing reforms to address years of 
neglectful and apathetic policies that have led 
to poor health outcomes for communities of 
color in the United States; and 
(D) promoting efforts to address the social 
determinants of health—especially for Black, 
Latino, and Native American people, and other 
people of color in the United States; and 
(4) charges the Nation with moving forward 
with urgency to ensure that the United States 
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stands firmly in honoring its moral purpose of ad-
vancing 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. 
Æ 
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