I 
117TH CONGRESS 
1ST SESSION H. R. 3904 
To increase the annual funding for the Chronic Disease Prevention and 
Health Promotion Fund, the National Institute on Minority Health and 
Health Disparities, and the Offices of Minority Health within the Office 
of the Secretary of Health and Human Services, the Agency for 
Healthcare Research and Quality, the Centers for Disease Control and 
Prevention, the Centers for Medicare & Medicaid Services, the Food 
and Drug Administration, the Health Resources and Services Administra-
tion, and the Substance Abuse and Mental Health Services Administra-
tion to enable the United States and State departments of public health 
to better combat disparities that have emerged during the COVID– 
19 crisis and beyond, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 15, 2021 
Mrs. HAYES (for herself and Mr. THOMPSON of Mississippi) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To increase the annual funding for the Chronic Disease 
Prevention and Health Promotion Fund, the National 
Institute on Minority Health and Health Disparities, and 
the Offices of Minority Health within the Office of the 
Secretary of Health and Human Services, the Agency 
for Healthcare Research and Quality, the Centers for 
Disease Control and Prevention, the Centers for Medi-
care & Medicaid Services, the Food and Drug Adminis-
tration, the Health Resources and Services Administra-
tion, and the Substance Abuse and Mental Health Serv-
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ices Administration to enable the United States and 
State departments of public health to better combat dis-
parities that have emerged during the COVID–19 crisis 
and beyond, and for other purposes. 
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 ‘‘Reducing COVID–19 
Disparities by Investing in Public Health Act’’. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) Funding under this Act is essential to core 
efforts at the Department of Health and Human 
Services and in local and State health departments 
to prevent and control the spread of chronic disease 
and conditions. The National Center for Chronic 
Disease Prevention and Health Promotion works to 
raise awareness of health disparities faced by minor-
ity populations of the United States such as Amer-
ican Indians, Alaska Natives, Asian Americans, Afri-
can Americans, Latino Americans, and Native Ha-
waiians or other Pacific Islanders. One of the pri-
mary functions of the Center is to reduce risk fac-
tors for groups affected by health disparities. 
(2) Six in ten Americans live with at least one 
chronic disease, like heart disease and stroke, can-
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cer, or diabetes. These and other chronic diseases 
are the leading causes of death and disability in 
America. Specifically, chronic diseases are respon-
sible for 7 in 10 deaths each year. According to the 
Centers 
for 
Disease 
Control 
and 
Prevention 
(‘‘CDC’’), individuals who are at high risk for severe 
illness from COVID–19 are people with chronic lung 
disease or moderate to severe asthma, people with 
serious 
heart 
conditions, 
people 
who 
are 
immunocompromised—sometimes because of cancer 
or HIV/AIDS, people with diabetes, people with liver 
disease, people with severe obesity, and people with 
chronic kidney disease undergoing dialysis. 
(3) According to the CDC, adults suffering 
from cancer, chronic kidney disease, chronic lung 
diseases, including chronic obstructive pulmonary 
disease (COPD), asthma, interstitial lung disease, 
cystic fibrosis, and pulmonary hypertension, demen-
tia or other neurological conditions, diabetes, Down 
syndrome, heart conditions, including heart failure, 
coronary artery disease, cardiomyopathies or hyper-
tension, HIV infection, liver disease, sickle cell dis-
ease, stroke, or cerebrovascular disease are more 
likely to get severely ill from COVID–19 and face in-
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creased rates of hospitalization, intensive care, as-
sisted ventilation, or even death. 
(4) According to hospital data from the first 
month of the COVID–19 epidemic in the United 
States released by the CDC, roughly 1 in 3 people 
who required hospitalizations from COVID–19 were 
African American. While 33 percent of total hos-
pitalized patients are Black, African Americans con-
stitute just 13 percent of the entire American popu-
lation. Early data released by States and municipali-
ties show that African Americans suffered higher 
mortality rates from COVID–19. 
(5) Racial and ethnic disparities in COVID–19 
hospitalization were driven by both a higher risk of 
exposure to the disease, often from essential front-
line work performed at disproportionate rates by 
Black and Latino workers, and social determinants 
of health. Social inequities and environmental injus-
tices, such as differing access to healthy food, clean 
air, safe drinking water, safe neighborhoods, edu-
cation, job security, and reliable transportation, af-
fect health risks and outcomes, reinforcing dispari-
ties in health and access to care. 
(6) Socioeconomic factors further contribute to 
racial disparities seen in both prevalence of chronic 
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conditions and exposure to COVID–19. Individuals 
in low-income communities and people of color are 
more likely to have many of the chronic health con-
ditions that have been identified as risk factors for 
complications from COVID–19, yet suffer decreased 
access to care, compounded by a decreased likelihood 
of undergoing appropriate treatment. 
(7) According to the American Diabetes Asso-
ciation, 12.5 percent of Hispanic Americans, 11.7 
percent of African Americans, 9.2 percent of Asian 
Americans, and 14.7 percent of American Indians/ 
Alaska Natives have been diagnosed with diabetes, 
compared to just 7.5 percent of White Americans. 
The CDC calculated that compared to non-Hispanic 
Whites, Hispanics are 40 percent more likely to die 
from diabetes, African Americans are twice as likely 
to die from diabetes, and American Indians/Alaska 
Natives are almost twice as likely to die from the 
disease. 
(8) According to the National Institutes of 
Health, African Americans are more than 30 percent 
more likely to die from heart disease, are twice as 
likely to have a stroke—which tends to be more se-
vere with a higher morbidity and results in higher 
mortality, are 40 percent more likely to have high 
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blood pressure, and have a higher rate of hyper-
tension and heart failure than their White counter-
parts. 
(9) Minority groups suffer from asthma at a 
disproportionate rate, have the highest number of 
emergency room visits and hospital stays due to 
asthma, and have higher mortality rates from asth-
ma than their White counterparts. African Ameri-
cans, American Indians, and Alaska Natives are 42 
percent more likely than their White counterparts to 
have asthma. The prevalence of childhood asthma 
for African Americans is 11.7 percent higher than 
for White Americans, while mortality rates in chil-
dren and adults are eightfold and threefold higher, 
respectively, for African Americans compared to 
White Americans. 
(10) Vaccinations are key to disease prevention 
and overall health outcomes, especially in the case of 
COVID–19. However, a longstanding history and 
legacy of systemic racism, discrimination, and mis-
treatment has contributed to a larger distrust of the 
health care system and medical establishment within 
communities of color, which can further engender 
disparities and perpetuate rates of chronic disease. 
According to data from the CDC, despite higher 
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COVID–19 mortality, hospitalization, and infection 
rates amongst African Americans, the rate of 
COVID–19 vaccination amongst Black Americans 
still lags behind those of White individuals in almost 
every State. This necessitates increased funding for 
education, increased access to care, and targeted ef-
forts to reach communities of color and address ra-
cial inequities. 
(11) Cuts to, or even level funding for, the 
Chronic Disease Prevention and Health Promotion 
Fund and other public health prevention efforts un-
dermine efforts to create an affordable and acces-
sible health care system, and a better quality of life 
for Americans of all ethnic, racial, and socio-
economic backgrounds. Cuts to this Fund would also 
exacerbate existing disparities and underlying health 
conditions that have created seemingly vast dispari-
ties in hospitalization and mortality rates due to 
COVID–19. 
(12) Prevention efforts have proven to be effec-
tive. Funding increases for community-based public 
health programs reduce preventable disease caused 
by diabetes, cancer, and cardiovascular disease. Im-
proved access to intervention, treatment, and afford-
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able care is also proven to mitigate the development 
of associated chronic diseases and mortality rates. 
(13) Increasing the Chronic Disease Prevention 
and 
Health 
Promotion 
Fund 
funding 
to 
$2,400,000,000 annually will allow the Fund to in-
vest in more innovative, evidence-based public health 
programs, maintain and expand investments in pro-
grams with demonstrated success, and help reduce 
racial health disparities and rates of chronic disease 
that can put persons of color at greater risk of hos-
pitalization or death from COVID–19. 
(14) Further, the Office of Minority Health in 
the Office of the Secretary of Health and Human 
Services (established by section 1707 of the Public 
Health Service Act (42 U.S.C. 300u–6)) was de-
signed for the purpose of ‘‘improving minority health 
and the quality of health care minorities receive, and 
eliminating racial and ethnic disparities’’. The Office 
of Minority Health and Health Equity at the CDC 
serves to decrease health disparities, address social 
determinants of health, and promote access to high- 
quality preventative health care. The Office of Mi-
nority Health and Health Equity at the Food and 
Drug Administration promotes and protects the 
health of diverse populations through research and 
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Services Administration (as established pursuant to sec-
tion 1707A of the Public Health Service Act (42 U.S.C. 
300u–6a)), for fiscal year 2021 and each subsequent fiscal 
year, the amount that is twice the amount of funds made 
available to the respective Office of Minority Health for 
fiscal year 2021. 
Æ 
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