I 
116TH CONGRESS 
2D SESSION 
H. R. 6638 
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 
APRIL 28, 2020 
Mrs. HAYES 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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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 immuno-
compromised—sometimes because of cancer or HIV/ 
AIDS, people with diabetes, people with liver dis-
ease, people with severe obesity, and people with 
chronic kidney disease undergoing dialysis. 
(3) 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 suffer higher mor-
tality rates from COVID–19. Socioeconomic factors 
further contribute to racial disparities seen in both 
prevalence of chronic conditions and exposure to 
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COVID–19. Individuals in low-income communities 
and people of color are more likely to have many of 
the chronic health conditions that have been identi-
fied as risk factors for complications from COVID– 
19, yet suffer decreased access to care, compounded 
by a decreased likelihood of undergoing appropriate 
treatment. 
(4) According to the American Diabetes Asso-
ciation, 12.1 percent of Hispanic Americans, 12.7 
percent of African Americans, 8 percent of Asian 
Americans, and 15.1 percent of American Indians/ 
Alaska Natives have been diagnosed with diabetes, 
compared to just 7.4 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. 
(5) 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. 
(6) 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. The prevalence of 
childhood asthma for African Americans is 12.7 per-
cent compared to 8 percent for White Americans, 
while mortality rates in children and adults are 
eightfold and threefold higher, respectively, for Afri-
can Americans compared to White Americans. 
(7) President Trump has consistently proposed 
budgets that would cut the Chronic Disease Preven-
tion and Health Promotion Fund. In fiscal year 
2021, the President proposed to consolidate the 
CDC’s primary chronic disease prevention activities, 
including tobacco, diabetes, heart disease, and 
stroke, and nutrition and physical activity, into a 
single block grant to States, while proposing a 
$427,000,000 cut to the account. In fiscal year 
2020, the President proposed a $236,500,000 cut to 
the account. In fiscal year 2019, the President pro-
posed a $138,300,000 cut to the account. In fiscal 
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year 2018, the President proposed a $222,300,000 
cut to the account. 
(8) Cuts to this Fund and other public health 
prevention efforts undermine efforts to create an af-
fordable and accessible health care system, and a 
better quality of life for Americans of all ethnic, ra-
cial, and socioeconomic backgrounds. Cuts to this 
Fund would also exacerbate existing disparities and 
underlying health conditions that have created seem-
ingly vast disparities in hospitalization and mortality 
rates due to COVID–19. 
(9) 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-
able care is also proven to mitigate the development 
of associated chronic diseases and mortality rates. 
(10) 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 
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that can put persons of color at greater risk of hos-
pitalization or death from COVID–19. 
(11) 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 
communication of science that addresses health dis-
parities. The National Institute on Minority Health 
and Health Disparities leads scientific research that 
advances understanding of minority health and 
health disparities. 
(12) Increasing funding for these and other 
critical health programs will enable the United 
States and State departments of public health to 
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better combat disparities that have emerged during 
the COVID–19 crisis and beyond. 
SEC. 3. REDUCING COVID–19 DISPARITIES BY INVESTING IN 
PUBLIC HEALTH. 
(a) CHRONIC DISEASE PREVENTION AND HEALTH 
PROMOTION.—There is authorized to be appropriated, and 
there is hereby appropriated, out of any money in the 
Treasury not otherwise appropriated, for ‘‘Centers for 
Disease Control and Prevention—Chronic Disease Preven-
tion and Health Promotion’’, for fiscal year 2020 and each 
subsequent fiscal year, $2,400,000,000. 
(b) NATIONAL INSTITUTE ON MINORITY HEALTH 
AND HEALTH DISPARITIES.—There is authorized to be 
appropriated, and there is hereby appropriated, out of any 
money in the Treasury not otherwise appropriated, to the 
National Institute on Minority Health and Health Dis-
parities, for fiscal year 2020 and each subsequent fiscal 
year, $672,000,000. 
(c) OFFICE OF MINORITY HEALTH.—There is au-
thorized to be appropriated, and there is hereby appro-
priated, out of any money in the Treasury not otherwise 
appropriated, to the Office of Minority Health in the Of-
fice of the Secretary of Health and Human Services (es-
tablished by section 1707 of the Public Health Service Act 
(42 U.S.C. 300u–6)), for fiscal year 2021 and each subse-
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