I 
118TH CONGRESS 
1ST SESSION H. R. 6746 
To amend the Public Health Service Act to provide for a public awareness 
campaign with respect to iron deficiency. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 13, 2023 
Ms. CARAVEO (for herself, Ms. BUDZINSKI, Ms. SEWELL, Ms. CLARKE of New 
York, Ms. PETTERSEN, Mr. CARTER of Louisiana, Mr. GRIJALVA, Mr. 
DAVIS of North Carolina, and Mr. GARCI´A of Illinois) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend the Public Health Service Act to provide for 
a public awareness campaign with respect to iron deficiency. 
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 ‘‘Iron Deficiency Edu-
cation and Awareness Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Iron deficiency occurs when there are insuf-
ficient amounts of iron in the body. Without enough 
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iron, the body cannot produce sufficient amounts of 
hemoglobin, which is the protein that enables red 
blood cells to carry oxygen. 
(2) Menstrual bleeding and pregnancy are 
major reasons for lower levels of iron in the body. 
The symptoms of iron deficiency include fatigue, 
cold extremities, hair loss, cognitive issues, shortness 
of breath, headaches, and sleep disorders. 
(3) Iron deficiency often goes undiagnosed due 
to difficulty recognizing symptoms and lack of ur-
gency in diagnosing. When left untreated, the condi-
tion can progress to iron-deficiency anemia. This 
may increase the risk of developing organ complica-
tions, such as an abnormally fast heartbeat, or tach-
ycardia, and heart failure. 
(4) Among pregnant women, iron deficiency 
and iron-deficiency anemia has been linked to in-
creased maternal illness, premature birth and low 
birth weight among babies, and intrauterine growth 
restriction. 
(5) Approximately 35 percent of women of re-
productive age in the United States do not have a 
sufficient amount of iron in their bodies. Addition-
ally, nearly 40 percent of girls and young women 
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ages 12 to 21 are affected by iron deficiency, and 6 
percent are iron-deficient anemic. 
(6) Children under the age of two are at a high 
risk for iron deficiency. About 6 percent of children 
ages 1–2 have iron deficiency. 
(7) Eliminating barriers to awareness, edu-
cation, and screening will assist in preventing and 
treating iron deficiency, iron deficiency anemia, and 
related health issues among women and children 
under the age of two. 
SEC. 3. IRON DEFICIENCY AWARENESS CAMPAIGN. 
(a) IN GENERAL.—Section 317 of the Public Health 
Service Act (42 U.S.C. 247b) is amended by adding at 
the end the following: 
‘‘(o) IRON DEFICIENCY PUBLIC AWARENESS CAM-
PAIGN.— 
‘‘(1) IN GENERAL.—The Secretary shall carry 
out a national campaign to— 
‘‘(A) increase awareness of the importance 
of iron deficiency screening; 
‘‘(B) combat misconceptions about iron de-
ficiency, including misconceptions in diagnosis 
and management of iron deficiency; 
‘‘(C) increase awareness about missed di-
agnoses due to inadequate screening tests; and 
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‘‘(D) increase iron deficiency screening 
among women and children under the age of 
two. 
‘‘(2) CONSULTATION.—In carrying out the na-
tional campaign required by paragraph (1), the Sec-
retary shall consult with the National Academy of 
Medicine, health care providers, public health asso-
ciations, nonprofit organizations, State and local 
public health departments, and institutions of higher 
education to solicit advice on evidence-based infor-
mation for policy development and program develop-
ment, implementation, and evaluation. 
‘‘(3) REQUIREMENTS.—The national campaign 
required by paragraph (1) shall— 
‘‘(A) include the use of evidence-based 
media and public engagement; 
‘‘(B) be carried out through competitive 
grants or cooperative agreements awarded to 1 
or more private, nonprofit entities with a his-
tory developing and implementing similar cam-
paigns; 
‘‘(C) include the development of culturally 
and linguistically competent resources that shall 
be tailored for— 
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‘‘(i) women who are pregnant, re-
cently gave birth, or are breastfeeding; 
‘‘(ii) women who menstruate, espe-
cially if menstrual periods are heavy; 
‘‘(iii) women who have undergone 
major surgery or physical trauma; 
‘‘(iv) women with limited English pro-
ficiency; 
‘‘(v) women with gastrointestinal dis-
eases, such as Celiac disease and inflam-
matory bowel diseases such as ulcerative 
colitis and Crohn’s disease; 
‘‘(vi) women with peptic ulcer disease; 
‘‘(vii) populations with a high preva-
lence of iron deficiency (such as Black and 
Hispanic women); 
‘‘(viii) parents with children under the 
age of two; 
‘‘(ix) rural communities; and 
‘‘(x) such other communities as the 
Secretary determines appropriate; 
‘‘(D) include the dissemination of iron defi-
ciency information and communication re-
sources to health care providers and health care 
facilities (including pediatricians, primary care 
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providers, community health centers, dentists, 
obstetricians, and gynecologists), State and 
local public health departments, elementary and 
secondary schools, child care centers, and col-
leges and universities; 
‘‘(E) be complementary to, and coordi-
nated with, any other Federal efforts with re-
spect to iron deficiency awareness; 
‘‘(F) include message testing to identify 
culturally competent and effective messages for 
behavioral change; and 
‘‘(G) include the award of grants or coop-
erative agreements to State, local, and Tribal 
public health departments to engage with— 
‘‘(i) communities specified in subpara-
graph (C); 
‘‘(ii) local educational agencies; 
‘‘(iii) health care providers; 
‘‘(iv) community organizations; or 
‘‘(v) other groups the Secretary deter-
mines are appropriate to develop and de-
liver effective strategies to decrease iron 
deficiency rates. 
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‘‘(4) OPTIONS FOR DISSEMINATION OF INFOR-
MATION.—The national campaign required by para-
graph (1) may— 
‘‘(A) include the use of— 
‘‘(i) social media, television, radio, 
print, the internet, and other media; 
‘‘(ii) in-person or virtual public com-
munications; and 
‘‘(iii) recognized, trusted figures; 
‘‘(B) be targeted to specific communities 
specified in paragraph (3)(C); and 
‘‘(C) include the dissemination of informa-
tion highlighting— 
‘‘(i) appropriate screening for iron de-
ficiency, including the recommended popu-
lations to be screened by age range or 
other criteria; 
‘‘(ii) the prevalence of iron deficiency; 
‘‘(iii) symptoms of iron deficiency; and 
‘‘(iv) mechanisms of preventing and 
managing iron deficiency. 
‘‘(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $7,000,000 for each of fiscal years 
2024 through 2028.’’. 
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(b) REPORT TO CONGRESS.— 
(1) IN GENERAL.—Not later than the end of 
fiscal year 2027, the Secretary of Health and 
Human Services shall submit to the Committee on 
Energy and Commerce of the House of Representa-
tives and the Committee on Health, Education, 
Labor, and Pensions of the Senate a report on the 
campaign under section 317(o) of the Public Health 
Service Act, as added by subsection (a). 
(2) QUALITATIVE
ASSESSMENT.—The report 
under paragraph (1) shall include a qualitative as-
sessment of— 
(A) the overall campaign under section 
317(o) of the Public Health Service Act, as 
added by subsection (a); and 
(B) the impacts of the activities conducted 
through the campaign, including such impacts 
on iron deficiency, and iron deficiency anemia, 
among women and children under the age of 
two. 
Æ 
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