treated, pre-diabetes dramatically increases the risk 
for developing type 2 diabetes and increases the risk 
of heart disease by nearly 50 percent. As with diabe-
tes, this condition also disproportionately affects mi-
nority populations. 
(5) Physical inactivity and obesity are the main 
contributing risk factors to the rising numbers of di-
abetes cases within these racial and ethnic minority 
populations. 
(6) Critical facets of daily living that can con-
tribute to diabetes risk can be modified including 
poor diet, lack of recess and physical education for 
children, specific eating habits for families and 
adults that may be culturally indicative to the mi-
nority group, and psychological factors that may 
interfere with proper meal planning and dietary edu-
cation. 
(7) For certain socioeconomic groups, unhealthy 
food is the only nutritional source available within 
the community, such as fast food in poor areas. Ad-
ditionally, there are limited options for physical ac-
tivity within certain neighborhoods, communities, or 
geographical areas. 
(8) Type 2 diabetes is also being increasingly 
diagnosed in adolescents in high numbers within
these populations. This is partly due to nonnutri-
tional diets and a lack of physical activity. 
(9) The most effective prevention and control 
strategies include: increased physical activity, im-
proved nutrition, quality diabetes care, and improved 
self-management practice. 
(10) Multiple acute and chronic complications 
result from poor diabetes diagnosis, care, and man-
agement. There is a need for prevention strategies 
and measures in order to educate individuals about 
diabetes and its complications, and to decrease cur-
rent numbers within these populations. 
(11) Recent discoveries regarding disparities in 
health care among these populations have identified 
a need for culturally sensitive modes of treatment 
that are conducive to the lifestyle of the patient: Pa-
tients and consumers should be guaranteed effective, 
understandable, and respectful care that is provided 
in a manner that properly addresses their cultural 
health beliefs, practices, and preferred language. 
(12) Effective communication, cultural conflict 
resolution, and cultural differences on health pro-
motion and disease prevention should be addressed.
TITLE I—RESEARCH 
SEC. 101. RESEARCH. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by inserting after 
section 399N the following section:
‘‘SEC. 399O. DIABETES; MINORITY HEALTH AND HEALTH 
DISPARITIES RESEARCH. 
‘‘(a) NATIONAL INSTITUTES OF HEALTH.—
‘‘(1) IN GENERAL.—The Director of the Na-
tional Institutes of Health shall expand, intensify, 
conduct, coordinate, and support research and other 
activities with respect to pre-diabetes and diabetes, 
particularly type 2, in minority populations, includ-
ing research to identify clinical, socioeconomic, geo-
graphical, cultural, and organizational factors that 
contribute to type 2 diabetes in such populations. 
‘‘(2) CERTAIN
ACTIVITIES.—Activities under 
paragraph (1) regarding type 2 diabetes in minority 
populations shall include the following: 
‘‘(A) Research on behavior and obesity, in-
cluding research through the obesity research 
center that is sponsored by the National Insti-
tutes of Health. 
‘‘(B) Research on the causes and effects of 
health care access disparities and racial dis-
crimination, including research to identify the 
following: 
‘‘(i) Linguistic difficulties and lan-
guage barriers of diabetes diagnosis, treat-
ment, and care within these populations. 
‘‘(ii) Environmental barriers in access-
ing transportation to health centers and 
health care providers. 
‘‘(iii) Financial difficulties of health 
care financing and delivery to receive treat-
ment. 
‘‘(iv) Diabetes care and treatment dis-
crimination against individuals with diabe-
tes in prisons, the workplace, and schools. 
‘‘(v) The manner in which racial 
stereotypes evolve, persist, shape expecta-
tions, and affect interpersonal interactions 
with diabetes diagnosis, treatment, and 
education. 
‘‘(vi) The manner in which patient 
and provider relationships can be strength-
ened by greater diversity in the health pro-
fessions for diabetes care. 
‘‘(C) Research on environmental factors 
that may contribute to the increase in type 2
diabetes, which shall be conducted or supported 
through the National Institute of Environ-
mental Health Sciences and the National 
Human Genome Research Institute. 
‘‘(D) Support for new methods to identify 
environmental triggers and genetic interactions 
that lead to the development of type 1 and type 
2 diabetes in minority newborns with a high ge-
netic susceptibility to the disease. Such research 
should follow the newborns through puberty, 
which is a high-risk period for developing type 
1 diabetes, and—increasingly—type 2 diabetes. 
‘‘(E) Research to identify genes that pre-
dispose individuals to the onset of developing 
type 1 and type 2 diabetes and to develop com-
plications with the goal of developing improved 
prevention and treatment strategies. 
‘‘(F) Research to prevent complications in 
individuals who have already developed diabe-
tes, such as attempting to identify the genes 
that predispose individuals with diabetes to the 
development of complications, as well as meth-
ods and alternative therapies to control blood 
glucose.
‘‘(G) The support of ongoing research ef-
forts examining the level of glycemia at which 
adverse outcomes develop during pregnancy and 
to address the many clinical issues associated 
with minority mothers and fetuses during dia-
betic and gestational diabetic pregnancies. 
‘‘(b) CENTERS FOR DISEASE CONTROL AND PREVEN-
TION.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall conduct and support 
research and other activities with respect to diabetes 
in minority populations. 
‘‘(2) CERTAIN
ACTIVITIES.—Activities under 
paragraph (1) regarding diabetes in minority popu-
lations shall include the following: 
‘‘(A) Expanding the National Diabetes 
Laboratory for translational research, and the 
identification of genetic and immunological risk 
factors associated with diabetes. 
‘‘(B) Enhancing the National Health and 
Nutrition Examination Survey on eating and di-
etary habits, with a focus, including cultural 
and socioeconomic factors, on Hispanic Amer-
ican, African-American, American Indian and
Alaskan Native, and Asian American and Pa-
cific Islander communities. 
‘‘(C) Establishing and implementing model 
demonstration projects to design, implement,
and evaluate effective diabetes prevention and 
control interventions. 
‘‘(D) Increased funding for the Translating 
Research Into Action for Diabetes study to con-
duct interventions for improving the quality of 
diabetes care received by these populations in 
managed care settings. 
‘‘(E) Prevention research within the Divi-
sion of Diabetes Translation to better under-
stand how to influence healthcare systems 
changes to improve quality of care being deliv-
ered to such populations. 
‘‘(F) Within the Division of Diabetes 
Translation, carrying out model demonstration 
projects to design, implement, and evaluate ef-
fective diabetes prevention and control interven-
tion for these populations. 
‘‘(G) Carrying out culturally appropriate 
community-based interventions within the Divi-
sion of Diabetes Translation designed to ad-
dress issues and problems experienced by these 
populations. 
‘‘(H) Conducting applied research within 
the Division of Diabetes Translation on health 
systems, community, and communication inter-
ventions to reduce those barriers of discrimina-
tion, and reduce health disparities within these 
populations with diabetes. 
‘‘(I) Conducting applied research on pri-
mary prevention within the Division of Diabetes 
Translation to reduce those barriers within var-
ious arenas of discrimination, and reduce diabe-
tes-related health disparities within these popu-
lations with diabetes. 
‘‘(c) ADDITIONAL PROGRAMS.—
‘‘(1) IN
GENERAL.—In addition to activities 
under subsections (a) and (b), the Secretary shall 
conduct and support research and other activities 
with respect to diabetes within minority populations. 
‘‘(2) CERTAIN
ACTIVITIES.—Activities under 
paragraph (1) regarding diabetes in minority popu-
lations shall include the following: 
‘‘(A) Through the National Institutes of 
Health and the Centers for Disease Control and 
Prevention, identifying culturally sensitive ap-
proaches to research, including the clinical, cul-
tural, socioeconomic, and organizational factors 
that contribute to high levels of diabetes within 
such populations.
‘‘(B) Expanding the National Diabetes 
Education Program. 
‘‘(C) Through the National Center on Mi-
nority Health and Health Disparities, the Office 
of Minority Health under section 1707, the 
Health Resources and Service Administration, 
the Centers for Disease Control and Prevention, 
and the Indian Health Service, establishing 
partnerships within minority populations to 
conduct studies on cultural, familial, and social 
factors that may influence health promotion, di-
abetes management, and prevention. 
‘‘(D) Through the Indian Health Service, 
in collaboration with other appropriate Federal 
agencies, conducting research on ethnic and cul-
turally appropriate diabetes treatment, care, 
prevention, and services by health care profes-
sionals to the American Indian population. 
‘‘(d) DEFINITION.—For purposes of this section, the 
term ‘minority populations’ means racial and ethnic mi-
nority groups within the meaning of section 1707.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) NATIONAL INSTITUTES OF HEALTH.—For 
the purpose of carrying out subsection (a), there are 
authorized to be appropriated such sums as may be 
necessary for fiscal year 2004 and each subsequent 
fiscal year. 
‘‘(2) CENTERS
FOR
DISEASE
CONTROL
AND 
PREVENTION.—For the purpose of carrying out sub-
section (b), there are authorized to be appropriated 
such sums as may be necessary for fiscal year 2004 
and each subsequent fiscal year. 
‘‘(3) ADDITIONAL PROGRAMS.—For the purpose 
of carrying out subsection (c), there are authorized 
to be appropriated such sums as may be necessary 
for fiscal year 2004 and each subsequent fiscal 
year.’’. 
SEC. 102. DIABETES MELLITUS INTERAGENCY COORDI-
NATING COMMITTEE. 
Section 429 of the Public Health Service Act (42 
U.S.C. 285c–3) is amended by adding at the end the fol-
lowing subsection: 
‘‘(d)(1) In addition to other duties established in this 
section for the Diabetes Mellitus Interagency Coordinating 
Committee, such Committee shall—
‘‘(A) assess the current activities of all current 
Federal health programs to determine their ade-
quacy as a systemic method of addressing the im-
pact of diabetes mellitus on minority populations; 
‘‘(B) undertake strategic planning activities to 
develop an effective and comprehensive Federal plan 
to address diabetes mellitus within communities of 
color which will involve all appropriate Federal 
health programs; and 
‘‘(C) conduct the implementation of such a plan 
throughout all Federal health programs. 
‘‘(2) The Federal plan under paragraph (1)(B) 
shall—
‘‘(A) include steps to address issues including, 
but not limited to, type 1 and type 2 diabetes in 
children and the disproportionate impact of diabetes 
mellitus on minority populations; and 
‘‘(B) remain consistent with the programs and 
activities identified in sections 399O through 399R, 
as well as remaining consistent with the intent of 
the Diabetes Prevention Access and Care Act. 
‘‘(3) For purposes of this subsection, the term ‘mi-
nority populations’ means racial and ethnic minority 
groups within the meaning of section 1707.