Title: A resolution declaring racism a public health crisis.
Policy area: Health

Summary:
This resolution declares racism a public health crisis and commits to efforts to address health disparities and inequities.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 875 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  2d Session
S. RES. 875

                Declaring racism a public health crisis.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 20, 2022

   Mr. Brown (for himself, Mr. Booker, Mr. Padilla, Ms. Warren, Ms. 
   Stabenow, Mr. Warnock, Mr. Menendez, Mr. Cardin, Mr. Merkley, Mr. 
Blumenthal, Mrs. Feinstein, Ms. Baldwin, Mr. Carper, Ms. Klobuchar, Mr. 
 Leahy, Mr. Sanders, Ms. Smith, Mr. Van Hollen, Mr. Wyden, Mr. Markey, 
Ms. Hirono, Ms. Duckworth, Mr. Reed, and Mr. Whitehouse) submitted the 
 following resolution; which was referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                               RESOLUTION


 
                Declaring racism a public health crisis.

Whereas a public health issue is an issue--

    (1) that affects many people, is a threat to the public, and is 
ongoing;

    (2) that is unfairly distributed among different populations, 
disproportionately impacting health outcomes, access to health care, and 
life expectancy;

    (3) the effects of which could be reduced by preventive measures; and

    (4) for which those preventive measures are not yet in place;

Whereas public health experts agree that significant racial inequities exist in 
        the prevalence, severity, and mortality rates of various health 
        conditions in the United States;
Whereas examples of such inequities include--

    (1) life expectancy rates for Black and Native American people in the 
United States being significantly lower than those of White people in the 
United States;

    (2) Black and Native American women being 2 to 4 times more likely than 
White women to suffer severe maternal morbidity or die of pregnancy-related 
complications;

    (3) Black and Native American infants being 2 to 3 times as likely to 
die as White infants, and the Black infant mortality rate in the United 
States being higher than the infant mortality rates recorded in 27 of the 
36 democratic countries with market-based economies that are members of the 
Organization for Economic Co-operation and Development; and

    (4) during the COVID-19 pandemic, Black, Hispanic/Latino, Asian 
American, Native Hawaiian, Pacific Islander, and Native American 
communities experiencing disproportionately high rates of COVID-19 
infection, hospitalization, and mortality compared to the White population 
of the United States;

Whereas inequities in health outcomes are exacerbated for people of color who 
        are LGBTQIA+ and have disabilities;
Whereas, historically, explanations for health inequities focused on false 
        genetic science (for example, eugenics) and incomplete social scientific 
        analyses that narrowly focus on individual behavior to highlight 
        ostensible deficiencies within racial and ethnic minority groups;
Whereas modern public health discourse recognizes the broader social context in 
        which health inequities emerge and acknowledges the impact of historical 
        and contemporary racism on health;
Whereas, since its founding, the United States has had a longstanding history 
        and legacy of racism, mistreatment, and discrimination that has 
        perpetuated health inequities for members of racial and ethnic minority 
        groups;
Whereas that history and legacy of racism, mistreatment, and discrimination 
        includes--

    (1) the immoral paradox of freedom and slavery, which is an atrocity 
that can be traced throughout the history of the United States, as African 
Americans lived under the oppressive institution 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;

    (2) the failure of the United States to carry out the responsibilities 
and promises made in more than 350 treaties ratified with sovereign 
indigenous communities, 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 inequities faced by Native 
American people, and the inaccessibility of many Federal public health and 
social programs in Native American communities;

    (3) the enactment of immigration laws in the United States, such as--

    G    (A) the Page Act of 1875, which effectively prohibited the entry 
of East Asian women into the United States;

    G    (B) the Chinese Exclusion Act in 1882, which ostracized thousands 
of Chinese-born laborers, who were essential in the completion of the 
transcontinental railroad and development of the West Coast; and

    G    (C) the Immigration Act of 1917, which barred all immigrants from 
the ``Asiatic zone'' and prevented the migration of individuals from South 
Asia, Southeast Asia, and East Asia, scapegoating Asians, separating 
families, and branding Asians as perpetual outsiders in the United States;

    (4) during the Great Depression Era, the deportation by the United 
States of approximately 1,800,000 individuals based on their Mexican ethnic 
identity, when approximately 60-percent of the individuals deported to 
Mexico were United States citizens, and the targeting of individuals of 
Mexican descent for ``repatriation'' due to scapegoating efforts, which 
blamed them for ``stealing'' jobs from ``real'' Americans; and

    (5) in 1967, President Lyndon B. Johnson establishing 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 division 
and continued exclusion of Black communities from the benefits of economic 
progress;

Whereas overt racism was embedded in the development of medical science and 
        medical training during the 18th, 19th, and 20th centuries, causing 
        disproportionate physical and psychological harm to members of racial 
        and ethnic minority groups, including--

    (1) the unethical practices and abuses experienced by Black patients 
and research participants, such as the Tuskegee Syphilis Study, which serve 
as foundations for the mistrust the Black community has for the medical 
system; and

    (2) the egregiously unethical and cruel treatment enslaved Black women 
were forced to endure as subjects of insidious medical experiments to 
advance modern gynecology, including those perpetuated by the so-called 
``father of gynecology'', J. Marion Sims;

Whereas structural racism cemented historical racial and ethnic inequities in 
        access to resources and opportunities, contributing to worse health 
        outcomes;
Whereas examples of that structural racism include--

    (1) that, 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 doctors' offices throughout northern and 
southern States complied with Jim Crow laws and were completely segregated 
by race, leaving Black communities with little to no access to health care 
services;

    (2) the landmark case Simkins v. Moses H. Cone Memorial Hospital (323 
F.2d 959 (4th Cir. 1963)), which challenged the use of public funds by the 
Federal Government to expand, support, and sustain segregated hospital 
care, and provided justification for title VI of the Civil Rights Act of 
1964 (42 U.S.C. 2000d et seq.) and the Medicare hospital certification 
program, establishing Medicare hospital racial integration guidelines that 
applied to every hospital that participated in the Federal program;

    (3) Pacific Islanders from the Freely Associated States experiencing 
unique health inequities resulting from United States nuclear weapons tests 
on their home islands, while they have been categorically denied access to 
Medicaid and other Federal health benefits; and

    (4) language minorities, including Chinese-, Korean-, Vietnamese-, 
Russian-, and Spanish-speaking Americans, not being assured 
nondiscriminatory access to federally funded services, including health 
services, until the signing of Executive Order 13166 (42 U.S.C. 2000d-1 
note; related to improving access to services for persons with limited 
English proficiency) in 2000;

Whereas, although overt racism has been outlawed in the United States, subtle or 
        implicit racism in all sectors of the medical service profession 
        continues to cause disproportionate physical and psychological harm to 
        members of racial and ethnic minority groups;
Whereas examples of subtle or implicit racism in the medical service profession 
        include--

    (1) the history and persistence of racist and nonscientific medical 
beliefs, which are associated with ongoing racial inequities in treatment 
and health outcomes;

    (2) implicit racial and ethnic biases within the health care system, 
which have an explicit impact on the quality of care experienced by members 
of racial and ethnic minority groups, such as the undertreatment of pain in 
Black patients;

    (3) nearly 1 in 5 Hispanic/Latino Americans avoiding medical care due 
to concern about being discriminated against or treated poorly;

    (4) the United States health care system and other economic and social 
structures remaining fraught with biases based on race, ethnicity, sex 
(including sexual orientation and gender identity), and class that lead to 
health inequities;

    (5) women of color, including Black, Native American, Hispanic/Latina, 
Asian American, Native Hawaiian, and Pacific Islander women, continuing to 
face attacks on their prenatal, maternal, and reproductive health and 
rights throughout history; and

    (6) physicians routinely, through the late 1960s and early 1980s, 
sterilizing members of racial and ethnic minority groups, specifically 
African American and Latina women, performing excessive and medically 
unnecessary procedures without their informed consent;

Whereas structural racism perpetuates racial and ethnic inequities in the social 
        determinants of health, which produces unintended negative health 
        outcomes for members of racial and ethnic minority groups;
Whereas examples of that structural racism include--

    (1) that there are fewer pharmacies, medical practices, and hospitals 
in predominantly Black and Hispanic/Latino neighborhoods, compared to White 
or more diverse neighborhoods;

    (2) environmental hazards, such as toxic waste facilities, garbage 
dumps, and other sources of airborne pollutants, being disproportionately 
located in predominantly Black, Hispanic/Latino, Asian American, Native 
Hawaiian, Pacific Islander, and low-income communities, resulting in poor 
air quality conditions, which can increase the likelihood of chronic 
respiratory illness and premature death from particle pollution;

    (3) that employed Black adults are 10-percent less likely to have 
workplace insurance than are employed White adults because of racial 
segregation in occupation sectors and types of organizations they work in, 
and that certain groups of nonelderly Asian American adults, including 
Native Hawaiian, Pacific Islander, Korean, Vietnamese, and Cambodian 
adults, also have lower levels of insurance than White adults;

    (4) that several States with higher percentages of Black, Hispanic/
Latino, and Native American populations have not expanded their Medicaid 
programs, continuing to disenfranchise minority communities from access to 
health care to this day;

    (5) discriminatory housing practices, such as redlining, which have, 
for decades, systemically excluded members of racial and ethnic minority 
groups from housing, robbing them of capital in the form of low-cost, 
stable mortgages and opportunities to build wealth, and the Federal 
Government using its financial power to segregate renters in newly built 
public housing;

    (6) social inequities such as differing access to quality health care, 
healthy food and safe drinking water, safe neighborhoods, education, job 
security, and reliable transportation, which affect health risks and 
outcomes;

    (7) that, as much as 60-percent of the health of a person in the United 
States can be determined by their ZIP Code;

    (8) that the COVID-19 pandemic has exacerbated economic, health, 
housing, and food security barriers for Black, Hispanic/Latino, and Native 
American households, which already suffer from disproportionately higher 
rates of food insecurity; and

    (9) members of the Black, Native American, Alaska Native, Asian 
American, Native Hawaiian, Pacific Islander, and Hispanic/Latino 
communities being disproportionately impacted by the criminal justice and 
immigration enforcement systems and facing a higher risk of contracting 
COVID-19 within prison populations and detention centers due to the over-
incarceration of members of those communities;

Whereas structural racism perpetuates ongoing knowledge gaps in data, research, 
        and development, which produces unintended negative health outcomes for 
        members of racial and ethnic minority groups;
Whereas examples of that structural racism include that--

    (1) most participants in clinical trials are White, so there is 
insufficient data to develop evidence-based recommendations for people from 
racial and ethnic minority groups;

    (2) medical research equipment and medical devices are typically 
developed by majority-White teams and thus can have racial blind spots 
unintentionally built into their design, rendering them less effective for 
people from racial and ethnic minority groups, such as--

    G    (A) electroencephalogram (EEG) electrodes used in neuroimaging 
research do not collect reliable data when used on scalps with thick, curly 
hair; and

    G    (B) pulse oximeters produce less accurate oxygen saturation 
readings when used on fingertips with darker skin;

    (3) a lack of images depicting darker skin in medical textbooks, 
literature, and journals contributes to higher rates of underdiagnosis or 
misdiagnosis in patients with darker skin; and

    (4) many health-related studies fail to include disaggregated data on, 
or do not disaggregate data among, Asian Americans, Native Hawaiians, and 
Pacific Islanders, leading to their invisibility in health data and unjust 
resource allocation and policies;

Whereas racism produces unjust outcomes and treatment for members of racial and 
        ethnic minority groups, with such negative experiences serving as 
        stressors that over time have a negative impact on physical health 
        (leading, for example, to high blood pressure or hypertension) and 
        mental health (leading, for example, to anxiety or depression);
Whereas there is evidence that racial and ethnic minority groups continue to 
        face discrimination in the United States, examples of which include 
        that--

    (1) compared to White Americans, Black Americans are 5 times more 
likely to report experiencing discrimination when interacting with the 
police, Hispanic/Latino Americans and Native Americans are nearly 3 times 
as likely, and Asian Americans, Native Hawaiians, and Pacific Islanders are 
nearly twice as likely;

    (2) 42-percent of United States employees have experienced or witnessed 
racism in the workplace;

    (3) social scientists have documented racial microaggressions in 
contemporary United States society, including--

    G    (A) assumptions that members of racial and ethnic minority groups 
are not true Americans;

    G    (B) assumptions of lesser intelligence;

    G    (C) statements that convey color-blindness or denial of the 
importance of race;

    G    (D) assumptions of criminality or dangerousness;

    G    (E) denial of individual racism;

    G    (F) promotion of the myth of meritocracy;

    G    (G) assumptions that one's cultural background and communication 
styles are pathological;

    G    (H) treatment as a second-class citizen; and

    G    (I) environmental messages of being unwelcome or devalued;

    (4) Muslims, South Asians, and Sikhs were unjustly targeted for 
profiling, surveillance, arrest, discrimination, harassment, assault, and 
murder after 9/11;

    (5) xenophobic rhetoric, including anti-immigrant rhetoric and 
scapegoating people of East Asian and Southeast Asian descent for the 
COVID-19 pandemic, has resulted in a surge of hate incidents against Asian 
Americans, Native Hawaiians, and Pacific Islanders, including increased 
harassment, discrimination, bullying, vandalism, and assault; and

    (6) more than 50-percent of Hispanic/Latino adults experience at least 
one form of discrimination due to their racial or ethnic heritage, such as 
being treated as if they were not smart, criticized for speaking Spanish, 
told to return to their country, called offensive names, or unfairly 
stopped by the police;

Whereas Black people in the United States experience overt and direct forms of 
        violence that, when not fatal, can cause severe physical or 
        psychological harm;
Whereas examples of such forms of violence include--

    (1) Black people being confronted and threatened by armed citizens 
while performing everyday tasks, such as jogging in neighborhoods, driving 
while Black, or playing in a park;

    (2) Black people being 3 times more likely to be killed by police than 
White people, and police violence being the sixth leading cause of death 
for young Black men;

    (3) Black communities leading the United States in mourning the 
killings of Ahmaud Arbery, Breonna Taylor, George Floyd, Elijah McClain, 
and countless other Black Americans, and in calling for justice and long-
term changes to dismantle systems of oppression;

    (4) that it took the United States 66 years after the senseless and 
brutal murder of 14-year-old Emmett Till to make lynching a Federal crime;

    (5) since 2015, mass shootings around the country, such as in Buffalo, 
New York, and Charleston, South Carolina, serving as reminders of the 
unresolved history of racism in the United States and highlighting the 
threats Black people must take into consideration when going about their 
daily lives, both when outside their communities and within those 
communities; and

    (6) the real threat of brutality and violence adversely impacting 
mental health among Black communities;

Whereas Native Americans, Alaska Natives, Hispanic/Latinos, Asian Americans, 
        Native Hawaiians, and Pacific Islanders experience racially motivated 
        kidnapping, murders, and mass violence, such as shootings in Oak Creek, 
        Wisconsin, El Paso, Texas, Atlanta, Georgia, and Indianapolis, Indiana, 
        that, even when not fatal, can cause severe physical or psychological 
        harm;
Whereas, throughout the history of the United States, members of racial and 
        ethnic minority groups 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 racial inequities in health continue to persist because of historical 
        and contemporary racism;
Whereas public health experts agree that racism meets the criteria of a public 
        health crisis, because--

    (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 the Centers for Disease Control and Prevention--

    (1) declared racism a serious threat to public health; and

    (2) acknowledged the need for additional research and investments to 
address that serious threat;

Whereas a Federal public health crisis declaration defines racism as a pervasive 
        health issue and alerts the people of the United States to the need to 
        enact immediate and effective cross-governmental efforts to address the 
        root causes of structural racism and the downstream impacts of that 
        racism; and
Whereas such a declaration requires the response of governments to engage 
        significant resources to empower the communities that are impacted: Now, 
        therefore, be it
    Resolved, That the Senate--
            (1) supports the resolutions drafted, introduced, and 
        adopted by cities and localities across the United States 
        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 inequities across all sectors in 
                society;
                    (B) dismantling systemic practices and policies 
                that perpetuate racism;
                    (C) advancing reforms to address years of 
                neglectful and apathetic policies that have led to poor 
                health outcomes for members of racial and ethnic 
                minority groups; and
                    (D) promoting efforts to address the social 
                determinants of health for all racial and ethnic 
                minority groups in the United States, and especially 
                for Black and Native American communities; and
            (4) places a charge on the people of the United States to 
        move forward with urgency to ensure that the United States 
        stands firmly in honoring its moral purpose of advancing 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.
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