[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 185 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. RES. 185
Declaring racism a public health crisis.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 28, 2023
Mrs. Hayes (for herself and Mr. Cardenas) submitted the following
resolution; which was referred to the Committee on Energy and Commerce,
and in addition to the Committee on the Judiciary, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
RESOLUTION
Declaring racism a public health crisis.
Whereas since the Nation's founding, the United States has had a longstanding
history and legacy of racism, mistreatment, and discrimination against
African Americans, Latinos, Native Americans, and other people of color;
Whereas the United States ratified over 350 treaties with sovereign indigenous
communities, has broken the promises made in such treaties, and has
historically failed to carry out its trust responsibilities to Native
Americans, 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 disparities faced by
Native American people, and the inaccessibility of many Federal public
health and social programs in Native American communities;
Whereas people of Mexican and Puerto Rican descent, who became Americans through
conquest, were subject to, but never full members of the polity of the
United States and experienced widespread discrimination in employment,
housing, education, and health care;
Whereas the immoral paradox of slavery and freedom is an indelible wrong traced
throughout the Nation's history, 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;
Whereas 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;
Whereas between 1956 and 1967, the National Association for the Advancement of
Colored People (NAACP) Legal Defense and Educational Fund litigated a
series of court cases to eliminate discrimination in hospitals and
professional associations;
Whereas the landmark case Simkins v. Moses H. Cone Memorial Hospital, 323 F.2d
959 (1963), challenged the Federal Government's use of public funds to
expand, support, and sustain segregated hospital care, and provided
justification for title VI of the 1964 Civil Rights Act and the Medicare
hospital certification program--establishing Medicare hospital racial
integration guidelines that applied to every hospital that participated
in the Federal program;
Whereas, in 1967, President Lyndon B. Johnson established 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 language minorities, including Latinos, Asian Americans, and Pacific
Islanders, were not assured nondiscriminatory access to federally funded
services, including health services, until the signing of Executive
Order 13166 in 2000;
Whereas the Patient Protection and Affordable Care Act (Public Law 111-148)
included provisions to expand the Medicaid program and--for the first
time in the United States--established a Federal prohibition against
discrimination on the basis of race, color, national origin, sex, age,
or disability in certain health programs, building on other Federal
civil rights laws;
Whereas the Patient Protection and Affordable Care Act required reporting to
Congress on health disparities based on race, color, national origin,
sex, age, or disability;
Whereas several Federal programs have been established to address some, but not
all, of the health outcomes that are disproportionately experienced by
communities of color, including sickle cell disease, tuberculosis,
infant mortality, and HIV/AIDS;
Whereas the National Center for Chronic Disease Prevention and Health Promotion
works to raise awareness of health disparities faced by minority
populations in the United States, such as Native Americans, Asian
Americans, Black Americans, and Latino Americans, aiming to reduce risk
factors for groups affected by such health disparities;
Whereas the United States health care system and other economic and social
structures remain fraught with racism and racial, ethnic, sex (including
sexual orientation and gender identity), and class biases that lead to
health inequity and health disparities;
Whereas life expectancy rates for Black and Native American people in the United
States are significantly lower than those of White people in the United
States;
Whereas disparities in health outcomes are exacerbated for LGBTQIA+ people of
color;
Whereas disparities in health outcomes are worsened for people of color with
disabilities due to bias and inequitable access to health care;
Whereas several States with higher percentages of Black, Latino, and Native
American populations have not expanded their Medicaid programs pursuant
to subclause (VIII) of section 1902(a)(10)(A)(i) of the Social Security
Act (42 U.S.C. 1396a(a)(10)(A)(i))--continuing to disenfranchise
minority communities from access to health care;
Whereas 16 States have failed to take advantage of the Federal option to expand
access to the Medicaid program under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) and the Children's Health Insurance Program
under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) to
lawfully residing immigrant children within the first 5 years of lawful
status, and 26 States have failed to do so for similarly situated
pregnant women;
Whereas between 2016 and 2018, the child uninsured rate increased from 4.7
percent to 5.2 percent and the Latino child uninsured rate increased
from 7.7 percent to 8.1 percent, and children of color are far more
likely to be uninsured than White children;
Whereas a climate of fear and confusion for immigrant families due to the public
charge rule discourages such families from enrolling eligible children
in the Medicaid program and the Children's Health Insurance Program;
Whereas Pacific Islanders from the Freely Associated States experience unique
health disparities resulting from United States nuclear weapons tests on
their home islands, but such people have been categorically denied
access to Medicaid and other Federal health benefits;
Whereas the United States has historically facilitated outsider status toward
Asian Americans and Pacific Islanders, such as the authorization of the
internment of Japanese Americans during World War II, which resulted in
profound economic, social, and psychological burdens for the people
impacted;
Whereas the history and persistence of racist and nonscientific medical beliefs
are associated with ongoing racial disparities in treatment and health
outcomes;
Whereas implicit racial and ethnic biases within the health care system have an
impact on the quality of care experienced by communities of color, such
as the undertreatment of pain in Black patients;
Whereas the historical context of unethical practices and abuses experienced by
Black patients and research participants, such as the Tuskegee Syphilis
Study, serve as symbols of the Black community's mistrust of the medical
system;
Whereas women of color continue to face attacks, documented throughout history,
on their prenatal, maternal, and reproductive health and rights;
Whereas enslaved Black women were forced to endure egregiously unethical and
cruel treatment, as subjects of insidious medical experiments, to
advance modern gynecology;
Whereas through the late 1960s and early 1980s, physicians routinely sterilized
people of color, performing excessive and medically unnecessary
procedures on patients of color without their informed consent;
Whereas Black and Native American women are 2 to 4 times more likely than White
women to suffer severe maternal morbidity or die of pregnancy-related
complications, and implicit racial biases and lower quality care are
contributing factors to the health care disparities that lead to these
outcomes;
Whereas Black and Native American infants are twice as likely to die as White
infants, and the Black infant mortality rate in the United States is
higher than in 97 countries worldwide;
Whereas researchers have developed the analytical framework of ``weathering'' to
describe how the constant stress of racism leads to poor health outcomes
for Black Americans;
Whereas the daily experience of racism is associated with stress, depression,
and anxiety, and may cause physiological reactivity or contribute to
chronic health conditions;
Whereas racism is linked to mental health challenges for children and
adolescents;
Whereas children of color are overrepresented in the United States child welfare
system, and up to 80 percent of children in foster care enter State
custody with significant mental health challenges;
Whereas disparities in educational access and attainment, along with racism
experienced in the educational setting, affect the trajectory of
academic achievement for children and adolescents, and ultimately impact
health and racial inequities in school discipline, which has long-term
consequences for children;
Whereas racism and segregation in the United States contribute to poor health
outcomes by segregating Black, Latino, and Native-American communities
from opportunity;
Whereas, for decades, discriminatory housing practices, such as redlining,
systemically excluded people of color from housing, robbing them of
capital in the form of low-cost, stable mortgages and opportunities to
build wealth, and the Federal Government used its financial power to
segregate renters in newly built public housing;
Whereas environmental injustices, such as proximity and exposure to toxic waste
or hazardous air pollutants, continue to harm the health of communities
of color, low-income communities, and indigenous communities around the
Nation;
Whereas social inequities such as differing access to quality health care,
healthy food and safe drinking water, safe neighborhoods, education, job
security, and reliable transportation affect health risks and outcomes;
Whereas during the COVID-19 pandemic, the effects of racism and discrimination
are seen in COVID-19 infection, hospitalization, and mortality rates--
disproportionately high among Black, Latino, and Native-American
populations compared to the overall population--exacerbating health
disparities and highlighting barriers to care for Black, Latino, and
Native American patients across the United States;
Whereas because of racial and ethnic disparities, people of color are more
likely to have preexisting, preventable, and chronic conditions, which
lead to higher COVID-19 morbidity and mortality rates;
Whereas people of color are overrepresented in the number of people in the
United States living under poor air quality conditions, which can
increase the likelihood of COVID- 19 morbidity and mortality;
Whereas the COVID-19 pandemic has worsened barriers for Black, Latino, and
Native-American households that suffer from disproportionately higher
rates of food insecurity;
Whereas Black and Latino workers make up a disproportionate number of frontline
workers, are less likely to receive paid sick leave or have the ability
to work from home, and have been excluded from many forms of relief
readily available to other groups;
Whereas people of color are disproportionately impacted by the criminal justice
and immigration enforcement systems and face a higher risk of
contracting COVID-19 within prison populations and detention centers due
to the over-incarceration of people of color;
Whereas during the COVID-19 pandemic, an increased use of anti-Asian rhetoric
has resulted in Asian Americans being harassed, assaulted, and
scapegoated for the pandemic;
Whereas communities of color continue to bear the burdens of inequitable social,
economic, and criminal justice policies, practices, and investments that
cause deep disparities, hurt, harm, danger, and mistrust;
Whereas over 40 percent of Latinos report being discriminated against or
harassed because of their race;
Whereas approximately 24 percent of the Latino population in the United States
identifies as ``Afro-Latino'' and is thus potentially subject to both
race and national origin discrimination;
Whereas a public health issue is defined as meeting the following 4 criteria--
(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 racism meets the criteria of a public health crisis, and public health
experts agree;
Whereas a Federal public health crisis declaration would define racism as a
pervasive health issue and alerts the Nation to the need to enact
immediate and effective cross-governmental efforts to address the root
causes of institutional racism and their downstream impacts; and
Whereas such declaration requires the response of the Government to engage
significant resources to empower those communities that are impacted:
Now, therefore, be it
Resolved, That the House of Representatives--
(1) supports the resolutions drafted, introduced, and
adopted by cities and localities across the Nation 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 inequity across all sectors in
the United States;
(B) dismantling systemic practices and policies
that perpetuate racism in the United States;
(C) advancing reforms to address years of
neglectful and apathetic policies that have led to poor
health outcomes for communities of color in the United
States; and
(D) promoting efforts to address the social
determinants of health--especially for Black, Latino,
and Native-American people, and other people of color
in the United States; and
(4) charges the Nation with moving 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.
<all>