[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2391 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2391

    To establish a National Center for Research on Domestic Health 
                              Disparities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 30, 1999

 Mr. Jackson of Illinois (for himself, Mr. Norwood, Mrs. Christensen, 
  Mr. Clyburn, Mr. Rodriguez, Mr. Underwood, Mr. Wu, Mr. Sanders, Mr. 
 DeFazio, Mr. Bonior, Mr. Menendez, Mr. Brown of Ohio, Mr. Stark, Mr. 
 Abercrombie, Ms. Millender-McDonald, Mr. Thompson of Mississippi, Mr. 
   Hilliard, Mr. Filner, Mr. Faleomavaega, Mrs. Meek of Florida, Mr. 
Serrano, Mr. Hinchey, Mr. Jefferson, Mr. Ford, Ms. McKinney, Mrs. Jones 
 of Ohio, Ms. Lee, Ms. Pelosi, Ms. Kilpatrick, Mr. Scott, Ms. Norton, 
Mr. Clay, Mr. Owens, Ms. Velazquez, Mr. Payne, Mr. Wynn, Mr. Rush, Mr. 
Cummings, Mr. Davis of Illinois, Mr. Pastor, Mr. Meeks of New York, Ms. 
   Jackson-Lee of Texas, Ms. Brown of Florida, Ms. Waters, Ms. Eddie 
 Bernice Johnson of Texas, Mr. Romero-Barcelo, Mr. Bishop, Ms. Carson, 
Mrs. Clayton, Mr. Conyers, Mr. Rangel, Mr. Reyes, Mr. Lewis of Georgia, 
   Mr. Towns, Mr. Dixon, Mr. Fattah, Mr. Watt of North Carolina, Mr. 
Gonzalez, Mr. Nadler, Mr. Brown of California, Mr. Matsui, Mr. Lantos, 
 Ms. Kaptur, Mrs. Napolitano, Ms. Schakowsky, Mr. Hastings of Florida, 
   Mr. Frank of Massachusetts, Mr. Ortiz, Ms. Woolsey, Mrs. Mink of 
   Hawaii, and Mr. Becerra) introduced the following bill; which was 
                 referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
    To establish a National Center for Research on Domestic Health 
                              Disparities.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Center for Research on 
Domestic Health Disparities Act''.

SEC. 2. FINDINGS.

    The Congress makes the following findings:
            (1) The United States ranks below most industrialized 
        nations in health status measured by longevity, sickness, and 
        mortality.
            (2) The United States ranks 24th among industrialized 
        nations in infant mortality.
            (3) This poor rank in health status is attributed in large 
        measure to the lower health status of America's minority 
        populations.
            (4) Many minority groups suffer disproportionately from 
        cancer. Disparities exist in both mortality and incidence 
        rates. For men and women combined, African Americans have a 
        cancer death rate about 35 percent higher than that for whites. 
        Paralleling the death rate, the incidence rate for lung cancer 
        in African American men is about 50 percent higher than white 
        men. Native Hawaiian men also have elevated rates of lung 
        cancer compared with white men. Alaska Native men and women 
        suffer from higher rates of cancers of the colon and rectum 
        than do whites. Vietnamese women in the United States have a 
        cervical cancer incidence rate more than five times greater 
        than white women. Hispanic women also suffer elevated rates of 
        cervical cancer.
            (5) Infant death rates among African American, American 
        Indians and Alaska Natives, and Hispanics were well above the 
        national average. The greatest disparity exists for African 
        Americans. The overall American Indian rate does not reflect 
        the diversity among Indian communities, some of which have 
        infant mortality rates approaching twice the national rate.
            (6) SIDS accounts for approximately 10 percent of all 
        infant deaths in the first year of life. Minority populations 
        are at greater risk for SIDS. In addition to the greater risks 
        among African Americans, the rates are three to four times as 
        high for some American Indians and Alaska Native populations.
            (7) Cardiovascular disease is the leading cause of death 
        for all racial and ethnic groups. Major disparities exist among 
        population groups, with a disproportionate burden of death and 
        disability from cardiovascular disease in minority and low-
        income populations. Stroke is the only leading cause of death 
        for which mortality is higher for Asian-American males than for 
        white males.
            (8) Racial and ethnic minorities have higher rates of 
        hypertension, tend to develop hypertension at an earlier age, 
        and are less likely to undergo treatment to control their high 
        blood pressure.
            (9) Diabetes, the seventh leading cause of death in the 
        United States, is a serious public health problem affecting 
        racial and ethnic communities. The prevalence of diabetes in 
        African Americans is approximately 70 percent higher than 
        whites and the prevalence in Hispanics is nearly double that of 
        whites. The prevalence rate of diabetes among American Indians 
        and Alaska Natives is more than twice that for the total 
        population and at least one tribe, the Pimas of Arizona, have 
        the highest known prevalence of diabetes of any population in 
        the world.
            (10) The human immunodeficiency virus (``HIV''), which 
        causes acquired immune deficiency syndrome (``AIDS''), results 
        in disproportionate suffering in minority populations. Minority 
        persons represent 25 percent of the total United States 
        population, but 54 percent of all cases of AIDS.
            (11) More than 75 percent of AIDS cases reported among 
        women and children occur in minority women and children.
            (12) Despite suffering disproportionate rates of illness, 
        death, and disability, minorities have not been proportionately 
        represented in many clinical research trials, except in studies 
        of behavioral risk factors associated with negative 
        stereotypes.
            (13) Culturally sensitive approaches to research are needed 
        to encourage minority participation in research studies.
            (14) There is a national need for minority scientists in 
        the field of biomedical, clinical, and health services 
        research.
            (15) In 1990, only 3.3 percent of all United States medical 
        school faculties were underrepresented minority persons.
            (16) Only 1 percent of full professors were 
        underrepresented minority persons in 1990.
            (17) The proportion of underrepresented minorities in 
        higher rank academic ranks, such as professors and associated 
        professors, actually decreased from 1980 to 1990.

SEC. 3. ESTABLISHMENT OF NATIONAL CENTER FOR RESEARCH ON DOMESTIC 
              HEALTH DISPARITIES.

    (a) In General.--Part E of title IV of the Public Health Service 
Act (42 U.S.C. 287 et seq.), as amended by section 601 of the 
Departments of Labor, Health and Human Services, and Education, and 
Related Agencies Appropriations Act, 1999 (as contained in section 
101(f) of Public Law 105-277) (112 Stat. 2681-387), is amended by 
adding at the end the following subpart:

     ``Subpart 6--National Center for Research on Domestic Health 
                              Disparities

    ``Sec. 485E. (a) In General.--The general purpose of the National 
Center for Research on Domestic Health Disparities (in this subpart 
referred to as the `Center') is the conduct and support of basic and 
clinical research, training, the dissemination of health information, 
and other programs with respect to minority health.
    ``(b) Coordination of Activities.--
            ``(1) In general.--The Director of the Center shall 
        coordinate the activities of the Center with related activities 
        of the other agencies of the National Institutes of Health, 
        including the national research institutes.
            ``(2) Agencywide recommendations through comprehensive 
        plan.--The Director of NIH, the Director of the Center, and the 
        directors of the national research institutes shall collaborate 
        for the purpose of developing, and periodically reviewing and 
        as appropriate revising, a comprehensive plan that provides 
        recommendations for the conduct and support by the National 
        Institutes of Health of the activities described in subsection 
        (a) with respect to minority health.
            ``(3) Certain activities.--For purposes of the 
        comprehensive plan under paragraph (2), the Director of the 
        Center shall--
                    ``(A) identify projects of research on minority 
                health that should be conducted or supported by the 
                Center and the other agencies of the National 
                Institutes of Health, including the national research 
                institutes;
                    ``(B) identify multidisciplinary research relating 
                to research on minority health that should be so 
                conducted or supported;
                    ``(C) promote coordination and collaboration among 
                entities conducting research identified under 
                subparagraph (A) or (B);
                    ``(D) encourage the conduct of such research by 
                entities receiving funds from the national research 
                institutes;
                    ``(E) recommend an agenda for conducting and 
                supporting such research; and
                    ``(F) promote the sufficient allocation of the 
                resources of the national research institutes for 
                conducting and supporting such research.
    ``(c) Clinical Research Equity.--The Director of the Center shall 
assist in the administration of section 492B with respect to the 
inclusion of members of minority groups as subjects in clinical 
research.
    ``(d) Research Endowments.--The Director of the Center may carry 
out a program to facilitate research on minority health by providing 
for research endowments at centers of excellence under section 736.
    ``(e) Advisory Council.--The Secretary shall, in accordance with 
section 406, establish an advisory council to advise, assist, consult 
with, and make recommendations to the Director of the Center on matters 
relating to the activities described in subsection (a), and with 
respect to such activities to carry out any other functions described 
in section 406 for advisory councils under such section.
    ``(f) Biennial Report.--The Director of the Center shall prepare 
biennial reports on the activities carried out or to be carried out by 
the Center, and shall submit each such report to the Director of NIH 
for inclusion in the biennial report under section 403.
    ``(g) Authorization of Appropriations.--For the purpose of carrying 
out this subpart, there are authorized to be appropriated $100,000,000 
for fiscal year 2000, and such sums as may be necessary for each of the 
fiscal years 2001 through 2004. Such authorization of appropriations is 
in addition to other authorizations of appropriations that are 
available for the conduct and support of research on minority health by 
the national research institutes and other agencies of the National 
Institutes of Health.''.
    (b) Conforming Amendment.--Part A of title IV of the Public Health 
Service Act (42 U.S.C. 281 et seq.) is amended by striking section 404.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this Act take effect October 1, 1999, or 
upon the date of the enactment of this Act, whichever occurs later.
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