I 111th CONGRESS 1st Session H. R. 2354 IN THE HOUSE OF REPRESENTATIVES May 12, 2009 Ms. Schakowsky (for herself, Mr. Burgess, and Mr. Gene Green of Texas) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To provide for increased research, coordination, and expansion of health promotion programs through the Department of Health and Human Services.

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Short title

This Act may be cited as the Health Promotion Funding Integrated Research, Synthesis, and Training Act or the Health Promotion FIRST Act.

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Findings

Congress makes the following findings: (1)Lifestyle factors are responsible for almost half of the premature deaths in developed nations and a large portion of the deaths in developing nations. (2)Lifestyle factors are a primary cause of the 6 leading causes of death in the United States, including heart disease, cancer, stroke, respiratory diseases, accidents, and diabetes, which account for almost 75 percent of all deaths in the United States. (3)A significant portion of the health disparities in the United States are caused by lifestyle factors, which could be improved by health promotion programs. (4)The United States is experiencing epidemics in diabetes and obesity among adults and children, at the same time a majority of the population is sedentary and eats an unhealthy diet. (5)Per capita medical care costs in the United States are more than double those of all but 4 other countries in the world, yet the United States ranks 42nd in the world in life expectancy. (6)Medical care costs are second only to education in State government budgets. (7)Lifestyle factors are responsible for at least 25 percent of employer’s medical care costs in the United States. (8)National costs of obesity account for 9.1 percent of all medical costs, reaching $93,000,000 in 2002. Approximately ½ of these costs were paid by the Medicare & Medicaid Programs. (9)More than 440,000 people die each year from tobacco use and more than 12,000,000 are living with chronic conditions caused by tobacco. Tobacco accounts for at least $96,000,000,000 in direct medical expenditures. (10)Significant gaps exist in the basic and applied research base of health promotion regarding how to best reach and serve people of color, low-income people, people with little formal education, children, and older adults, how to create long-term health improvements, how to create supportive environments, and how to address gender issues. More focused research can reduce these gaps. (11)Significant gaps exist between the best and the typical health promotion programs. Better synthesis and dissemination of results can reduce these gaps. (12)Health promotion is the art and science of motivating people to enhance their lifestyles to achieve complete health, not just the absence of disease. Complete health involves a balance of physical, mental, and social health. (13)Health promotion programs focus on practices such as exercising regularly, eating a nutritious diet, maintaining a healthy weight, managing stress, avoiding dangerous substances such as tobacco and illegal drugs, drinking alcohol in moderation or not at all, driving safely, being wise consumers of health care, and a number of other health related practices. (14)The most effective health promotion programs include a combination of strategies to increase awareness, enhance motivation, facilitate behavior change, and develop cultures and physical environments that encourage and support healthy lifestyle practices. (15)Health promotion programs can be provided in family, clinical, child care, school, workplace, Federal, State, and community settings. (16)People living in rural areas have additional unique challenges of high risk work environments, more limited access to major educational and medical complexes, as well as facilities for fitness and recreational facilities and in some cases to grocery stores. (17)Individuals with physical disabilities respond very well to exercise treatment. This is a core component of all high quality physical therapy programs. However, additional research and more intensive efforts to disseminate information in this area are necessary.

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Health promotion research and dissemination

The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following: .