[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1001 Introduced in Senate (IS)]
111th CONGRESS
1st Session
S. 1001
To provide for increased research, coordination, and expansion of
health promotion programs through the Department of Health and Human
Services.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 7, 2009
Mr. Lugar (for himself and Mr. Bingaman) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for increased research, coordination, and expansion of
health promotion programs through the Department of Health and Human
Services.
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 ``Health Promotion Funding Integrated
Research, Synthesis, and Training Act'' or the ``Health Promotion FIRST
Act''.
SEC. 2. 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 42d 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
\1/2\ 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.
SEC. 3. 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:
``TITLE XXXI--HEALTH PROMOTION RESEARCH AND DISSEMINATION
``Subtitle A--Coordination of Programs of the Department of Health and
Human Services
``SEC. 3101. PLAN FOR HEALTH PROMOTION PROGRAMS.
``(a) In General.--The Secretary shall develop, and periodically
review and as appropriate revise, a plan in accordance with this
section for activities of the Department of Health and Human Services
relating to health promotion. The plan shall include provisions for
coordinating all such activities of the Department, including
activities under section 1701 to--
``(1) formulate national goals, and a strategy to achieve
such goals, with respect to health information and health
promotion, preventive health services, and education in the
appropriate use of health care;
``(2) analyze the necessary and available resources for
implementing the goals and strategy formulated pursuant to
paragraph (1), and recommend appropriate educational and
quality assurance policies for the needed manpower resources
identified by such analysis;
``(3) undertake and support necessary activities and
programs to--
``(A) incorporate appropriate health promotion
concepts into our society, especially into all aspects
of education and health care;
``(B) increase the application and use of health
knowledge, skills, and practices by the general
population in its patterns of daily living; and
``(C) establish systematic processes for the
exploration, development, demonstration, and evaluation
of innovative health promotion concepts; and
``(4) undertake and support research and demonstration
programs relating to health information and health promotion,
preventive health services, and education in the appropriate
use of health care.
``(b) Basic and Applied Science.--The plan developed under
subsection (a) shall contain provisions to address how to best develop
the basic and applied science of health promotion, including--
``(1) a research agenda;
``(2) an identification of the best combination of Federal
agency, university, and other community resources most
qualified to pursue each of the components of such agenda;
``(3) protocols to facilitate ongoing cooperation and
collaboration among the Federal agencies to pursue the agenda;
and
``(4) budgetary requirements with respect to the agenda.
``(c) Dissemination of Information.--The plan developed under
subsection (a) shall contain provisions to address how to best
synthesize and disseminate health promotion research findings to
scientists, professionals, and the public, including provisions for the
following:
``(1) Protocols for ongoing monitoring of all health
promotion research.
``(2) Preparation of systematic reviews and meta-analyses.
``(3) Distillation of findings into practice guidelines for
programs offered in clinical, workplace, school, home,
neighborhood, municipal, and State settings.
``(4) Strategies to incorporate findings into college,
university, and continuing educational curriculum for all
related health professions.
``(5) Communication of key findings to policy makers in
business, government, educational, and community settings who
influence investment decisions.
``(6) Identification of the optimal combination of
government agencies to coordinate the matters referred to in
paragraphs (1) through (5).
``(d) Rural and Low Income Needs.--The plan developed under
subsection (a) shall contain strategies to best meet the health
promotion needs of individuals in rural areas and low income inner city
areas.
``(e) Support and Development of Professional and Scientific
Community.--The plan developed under subsection (a) shall contain
provisions to address how to best support and develop the health
promotion professional and scientific community through enhancement of
existing or development of new professional organizations.
``(f) Integration of Health Promotion; Internal Department
Activities.--The plan developed under subsection (a) shall contain
provisions to address how resources, policies, structures, and
legislation within the Department of Health and Human Services can best
be modified or developed to integrate health promotion into all health
professions and sectors of society and make health promoting
opportunities available to all members of the public.
``(g) Integration of Health Promotion External Activities.--The
plan developed under subsection (a) shall contain provisions to address
how overall Federal Government policies, structures, and legislation
external to the Department of Health and Human Services can best be
modified or developed to integrate health promotion into all health
professions and sectors of society and to make health promoting
opportunities available to all individuals.
``(h) Other Federal Strategic Plans.--The Secretary shall request
the Secretary of Agriculture, the Secretary of the Interior, the
Secretary of Commerce, the Attorney General, the Secretary of Defense,
the Secretary of Labor, the Secretary of Education, the Secretary of
State, the Secretary of Energy, the Secretary of Transportation, the
Secretary of the Treasury, the Secretary of Homeland Security, the
Secretary of Veterans Affairs, and the Secretary of Housing and Urban
Development to develop strategic plans for the use by each respective
Federal agency of the resources and authorities of such agency to
enhance the health and well-being of the American people by providing
access to more opportunities for physical activity, enhancing access to
more nutritious foods at more affordable prices, and reducing exposure
to toxic substances such as secondhand smoke. Each such Secretary shall
solicit suggestions and advice from experts of the type described in
subsection (i).
``(i) Perspectives.--Due to 30 years of experience showing that
traditional medical and educational approaches are not sufficient to
motivate people to make and sustain basic health behavior changes, in
developing the plan under subsection (a), the Secretary shall seek
perspectives from individuals representing a diverse range of
disciplines, including the following areas:
``(1) Agriculture.
``(2) Anthropology.
``(3) Child development.
``(4) City planning.
``(5) Commerce.
``(6) Economics.
``(7) Environmental planning and design.
``(8) Exercise physiology.
``(9) Financial analysis.
``(10) Health education.
``(11) Health policy.
``(12) Individual psychology.
``(13) Management.
``(14) Medicine.
``(15) Nursing.
``(16) Nutrition.
``(17) Organization psychology.
``(18) Taxation.
``(19) Transportation planning.
``Subtitle B--Science Programs Through National Institutes of Health
``SEC. 3111. SCIENCE OF HEALTH PROMOTION.
``(a) Plan.--The Director of the National Institutes of Health
(referred to in this subtitle as `NIH'), acting through the Office of
Behavioral and Social Sciences Research, shall develop, and
periodically review and as appropriate revise, a plan on how to best
develop the science of health promotion through the NIH agencies. The
plan shall be consistent with and shall elaborate upon applicable
provisions of the Departmental plan under section 3101(a).
``(b) Certain Components of Plan.--The plan developed under
subsection (a) shall include the following provisions:
``(1) A research agenda to develop the science of health
promotion.
``(2) Recommendations on funding levels for the various
areas of research on such agenda.
``(3) Recommendations on the best combination of NIH
agencies and non-Federal entities to carry out research under
the agenda.
``(c) Allocation of Resources.--Subject to compliance with
appropriation Acts, the plan developed under subsection (a) shall
provide for the allocation of resources for research under such plan
relative to other areas of health, as appropriate taking into account
the burden of lifestyle factors on morbidity and mortality, and the
progress likely in advancing the science of health promotion given the
current and evolving level of science on health promotion, and the
relative cost of conducting research on health promotion compared to
other areas of research.
``SEC. 3112. EARLY RESEARCH PROGRAMS.
``The Director of NIH, acting through the Office of Behavioral and
Social Sciences Research, shall conduct or support early research
programs and research training regarding health promotion.
``Subtitle C--Applied Research Programs Through Centers for Disease
Control and Prevention
``SEC. 3121. RESEARCH AGENDA.
``The Secretary, acting through the Director of the Centers for
Disease Control and Prevention (referred to in this subtitle as the
`Director of CDC'), shall develop, and periodically review and as
appropriate revise, a plan that establishes for such Centers a research
agenda regarding health promotion. The plan shall be consistent with
and shall elaborate upon applicable provisions of the Departmental plan
developed under section 3101(a).
``SEC. 3122. PREVENTION RESEARCH CENTERS.
``(a) In General.--The Director of the National Center for Chronic
Disease Prevention and Health Promotion (referred to in this section as
the `Director') shall expand the eligibility of entities for Prevention
Research Centers (referred to in this section as `Centers') grants to
include the entities described in subsection (b). The Center for
Chronic Disease Prevention and Health Promotion shall retain the
authority to specify the qualities of entities it deems to be most
important in performing the responsibilities of Centers and shall
retain the responsibility for judging which organizations possess these
qualities.
``(b) Entities Described.--The entities described in this
subsection include--
``(1) institutions of higher education;
``(2) public and private research institutions;
``(3) departments or schools of--
``(A) agriculture;
``(B) architecture;
``(C) business;
``(D) city planning;
``(E) education;
``(F) engineering;
``(G) exercise science;
``(H) health promotion;
``(I) nursing;
``(J) nutrition;
``(K) population health;
``(L) preventive medicine;
``(M) psychology;
``(N) public health;
``(O) public policy;
``(P) social work; and
``(Q) transportation; and
``(4) private research, membership, or service
organizations.
``Subtitle D--Other Programs and Policies
``SEC. 3131. MODIFICATION OF APPLICATIONS AWARD PROCESS TO ATTRACT MOST
QUALIFIED SCIENTISTS AND PRACTITIONERS; DEVELOPING HEALTH
PROMOTION INFRASTRUCTURE.
``(a) Modification of Awards Application Process.--In awarding
grants, cooperative agreements, and contracts under this title, the
Secretary shall modify the application process to attract the most
qualified individuals and organizations.
``(b) General Priority of Developing Health Promotion
Infrastructure.--The Secretary shall ensure that programs carried out
pursuant to this title are consistent with the general priority of
developing the health promotion infrastructure among universities,
nonprofit organizations, and for-profit organizations, rather than
increasing the size of State or local governments or the Federal
Government.''.
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