[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4533 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 4533

  To amend the Public Health Service Act to provide for public health 
 research and investment into understanding and eliminating structural 
                      racism and police violence.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 8, 2020

 Ms. Warren (for herself, Ms. Hirono, Mr. Markey, Mr. Merkley, and Ms. 
Smith) introduced the following bill; which was read twice and referred 
       to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to provide for public health 
 research and investment into understanding and eliminating structural 
                      racism and police violence.

    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 ``Anti-Racism in Public Health Act of 
2020''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) For centuries, structural racism, defined by the 
        National Museum of African American History and Culture as an 
        ``overarching system of racial bias across institutions and 
        society'', in the United States has negatively affected 
        communities of color, especially Black, Latinx, Asian American, 
        Pacific Islander, and American Indian and Alaska Native people, 
        to expand and reinforce White supremacy.
            (2) Structural racism determines the conditions in which 
        people are born, grow, work, live, and age and determine 
        people's access to quality housing, education, food, 
        transportation, and political power, and other social 
        determinants of health.
            (3) Structural racism serves as a major barrier to 
        achieving health equity and eliminating racial and ethnic 
        inequities in health outcomes that exist at alarming rates and 
        are determined by a wider set of forces and systems.
            (4) Due to structural racism in the United States, people 
        of color are more likely to suffer from chronic health 
        conditions (such as heart disease, diabetes, asthma, hepatitis, 
        and hypertension) and infectious diseases (such as HIV/AIDS, 
        and COVID-19) compared to their White counterparts.
            (5) Due to structural racism in maternal health care in the 
        United States, Black and American Indian and Alaska Native 
        infants are more than twice as likely to die than White 
        infants, Black women are 3 to 4 times more likely to die from 
        pregnancy-related causes than White women, and American Indian 
        and Alaska Native women are 5 times more likely to die from 
        pregnancy-related causes than White women. This trend persists 
        even when adjusting for income and education.
            (6) Due to structural racism in the United States, Non-
        Hispanic Black women have the highest rates for 22 of 25 severe 
        morbidity indicators used by the Center for Disease Control and 
        Prevention (CDC).
            (7) Due to structural racism in the United States, people 
        of color comprise a disproportionate percentage of persons with 
        disabilities in the United States.
            (8) Due to structural racism in the United States, Black 
        men are up to three and a half times as likely to be killed by 
        police as White men, and 1 in every 1,000 Black men will die as 
        a result of police violence. Policing has adverse effects on 
        mental health in Black communities.
            (9) Due to the confluence of structural racism and factors 
        such as gender, class, and sexual orientation or gender 
        identity, commonly referred to as intersectionality, Black and 
        Latinx transgender women are more likely to die due to violence 
        and homicide than their White counterparts.
            (10) Due to structural racism, inequitable access to 
        quality health care and long-term services and supports also 
        disproportionately burdens communities of color; people of 
        color and immigrants are less likely to be insured and are more 
        likely to live in medically underserved areas.
            (11) Due to structural racism, older adults of color are 
        also more likely to be admitted to nursing homes and assisted 
        living facilities and to reside in those of poor quality, and 
        when older adults of color do receive home and community based 
        services, Medicaid spends less money on their services and they 
        are more likely to be hospitalized than older White adults.
            (12) In addition, the Federal Government's failure to honor 
        the unique political status of American Indian and Alaska 
        Native people, to respect the inherent sovereignty of Tribal 
        Nations, and to uphold its trust and treaty obligations to 
        Tribal Nations and American Indian and Alaska Native people, is 
        an ongoing and unjust manifestation of centuries of oppression, 
        with the consequence of adverse health outcomes for Native 
        peoples.
            (13) The COVID-19 pandemic has exposed the devastating 
        impact of structural racism on the United States ability to 
        ensure equitable health outcomes for people of color, and made 
        these communities more likely to suffer from severe outcomes 
        due to the coronavirus infection.
            (14) Racial and ethnic inequity in public health is a 
        result of systematic, personally mediated, and internalized 
        racism and racist public and private policies and practices, 
        and dismantling structural racism is integral to addressing 
        public health.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Antiracism.--The term ``antiracism'' is a collection of 
        antiracist policies that lead to racial equity, and are 
        substantiated by antiracist ideas.
            (2) Antiracist.--The term ``antiracist'' is any measure 
        that produces or sustains racial equity between racial groups.

SEC. 4. PUBLIC HEALTH RESEARCH AND INVESTMENT IN DISMANTLING STRUCTURAL 
              RACISM.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by adding at the end the following:

``SEC. 320B. NATIONAL CENTER ON ANTIRACISM AND HEALTH.

    ``(a) In General.--
            ``(1) National center.--There is established within the 
        Centers for Disease Control and Prevention a center to be known 
        as the `National Center on Antiracism and Health' (referred to 
        in this section as the `Center'). The Director of the Centers 
        for Disease Control and Prevention shall appoint a director to 
        head the Center who has experience living in and working with 
        racial and ethnic minority communities. The Center shall 
        promote public health by--
                    ``(A) declaring racism a public health crisis and 
                naming racism as an historical and present threat to 
                the physical and mental health and well-being of the 
                United States and world;
                    ``(B) aiming to develop new knowledge in the 
                science and practice of antiracism, including by 
                identifying the mechanisms by which racism operates in 
                the provision of health care and in systems that impact 
                health and well-being;
                    ``(C) transferring that knowledge into practice, 
                including by developing interventions that dismantle 
                the mechanisms of racism and replace such mechanisms 
                with equitable structures, policies, practices, norms, 
                and values so that a healthy society can be realized; 
                and
                    ``(D) contributing to a national and global 
                conversation regarding the impacts of racism on the 
                health and well-being of the United States and world.
            ``(2) General duties.--The Secretary, acting through the 
        Center, shall undertake activities to carry out the mission of 
        the Center as described in paragraph (1), such as the 
        following:
                    ``(A) Conduct research into, collect, analyze and 
                make publicly available data on, and provide leadership 
                and coordination for the science and practice of 
                antiracism, the public health impacts of structural 
                racism, and the effectiveness of intervention 
                strategies to address these impacts. Topics of research 
                and data collection under this subparagraph may include 
                identifying and understanding--
                            ``(i) policies and practices that have a 
                        disparate impact on the health and well-being 
                        of communities of color;
                            ``(ii) the public health impacts of 
                        implicit racial bias, White supremacy, 
                        weathering, xenophobia, discrimination, and 
                        prejudice;
                            ``(iii) the social determinants of health 
                        resulting from structural racism, including 
                        poverty, housing, employment, political 
                        participation, and environmental factors; and
                            ``(iv) the intersection of racism and other 
                        systems of oppression, including as related to 
                        age, sexual orientation, gender identity, and 
                        disability status.
                    ``(B) Award noncompetitive grants and cooperative 
                agreements to eligible public and nonprofit private 
                entities, including State, local, territorial, and 
                Tribal health agencies and organizations, for the 
                research and collection, analysis, and reporting of 
                data on the topics described in subparagraph (A).
                    ``(C) Establish, through grants or cooperative 
                agreements, at least 3 regional centers of excellence, 
                located in racial and ethnic minority communities, in 
                antiracism for the purpose of developing new knowledge 
                in the science and practice of antiracism in health by 
                researching, understanding, and identifying the 
                mechanisms by which racism operates in the health 
                space, racial and ethnic inequities in health care 
                access and outcomes, the history of successful 
                antiracist movements in health, and other antiracist 
                public health work.
                    ``(D) Establish a clearinghouse within the Centers 
                for Disease Control and Prevention for the collection 
                and storage of data generated under the programs 
                implemented under this section for which there is not 
                an otherwise existing surveillance system at the 
                Centers for Disease Control and Prevention. Such data 
                shall--
                            ``(i) be comprehensive and disaggregated, 
                        to the extent practicable, by including racial, 
                        ethnic, primary language, sex, gender identity, 
                        sexual orientation, age, socioeconomic status, 
                        and disability disparities;
                            ``(ii) be made publicly available;
                            ``(iii) protect the privacy of individuals 
                        whose information is included in such data; and
                            ``(iv) comply with privacy protections 
                        under the regulations promulgated under section 
                        264(c) of the Health Insurance Portability and 
                        Accountability Act of 1996.
                    ``(E) Provide information and education to the 
                public on the public health impacts of structural 
                racism and on antiracist public health interventions.
                    ``(F) Consult with other Centers and National 
                Institutes within the Centers for Disease Control and 
                Prevention, including the Office of Minority Health and 
                Health Equity and the Center for State, Tribal, Local, 
                and Territorial Support, to ensure that scientific and 
                programmatic activities initiated by the agency 
                consider structural racism in their designs, 
                conceptualizations, and executions, which shall 
                include--
                            ``(i) putting measures of racism in 
                        population-based surveys;
                            ``(ii) establishing a Federal Advisory 
                        Committee on racism and health for the Centers 
                        for Disease Control and Prevention;
                            ``(iii) developing training programs, 
                        curricula, and seminars for the purposes of 
                        training public health professionals and 
                        researchers around issues of race, racism, and 
                        antiracism;
                            ``(iv) providing standards and best 
                        practices for programming and grant recipient 
                        compliance with Federal data collection 
                        standards, including section 4302 of the 
                        Patient Protection and Affordable Care Act; and
                            ``(v) establishing leadership and 
                        stakeholder councils with experts and leaders 
                        in racism and public health disparities.
                    ``(G) Coordinate with the Indian Health Service and 
                with the Centers for Disease Control and Prevention's 
                Tribal Advisory Committee to ensure meaningful Tribal 
                consultation, the gathering of information from Tribal 
                authorities, and respect for Tribal data sovereignty.
                    ``(H) Engage in government to government 
                consultation with Indian Tribes and Tribal 
                organizations.
                    ``(I) At least every 2 years, produce and publicly 
                post on the Centers for Disease Control and 
                Prevention's website a report on antiracist activities 
                completed by the Center, which may include newly 
                identified antiracist public health practices.
    ``(b) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this 
section.''.

SEC. 5. PUBLIC HEALTH RESEARCH AND INVESTMENT IN POLICE VIOLENCE.

    (a) In General.--The Secretary of Health and Human Services shall 
establish within the National Center for Injury Prevention and Control 
of the Centers for Disease Control and Prevention (referred to in this 
section as the ``Center'') a law enforcement violence prevention 
program.
    (b) General Duties.--In implementing the program under subsection 
(a), the Center shall conduct research into, and provide leadership and 
coordination for--
            (1) the understanding and promotion of knowledge about the 
        public health impacts of uses of force by law enforcement, 
        including police brutality and violence;
            (2) developing public health interventions and perspectives 
        for eliminating deaths, injury, trauma, and negative mental 
        health effects from police presence and interactions, including 
        police brutality and violence; and
            (3) ensuring comprehensive data collection, analysis, and 
        reporting regarding police violence and misconduct in 
        consultation with the Department of Justice and independent 
        researchers.
    (c) Functions.--Under the program under subsection (a), the Center 
shall--
            (1) summarize and enhance the knowledge of the 
        distribution, status, and characteristics of law enforcement-
        related death, trauma, and injury;
            (2) conduct research and prepare, with the assistance of 
        State public health departments--
                    (A) statistics on law enforcement-related death, 
                injury, and brutality;
                    (B) studies of the factors, including legal, 
                socioeconomic, discrimination, and other factors that 
                correlate with or influence police brutality;
                    (C) public information about uses of force by law 
                enforcement, including police brutality and violence, 
                for the practical use of the public health community, 
                including publications that synthesize information 
                relevant to the national goal of understanding police 
                violence and methods for its control;
                    (D) information to identify socioeconomic groups, 
                communities, and geographic areas in need of study, and 
                a strategic plan for research necessary to comprehend 
                the extent and nature of police uses of force by law 
                enforcement, including police brutality and violence, 
                and determine what options exist to reduce or eradicate 
                death and injury that result; and
                    (E) best practices in police violence prevention in 
                other countries;
            (3) award grants, contracts, and cooperative agreements to 
        provide for the conduct of epidemiologic research on uses of 
        force by law enforcement, including police brutality and 
        violence, by Federal, State, local, and private agencies, 
        institutions, organizations, and individuals;
            (4) award grants, contracts, and cooperative agreements to 
        community groups, independent research organizations, academic 
        institutions, and other entities to support, execute, or 
        conduct research on interventions to reduce or eliminate uses 
        of force by law enforcement, including police brutality and 
        violence;
            (5) coordinate with the Department of Justice, and other 
        Federal, State, and local agencies on the standardization of 
        data collection, storage, and retrieval necessary to collect, 
        evaluate, analyze, and disseminate information about the extent 
        and nature of uses of force by law enforcement, including 
        police brutality and violence, as well as options for the 
        eradication of such practices;
            (6) submit an annual report to Congress on research 
        findings with recommendations to improve data collection and 
        standardization and to disrupt processes in policing that 
        preserve and reinforce racism and racial disparities in public 
        health;
            (7) conduct primary research and explore uses of force by 
        law enforcement, including police brutality and violence, and 
        options for its control; and
            (8) study alternatives to law enforcement response as a 
        method of reducing police violence.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated, such sums as may be necessary to carry out this section.
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