[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 875 Introduced in Senate (IS)]
<DOC>
117th CONGRESS
2d Session
S. RES. 875
Declaring racism a public health crisis.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 20, 2022
Mr. Brown (for himself, Mr. Booker, Mr. Padilla, Ms. Warren, Ms.
Stabenow, Mr. Warnock, Mr. Menendez, Mr. Cardin, Mr. Merkley, Mr.
Blumenthal, Mrs. Feinstein, Ms. Baldwin, Mr. Carper, Ms. Klobuchar, Mr.
Leahy, Mr. Sanders, Ms. Smith, Mr. Van Hollen, Mr. Wyden, Mr. Markey,
Ms. Hirono, Ms. Duckworth, Mr. Reed, and Mr. Whitehouse) submitted the
following resolution; which was referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
RESOLUTION
Declaring racism a public health crisis.
Whereas a public health issue is an issue--
(1) that affects many people, is a threat to the public, and is
ongoing;
(2) that is unfairly distributed among different populations,
disproportionately impacting health outcomes, access to health care, and
life expectancy;
(3) the effects of which could be reduced by preventive measures; and
(4) for which those preventive measures are not yet in place;
Whereas public health experts agree that significant racial inequities exist in
the prevalence, severity, and mortality rates of various health
conditions in the United States;
Whereas examples of such inequities include--
(1) life expectancy rates for Black and Native American people in the
United States being significantly lower than those of White people in the
United States;
(2) Black and Native American women being 2 to 4 times more likely than
White women to suffer severe maternal morbidity or die of pregnancy-related
complications;
(3) Black and Native American infants being 2 to 3 times as likely to
die as White infants, and the Black infant mortality rate in the United
States being higher than the infant mortality rates recorded in 27 of the
36 democratic countries with market-based economies that are members of the
Organization for Economic Co-operation and Development; and
(4) during the COVID-19 pandemic, Black, Hispanic/Latino, Asian
American, Native Hawaiian, Pacific Islander, and Native American
communities experiencing disproportionately high rates of COVID-19
infection, hospitalization, and mortality compared to the White population
of the United States;
Whereas inequities in health outcomes are exacerbated for people of color who
are LGBTQIA+ and have disabilities;
Whereas, historically, explanations for health inequities focused on false
genetic science (for example, eugenics) and incomplete social scientific
analyses that narrowly focus on individual behavior to highlight
ostensible deficiencies within racial and ethnic minority groups;
Whereas modern public health discourse recognizes the broader social context in
which health inequities emerge and acknowledges the impact of historical
and contemporary racism on health;
Whereas, since its founding, the United States has had a longstanding history
and legacy of racism, mistreatment, and discrimination that has
perpetuated health inequities for members of racial and ethnic minority
groups;
Whereas that history and legacy of racism, mistreatment, and discrimination
includes--
(1) the immoral paradox of freedom and slavery, which is an atrocity
that can be traced throughout the history of the United States, 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;
(2) the failure of the United States to carry out the responsibilities
and promises made in more than 350 treaties ratified with sovereign
indigenous communities, 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 inequities faced by Native
American people, and the inaccessibility of many Federal public health and
social programs in Native American communities;
(3) the enactment of immigration laws in the United States, such as--
G (A) the Page Act of 1875, which effectively prohibited the entry
of East Asian women into the United States;
G (B) the Chinese Exclusion Act in 1882, which ostracized thousands
of Chinese-born laborers, who were essential in the completion of the
transcontinental railroad and development of the West Coast; and
G (C) the Immigration Act of 1917, which barred all immigrants from
the ``Asiatic zone'' and prevented the migration of individuals from South
Asia, Southeast Asia, and East Asia, scapegoating Asians, separating
families, and branding Asians as perpetual outsiders in the United States;
(4) during the Great Depression Era, the deportation by the United
States of approximately 1,800,000 individuals based on their Mexican ethnic
identity, when approximately 60-percent of the individuals deported to
Mexico were United States citizens, and the targeting of individuals of
Mexican descent for ``repatriation'' due to scapegoating efforts, which
blamed them for ``stealing'' jobs from ``real'' Americans; and
(5) in 1967, President Lyndon B. Johnson establishing 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 overt racism was embedded in the development of medical science and
medical training during the 18th, 19th, and 20th centuries, causing
disproportionate physical and psychological harm to members of racial
and ethnic minority groups, including--
(1) the unethical practices and abuses experienced by Black patients
and research participants, such as the Tuskegee Syphilis Study, which serve
as foundations for the mistrust the Black community has for the medical
system; and
(2) the egregiously unethical and cruel treatment enslaved Black women
were forced to endure as subjects of insidious medical experiments to
advance modern gynecology, including those perpetuated by the so-called
``father of gynecology'', J. Marion Sims;
Whereas structural racism cemented historical racial and ethnic inequities in
access to resources and opportunities, contributing to worse health
outcomes;
Whereas examples of that structural racism include--
(1) that, 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;
(2) the landmark case Simkins v. Moses H. Cone Memorial Hospital (323
F.2d 959 (4th Cir. 1963)), which challenged the use of public funds by the
Federal Government to expand, support, and sustain segregated hospital
care, and provided justification for title VI of the Civil Rights Act of
1964 (42 U.S.C. 2000d et seq.) and the Medicare hospital certification
program, establishing Medicare hospital racial integration guidelines that
applied to every hospital that participated in the Federal program;
(3) Pacific Islanders from the Freely Associated States experiencing
unique health inequities resulting from United States nuclear weapons tests
on their home islands, while they have been categorically denied access to
Medicaid and other Federal health benefits; and
(4) language minorities, including Chinese-, Korean-, Vietnamese-,
Russian-, and Spanish-speaking Americans, not being assured
nondiscriminatory access to federally funded services, including health
services, until the signing of Executive Order 13166 (42 U.S.C. 2000d-1
note; related to improving access to services for persons with limited
English proficiency) in 2000;
Whereas, although overt racism has been outlawed in the United States, subtle or
implicit racism in all sectors of the medical service profession
continues to cause disproportionate physical and psychological harm to
members of racial and ethnic minority groups;
Whereas examples of subtle or implicit racism in the medical service profession
include--
(1) the history and persistence of racist and nonscientific medical
beliefs, which are associated with ongoing racial inequities in treatment
and health outcomes;
(2) implicit racial and ethnic biases within the health care system,
which have an explicit impact on the quality of care experienced by members
of racial and ethnic minority groups, such as the undertreatment of pain in
Black patients;
(3) nearly 1 in 5 Hispanic/Latino Americans avoiding medical care due
to concern about being discriminated against or treated poorly;
(4) the United States health care system and other economic and social
structures remaining fraught with biases based on race, ethnicity, sex
(including sexual orientation and gender identity), and class that lead to
health inequities;
(5) women of color, including Black, Native American, Hispanic/Latina,
Asian American, Native Hawaiian, and Pacific Islander women, continuing to
face attacks on their prenatal, maternal, and reproductive health and
rights throughout history; and
(6) physicians routinely, through the late 1960s and early 1980s,
sterilizing members of racial and ethnic minority groups, specifically
African American and Latina women, performing excessive and medically
unnecessary procedures without their informed consent;
Whereas structural racism perpetuates racial and ethnic inequities in the social
determinants of health, which produces unintended negative health
outcomes for members of racial and ethnic minority groups;
Whereas examples of that structural racism include--
(1) that there are fewer pharmacies, medical practices, and hospitals
in predominantly Black and Hispanic/Latino neighborhoods, compared to White
or more diverse neighborhoods;
(2) environmental hazards, such as toxic waste facilities, garbage
dumps, and other sources of airborne pollutants, being disproportionately
located in predominantly Black, Hispanic/Latino, Asian American, Native
Hawaiian, Pacific Islander, and low-income communities, resulting in poor
air quality conditions, which can increase the likelihood of chronic
respiratory illness and premature death from particle pollution;
(3) that employed Black adults are 10-percent less likely to have
workplace insurance than are employed White adults because of racial
segregation in occupation sectors and types of organizations they work in,
and that certain groups of nonelderly Asian American adults, including
Native Hawaiian, Pacific Islander, Korean, Vietnamese, and Cambodian
adults, also have lower levels of insurance than White adults;
(4) that several States with higher percentages of Black, Hispanic/
Latino, and Native American populations have not expanded their Medicaid
programs, continuing to disenfranchise minority communities from access to
health care to this day;
(5) discriminatory housing practices, such as redlining, which have,
for decades, systemically excluded members of racial and ethnic minority
groups from housing, robbing them of capital in the form of low-cost,
stable mortgages and opportunities to build wealth, and the Federal
Government using its financial power to segregate renters in newly built
public housing;
(6) social inequities such as differing access to quality health care,
healthy food and safe drinking water, safe neighborhoods, education, job
security, and reliable transportation, which affect health risks and
outcomes;
(7) that, as much as 60-percent of the health of a person in the United
States can be determined by their ZIP Code;
(8) that the COVID-19 pandemic has exacerbated economic, health,
housing, and food security barriers for Black, Hispanic/Latino, and Native
American households, which already suffer from disproportionately higher
rates of food insecurity; and
(9) members of the Black, Native American, Alaska Native, Asian
American, Native Hawaiian, Pacific Islander, and Hispanic/Latino
communities being disproportionately impacted by the criminal justice and
immigration enforcement systems and facing a higher risk of contracting
COVID-19 within prison populations and detention centers due to the over-
incarceration of members of those communities;
Whereas structural racism perpetuates ongoing knowledge gaps in data, research,
and development, which produces unintended negative health outcomes for
members of racial and ethnic minority groups;
Whereas examples of that structural racism include that--
(1) most participants in clinical trials are White, so there is
insufficient data to develop evidence-based recommendations for people from
racial and ethnic minority groups;
(2) medical research equipment and medical devices are typically
developed by majority-White teams and thus can have racial blind spots
unintentionally built into their design, rendering them less effective for
people from racial and ethnic minority groups, such as--
G (A) electroencephalogram (EEG) electrodes used in neuroimaging
research do not collect reliable data when used on scalps with thick, curly
hair; and
G (B) pulse oximeters produce less accurate oxygen saturation
readings when used on fingertips with darker skin;
(3) a lack of images depicting darker skin in medical textbooks,
literature, and journals contributes to higher rates of underdiagnosis or
misdiagnosis in patients with darker skin; and
(4) many health-related studies fail to include disaggregated data on,
or do not disaggregate data among, Asian Americans, Native Hawaiians, and
Pacific Islanders, leading to their invisibility in health data and unjust
resource allocation and policies;
Whereas racism produces unjust outcomes and treatment for members of racial and
ethnic minority groups, with such negative experiences serving as
stressors that over time have a negative impact on physical health
(leading, for example, to high blood pressure or hypertension) and
mental health (leading, for example, to anxiety or depression);
Whereas there is evidence that racial and ethnic minority groups continue to
face discrimination in the United States, examples of which include
that--
(1) compared to White Americans, Black Americans are 5 times more
likely to report experiencing discrimination when interacting with the
police, Hispanic/Latino Americans and Native Americans are nearly 3 times
as likely, and Asian Americans, Native Hawaiians, and Pacific Islanders are
nearly twice as likely;
(2) 42-percent of United States employees have experienced or witnessed
racism in the workplace;
(3) social scientists have documented racial microaggressions in
contemporary United States society, including--
G (A) assumptions that members of racial and ethnic minority groups
are not true Americans;
G (B) assumptions of lesser intelligence;
G (C) statements that convey color-blindness or denial of the
importance of race;
G (D) assumptions of criminality or dangerousness;
G (E) denial of individual racism;
G (F) promotion of the myth of meritocracy;
G (G) assumptions that one's cultural background and communication
styles are pathological;
G (H) treatment as a second-class citizen; and
G (I) environmental messages of being unwelcome or devalued;
(4) Muslims, South Asians, and Sikhs were unjustly targeted for
profiling, surveillance, arrest, discrimination, harassment, assault, and
murder after 9/11;
(5) xenophobic rhetoric, including anti-immigrant rhetoric and
scapegoating people of East Asian and Southeast Asian descent for the
COVID-19 pandemic, has resulted in a surge of hate incidents against Asian
Americans, Native Hawaiians, and Pacific Islanders, including increased
harassment, discrimination, bullying, vandalism, and assault; and
(6) more than 50-percent of Hispanic/Latino adults experience at least
one form of discrimination due to their racial or ethnic heritage, such as
being treated as if they were not smart, criticized for speaking Spanish,
told to return to their country, called offensive names, or unfairly
stopped by the police;
Whereas Black people in the United States experience overt and direct forms of
violence that, when not fatal, can cause severe physical or
psychological harm;
Whereas examples of such forms of violence include--
(1) Black people being confronted and threatened by armed citizens
while performing everyday tasks, such as jogging in neighborhoods, driving
while Black, or playing in a park;
(2) Black people being 3 times more likely to be killed by police than
White people, and police violence being the sixth leading cause of death
for young Black men;
(3) Black communities leading the United States in mourning the
killings of Ahmaud Arbery, Breonna Taylor, George Floyd, Elijah McClain,
and countless other Black Americans, and in calling for justice and long-
term changes to dismantle systems of oppression;
(4) that it took the United States 66 years after the senseless and
brutal murder of 14-year-old Emmett Till to make lynching a Federal crime;
(5) since 2015, mass shootings around the country, such as in Buffalo,
New York, and Charleston, South Carolina, serving as reminders of the
unresolved history of racism in the United States and highlighting the
threats Black people must take into consideration when going about their
daily lives, both when outside their communities and within those
communities; and
(6) the real threat of brutality and violence adversely impacting
mental health among Black communities;
Whereas Native Americans, Alaska Natives, Hispanic/Latinos, Asian Americans,
Native Hawaiians, and Pacific Islanders experience racially motivated
kidnapping, murders, and mass violence, such as shootings in Oak Creek,
Wisconsin, El Paso, Texas, Atlanta, Georgia, and Indianapolis, Indiana,
that, even when not fatal, can cause severe physical or psychological
harm;
Whereas, throughout the history of the United States, members of racial and
ethnic minority groups have been at the forefront of civil rights
movements for essential freedoms, human rights, and equal protection for
marginalized groups and continue to fight for racial and economic
justice today;
Whereas racial inequities in health continue to persist because of historical
and contemporary racism;
Whereas public health experts agree that racism meets the criteria of a public
health crisis, because--
(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 the Centers for Disease Control and Prevention--
(1) declared racism a serious threat to public health; and
(2) acknowledged the need for additional research and investments to
address that serious threat;
Whereas a Federal public health crisis declaration defines racism as a pervasive
health issue and alerts the people of the United States to the need to
enact immediate and effective cross-governmental efforts to address the
root causes of structural racism and the downstream impacts of that
racism; and
Whereas such a declaration requires the response of governments to engage
significant resources to empower the communities that are impacted: Now,
therefore, be it
Resolved, That the Senate--
(1) supports the resolutions drafted, introduced, and
adopted by cities and localities across the United States
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 inequities across all sectors in
society;
(B) dismantling systemic practices and policies
that perpetuate racism;
(C) advancing reforms to address years of
neglectful and apathetic policies that have led to poor
health outcomes for members of racial and ethnic
minority groups; and
(D) promoting efforts to address the social
determinants of health for all racial and ethnic
minority groups in the United States, and especially
for Black and Native American communities; and
(4) places a charge on the people of the United States to
move 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.
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