[Congressional Record Volume 149, Number 171 (Saturday, November 22, 2003)]
[Extensions of Remarks]
[Pages E2403-E2404]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        HEALTH EMPOWERMENT ZONE

                                 ______
                                 

                       HON. DONNA M. CHRISTENSEN

                         of the virgin islands

                    in the house of representatives

                       Friday, November 21, 2003

  Mrs. CHRISTENSEN. Mr. Speaker, on March 20, 2002, the Institute of 
Medicine (IOM) released a landmark report entitled: Unequal Treatment: 
Confronting Racial and Ethnic Disparities in Health Care. Among other 
key findings, the report documented that minorities in the United 
States receive fewer life-prolonging cardiac medications and surgeries, 
are less likely to receive dialysis and kidney transplants, and are 
less likely to receive adequate treatment for pain. Its first and most 
telling finding States that ``racial and ethnic disparities in 
healthcare exist and, because they are associated with worse outcomes 
in many cases, are unacceptable.'' The reasons for these disparities in 
treatment are wide and varied, and include, but are not limited to: 
healthcare provider prejudice or bias, the implicit nature of 
stereotypes, and broader historic and contemporary social and economic 
inequality. The report included a series of recommendations and 
interventions for policy changes to eliminate these unacceptable 
disparities.
  Whether it is the recently released IOM report on Unequal Treatment: 
Confronting Racial and Ethnic Disparities in Health Care, the 
Commonwealth Fund's report Diverse Communities, Common Concerns: 
Assessing Health Care Quality for Minority Americans or a recent report 
by Physicians for Human Rights (2003) found that many minority groups 
receive lower quality evaluation and treatment than white Americans for 
a wide range of medical conditions, even when each has health 
insurance.
  We are continually reminded that throughout the history of our great 
Nation, our people have been denied access to the best that medical 
science has had to offer--often relegated to hospitals with outdated 
equipment and served by African-American health care providers who, 
although as capable, intelligent, and gifted as their white 
counterparts, often could not obtain equivalent training because of 
racist practices such as segregation.
  This segregated health system was largely responsible for the health 
inequities that existed during the early and middle part of this 
century. Indeed, in 1951 Dr. W. Montague Cobb, editor of the Journal of 
the National Medical Association, stated ``For nearly fifty years the 
retarded health status of our Negro population has been common 
knowledge and the object of sporadic corrective effort''. With the 
Civil Rights came an acknowledgment came greater equality in many 
aspects of life for African-Americans, including greater access to 
quality health care.

  As an effort to extend such acknowledgment I am proud to introduce 
the Health Empowerment Zone Act of 2003. This act directs the Secretary 
of Health and Human Services with the Administrator of the Health 
Resources and Services administration and the Directors of the Office 
of Minority Health, of the Office of Community Services and National 
Center for Minority Health and Health Disparities to establish health 
empowerment zone programs in communities that disproportionately 
experience disparities in health status and health care, and for other 
purposes.
  To be eligible the communities must demonstrate that they experience 
disproportionate disparities in health status and health care, set 
forth a strategic plan and create a partnership, with individuals, 
businesses, schools, minority health associations, nonprofit 
organizations, community-based organizations, hospitals, health care 
clinics, and foundations.

[[Page E2404]]

  The health empowerment zone designation would provide communities the 
ability to effectively access Federal programs (namely in the 
Department of Health and Human Services, the Department of Agriculture, 
the Department of Education, the Department of Labor, the Department of 
Housing and Urban Development and the Small Business Administration) to 
improve the health or environment of minority individuals in the 
community and to coordinate the efforts regarding the elimination of 
racial and ethnic disparities in health status and health care. Special 
consideration is given to community that have demonstrated expertise in 
providing culturally appropriate and linguistically responsive 
services.
  The bill directs communities to establish a health empowerment zone 
coordinating committee that will provide technical assistance and 
evidence-based strategies to the zone, including providing guidance on 
research, strategies, health outcomes, program goals, management, 
implementation, monitoring, assessment, and evaluation processes.
  This bill recognizes that disparities in health and health care found 
among minority Americans have multiple causes. Lower socioeconomic 
status and a higher rate of uninsurance are major contributors to the 
health disparities experienced by minority Americans but non-health 
factors also play an important role.
  The bill codifies legislatively the framework needed to implement 
sound public health practices such as:
  Primary health promotion and disease prevention: Identifying and 
strengthening protective ecological conditions conducive to health; and 
identifying and reducing various health risks.
  Secondary health promotion and disease prevention: Identifying, 
adopting, and reinforcing specific protective behaviors; and early 
detection and reduction of existing health problems.

  Tertiary health promotion and disease prevention: Improving the 
quality of life of community members affected by health problems; and 
avoiding deterioration, reducing complications from specific disorders, 
and preventing relapse of risky behaviors.
  This bill is a start to a new paradigm for health and I urge my 
colleagues to support this bill, so that we do what is so clearly 
needed to improve the health and health care for millions of minority 
Americans.

                          ____________________