Congressional Record, Volume 153 Issue 113 (Monday, July 16, 2007)

[Congressional Record Volume 153, Number 113 (Monday, July 16, 2007)]
[House]
[Pages H7826-H7835]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

CONGRESSIONAL BLACK CAUCUS

The SPEAKER pro tempore. Under the Speaker's announced policy of
January 18, 2007, the gentlewoman from Ohio (Mrs. Jones) is recognized
for 60 minutes as the designee of the majority leader.
Mrs. JONES of Ohio. Mr. Speaker, tonight I'm joined by members of the
Congressional Black Caucus on the first of what will be many CBC
message hours. This evening we will be discussing health care
disparities, as well as the SCHIP program, which is the State insurance
health program.
But before I get into it, I need to ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on the subjects that I just
mentioned, that of health care disparity and the State Children's
Health Insurance Program.
For the past few Congresses, the CBC has made confronting health
disparities one of its major initiatives. We have been champions for
access to affordable health care, meaningful coverage for prescription
medications for every American, and increased representation of African
Americans across all health care professions.
The health care statistics are staggering in the African American
community. While African Americans comprise approximately 12 percent of
the U.S. population, in 2000 they represented 19.6 percent of the
uninsured. The African American AIDS diagnosis rate was 11 times that
of the White diagnosis rate, 23 times more for women and nine times
more for men.
African Americans are two times more likely to have diabetes than
whites, four times more likely to see their diabetes progress to end-
stage renal disease, and four times more likely to have a stroke. And
African Americans are only 2.9 percent of the doctors, 9.2 percent of
the nurses, 1.5 percent of dentists, and 0.4 percent of health care
administrators. Yet African Americans comprise 12 percent of our
population.
These problems are just the tip of the iceberg. Tonight, along with
my colleagues, we will outline some of the various health issues that
currently impact the African American community. Additionally, many of
us have legislation that we are working to have passed to provide
necessary care and resources to the African American community.
I want to thank the Chair of the Congressional Black Caucus,
Congresswoman Carolyn Cheeks Kilpatrick, and our executive director,
Dr. Joe Leonard, for their assistance and work in this effort, and for
the record, my communications director Nicole Williams.
At this point I'd like to yield 5 minutes to the gentleman from
Virginia, Mr. Bobby Scott.
Mr. SCOTT of Virginia. Mr. Speaker, I rise today to stress the
importance of health care to the well-being of our children and to our
Nation. In 2003, a report was released by the National Academy of
Science entitled ``Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care.'' It

[[Page H7827]]

confirmed what many of us have known for a long time, that even when
African Americans and other minorities have equal insurance and equal
access to physicians, their outcomes are different.
Minority populations just don't get the same health care and are not
offered the same treatments. Unfortunately, we're foundering under the
constraints of a profit-driven, multi-tiered health care where racial
and ethnic stereotypes often distort the decision-making process by
many health care providers.
The situation becomes even more critical when we realize that over 20
percent of all African Americans do not have health insurance. Those
who do are more likely to have public insurance or Medicaid, which,
unfortunately, often does not command the full measure of services
available in private insurance.
Every day, more and more African Americans are diagnosed with life-
threatening illnesses which can be avoided with proper care and
prevention. The diagnosis of illnesses such as diabetes, high blood
pressure, heart disease and HIV/AIDS continues to increase among
African Americans in the African American culture as access to health
care becomes more and more elusive.
It is no surprise that when it comes to taking care of our medical
needs, many of us and our Hispanic, Native American and Asian Pacific
Islanders are slipping through the safety nets available to other
Americans.
Mr. Speaker, the total number of uninsured has actually increased
from 41 million, just a few years ago, to 46 million by the most recent
numbers. In the country where we pride ourselves as being the world's
leading and most prosperous democracy, we have millions of children and
young adults walking around without health insurance.
A sad reflection of how ominous the absence of health care insurance
can be is the death of a 16-year-old boy in Maryland who died from
infections caused by an abscessed tooth because his family had no
health insurance to seek medical care.
Mr. Speaker, in the next few weeks, we'll address the reauthorization
of the State Children's Health Insurance Program, or SCHIP, which is a
vital Federal program which allows States to target and cover low-
income children with no health insurance and families with incomes
above the Medicaid eligibility levels.
Almost 90 percent of these children live in households with a working
parent. More than half live in two-family households. Many of these
children are actually eligible for coverage under SCHIP or Medicaid but
are not enrolled due in large part to barriers to enrollment in
programs and complex eligibility rules that make it difficult to obtain
or keep coverage. Millions more children are underinsured or at risk of
losing coverage if their parents change jobs or if employers drop
health coverage for families.
Mr. Speaker, we need to do more than just renew SCHIP. We need to
expand it so that it adequately covers every uninsured child living in
the United States.
Early and preventive screening, diagnosis and treatment, EPSDT, which
would include services such as dental, vision and mental health
services should be available to all children. EPSDT is the current
requirement under Medicaid to make sure that the health needs of
children are being met, and we should bring this requirement to SCHIP.
Coverage for low-income pregnant women. We need to make sure that
women are receiving the necessary prenatal care needed to ensure that
infants have a healthy start in life.
Presumptive eligibility. We need a unified application system for
SCHIP. There are many social services programs, such as reduced or free
school lunch, that have eligibility requirements clearly more
restrictive than SCHIP. So if a child is eligible for such a program,
it is a virtual certainty that he's also eligible for SCHIP.
The problem arises that States do not presume eligibility, and
parents are required to fill out different applications in different
offices, often with the exact same information, just to access the
services they obviously qualify for.
A commonsense solution would be to streamline the application process
for SCHIP and other programs so that if you're enrolled in another
social service program, you should not have to fill out another
application just to get health care benefits. Money to promote the
streamlining of this process should be included in the reauthorization
of SCHIP.
Mr. Speaker, there is an urgent need for expanded health care
coverage for children, and that's why I introduced H.R. 1688, the All
Healthy Children's Act. That act has been endorsed by the Children's
Defense Fund. It's a logical, smart, and achievable incremental next
step to close the child coverage gap and guarantees that all children
will have access to health care coverage that they need to survive,
thrive, and learn.
This proposal will ensure that all children are covered by expanding
the coverage of both Medicaid and SCHIP programs, while eliminating the
procedural red tape that currently prevents children from being covered
by either program. The comprehensive program would include all basic
health care, as well as coverage for mental health and prenatal care.
Mr. Speaker, the United States health care system has yet to solve
the fundamental challenge, delivering health care coverage to all
Americans at an affordable price. The tragedy is that we know what to
do to fix the problem once and for all. And what is required is a
national health care system with universal access to comprehensive
prevention-oriented benefits. And it is time to take action, and we
should start with our children by passing the All Healthy Children's
Act.
Mrs. JONES of Ohio. Mr. Scott, thank you very much for your
leadership on that issue.
Let me speak for a moment about another piece of legislation that
I've introduced with regard to health care disparities. About 7 years
ago, one of my staffers approached me with an idea for a piece of
legislation. He told me a story of one of his female friends who had
been suffering from uterine fibroids. Her condition had taken a
tremendous toll on both her and her family, mainly because she was
unsure of her options.
This young lady is not alone. There are many women across this
country who are silently dealing with this painful, sometime deadly,
disease.
Uterine fibroids are noncancerous tumors that form within a woman's
uterine lining. It is estimated that three in every four American women
have uterine fibroids, with one in four women seeking medical care for
the condition. African American women are three to nine times more
likely to develop uterine fibroids.
Uterine fibroids can be hard diseases to combat, given the fact that
women are diagnosed with the disease at various stages and physical
conditions. While the fibroids may develop slowly in some women, others
may develop more aggressively.
Right now, hysterectomy is the most common treatment for uterine
fibroids, accounting for 200,000, or 30 percent, of all hysterectomies
in the United States. It is for this reason that I have reintroduced
the Uterine Fibroid Research and Education Act to find new and better
ways to treat, or even cure, uterine fibroids.
The Uterine Fibroid Research and Education Act would double Federal
funding for uterine fibroid research and fund a public education
campaign on the condition. Senator Barbara Mikulski of Maryland
introduced companion legislation in the Senate, and we introduced
identical legislation in the 109th Congress, but neither received a
floor vote.
Even though an estimated three-quarters of all reproductive-age women
have uterine fibroids, little is known about them, and there are still
few good treatment options available. Women deserve better. I have made
it a priority to make sure women are not left out or left behind when
it comes to health care.
This legislation would authorize $30 million in Federal funding for
uterine fibroid research each year for 5 years, doubling the budget
from last year's $15 million. Research is needed to find out what
causes uterine fibroids, why African American women are
disproportionately affected, and what can be done to prevent and treat
the condition.

[[Page H7828]]

It is time that we put the health of the women of America in the
forefront of our agenda. Therefore, I'm asking all to be supportive on
this crucial issue.
Right now I'd like to yield such time as she may consume to
Representative Donna Christensen, who is, in fact, a medical doctor;
and she chairs the Congressional Black Caucus Health Disparities Health
Brain Trust. And this weekend in the Virgin Islands you're hosting a
health care health disparities conference, correct?
Mrs. CHRISTENSEN. Yes. Not only that, but Congressman Clyburn's
district will be hosting a disparities conference, as well as the Tri-
Caucus, the Hispanic, Black and Asian Pacific Caucus this weekend.
Mr. Speaker, I'm pleased to join my colleagues to call attention to
some critical unmet health care needs that this 110th Congress is
called upon to address.
And I also want to applaud our chairwoman, Carolyn Cheeks Kilpatrick,
for making this hour available to us and to thank Congresswoman
Stephanie Tubbs Jones for her leadership as well.
Before I speak about the children's health insurance program, which
is up for reauthorization, I want to remind this body that we have not
yet appropriated the level of funding that would make a dent in the
health disparities that result in 100,000 unnecessary deaths every year
because of our country's failure to address them. We worry more about a
few dollars that may be less than necessary than we worry about the
unnecessary loss of life that happens every day in this country,
although we have the wherewithal to stop them.

{time} 2015

Until our country funds disparity elimination adequately, people of
color will continue to get to health care services late, if at all, and
become disabled or die prematurely from preventable causes.
This Congress will have the opportunity to do just that by passing
the Healthcare Equity and Accountability Act, introduced by the Black,
Hispanic, and Asian Pacific Caucus last week. That is the way to
improve health for everyone and to begin to drive down the skyrocketing
cost of health care.
Mr. Speaker, I also want to call our attention to the now chronic
underfunding for the AIDS Drug Assistance Program, or ADAP. As we have
underfunded it every year, the gaps have grown and the waiting lists
for lifesaving medicines have grown longer. Some of those waiting in
line have died because of our neglect. This Congress, led by Democrats
who have always understood the challenges faced by the HIV/AIDS
community, more than half of which are people of color, needs to
correct this deficiency in funding for this important program.
And, also, Mr. Speaker, very soon we will be reauthorizing the State
Children's Health Insurance Program. We need to do so fully. Now when
we have the opportunity to do the right thing for America's children
with whose welfare we are charged, we are poised to shortchange them,
to let them down, and to leave them without access to health care. That
is unbelievable. There are 9 million uninsured children, of which 6
million are at or below 200 percent of poverty and eligible for SCHIP.
I think we should cover all of them, but current proposals don't even
cover one-third of those who are eligible.
This Congress should do nothing less than cover all 6 million
eligible children, and we must do so with robust programs to foster
their mental, dental, and nutritional health. Investing in our children
is investing in our future.
The CBO has said that it would cost at least $60 billion to cover all
of those eligible children. We are told there are not enough offsets,
not enough money to cover the costs.
Well, there are no offsets for the civil war in Iraq, which we are
funding while our children are being caught in the crossfire, and there
were no offsets for the tax cuts to the wealthiest individuals in this
country, both of which are funded in part with money borrowed from
Communist China. If we can go into bad debt for those, then we can
certainly go into good debt for our children because it is an
investment that pays back invaluable dividends. I am willing to bet,
Mr. Speaker and colleagues, that we will have to set PAYGO aside for
some measure that is deemed important, probably even before this
Congress adjourns. So let's do it now for America's children. There is
no one and nothing more important than they.
There is one other alternative, and that would be to provide funding
to cover all 6 million children for a shorter period of time and
revisit that program 2 or 3 years from now when we should be out of
Iraq and the tax cuts for the rich would expire. That, I think, is
another viable alternative.
We know that the President has said that he will veto a bill if it
costs what he considers too much and even the modest proposals from the
House and Senate fit that bill. I think that that is a fight the
American people would want us to take on because our children are just
that important. And so using his own words, I would say ``bring it
on.''
Let's not let there be any more Deamonte Drivers, the 11-year-old who
died because he could not get an $80 tooth extraction. We are a better
country than that.
Thank you, Congresswoman Tubbs Jones.
Mrs. JONES of Ohio. Thank you, Dr. Christensen, for your leadership
not only this year but every year that I have been in Congress on the
health disparities issue and health care on behalf of all Americans
while particularly focused on African Americans.
Mr. Speaker, it gives me great pleasure at this time to yield to my
colleague and good friend Danny Davis from Illinois.
Mr. DAVIS of Illinois. Mr. Speaker, I want to commend and thank the
gentlewoman from Ohio for not only her leadership on this but her
leadership on many issues that affect not only African Americans but
people all over America.
Although we are talking about health disparities, let it be known
that we don't believe that merely dealing with the disparities is going
to get us where we need to be relative to health care in this country.
I am firmly convinced that the only way that we will address adequately
all of the health care needs that exist in this country is to have a
national health plan where everybody is in and nobody is out; where
everybody will have access to quality, comprehensive health care
without regard to their ability to pay.
I have spent a great deal of my time over the last 2 or 3 years
dealing with the particular needs of young African American males. And
if we look at that population group, nearly four out of 10 young
African American men lack health insurance. The percentage of uninsured
African American men, while higher than that of whites, is lower than
that of Hispanics, American Indians, and Native Hawaiians. Young men,
regardless of race or ethnicity, are more likely to be uninsured than
any other age group.
People without health insurance are more likely than those with
health insurance to delay needed care, less likely to fill
prescriptions, and more likely to be diagnosed at a later stage when
they do finally seek care. They are also less likely to have a usual or
regular source of care.
Young African American men die at the rate that is at least 1.5 times
that of young white and Hispanic men and almost three times the rate of
young Asian men. While the death rate drops for men ages 25 to 29 for
most groups, it continues to rise among African Americans. The leading
causes of death for all young men ages 15 to 29, regardless of race or
ethnicity, are unintentional injuries such as car accident, firearm, or
drowning, suicide and homicide. For young African American men, more
deaths are caused by homicide than any other cause.
Additionally, HIV is the sixth leading cause of death for young
African American and Hispanic men. Yet for other racial groups, HIV is
not among the top 10 causes of death.
When I hear my colleagues talk about what we need to do and when
Representative Clarke was here a few minutes ago talking about the need
for gun control legislation that would make it more difficult to
acquire and make use of handguns, that is so real. Not only are those
tragedies taking place in New York, but I also take this

[[Page H7829]]

opportunity to commend Reverend Jessie Jackson and a coalition of
individuals, including Reverend Gregory Livingston, who every Saturday
morning have been picketing gun shops outside the City of Chicago.
Fortunately, you cannot purchase a handgun in Chicago, but you can go
right outside and purchase all that you want.
So I commend them for their efforts to make real the notion that
change can occur, but it only comes as we are activated, motivated,
stimulated, and involved.
So, again, Representative Jones, I thank you for your leadership.
Thank you for giving us the opportunity to put a face on this problem
that is plaguing African Americans all over America.
Mrs. JONES of Ohio. I want to say to you, Mr. Davis, also your
leadership on the Second Chance Act, you and I have been working on
that issue for several years, and, hopefully, it will come to fruition
in the next couple, 3 weeks. I look forward to working with you on that
and discussing that issue with you.
Mr. DAVIS of Illinois. I must tell you, I was in Detroit at the NAACP
convention last week, and there were some folks there from Ohio. And as
we talked about what needed to happen, I know I don't have to ask you,
but I just know that my representative, Representative Stephanie Tubbs
Jones, is up on this, as in my man, you got it right. You're on it;
stay on it. We appreciate you so much.
Mrs. JONES of Ohio. Thank you very much.
Mr. Speaker, it gives me great pleasure at this time to have the
opportunity to yield to the awesome Chair of the Congressional Black
Caucus. She has shown such great leadership not only in this role but
as Chair of so many other events that the Congressional Black Caucus
has done.
I yield to my sister, the Congresswoman from the great State of
Michigan, Carolyn Cheeks Kilpatrick.
Ms. KILPATRICK. I thank you, Madam Chair, for yielding. I certainly
appreciate your leadership and all that you do for this body. I thank
you for being the coordinator for this Special Order as we move through
this 110th session. We thank you for your leadership, delta woman. We
appreciate you.
Mr. Speaker, I am honored to stand here tonight as chairperson of the
Congressional Black Caucus. We are from 26 States. We are 43 Members.
We represent over 40 million Americans. Eighteen of our Members have
less than 50 percent populations of African Americans. The highest
percentage that any Member represents is 61 percent African Americans.
So we represent all ethnicities of America: Latino Americans, Asian
Americans, Native Americans, Arab Americans, Italian Americans,
European, and the whole conglomerate. So we call ourselves the
conscience of the Congress because we are they, 43 of us, 26 States,
representing over 40 million Americans who can speak and represent all
ethnicities in America.
Disparities in health care is real. It's alive. And it is really
determined by how you live, where you live, what economic standards are
you able to afford with you and your family, from generations yet
unborn. So we are here tonight to talk about how do we close that gap?
What ought to be the policies of our United States government to take
care of American citizens, 300 million of us, from disparate
backgrounds? What can we do to close the gap?
One thing we can do is to make sure that education, quality
education, is had for every American; that they may compete not against
Ohio or Michigan or California and New York, but to compete in the
world, China, India, other countries of the world who revere, and in
knowing that education is the key not only to a successful life but a
key to adequate health care opportunities.
Number two, that we invest in those communities so that we put the
dollars where they are necessary, so that we don't have underserved
communities as we have today across America, underserved as it relates
to health care, their access to quality health care. Can they really
participate in programs that make their lives better?
When we have a healthy America, then we have healthier families, we
have healthier cities, and then, of course, our country is one of
health.
We talk about disparities of health care, and it refers to the
difference between two or more population groups, the outcomes and the
prevalence of certain illnesses, heart disease, diabetes, access to
quality health care, are we really providing what is necessary for
America's families? And we, the members of the Congressional Black
Caucus, don't believe that we do.
Our Federal budget is 2.9 trillion of your tax dollars. We round that
off and say $3 trillion in this 2008 budget that we are dealing with.
Of that budget three entitlements: Medicare, health insurance for 44
million American seniors; Medicaid, over 40 million low-income,
disabled, and children's programs; and then our veterans, our proud
veterans, who have fought in our wars ever since the beginning, some in
battle, some in theater, some not, but defending our country.

{time} 2030

When you take out the main three entitlements, our Appropriations
Committee handled 600 to $800 billion. Two-thirds of those monies goes
to the entitlements, as was mentioned, and a few others handled by the
Ways and Means Committee, where some of those health programs were had.
And the other, what we call discretionary funding, is what is handled
in the Appropriations Committee.
Of the $800 billion in 2008, $600 billion of that is going to
defense, to defense. Proud that we are of our Defense Committee, but
never is it intended that two-thirds of that budget, three-fourths in
many instances, will go to defend the country. We have to end the war.
We've got to bring our soldiers home. We have to invest in American
families.
I believe that health care, education, housing, environment and
access to capital are those things that this Congress must fund. That's
why we have disparities, because many families start at a disadvantage;
low income, poor schools, health crisis, unable to get quality health
care.
So as we come to you tonight as members of the Congressional Black
Caucus, we ask you, America, stand up for what you believe. If you want
a strong family, if you want strong opportunities, if you want
investment in your children and in your families, speak to that.
Our theme for the Congressional Black Caucus is ``Change Course.'' Do
something different, America. Join. Speak out. Donate. Volunteer. Be a
part of something that you believe in that will make America stronger.
Health care, we believe, is one of those things that you will find
yourself participating in.
Change course and then confront the crisis. Confront the crisis of
education. Why is it that our schools can't compete with schools around
the world? Confront the crisis of the war. And yes, confront the crisis
of the disparities in health that we find ourselves in today. We can do
better. We can be better. Make sure you're a part of that equation.
And then let us all rise up and continue the legacy. Change course,
confront crises, and continue the legacy that all of us have put
together as members of the African American Congressional Black Caucus,
Latino Caucus, Tri-Caucus, the Asian Caucus as well. We work together
to make sure that we begin to address some of the disparities that we
see.
So, Madam Chair, thank you for your leadership. Thank you as we try
to talk to America to become involved, to change course, to confront
crises, to continue the legacy that so many have given their lives and
time that we might be on this floor tonight.
This is the greatest country in the world. Let's eliminate the health
disparities. Let's make our families stronger. Provide better education
opportunities, better work opportunities and, yes, access to capital.
When we do that, we will eliminate the disparities that we find now in
our health system.
With that, Madam Chair, I yield back the balance of my time.
Mrs. JONES of Ohio. Thank you, Madam Chair, for that great
presentation and for your leadership.
Being uninsured means going without needed care. It means minor
illnesses become major ones because care is delayed. Tragically, it
also means that one significant medical expense can wipe out a family's
life savings.

[[Page H7830]]

There are millions of working uninsured Americans who go to bed
worrying about what will happen to them and their families if a major
illness or injury strikes.
In my home State of Ohio, there are currently 1,362,000 uninsured, an
increase of 18,000 people since 2003. We've also seen the strain on
many of the local hospitals in my district when people are forced to
use emergency rooms as their source of primary care. The problem is
getting worse. As the price of health care continues to rise, fewer
individuals and families can afford to pay for the coverage. Fewer
small businesses are able to provide coverage for their employees, and
those that do are struggling to hold on to the coverage they offer. It
is a problem that affects all of us, and we cannot sit idly by while
the people of this country continue to go without health insurance.
I am pleased at this juncture to yield such time as she may consume
to my colleague and good friend from the great State of Texas,
Congresswoman Sheila Jackson-Lee.
Ms. JACKSON-LEE of Texas. Let me thank my distinguished colleague
from Cleveland, Ohio, the chairwoman of the Ethics Committee, and as
well the first African American woman, only African American woman on
the Ways and Means Committee. These two distinctive positions are so
important, one, for the health of this body, the Ethics Committee, and
two, for the great city that she represents. And I might compete with
her, she has the Cleveland Clinic; I have the Texas Medical Center. And
I know that we have had the opportunity to work with each other, and I
want to thank her for what I think is an enormously important Special
Order.
I want to begin, as many of my colleagues have begun, and I want to
acknowledge the chairwoman of the Congressional Black Caucus,
Congresswoman Kilpatrick, for the importance of putting a face on the
issue of disparities in health care.
In doing that, I'm reminded of the language in the beginning of the
Constitution that the Founding Fathers organized to create a more
perfect Union. But as they struck out on faith to establish this
fledgling United States of America, only 13 colonies, feeling the
redcoats breathing down their backs, afraid that at any moment this
very fragile government might be toppled, they had enough courage to
declare some words that I believe, if this Congress would use it as a
moral compass, these issues of Congresswoman Stephanie Tubbs Jones
would be very clear, and those are the words of the Declaration of
Independence that said we all are created equal with certain
inalienable rights; the right to pursue life, liberty and the pursuit
of happiness. We are all created equal with certain inalienable rights;
the rights of life, liberty and the pursuit of happiness.
Clearly, health care is intimately involved in life and the pursuit
of happiness. And so in actuality, the Founding Fathers put down a
marker of what kind of Nation they wanted this to be. Tragically, over
the last years, when our good friends were involved, many of the
serious issues of health care were diminished in terms of care and
funding. And so it is important that we stand here tonight to be able
to lay down the challenge and the charge that we are here to fix it up.
We are here to make it right. We are here to correct some of the ills,
governmental ills, budgetary ills that have caused health care to be
diminished.
And let me cite some important statistics that represent the
districts of individuals in this body coming from the south, coming
from the midwest, coming from the far west, next to Texas, and parts of
the mountain area.
The cost of the war in one district is costing $1 million. And out of
that waste of money in the Iraq war, we would be able to provide people
with health care: 336,000 adults and 527,000 children, plus, with
health care.
Another district, the war is costing them $1.2 million, plus. We
would be able to provide 420,000 people with health care if that war
was ended, 758,000 children.
Another district, the war is costing them $1.1 million--755,000
people would be able to have health care and 633,000 children. Another
district, $812,000 it's costing them, and we would be able to provide
310,000 adults with health care, and children, 502,000.
So, we can already see that we would be able to provide thousands,
hundreds of thousands of Americans with health care and hundreds of
thousands of children with health care if we, first of all, brought our
troops home and ended the Iraq war.
Now, why should we be concerned with that? And the Congressional
Black Caucus has gone on the record on questions of disparities in
health care. And I might say that this whole issue of disparities is
not just an issue of race; it's an issue of dealing with economics. It
is the kind of health care that poor people are able to manage to get
versus those who are covered, who have means. Some people have means
where they pay outright for the care. The Texas Medical Center, for
example, has long-time hosted international patients who outright pay
for good care. We don't have that luxury here in the United States for
many of those who are struggling.
And I might give you just a real-life example, Mr. Speaker, having
left my home district and had the challenge and the desire to visit
constituents who were ailing. They are now surviving because they
happen to be individuals who had the care and the sophistication of
family members who could get them to a spot that would, in fact,
determine what was the final need of their care. Mr. Speaker, they had
a disastrous cancerous organ that was not initially found, and they
could have died. But because they had the means, they were able to go
through test after test, and one expensive test that is rarely given,
an MRI, was able to find that cancerous organ, their life has been
saved. Another person with a severe injury or severe disease was able
to be cared for and is in the best of care because of means. They live
today. But that is not the case in the question of disparities on
economics, what you make, and also on race.
I'm very glad to be part of the CBC effort and Health Task Force to
focus on ensuring that the Ryan White CARE Act is passed with language
that emphasizes minority HIV organizations.
I believe in fixing health care disparities on the ground. I have
organized a series of testing activities or actions to engage the
community in being tested. Our first effort with a church, 245 persons
were tested. And our message is that HIV testing is not a one-shot
deal. Just recently, a good friend, Representative Borris Miles, was
able to get 7,000, or thousands of persons tested, possibly 7,000
persons, for HIV. We are going to launch another effort of testing and
a campaign that says ``HIV testing is not a one-shot deal.''

I am a strong supporter of believing in the Health Centers Renewal
Act of 2006. For the time that I have been here, I have emphasized that
we have not enough community-based health clinics that were privately
owned in neighborhoods accessible to grandmothers and young mothers
with children. And we have worked hard to ensure that more community
health centers come to Houston, Texas.
I'm proud that in my own congressional district we've opened one in
Fifth Ward. We've opened two that are under the auspices of the Martin
Luther King Community Center that I worked with and kept their doors
open with a $400,000 grant from HHS in the early years of my
congressional career. This is a stopgap to the disparities in health
care, allowing those in the community to have immediate access to
health care.
Then, of course, one of the largest, if I might use the term, Mr.
Speaker, ``elephants'' in the room, is the question of obesity in
America. As the cochair of the Congressional Children's Caucus, we have
worked on the issue of obesity in children. I was very proud to join
Congressman Donald Payne for a very thoughtful, forward-thinking
session on obesity in New Jersey, and providing remarks dealing with
the question of obesity in our children. And it is a disparity in
health care as it relates to Hispanic and African American children who
are victimized, if you will, in large numbers by the lack of nutritious
food that generates an overweight child. That turns into hypertension
as an adult, type II diabetes, coronary heart disease, stroke,
gallbladder disease, asthma, bronchitis, sleep apnea, and other
respiratory diseases.
There are also increases in overweight among children and teens. For

[[Page H7831]]

children age 2 to 5, the prevalence of overweight increased from 5
percent to 13 percent; 6 to 11 years, prevalence increased from 6.5
percent to 18.8 percent; and for age 12 to 19 years, 5 percent to 17.4
percent.
We're working to ensure in the agricultural reauthorization bill
that's coming forward that school lunches and school breakfasts are
nutritious. That has to be for those children who are poor and are
dependent upon those meals as sometimes their only meal.
I passed legislation that involved the creation of an Office of
Minority Populations that still stands today, and the idea is to keep
the question of disparities in health care before Health and Human
Services regardless of who the Secretary is. We can do better in this
Congress.
And there are issues dealing with our veterans. I'm very pleased that
my VISTA bill was marked up in the veterans which provides added
resources for visually impaired veterans in order to assist them in the
care of those who are impaired by their recent, if you will, deployment
to Iraq and those who are veterans who have suffered injury or have
lost their sight.
But we come now to the issue of the SCHIP, which is in the process of
being reauthorized. And the difficulty, of course, is that we need to
emphasize the crucialness of SCHIP in the Nation and in our States. I
believe that the work of the Congressional Black Caucus and all of us
in our respective States is a telling answer to health care for
children who are at a certain economic level.
Tragically, the State of Texas, after the passage of the 1997 budget
resolution which created SCHIP, was one of those States that turned
back $400 million because they could not enroll the children. As we
move forward, I want to make sure that we move forward on the package
that will cover 6 million children. I would like to see us go up to 9
million, but I think we need to look at process. I hope that we do not
privatize and make this a market-based program so that people can stuff
their pockets with money.

{time} 2045

This should be a program that goes directly to these families. Any
State that fails to enroll should be penalized by the State's having to
refund their own tax dollars, not the money sent for the children. Let
us not penalize the children, but let us cause those States to pay
fines for their inertia and their inability to enroll these children. I
hope that we will have that kind of reform.
Let me close by suggesting that we have an enormous road to take on
health care. I am gratified that I hear more African Americans and
Hispanics and others of a certain economic level who are prone to these
disparities in health care talking about eating right, talking about an
intake of less red meat. For those who are on the ranches, and I am
from Texas, a good steak is a good thing to have. But to focus on
vegetables, and some people have become vegetarians and are drinking
water. These are elements that can encourage good health care.
For those of us who have our schedule here in Washington, D.C., a
little walking, a little exercise would be good as well. We should
probably look at ourselves in the mirror and try to improve our own
health status. We have the capability and capacity if and when some
health matter would come to our attention, that is a personal matter,
but we must speak for the millions of Americans, 44 million, that are
uninsured, that do not have access to health care. I do believe that it
is time to move for universal access to health care.
So as we move in the 110th Congress and complete this session, I
would say to all of my colleagues, be reminded of the Declaration of
Independence; we all are created equal with certain inalienable rights
of life, liberty and the pursuit of happiness. Health care has to be a
constitutional issue and a right for Americans.
Certainly for the least of those we must stand ready to provide them
with a strong and forceful statement and action on health care in
America. We should have the SCHIP passed without hindrance and without
a market-based approach. We should pass universal access to health care
so that all Americans, all Americans, can have the ability to be
blessed with the virtues of the pursuit of happiness and have good
health care.
Mr. Speaker, let me thank my colleague for yielding. Might I also
suggest that we have our marching orders at this point, that we will
not take a ``no'' on passage of the SCHIP out of this House. We want to
see universal access to health care come to the floor.
On the disparity question, I am looking forward to the Congressional
Black Caucus and the Tri-Caucus health disparity bill being made in
regular order and being brought to this floor as soon as possible.
Mr. Speaker, we must save lives. We must.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in support of Special
Order to recognize the importance of closing the racial and ethnic
health disparities in this country. It is crucial that we continue to
bring awareness to the many health concerns facing minority communities
and to acknowledge that we need to find solutions to address these
concerns. My colleagues in the Congressional Black Caucus and I
understand the very difficult challenges facing us in the form of huge
health disparities among our community and other minority communities.
We will continue to seek solutions to those challenges. It is
imperative for us to improve the prospects for living long and healthy
lives and fostering an ethic of wellness in African-American and other
minority communities. I wish to pay special tribute to my colleague,
Congresswoman Donna Christensen, the Chair of the CBC Health
Braintrust, for leading the Congressional Black Caucus in its efforts
to bring attention to the health challenges facing minority
communities. I thank all of my CBC colleagues who have been toiling in
the vineyards for years developing effective public policies and
securing the resources needed to eradicate racial and gender
disparities in health and wellness.
Let me focus these brief remarks on what I believe are three of the
greatest impediments to the health and wellness of the African-American
community and other minority communities. The first challenge is to
provide everyone access to healthcare. This includes supporting the
reauthorization and expansion of the State Children's Heath Insurance
Program (SCHIP) so that all of our children who need health insurance
will receive it. The second challenge is combating the scourge of HIV/
AIDS. The third challenge is to reverse the dangerous trend of
increasing obesity in juveniles and young adults.

differential access may lead to disparities in quality; support for
healthcare legislation--h.r. 676

Across this great Nation the health disparities between minority and
majority populations are staggering. Most major diseases--diabetes,
heart disease, prostate cancer, HIV/AIDS, low-birth weight babies--all
hit minority communities harder. As minorities, we constantly have had
to endure decreased access to care, and often of lesser quality care,
than do members of the majority race in America.

h.r. 676, ``the united states national health insurance act''

Earlier this year, I was proud to be an original cosponsor of H.R.
676, ``The United States National Health Insurance Act.'' This Act
would allow for every American to receive heath insurance. You, the
American people called for universal health care, as it was one of the
most prominent issues for Americans in the 2006 election.
The need for a high-quality, accessible and affordable health care
system has never been more urgent. There are currently 47 million
uninsured Americans, 8 million of whom are children. Another 50 million
are underinsured. Although the U.S. spends twice as much on health care
per capita as countries with universal coverage, the World Health
Organization ranks us 37th in overall health system performance. Major
American corporations such as General Motors bear the brunt of an
outdated health care system because they are at a competitive
disadvantage relative to their international counterparts who pay less
for health care. A Harvard study found that almost half of all
bankruptcies are partially or fully related to health care bills.
Our plan, H.R. 676, ``The United States National Health Insurance
Act,'' guarantees every resident of the United States access to a full
range of medically necessary services, including primary care,
prescription drugs, mental health care and long term care. The role of
the government would be limited to collecting revenues and disbursing
payments; care would continue to be delivered privately. Patients could
continue to use the same hospital, physician or health clinic from
which they currently receive services. H.R. 676 is supported by over
210 labor unions and more than 100 grassroots groups across the
country. The former editor of the New England Journal of Medicine, two
former U.S. Surgeons General and 14,000 physicians support national
health insurance.

[[Page H7832]]

health equity and accountability act of 2007

I also strongly support the Health Equity and Accountability Act of
2007, an important bill that my colleague Congresswoman Donna
Christensen has crafted to address the health disparities we face in
our community. This bill will provide for:
Creation of Regional Minority Centers of Excellence Programs in
medically underserved regions of the country
Creation of Health Information Technology Zones
Data Collection and Analysis Grants for Historically Black Colleges
and Universities, Hispanic Services Institutions, and Tribal Colleges
and Universities, and Asian American and Pacific Islander-serving
institutions with accredited public health, health policy or health
services research programs
Reauthorization of the National Center for Minority Health and Health
Disparities
Expansion of funding the Minority AIDS Initiative ($610 million)
Grants for Racial and Ethnic Approaches to Community Health
Access to programs and activities and establishes support center to
those with limited English proficiency and ensures antidiscrimination
provisions and sets standards for these services, such as hiring
bilingual staff and informing patients of their rights in their primary
language.
Federal agencies that carry out health related activities are
mandated to adopt a guidance model on language services.
The Secretary is required to conduct a demonstration project in no
less than 30 states or territories showing the impact of costs and
health outcomes to those with limited English proficiency.
Grants to improve healthcare for those with communities with low
functional literacy.
The preparation and publication of a report that describes government
efforts to provide access to culturally and linguistically appropriate
healthcare services including an evaluation of activities and an
explanation of best practices and models.
DHHS will be responsible for submitting a report on health workforce
diversity with descriptions of any grant support provided for workforce
diversity initiatives.
Establishment of a technical clearinghouse for health workforce
diversity with statistical information, model health workforce
programs, admissions policies, etc.
Evaluation of workforce diversity initiatives, data collection and
reporting by health professional schools, and supporting institutions
committed to workforce diversity.
Providing career development for scientists and researchers and for
those non-research health professionals.
Provide cultural competence training for health care professionals.
To increase the number of individuals from disadvantaged backgrounds
in health professions by enhancing their academic skills and supporting
them in training.
Examination of providers and the delivery of culturally and
linguistically appropriate services in geographic areas
Makes public the data collected and analyzed.
Grants to eligible institutions to conduct and coordinate research on
the built environment and its influence on individual and population-
based health.
Such a bill will go a long way in providing for the healthcare needs
of minorities and will help to narrow the health disparity gap.
There is no reason why this country should continue down a dreadfully
deleterious road of denying healthcare to any citizen of this country
who needs it. Many of the health conditions, such as diabetes, obesity,
kidney failure, cancer, hypertension and HIV/AIDS, the prevalence of
which plagues our community the most, could be curtailed or even
prevented if everyone had access to health insurance. I will continue
to fight hard for the most effective policy measures that aim to narrow
the racial health disparity gap.

It is a misconception that minority healthcare is just about helping
minorities. Keeping Americans healthy ensures that children can stay in
school and that their parents can go to work. It ensures that our
emergency rooms are not glutted. It ensures that our hospitals are not
wasting time and money chasing the uninsured with massive bills they
cannot afford to pay anyway. Keeping Americans healthy ensures that all
of our friends, neighbors, and loved ones can have longer, more
productive lives to contribute to our communities and to our economy.
We all pay the cost of leaving people in America without health
coverage. We cannot afford to pay that high cost any longer. The time
for health equality is now. We need to work to improve access to care
for people, in general, but there are also areas where more specific
interventions are necessary.
I have worked to improve awareness on prostate cancer, and have
worked with MD Anderson to help start clinics in Houston that will open
access to quality affordable prostate screening and care. I have worked
with Hepatitis C advocates in Houston, and across the Nation, to spread
the word that Hep C is a silent killer that is cutting down our
minority communities and our veterans. There is so much misinformation
out there about Hep C. I am pushing the Government Accountability
Office to do a full report on the Hep C problem so that we can work to
stop this epidemic.
There is also a significant shortage of minority doctors, dentists,
and health professionals of all sorts; a shortage that contributes
significantly to quality healthcare access. It has been shown that
people tend to seek care from people who look like them, and share
similar backgrounds. So, the lack of diversity is not just a civil
rights issue, it is an issue of health access. We need to boost
minority enrollment in health professional programs.
Success will require young people to redouble their efforts to pursue
their scholarly pursuits with a renewed commitment to health and
medical research. I am very bullish on academic achievement. That is
one reason why I was so interested in securing increased funding for
science, technology, engineering, and mathematics education and
research.
There are so many areas in which we need to work together and address
the critical needs of the people who are being left out of our health
care system. Putting energy and resources into decreasing health
disparities is a solid investment, one that will reduce unnecessary
suffering, and make our workforce and our society stronger. I pledge to
you that I will continue to do my part. By your presence here today, I
have no doubt you will continue to do yours. And together, we will see
the eradication of serious health inequalities in our lifetimes.

We must ensure that all Americans have access to healthcare. Access
to healthcare is an important prerequisite to obtaining quality care.
Some access barriers, whether perceived or actual, can result in
adverse health outcomes. Patients may perceive barriers to delay
seeking needed care, resulting in presentation of illness at a later,
less treatable stage of illness. For example, a usual source of care
can serve as a navigator to the healthcare system and an advocate to
obtain needed evidence-based preventive and health care services. Of
the major measures of access, the lack of health insurance has
significant consequences. Avoidable hospitalizations are a good example
of the link between access and disparities in quality of care. These
hospitalizations may reflect, in part, the adequacy of primary care.
When health care needs are not met by the primary health care system,
rates of avoidable admissions may rise. Many racial and ethnic
minorities and individuals of lower socioeconomic status are less
likely to have a usual source of care. As a result:
Hispanics and people of lower socioeconomic status are more likely to
report unmet health care needs.
While most of the population has health insurance, racial and ethnic
minorities are less likely to report health insurance compared with
whites. Lower income persons are also less likely to report insurance
compared with higher income persons.
Higher rates of avoidable admissions by blacks and lower
socioeconomic position persons may be explained, in part, by lower
receipt of routine care by these populations.
Many of these circumstances are the direct result of lack of
heathcare coverage.

STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP)

Until we have a healthcare system that covers all Americans, it is
crucial that we reauthorize the State Children's Health Insurance
Program, SCHIP. We know that the lack of healthcare contributes greatly
to the racial and ethnic health disparities in this country, so we must
provide our children with the health insurance coverage to remain
healthy. SCHIP, established in 1997 to serve as the healthcare safety
net for low-income uninsured children, has decreased the number of
uninsured low-income children in the United States by more than one-
third. The reduction in the number of uninsured children is even more
striking for minority children.
In 2006, SCHIP provided insurance to 6.7 million children. Of these,
6.2 million were in families whose income was less than $33,200 a year
for a family of three. SCHIP works in conjunction with the Medicaid
safety net that serves the lowest income children and ones with
disabilities. Together, these programs provide necessary preventative,
primary and acute healthcare services to more than 30 million children.
Eighty-six percent of these children are in working families that are
unable to obtain or afford private health insurance for their
Meanwhile, health care through SCHIP is cost effective: it costs a mere
$3.34 a day or $100 a month to cover a child under SCHIP, according to
the Congressional Budget Office. There are significant benefits of the
State Children's Health Insurance Program when looking at specific
populations served by this program.

[[Page H7833]]

Children in Rural Areas

SCHIP is significantly important to children living in our country's
rural areas. In rural areas:
One in three children has healthcare coverage through SCHIP or more
than half of all children whose family income is under $32,180 received
healthcare coverage through Medicaid or SCHIP.
Seventeen percent of children continue to be of the 50 counties with
the highest rates of uninsured children, 44 are rural counties, with
many located in the most remote and isolated parts of the country.
Because the goal is to reduce the number of uninsured children,
reauthorizing and increasing support for SCHIP will be crucial to
helping the uninsured in these counties and reducing the 17 percent of
uninsured.

Minority Children

SCHIP has had a dramatic effect in reducing the number of uninsured
minority children and providing them access to care:
Between 1996 and 2005, the percentage of low-income African-American
and Hispanic children without insurance decreased substantially.
In 1998, roughly 30 percent of Latino children, 20 percent of
African-American children, and 18 percent of Asian American and
Pacific-Islander children were uninsured. After enactment, those
numbers had dropped by 2004 to about 12 percent, and 8 percent,
respectively.
Half of all African Americans and Hispanics are already covered by
SCHIP or Medicaid.
More than 80 percent of uninsured African-American children and 70
percent of uninsured Hispanic children are eligible but not enrolled in
Medicaid and SCHIP, so reauthorizing and increasing support for SCHIP
will be crucial to insuring this population.
Prior to enrolling in SCHIP, African-American and Hispanic children
were much less likely than non-Hispanic White children to have a usual
source of care. After they enrolled in SCHIP, these racial and ethnic
disparities largely disappeared. In addition, SCHIP eliminated racial
and ethnic disparities in unmet medical needs for African-American and
Hispanic children, putting them on par with White children.

Children in Urban Areas

SCHIP is also important to children living in urban areas of the
country. In urban areas: One in four children has healthcare coverage
through SCHIP. More than half of all children whose family income is
$32,180 received healthcare coverage through SCHIP.

HIV/AIDS

Ensuring that everyone has healthcare coverage will also help to
combat HIV/AIDS in this country, and in particular in African-American
and minority communities. In 1981, HIV/AIDS was thought by most
Americans to be a new, exotic, and mysterious disease which seemed to
inflict primarily gay white males in New York City and San Francisco.
But since then we have learned that in the America of 2006, AIDS is
overwhelmingly a black and brown disease. And that means that we have
to assume the major responsibility for finding the solutions to rid our
communities of this scourge. Consider the magnitude of the challenge
confronting us:
HIV/AIDS is now the leading cause of death among African Americans
ages 25 to 44--ahead of heart disease, accidents, cancer, and homicide.
The rate of AIDS diagnoses for African Americans in 2003 was almost
10 times the rate for whites.
Between 2000 and 2003, the rate of HIV/AIDS among African-American
males was seven times the rate for white males and three times the rate
for Hispanic males.
African-American adolescents accounted for 65 percent of new AIDS
cases reported among teens in 2002, although they only account for 15
percent of American teenagers.
Billions and billions of private and federal dollars have been poured
into drug research and development to treat and ``manage'' infections,
but the complex life cycle and high mutation rates of HIV strains have
only marginally reduced the threat of HIV/AIDS to global public health.
Although the drugs we currently have are effective in managing
infections and reducing mortality by slowing the progression to AIDS in
an individual, they do little to reduce disease prevalence and prevent
new infections. It simply will not suffice to rely upon drugs to manage
infection. We can make and market drugs until we have 42 million
individually tailored treatments, but so long as a quarter of those
infected remain detached from the importance of testing, we have no
chance of ending or even ``managing'' the pandemic.
Currently, the only cure we have for HIV/AIDS is prevention. While we
must continue efforts to develop advanced treatment options, it is
crucial that those efforts are accompanied by dramatic increases in
public health education and prevention measures.
Learning whether one is infected with HIV before the virus has
already damaged the immune system represents perhaps the greatest
opportunity for preventing and treating HIV infection. According to the
Centers for Disease Control, CDC, between 2000 and 2003, 56 percent of
late testers--defined as those who were diagnosed with full-blown AIDS
within 1 year after learning they were HIV-positive--were African
Americans, primarily African-American males.
African Americans with HIV have tended to delay being tested because
of psychological or social reasons, which means they frequently are
diagnosed with full-blown AIDS soon after learning they are infected
with HIV. This is the main reason African Americans with AIDS do not
live as long as persons with HIV/AIDS from other racial/ethnic groups.
Researchers have identified two unequal tracks of HIV treatment and
care in the United States. In the first, or ``ideal track,'' a person
discovers she or he is HIV-infected, seeks medical care, has regular
follow-ups, and follows a regimen without complications. Persons in
this track can now in most cases lead a normal life.
But some individuals follow a second, more-dangerous track. These
individuals come to the hospital with full-blown AIDS as their initial
diagnosis. They may have limited access to care because of finances or
because other social or medical problems interfere. The vast majority
of deaths from HIV/AIDS are among this second group. And the persons
making up this group are disproportionately African-American males.
I have strongly supported legislation sponsored by CBC members and
others to give increased attention and resources to combating HIV/AIDS,
including the Ryan White CARE Act. I support legislation to reauthorize
funding for community health centers (H.R. 5573, Health Centers Renewal
Act of 2006), including the Montrose and Fourth Ward clinics in my home
city of Houston, and to provide more nurses for the poor urban
communities in which many of these centers are located (H.R. 1285,
Nursing Relief Act for Disadvantaged Areas). I have also authored
legislation aimed to better educate our children (H.R. 2553,
Responsible Education About Life Act in 2006) and eliminate health
disparities (H.R. 3561, Healthcare Equality and Accountability Act and
the Good Medicine Cultural Competency Act in 2003, H.R. 90).
Twenty-five years from now, I hope that we will not be discussing
data on prevalence and mortality of HIV/AIDS among African Americans,
but rather how our sustained efforts at elimination have come into
fruition. But for us to have that discussion, we must take a number of
actions now. We must continue research on treatments and antiretroviral
therapies, as well as pursue a cure. We absolutely have to ensure that
everyone who needs treatment receives it. And we simply must increase
awareness of testing, access to testing, and the accuracy of testing.
Because we will never be able to stop this pandemic if we lack the
ability to track it.

African Americans are 11 times as likely to be infected with HIV/
AIDS, so we must make 11 times the effort to educate them until HIV/
AIDS becomes a memory. We simply do not have any other alternative but
to work continuously to eliminate HIV/AIDS in our community.
When it comes to the scourge of HIV/AIDS, the African-American
community is at war. It is a war we absolutely have to win because at
stake is our very survival. With HIV/AIDS we need not wonder whether
the enemy will follow us. The enemy is here now. But so is the army
that can vanquish the foe. It is us. It is up to us. For if not us,
who? If not now, when? If we summon the faith of our ancestors, the
courage of our great grandparents, and the determination of our
parents, we will march on until victory is won.

OBESITY

The obesity epidemic in the African-American and other minority
communities is also of great concern. Although the obesity rates among
all African Americans are alarming, as Chair of the Congressional
Children's Caucus, I am especially concerned about the childhood
obesity epidemic among African-American youth. More than 40 percent of
African-American teenagers are overweight, and nearly 25 percent are
obese.
Earlier this year, my office in concert with the office of
Congressman Towns and the Congressional Black Caucus Foundation, held a
widely-attended issue forum entitled, ``Childhood Obesity: Factors
Contributing to Its Disproportionate Prevalence in Low Income
Communities.'' At this forum, a panel of professionals from the fields
of medicine, academia, nutrition, and the food industry discussed the
disturbing increasing rates of childhood obesity in minority and low-
income communities, and the factors that are contributing to the
prevalence in these communities.
What we know is that African-American youth are consuming less
nutritious foods such as fruits and vegetables and are not getting
enough physical exercise. This combination has led to an epidemic of
obesity, which directly contributes to numerous deadly or life-
threatening diseases or conditions, including

[[Page H7834]]

the following: hypertension; dyslipidemia (high cholesterol or high
triglyceride levels), Type 2 diabetes; coronary heart disease; stroke;
gallbladder disease; osteoarthritis; asthma; bronchitis; sleep apnea;
and other respiratory problems; and cancer (breast, colon, and
endometrial).
When ethnicity and income are considered, the picture is even more
troubling. African-American youngsters from low-income families have a
higher risk for obesity than those from higher-income families. Since
the mid-1970s, the prevalence of overweight and obesity has increased
sharply for both adults and children. According to the Centers for
Disease Control and Prevention (CDC), among African-American male
adults aged 20-74 years the prevalence of obesity increased from 15.0
percent in 1980 survey to 32.9 percent in the 2004.

There were also increases in overweight among children and teens. For
children aged 2-5 years, the prevalence of overweight increased from
5.0 percent to 13.9 percent; for those aged 6-11 years, prevalence
increased from 6.5 percent to 18.8 percent; and for those aged 12-19
years, prevalence increased from 5.0 percent to 17.4 percent.
As the debate over how to address the rising childhood obesity
epidemic continues, it is especially important to explore how
attitudes, environmental factors, and public policies influence
contribute to obesity among African Americans and other minorities.
Some of these contributing factors are environmental, others are
cultural, still others are economic, and others still may be lack of
education or information. But one thing is clear: we must find ways to
remove them.
Mr. Speaker, I urge my colleagues to continue to support initiatives
and programs that close the racial and health disparities gaps. It is
imperative that we continue to seek workable solutions to the health
and wellness challenges facing our communities. I look forward to
working with all of my colleagues to achieve these goals.
Mrs. JONES of Ohio. Mr. Speaker, the State Children's Health
Insurance Program is one of the most important priorities for the
Congressional Black Caucus. Let me give you some information about
SCHIP.
Of children living in rural areas, one in three children have health
care coverage through SCHIP or Medicaid. More than half of all those
whose family income is under $32,180 receive health care coverage
through Medicaid or SCHIP. Of the 50 counties with the highest rate of
uninsured, 44 are rural counties, with many located in the most remote
and isolated parts of the country. Because SCHIP's goal is to reduce
the number of uninsured children, reauthorizing and increasing support
for this program will be crucial to helping the uninsured in these
counties and reducing the 17 percent of uninsured.
Let's talk about children living in urban areas. One in four children
have health care coverage through SCHIP or Medicaid. More than half of
all the children whose family income is under $32,180 receive health
care coverage through Medicaid or SCHIP. Nineteen percent continue to
be uninsured. Because SCHIP's goal is to reduce the number of uninsured
children, reauthorizing and increasing the support will be crucial in
this area.
Let me talk about minority children just for a moment. SCHIP had a
dramatic effect in reducing the number of uninsured minority children
and providing them access to health care. Between 1996 and 2005, the
percentage of low-income African American and Hispanic children without
insurance decreased substantially. In 1998, roughly 30 percent of
Latino children, 20 percent of African American children, and 18
percent of Asian American and Pacific Islander children were uninsured.
After SCHIP's enactment, those numbers have dropped by 2004 to about 21
percent, 12 percent, and 8 percent.
Half of all African American and Hispanic children are already
covered by SCHIP or Medicaid. More than 80 percent of the uninsured
African American children and 70 percent of the uninsured Hispanic
children are eligible but not enrolled in Medicaid and SCHIP, so
reauthorizing and increasing support will be crucial to insuring this
population.
One of the discussions that we have been having about the program is
apparently the difficulty in getting young children enrolled in the
program, whether they are African American, Hispanic, low-income,
rural, or urban. One of the things that we have been talking about with
the reauthorization is implementing new ways in which we can enroll
children and get parents on board with providing health care to their
children. The beauty of the program, as we have talked about
previously, is the preventive arm of the program, so that children who
have injuries or conditions can get treatment early in the process so
that their problems will not escalate.
One of the exciting things that is going on this weekend is the fact
that the Congressional Black Caucus is going to be participating in
health care disparity events all over the country. In South Carolina,
Congressman Clyburn will be hosting a health and wellness event in
Charleston this coming weekend. The 5th Annual Tri-Caucus Minority
Health Summit will be held in San Diego, California. As I said
previously, Representative Donna Christensen will be hosting an event
in St. Croix, Virgin Islands.
We continue to be concerned about the SCHIP program. We are
supportive of reauthorization. We are not only supportive, we are
demanding reauthorization and requiring that the amount of money that
is put into the program be extended such that it will cover most of the
young men and women, or children, excuse me, in America. There is some
debate about whether or not pregnant women ought to be included in this
process. But the reality is, if we don't take care of pregnant women,
the children will suffer as a result. So we are moving forward with
those issues, as well.
I want to close with just a few more additional facts in and around
the issue of health care disparities, because we can never say enough
about the impact that it has. Let me talk to you for a moment about
amputation. The differences in amputation rates reveal one of the many
treatment disparities that exist between racial and ethnic minorities.
In general, African Americans and Latinos have higher rates of lower
extremity amputation than non-Hispanic whites. It brings to my mind an
aunt that I have. Her name is Evelyn Shelton. She is in a nursing
facility, having lost both of her legs as a result of a condition of
diabetes. Among Medicare beneficiaries, the rate of amputation of all
or part of the lower limb was 6.7 percent per 1,000 for African
Americans and 1.9 percent per 1,000 for whites.
Let's talk about asthma care. Asthma rates are disproportionately
high among racial and ethnic minorities, particularly among the African
American community. Moreover, disparities also appear to exist in how
asthma is treated in minority populations, with racial and economic
minorities often receiving inadequate asthma care. Insured African
Americans with asthma are more likely than insured whites to be
hospitalized for asthma-related health conditions and are less likely
to be treated by an asthma specialist.
African American children are about three times more likely to be
hospitalized for asthma than their white peers, and about five times
more likely to seek care at an emergency room. Among families in which
parents lack any postsecondary education and do not have access to a
primary care physician, African American and Latino children with
asthma are more likely than white children to underuse routine
medications, such as anti-inflammatory agents.
There are other facts that I would like to go on and discuss at the
moment, but I don't have the time. There are issues around cancer care,
there are issues around, cardiovascular care, there are issues around
HIV treatment.
But I am pleased to stand this evening with my colleagues from the
Congressional Black Caucus to discuss the issue of health disparity and
to bring attention to those State Children's Health Insurance Program.
This is the first of future hours that the Congressional Black Caucus
will be hosting on issues that affect the African American community,
and particularly but often affect the entire community of our Nation.
Mr. Speaker, my colleague Baron Hill, we came to Congress at the same
time, and I thank you for having the opportunity to speak out on these
issues.
Mr. CONYERS. Mr. Speaker, I rise today in strong support for the
continuation of the State Children's Health Insurance Program (SCHIP).
Since 1997, this program has served as a safety net for our Nation's
low-income uninsured children. Today, the number of uninsured low-
income children participating in SCHIP has fallen by more than one-
third. The

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number of minority children that participate in the program has
decreased even more drastically.
In 2006, 6.7 million of America's children received health care
benefits through SCHIP; of these, 6.2 million came from families whose
income was less than $33,200 a year for a family of three. SCHIP
working in conjunction with Medicaid through State programs provides
necessary preventive, primary and acute health care services for the
lowest income children and those with disabilities. Overall, these
programs service more than 30 million children.
Children living in both rural and urban areas benefit from the SCHIP
program. In rural areas, one in three children is covered either
through SCHIP or Medicaid. In spite of this statistic, 17 percent of
the children living in these areas remain uninsured. In urban areas one
in four children has healthcare coverage through SCHIP or Medicaid, but
19 percent continue to be uninsured.
SCHIP also helps to reduce the number of uninsured minority children.
The percentage of low-income African-American and Hispanic children
without insurance decreased between 1996 and 2005 because of this
program. Prior to SCHIP's enactment, approximately 30 percent of Latino
children, 20 percent of African-American children, and 18 percent of
Asian-American and Pacific Islander children were uninsured. By 2004,
those numbers had dropped to 21 percent, 12 percent, and 8 percent
respectively.
Mr. Speaker, let's not undermine the purpose of the SCHIP program. We
have a responsibility to our children to provide them with one of the
most basic needs in our society, equal access to health care. Let us
not ignore the great strides that SCHIP has made in reducing the number
of uninsured children. Reauthorize the SCHIP program and keep our
children insured.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, members of the
Congressional Black Caucus wish to call greater attention upon the
disparities that exist in health care.
Chilren of color suffer disproportionately from a lack of health
insurance.
In my State of Texas, the problem is severe.
Texas has the highest rate of uninsured children in the Nation, with
over 21 percent of children--that's 1.4 million--lacking health care
coverage.
Across the nation, more than 9 million American children lacked
health care coverage in 2005.
The State Children's Health Insurance Program, called SCHIP, is
critically important to prevent low- and moderate-income minority
children from slipping through the cracks of our health care system.
One problem is that eligible children are not enrolling in SCHIP.
Nearly three-quarters of uninsured children were eligible for health
coverage through SCHIP or Medicaid in 2004.
A disproportionate number of those eligible, but uninsured, were
either Black or Hispanic.
Without insurance, children living in poverty are likely to have
poorer health compared to children with insurance.
Uninsured kids are more likely to lack a regular source of health
care, delay or have unmet health care needs, use less preventive care,
and receive poorer quality care than children with insurance.
I urge my colleagues to remember our uninsured--especially the
children--and have compassion on our Nation's most vulnerable.
Mrs. JONES of Ohio. Mr. Speaker, I yield back the balance of my time.

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