[Congressional Record Volume 167, Number 70 (Thursday, April 22, 2021)]
[Senate]
[Pages S2175-S2177]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     SENATE RESOLUTION 172--DECLARING RACISM A PUBLIC HEALTH CRISIS

  Mr. BROWN (for himself, Mr. Booker, Mr. Padilla, Ms. Duckworth, Mr. 
Warnock, Ms. Hirono, Mr. Markey, Ms. Baldwin, Mr. Blumenthal, Mr. 
Kaine, Mr. Merkley, Mr. Cardin, Mr. Menendez, Ms. Klobuchar, Mr. 
Warner, Mr. Casey, Mr. Bennet, Ms. Warren, Ms. Smith, Ms. Stabenow, Mr. 
Wyden, Mr. Carper, and Mrs. Murray) submitted the following resolution; 
which was referred to the Committee on Health, Education, Labor, and 
Pensions:

                              S. Res. 172

       Whereas, since its founding, the United States has had a 
     longstanding history and legacy of racism, mistreatment, and 
     discrimination against African Americans, Latinos, Native 
     Americans, and other people of color;
       Whereas the United States ratified over 350 treaties with 
     sovereign indigenous communities, has broken the promises 
     made in such treaties, and has historically failed to carry 
     out its trust responsibilities to Native Americans, 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 
     disparities faced by Native American people, and the 
     inaccessibility of many Federal public health and social 
     programs in Native American communities;
       Whereas people of Mexican and Puerto Rican descent, who 
     became Americans through conquest, were subject to, but never 
     full members of the polity of the United States and 
     experienced widespread discrimination in employment, housing, 
     education, and health care;
       Whereas the immoral paradox of slavery and freedom is an 
     indelible wrong 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;
       Whereas, 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;
       Whereas, between 1956 and 1967, the National Association 
     for the Advancement of Colored People (NAACP) Legal Defense 
     and Education Fund litigated a series of court cases to 
     eliminate discrimination in hospitals and professional 
     associations;
       Whereas the landmark case Simkins v. Moses H. Cone Memorial 
     Hospital, 323 F.2d 959 (1963), challenged the Federal 
     Government's use of public funds to expand, support, and 
     sustain segregated hospital care, and provided justification 
     for title VI of the 1964 Civil Rights Act and the Medicare 
     hospital certification program--establishing Medicare 
     hospital racial integration guidelines that applied to every 
     hospital that participated in the Federal program;
       Whereas, in 1967, President Lyndon B. Johnson established 
     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 language minorities, including Latinos, Asian 
     Americans, and Pacific Islanders, were not assured non-
     discriminatory access to federally funded services, including 
     health services, until the signing of Executive Order 13166 
     (42 U.S.C. 2000d-1 note; relating to improving access to 
     services for persons with limited English proficiency) in 
     2000;
       Whereas the Patient Protection and Affordable Care Act 
     (Public Law 111-148; 124 Stat. 119)--
       (1) included provisions to expand the Medicaid program 
     and--for the first time in the United States--established a 
     Federal prohibition against discrimination on the basis of 
     race, color, national origin, sex, age, or disability in 
     certain health programs, building on other Federal civil 
     rights laws; and
       (2) required reporting to Congress on health disparities 
     based on race, color, national origin, sex, age, or 
     disability;
       Whereas several Federal programs have been established to 
     address some, but not all, of the health outcomes that are 
     disproportionately experienced by communities of color, 
     including sickle cell disease, tuberculosis, infant 
     mortality, and HIV/AIDS;
       Whereas the National Center for Chronic Disease Prevention 
     and Health Promotion works to raise awareness of health 
     disparities faced by minority populations in the

[[Page S2176]]

     United States, including Native Americans, Asian Americans, 
     Black Americans, and Latino Americans, aiming to reduce risk 
     factors for groups affected by such health disparities;
       Whereas the United States health care system and other 
     economic and social structures remain fraught with racism and 
     racial, ethnic, sex (including sexual orientation and gender 
     identity), and class biases that lead to health inequity and 
     health disparities;
       Whereas life expectancy rates for Black and Native American 
     people in the United States are significantly lower than 
     those of White people in the United States;
       Whereas disparities in health outcomes are exacerbated for 
     LGBTQIA+ people of color;
       Whereas disparities in health outcomes are worsened for 
     people of color with disabilities due to bias and inequitable 
     access to health care;
       Whereas several States with higher percentages of Black, 
     Latino, and Native American populations have not expanded 
     their Medicaid programs--continuing to disenfranchise 
     minority communities from access to health care to this day;
       Whereas 16 States have failed to take advantage of the 
     Federal option to expand access to Medicaid and the 
     Children's Health Insurance Program to lawfully residing 
     immigrant children within the first 5 years of lawful status, 
     and 26 States have failed to do so for similarly situated 
     pregnant women;
       Whereas, between 2016 and 2018, the child uninsured rate 
     increased from 4.7 percent to 5.5 percent and the Latino 
     child uninsured rate increased from 7.7 percent to 8.1 
     percent, and children of color are far more likely to be 
     uninsured than White children;
       Whereas a climate of fear and confusion for immigrant 
     families due to the public charge rule discourages such 
     families from enrolling eligible children in Medicaid and the 
     Children's Health Insurance Program;
       Whereas Pacific Islanders from the Freely Associated States 
     experience unique health disparities resulting from United 
     States nuclear weapons tests on their home islands, but such 
     people have been categorically denied access to Medicaid and 
     other Federal health benefits;
       Whereas the United States has historically facilitated 
     outsider status toward Asian Americans and Pacific Islanders, 
     such as the authorization of the internment of Japanese 
     Americans during World War II, which resulted in profound 
     economic, social, and psychological burdens for the people 
     impacted;
       Whereas the history and persistence of racist and non-
     scientific medical beliefs are associated with ongoing racial 
     disparities in treatment and health outcomes;
       Whereas implicit racial and ethnic biases within the health 
     care system have an impact on the quality of care experienced 
     by communities of color, such as the undertreatment of pain 
     in Black patients;
       Whereas the historical context of unethical practices and 
     abuses experienced by Black patients and research 
     participants, such as the Tuskegee Syphilis Study, serve as 
     symbols of the Black community's mistrust of the medical 
     system;
       Whereas women of color continue to face attacks, documented 
     throughout history, on their prenatal, maternal, and 
     reproductive health and rights;
       Whereas enslaved Black women were forced to endure 
     egregiously unethical and cruel treatment, as subjects of 
     insidious medical experiments, to advance modern gynecology;
       Whereas, through the late 1960s and early 1980s, physicians 
     routinely sterilized people of color, performing excessive 
     and medically unnecessary procedures on patients of color 
     without their informed consent;
       Whereas Black and Native American women are 2 to 4 times 
     more likely than White women to suffer severe maternal 
     morbidity or die of pregnancy-related complications, and 
     implicit racial biases and lower quality care are 
     contributing factors to the health care disparities that lead 
     to these outcomes;
       Whereas Black and Native American infants are twice as 
     likely to die as White infants, and the Black infant 
     mortality rate in the United States is higher than in 97 
     countries worldwide;
       Whereas researchers have developed the analytical framework 
     of ``weathering'' to describe how the constant stress of 
     racism leads to poor health outcomes for Black Americans;
       Whereas the daily experience of racism is associated with 
     stress, depression, and anxiety, and may cause physiological 
     reactivity or contribute to chronic health conditions;
       Whereas racism is linked to mental health challenges for 
     children and adolescents;
       Whereas children of color are overrepresented in the United 
     States child welfare system, and up to 80 percent of children 
     in foster care enter State custody with significant mental 
     health challenges;
       Whereas disparities in educational access and attainment, 
     along with racism experienced in the educational setting, 
     affect the trajectory of academic achievement for children 
     and adolescents, and ultimately impact health and racial 
     inequities in school discipline, which has long-term 
     consequences for children;
       Whereas racism and segregation in the United States 
     contribute to poor health outcomes by segregating Black, 
     Latino, and Native American communities from opportunity;
       Whereas, for decades, discriminatory housing practices, 
     such as redlining, systemically excluded people of color from 
     housing, robbing them of capital in the form of low-cost, 
     stable mortgages and opportunities to build wealth, and the 
     Federal government used its financial power to segregate 
     renters in newly built public housing;
       Whereas environmental injustices, such as proximity and 
     exposure to toxic waste or hazardous air pollutants, continue 
     to harm the health of communities of color, low-income 
     communities, and Indigenous communities around the United 
     States;
       Whereas social inequities such as differing access to 
     quality health care, healthy food and safe drinking water, 
     safe neighborhoods, education, job security, and reliable 
     transportation affect health risks and outcomes;
       Whereas, during the COVID-19 pandemic, the effects of 
     racism and discrimination are seen in COVID-19 infection, 
     hospitalization, and mortality rates--disproportionately high 
     among Black, Latino, and Native American populations compared 
     to the overall population--exacerbating health disparities 
     and highlighting barriers to care for Black, Latino, and 
     Native American patients across the United States;
       Whereas discrimination and harassment relating to the 
     COVID-19 pandemic is on the rise, particularly discrimination 
     and harassment directed towards the Asian American and 
     Pacific Islander (AAPI) community;
       Whereas, because of racial and ethnic disparities, people 
     of color are more likely to have pre-existing, preventable, 
     and chronic conditions, which lead to higher COVID-19 
     morbidity and mortality rates;
       Whereas people of color are overrepresented in the number 
     of people in the United States living under poor air quality 
     conditions, which can increase the likelihood of COVID-19 
     morbidity and mortality;
       Whereas the COVID-19 pandemic has worsened barriers for 
     Black, Latino, and Native American households that suffer 
     from disproportionately higher rates of food insecurity;
       Whereas Black and Latino workers make up a disproportionate 
     number of frontline workers, are less likely to receive paid 
     sick leave or have the ability to work from home, and have 
     been excluded from many forms of relief readily available to 
     other groups;
       Whereas people of color are disproportionately impacted by 
     the criminal justice and immigration enforcement systems and 
     face a higher risk of contracting COVID-19 within prison 
     populations and detention centers due to the over-
     incarceration of people of color;
       Whereas, during the COVID-19 pandemic, an increased use of 
     anti-Asian rhetoric has resulted in Asian Americans being 
     harassed, assaulted, and scapegoated for the pandemic;
       Whereas communities of color continue to bear the burdens 
     of inequitable social, economic, and criminal justice 
     policies, practices, and investments that cause deep 
     disparities, hurt, harm, danger, and mistrust;
       Whereas over 40 percent of Latinos report being 
     discriminated against or harassed because they are Hispanic;
       Whereas approximately 24 percent of the Latino population 
     in the United States identifies as ``Afro-Latino'' and is 
     thus potentially subject to both race and national origin 
     discrimination;
       Whereas, because of racism, Black people in the United 
     States share a unique set of challenges and experiences that 
     require heightened levels of awareness and risk while 
     performing everyday tasks--such as jogging in neighborhoods, 
     driving while Black, or playing in a park--that are not 
     experienced by other populations;
       Whereas Black people in the United States are 3 times more 
     likely to be killed by police than White people in the United 
     States, and police violence is the 6th leading cause of death 
     for young Black men;
       Whereas the police brutality and violence experienced by 
     Black people in the United States adversely impacts mental 
     health among Black communities;
       Whereas Black communities led the United States in mourning 
     the killings of Ahmaud Arbery, Breonna Taylor, George Floyd, 
     Elijah McClain, and countless other Black Americans--calling 
     for justice and long-term changes to dismantle systems of 
     oppression;
       Whereas, throughout the history of the United States, 
     people of color 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 a public health issue is defined as meeting the 
     following 4 criteria:
       (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.
       (4) Those preventive measures are not yet in place;
       Whereas racism meets the criteria of a public health 
     crisis, and public health experts agree;
       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 this serious issue;
       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

[[Page S2177]]

     effective cross-governmental efforts to address the root 
     causes of institutional racism and their downstream impacts; 
     and
       Whereas such declaration requires the response of the 
     Government to engage significant resources to empower those 
     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 inequity 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 
     communities of color; and
       (D) promoting efforts to address the social determinants of 
     health--especially for Black, Latino, and Native American 
     people in the United States, and other people of color; 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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