[Congressional Record Volume 169, Number 130 (Thursday, July 27, 2023)]
[Senate]
[Pages S3767-S3769]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         SUBMITTED RESOLUTIONS

                                 ______
                                 

     SENATE RESOLUTION 319--DECLARING RACISM A PUBLIC HEALTH CRISIS

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

                              S. Res. 319

       Whereas a public health crisis is an issue--
       (1) that affects many people, is a threat to the public, 
     and is ongoing;
       (2) that is unfairly distributed among different 
     populations and disproportionately impacts health outcomes, 
     access to health care, and life expectancy;
       (3) the effects of which could be reduced by preventive 
     measures; and
       (4) for which those preventive measures are not yet in 
     place;
       Whereas public health experts agree that significant racial 
     inequities exist in the prevalence, severity, and mortality 
     rates of various health conditions in the United States;
       Whereas examples of those inequities include--
       (1) life expectancies for Black and Native American people 
     in the United States are significantly lower than those of 
     White people in the United States;
       (2) 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;
       (3) Black and Native American infants are 2 to 3 times more 
     likely to die than White infants;
       (4) the Black infant mortality rate in the United States is 
     higher than the infant mortality rates recorded in 27 of the 
     36 democratic countries with market-based economies that are 
     members of the Organization for Economic Co-operation and 
     Development;
       (5) Hispanic women are 40 percent more likely to be 
     diagnosed with and 30 percent more likely to die from 
     cervical cancer compared to non-Hispanic White women;
       (6) Asian Americans face health disparities in cancer and 
     chronic diseases, and are the only population in the United 
     States for which cancer is the leading cause of death;
       (7) Native Hawaiians and Pacific Islanders suffer from a 
     number of poor health outcomes such as high rates of 
     overweight status, obesity, hypertension, and asthma and 
     cancer mortality;
       (8) Native Hawaiians suffer from coronary heart disease, 
     stroke, heart failure, cancer, and diabetes at a rate 3 times 
     greater than in other ethnic populations in Hawaii and become 
     afflicted with those diseases a decade earlier in their lives 
     compared with other ethnic populations; and
       (9) during the COVID-19 pandemic, Black, Hispanic or 
     Latino, Asian American, Native Hawaiian or Pacific Islander, 
     and Native American communities experienced 
     disproportionately high rates of COVID-19 infection, 
     hospitalization, and mortality compared to the White 
     population of the United States;
       Whereas inequities in health outcomes are exacerbated for 
     people of color who are LGBTQIA+;
       Whereas inequities in health outcomes are exacerbated for 
     people of color who have disabilities;
       Whereas, historically, explanations for health inequities 
     have focused on false genetic science such as eugenics;
       Whereas, historically, explanations for health inequities 
     have focused on incomplete social scientific analyses that 
     narrowly focus on individual behavior to highlight ostensible 
     deficiencies within racial and ethnic minority groups;
       Whereas modern public health officials recognize the 
     broader social context in which health inequities emerge and 
     acknowledge the impact of historical and contemporary racism 
     on health;
       Whereas racism is recognized in modern public health 
     discourse as one of many social determinants of health, 
     which--
       (1) are a broad range of nonmedical factors that can 
     enhance or hinder quality of life and influence health 
     outcomes;
       (2) are the conditions in which people are born, grow, 
     work, live, and age, and include the wider set of forces and 
     systems shaping the conditions of daily life;
       (3) include such factors as housing, employment, education, 
     health care, food, transportation, social support, poverty, 
     crime, violence, segregation, and environmental toxins;
       (4) are linked to a lack of opportunity and resources to 
     protect, improve, and maintain health; and
       (5) taken together, create health inequities that stem from 
     unfair and unjust systems, policies, and practices, and limit 
     access to the opportunities and resources needed to live the 
     healthiest life possible;
       Whereas, since its founding, the United States has had a 
     longstanding history and legacy of racism, mistreatment, and 
     discrimination that has perpetuated health inequities for 
     members of racial and ethnic minority groups;
       Whereas that history and legacy of racism, mistreatment, 
     and discrimination includes--
       (1) the immoral paradox of freedom and slavery, which is an 
     atrocity that can be traced throughout the history of the 
     United States, as African Americans lived under the 
     oppressive institution of slavery from 1619 through 1865, 
     endured the practices and laws of segregation during the Jim 
     Crow era, and continue to face the ramifications of systemic 
     racism through unjust and discriminatory structures and 
     policies;
       (2) the failure of the United States to carry out the 
     responsibilities and promises made in more than 350 treaties 
     ratified with sovereign indigenous communities, including 
     American Indians, Alaska Natives, and Native Hawaiians or 
     Pacific Islanders, as made evident by the chronic and 
     pervasive underfunding of the Indian Health Service and 
     Tribal, Urban Indian, and Native Hawaiian health care, the 
     vast health and socioeconomic inequities faced by Native 
     American people, and the inaccessibility of many Federal 
     public health and social programs in Native American 
     communities;
       (3) the enactment of immigration laws in the United States 
     that scapegoated Asians, separated families, and branded 
     Asians as perpetual outsiders, such as--
          (A) the enactment of the Act entitled ``An Act 
     supplementary to the Acts in relation to immigration'', 
     approved March 3, 1875 (commonly known as the ``Page Act of 
     1875'') (18 Stat. 477, chapter 141), which effectively 
     prohibited the entry of East Asian women into the United 
     States;
          (B) the Act entitled ``An Act to execute certain treaty 
     stipulations relating to Chinese'', approved May 6, 1882 
     (commonly known as the ``Chinese Exclusion Act''; 22 Stat. 
     58, chapter 126), which banned thousands of Chinese-born 
     laborers, who were

[[Page S3768]]

     essential in the completion of the transcontinental railroad 
     and development of the West Coast of the United States; and
          (C) the Act entitled ``An Act to regulate the 
     immigration of aliens to, and the residence of aliens in, the 
     United States'', approved February 5, 1917 (commonly known as 
     the ``Immigration Act of 1917'') (39 Stat. 874, chapter 29), 
     which barred all immigrants from the ``Asiatic zone'' and 
     prevented the migration of individuals from South Asia, 
     Southeast Asia, and East Asia; and
       (4) during the Great Depression Era, the deportation of 
     approximately 1,800,000 individuals based on their Mexican 
     ethnic identity, although approximately 60 percent of the 
     deported individuals were citizens of the United States, and 
     the targeting of individuals of Mexican descent for 
     ``repatriation'' due to scapegoating efforts, which blamed 
     those individuals for ``stealing'' jobs from ``real'' 
     Americans;
       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, causing deepened racial division and the continued 
     exclusion of Black communities from the benefits of economic 
     progress;
       Whereas overt racism was embedded in the development of 
     medical science and medical training during the 18th, 19th, 
     and 20th centuries, causing disproportionate physical and 
     psychological harm to members of racial and ethnic minority 
     groups, including--
       (1) the unethical practices and abuses experienced by Black 
     patients and research participants, such as the Tuskegee 
     Study of Untreated Syphilis in the Negro Male, which serve as 
     the foundation for the mistrust the Black community has for 
     the medical system; and
       (2) the egregiously unethical and cruel treatment of 
     enslaved Black women who were forced to be the subject of 
     insidious medical experiments to advance modern gynecology, 
     including those perpetuated by the so-called ``father of 
     gynecology'', J. Marion Sims;
       Whereas structural racism cemented historical racial and 
     ethnic inequities in access to resources and opportunities, 
     contributing to worse health outcomes;
       Whereas examples of that structural racism include--
       (1) 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 the northern and southern United States 
     complied with Jim Crow laws and were completely segregated by 
     race, leaving Black communities with little to no access to 
     health care services;
       (2) the landmark case Simkins v. Moses H. Cone Memorial 
     Hospital, 323 F.2d 959 (4th Cir. 1963), which challenged the 
     use of public funds by the Federal Government to expand, 
     support, and sustain segregated hospital care and provided 
     justification for title VI of the Civil Rights Act of 1964 
     (42 U.S.C. 2000d et seq.) and the Medicare hospital 
     certification program by establishing Medicare hospital 
     racial integration guidelines that applied to every hospital 
     that participated in the Federal program;
       (3) Pacific Islanders from the Freely Associated States 
     experience unique health inequities resulting from United 
     States nuclear weapons tests on their home islands while they 
     have been categorically denied access to Medicaid and other 
     Federal health benefits;
       (4) language minorities, including Chinese-, Korean-, 
     Vietnamese-, and Spanish-speaking Americans, were not assured 
     nondiscriminatory 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;
       (5) the COVID-19 pandemic exacerbated economic, health, 
     housing, and food security barriers for Black, Hispanic or 
     Latino, Asian American, Native Hawaiian or Pacific Islander, 
     and Native American households, which already suffer from 
     disproportionately higher rates of food insecurity; and
       (6) members of the Black, Native American, Alaska Native, 
     Asian American, Native Hawaiian or Pacific Islander, and 
     Hispanic or Latino communities 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 members of those communities;
       Whereas subtle or implicit racism in all sectors of the 
     medical service profession continues to cause 
     disproportionate physical and psychological harm to members 
     of racial and ethnic minority groups;
       Whereas examples of subtle or implicit racism in the 
     medical service profession include--
       (1) the history and persistence of racist and nonscientific 
     medical beliefs, which are associated with ongoing racial 
     inequities in treatment and health outcomes;
       (2) implicit racial and ethnic biases within the health 
     care system, which have an explicit impact on the quality of 
     care experienced by members of racial and ethnic minority 
     groups, such as the undertreatment of pain in Black patients;
       (3) nearly \1/5\ of Hispanic or Latino Americans avoid 
     medical care due to concern about being discriminated against 
     or treated poorly;
       (4) the United States health care system and other economic 
     and social structures remain fraught with biases based on 
     race, ethnicity, sex (including sexual orientation and gender 
     identity), and class that lead to health inequities;
       (5) women of color, including Black, Native American, 
     Hispanic or Latina, Asian American, and Native Hawaiian or 
     Pacific Islander women, have faced and continue to face 
     attacks on their prenatal, maternal, and reproductive health 
     and rights; and
       (6) physicians routinely, through the early 1980s, 
     sterilized members of racial and ethnic minority groups, 
     specifically American Indian and Alaska Native women (with 
     \1/4\ of childbearing-age women sterilized by the Indian 
     Health Service) and African American and Latina women, 
     performing excessive and medically unnecessary procedures 
     without their informed consent;


 =========================== NOTE =========================== 

  
  On page S3768, July 27, 2023, in the second column, the 
following appears: (6) physicians routinely, [through the late 
1960s and early 1980s -- this seems like a wide time span for 
``through'', should it just be ``through the early 1980s''], 
sterilized . . .
  
  The online Record has been corrected to read: (6) physicians 
routinely, through the early 1980s, sterilized . . .


 ========================= END NOTE ========================= 


       Whereas structural racism perpetuates racial and ethnic 
     inequities in the social determinants of health, which 
     produces unintended negative health outcomes for members of 
     racial and ethnic minority groups;
       Whereas examples of that structural racism include--
       (1) there are fewer pharmacies, medical practices, and 
     hospitals in predominantly Black and Hispanic or Latino 
     neighborhoods, compared to White or more diverse 
     neighborhoods;
       (2) environmental hazards such as toxic waste facilities, 
     garbage dumps, and other sources of airborne pollutants, are 
     disproportionately located in predominantly Black, Hispanic 
     or Latino, Asian American, Native Hawaiian or Pacific 
     Islander, and low-income communities, resulting in poor air 
     quality conditions, which can increase the likelihood of 
     chronic respiratory illness and premature death from particle 
     pollution;
       (3) employed Black adults are 10 percent less likely to 
     have employer-sponsored health insurance than employed White 
     adults because of racial segregation in occupation sectors 
     and the types of organizations in which they work, nearly \1/
     4\ of American Indians and Alaska Natives lack health 
     insurance, and nonelderly Native Hawaiian or Pacific Islander 
     adults and certain groups of nonelderly Asian American 
     adults, including Korean, Vietnamese, and Cambodian adults, 
     also have lower levels of insurance than White adults;
       (4) several States with higher percentages of Black, 
     Hispanic or Latino, and Native American populations have not 
     expanded their Medicaid programs, continuing to 
     disenfranchise minority communities from access to health 
     care as of the date of adoption of this resolution;
       (5) discriminatory housing practices, such as redlining, 
     which have, for decades, systemically excluded members of 
     racial and ethnic minority groups from housing by robbing 
     them of capital in the form of low-cost, stable mortgages and 
     opportunities to build wealth, and the use by the Federal 
     Government of its financial power to segregate renters in 
     public housing;
       (6) social inequities such as differing access to quality 
     health care, healthy food and safe drinking water, safe 
     neighborhoods, education, job security, and reliable 
     transportation, which affect health risks and outcomes;
       (7) exclusionary disciplinary practices (such as detention 
     and suspension) in primary education and even early education 
     settings, which disproportionately affect children from 
     racial and ethnic minority backgrounds, particularly Black 
     children; and
       (8) that, as much as 60 percent of the health of a person 
     in the United States can be determined by their zip code;
       Whereas structural racism perpetuates ongoing knowledge 
     gaps in data, research, and development, which produces 
     unintended negative health outcomes for members of racial and 
     ethnic minority groups;
       Whereas examples of that structural racism include--
       (1) most participants in clinical trials are White, so 
     there is insufficient data to develop evidence-based 
     recommendations for people from racial and ethnic minority 
     groups;
       (2) medical research equipment and medical devices are 
     typically developed by majority-White teams and thus can have 
     racial blind spots unintentionally built into their design, 
     rendering them less effective for people from racial and 
     ethnic minority groups, such as--
          (A) electroencephalogram (EEG) electrodes used in 
     neuroimaging research do not collect reliable data when used 
     on scalps with thick, curly hair; and
          (B) pulse oximeters produce less accurate oxygen 
     saturation readings when used on fingertips with darker skin;
       (3) a lack of images depicting darker skin in medical 
     textbooks, literature, and journals contributes to higher 
     rates of underdiagnosis or misdiagnosis in patients with 
     darker skin; and
       (4) many health-related studies fail to include data on 
     Native Americans, Asian Americans, and Native Hawaiians or 
     Pacific Islanders, or do not disaggregate data among those 
     groups, leading to their invisibility in health data and 
     unjust resource allocation and policies;

[[Page S3769]]

       Whereas racism produces unjust outcomes and treatment for 
     members of racial and ethnic minority groups, with such 
     negative experiences serving as stressors that over time have 
     a negative impact on physical health (leading, for example, 
     to high blood pressure or hypertension) and mental health 
     (leading, for example, to anxiety or depression);
       Whereas there is evidence that racial and ethnic minority 
     groups continue to face discrimination in the United States, 
     examples of which include that--
       (1) social scientists have documented racial 
     microaggressions in contemporary United States society, 
     including--
          (A) assumptions that members of racial and ethnic 
     minority groups are not true Americans;
          (B) assumptions of lesser intelligence;
          (C) statements that convey color-blindness or denial of 
     the importance of race;
          (D) assumptions of criminality or dangerousness;
          (E) denial of individual racism;
          (F) promotion of the myth of meritocracy;
          (G) assumptions that the cultural background and 
     communication styles of an individual are pathological;
          (H) treatment as a second-class citizen; and
          (I) environmental messages of being unwelcome or 
     devalued;
       (2) compared to White Americans, Black Americans are 5 
     times more likely to report experiencing discrimination when 
     interacting with the police, Hispanic or Latino Americans and 
     Native Americans are nearly 3 times as likely, and Asian 
     Americans and Native Hawaiians or Pacific Islanders are 
     nearly twice as likely;
       (3) 42 percent of employees in the United States have 
     experienced or witnessed racism in the workplace;
       (4) Muslims, South Asians, and Sikhs were unjustly targeted 
     for profiling, surveillance, arrest, discrimination, 
     harassment, assault, and murder after 9/11;
       (5) xenophobic rhetoric, including anti-immigrant rhetoric 
     and the scapegoating of people of East Asian and Southeast 
     Asian descent for the COVID-19 pandemic, resulted in a surge 
     of hate against Asian Americans and Native Hawaiians or 
     Pacific Islanders, including increased harassment, 
     discrimination, bullying, vandalism, and assault;
       (6) nearly \1/2\ of Asian Americans and Native Hawaiians or 
     Pacific Islanders throughout the United States have 
     experienced discrimination or unfair treatment that may be 
     illegal and the majority of victims of discrimination name 
     race or related characteristics as the reason for the 
     discrimination; and
       (7) more than 50 percent of Hispanic or Latino adults 
     experience at least one form of discrimination due to their 
     racial or ethnic heritage, such as being treated as if they 
     were not smart, criticized for speaking Spanish, told to 
     return to their country, called offensive names, or unfairly 
     stopped by the police;
       Whereas Black people in the United States experience overt 
     and direct forms of violence that, when not fatal, can cause 
     severe physical or psychological harm;
       Whereas examples of such forms of violence include--
       (1) that Black people are confronted and threatened by 
     armed citizens while performing everyday tasks, such as 
     jogging in neighborhoods, driving, or playing in a park;
       (2) that Black people are 3 times more likely to be killed 
     by police than White people, and police violence is the sixth 
     leading cause of death for young Black men;
       (3) the killings of Tamir Rice, Ahmaud Arbery, Breonna 
     Taylor, George Floyd, Elijah McClain, Jayland Walker, Jeenan 
     Anderson, Timothy McCree Johnson, Jordan Neely, and countless 
     other Black Americans by law enforcement;
       (4) that it took the United States 66 years after the 
     senseless and brutal murder of 14-year-old Emmett Till to 
     make lynching a Federal crime;
       (5) that, since 2015, mass shootings around the country, 
     such as in Buffalo, New York, and Charleston, South Carolina, 
     serve as reminders of the unresolved history of racism in the 
     United States and highlight the threats Black people must 
     take into consideration when going about their daily lives, 
     both when outside their communities and within those 
     communities; and
       (6) that the real threat of brutality and violence 
     adversely impacts mental health among Black communities;
       Whereas American Indians and Alaska Natives experience 
     historical trauma, systemic oppression, and cultural genocide 
     that, even when not fatal, can cause severe physical or 
     psychological harm;
       Whereas examples of such forms of violence include--
       (1) forced relocation, termination, and assimilation 
     policies such as boarding schools that contributed to health 
     disparities and legacies of trauma inflicted on indigenous 
     people;
       (2) the United States Army attempting cultural genocide by 
     instigating numerous massacres, including the mass execution 
     of 38 Dakota men in Minnesota and the murder of 300 Lakota 
     people at the Battle of Wounded Knee, to eradicate American 
     Indians and Alaska Natives;
       (3) murder being the third leading cause of death for 
     Native women and \4/5\ of Indigenous women experiencing 
     violence in their lifetime;
       (4) since 2016, there have been 5,712 cases of missing and 
     murdered indigenous women and people across the United 
     States, including 506 cases in 71 urban cities and 153 cases 
     missing from law enforcement databases, with those missing 
     cases likely undercounting the actual number of cases due to 
     the underreporting of cases within American Indian and Alaska 
     Native communities;
       (5) the overall death rate from suicide among American 
     Indians and Alaska Natives is 20 percent higher compared to 
     non-Hispanic White populations; and
       (6) cycles of violence have overburdened indigenous 
     communities to respond to levels of violence such as gender-
     based violence, human trafficking, suicide, and homicide with 
     minimal resources;
       Whereas Hispanics or Latinos, Asian Americans, and Native 
     Hawaiians or Pacific Islanders experience racially motivated 
     kidnapping, murders, and mass violence, such as shootings in 
     Oak Creek, Wisconsin, El Paso and Allen, Texas, Atlanta, 
     Georgia, and Indianapolis, Indiana, that, even when not 
     fatal, can cause severe physical or psychological harm;
       Whereas, throughout the history of the United States, 
     members of racial and ethnic minority groups have been at the 
     forefront of civil rights movements for essential freedoms, 
     human rights, and equal protection for marginalized groups 
     and continue to fight for racial and economic justice today;
       Whereas racial inequities in health continue to persist 
     because of historical and contemporary racism;
       Whereas public health experts agree that racism meets the 
     criteria of a public health crisis because--
       (1) the condition affects many people, is seen as a threat 
     to the public, and is continuing to increase;
       (2) the condition is distributed unfairly;
       (3) preventive measures could reduce the effects of the 
     condition; and
       (4) those preventive measures are not yet in place;
       Whereas the Centers for Disease Control and Prevention--
       (1) declared racism a serious threat to public health; and
       (2) acknowledged the need for additional research and 
     investments to address that serious threat;
       Whereas a Federal public health crisis declaration 
     proclaims racism as a pervasive health issue and alerts the 
     people of the United States to the need to enact immediate 
     and effective cross-governmental efforts to address the root 
     causes of structural racism and the downstream impacts of 
     that racism; and
       Whereas such a declaration requires the response of 
     governments to engage significant resources to empower the 
     communities that are impacted: Now, therefore, be it
       Resolved, That the Senate--
       (1) supports the resolutions drafted, introduced, and 
     adopted by cities and localities across the United States 
     declaring racism a public health crisis;
       (2) declares racism a public health crisis in the United 
     States;
       (3) commits to--
       (A) establishing a nationwide strategy to address health 
     disparities and inequities across all sectors in society;
       (B) dismantling systemic practices and policies that 
     perpetuate racism;
       (C) advancing reforms to address years of neglectful and 
     apathetic policies that have led to poor health outcomes for 
     members of racial and ethnic minority groups; and
       (D) promoting efforts to address the social determinants of 
     health for all racial and ethnic minority groups in the 
     United States, and especially for Black and Native American 
     communities; and
       (4) places a charge on the people of the United States to 
     move forward with urgency to ensure that the United States 
     stands firmly in honoring its moral purpose of advancing the 
     self-evident truths that all people are created equal, that 
     they are endowed with certain unalienable rights, and that 
     among these are life, liberty, and the pursuit of happiness.

                          ____________________