[Congressional Record (Bound Edition), Volume 149 (2003), Part 17]
[House]
[Page 23617]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH DISPARITIES

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 7, 2003, the gentleman from New Jersey (Mr. Pallone) is 
recognized during morning hour debates for 5 minutes.
  Mr. PALLONE. Mr. Speaker, this afternoon I would like to discuss the 
issue of health disparities.
  Unfortunately, Mr. Speaker, we have a system of delivering health 
care in the United States that has resulted in severe disparities along 
racial and ethnic lines in health care access, quality of care, and 
also health outcomes. All Americans deserve equal treatment in health 
care, and in an effort to appropriately address this issue, Democrats 
will soon offer legislation to eliminate these racial and ethnic health 
disparities.
  Mr. Speaker, there are several principles that I would like to 
highlight that will be reflected in the Democrat's bill. I emphasize 
that Democrats are committed to ensuring that minority communities 
aren't burdened by higher prevalence or incidence of disease and 
illness than the general population.
  Some of these principles involve expanding the health care safety 
net. There is a lack of health insurance for many minorities and also 
access to adequate health services. This results in significant 
declines in health status within racial and ethnic minority 
communities.
  Also, we need, and this is the second principle, to diversify the 
health care workforce. Efforts must be made to recruit and train health 
care professionals from underrepresented groups.
  Third, we have to ensure that health care access is made in 
compliance with civil rights laws. There are many people with limited 
English proficiency in the country that have a difficult time accessing 
federally conducted and supported programs. Persons with limited 
English proficiency should not be inhibited from accessing vital health 
care services, paid for often by their families and their own personal 
Federal income taxes.
  Fourthly, we have to promote the collection and dissemination of data 
that is helpful to give indication of disparities amongst minorities. 
In order to fully understand the scope of health care disparities, it 
is necessary to have data on an individuals' health care access and 
utilization that includes race, ethnicity, primary language, 
immigration status and socioeconomic status.
  Fifth, Mr. Speaker, we have to combat diseases that disproportionally 
affect racial and ethnic minorities. Existing research has illustrated 
that diseases such as diabetes, obesity, heart disease, asthma and HIV/
AIDS disproportionately impact racial and ethnic minorities.
  Federal initiatives should focus on preventing and treating these 
diseases, educating all communities about their impact, and identifying 
the behavioral, emotional and environmental factors that contribute to 
these diseases.
  Next we have to enhance medical research that benefits these 
communities. It is important that Federal medical research be conducted 
by and on behalf of racial and ethnic minorities.
  Lastly, I want to emphasize, Mr. Speaker, prevention and behavioral 
health. Estimates suggest that as much as 50 percent of health care 
costs are caused by behavior-related illnesses, including heart 
disease, high blood pressure, obesity and substance abuse. Cultural and 
social factors can contribute to the behavioral patterns underlying 
these illnesses, and intervention is necessary to prevent such 
illnesses and save billions of dollars in health care costs.
  Now, Mr. Speaker, I wanted to talk about in the context of the 
overall issue of disparities and the principles that the Democrats seek 
to initiate in this legislation that we are soon to introduce, I wanted 
to pay particular attention to the problems of Native Americans because 
I am the vice chair of the Native American Caucus.
  And Democrats feel that, in particular, when we address health care 
disparities, we cannot leave out Native Americans. Native Americans 
have been subject to extreme discrimination in health care access and, 
as a result, they are a population with overall low health status.
  Some of these issues will be addressed in not only the legislation I 
mention, but also in a hearing tomorrow in the House Committee on 
Resources where we will be holding a hearing on the Indian Health Care 
Improvement Act which is vital, I think, to the health care and well-
being of American Indians as well as Alaskan natives.
  The focus of the hearing tomorrow will be on Title I of the Indian 
Health Care Improvement Act which deals with Indian health, human 
resource, and development in an effort to address the need for an 
adequate supply of health care professionals in the Indian health 
system and creating more opportunities for Native Americans to pursue 
health careers.
  I want to emphasize, Mr. Speaker, that Congress has never funded 
Indian health care at a level that would result in health services that 
are comparable to services received by other Americans. So the big 
problem in the disparity issue, with regard to Native Americans, is 
making sure there is adequate funding for the Federal Indian Health 
Service Program.
  The Native American population is approximately 40 percent rural and 
predominantly lives in geographically dispersed areas with low 
population density. And this demographic aspect makes access to health 
care more difficult. There are Indian Health Service facilities 
available throughout the country, however, there are still some States 
that completely lack any Indian Health Service facilities.
  Overall, Mr. Speaker, I believe access to primary health care and 
prevention services is good amongst Native Americans. However, beyond 
primary care, the situation quickly gets worse. For example, speciality 
services are sparse. What services are available are typically 
overcrowded and patients are often prioritized.
  So we must address these issues, and I hope they can be addressed 
both in the Democratic health disparities legislation and in the 
hearing we have tomorrow on the Indian Health Care Improvement Act.

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