[Congressional Record (Bound Edition), Volume 161 (2015), Part 4]
[House]
[Pages 4814-4822]
[From the U.S. Government Publishing Office, www.gpo.gov]




  THE STATE OF BLACK HEALTH: A CONGRESSIONAL BLACK CAUCUS ASSESSMENT 
                 DURING NATIONAL MINORITY HEALTH MONTH

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2015, the gentlewoman from Illinois (Ms. Kelly) is 
recognized for 60 minutes as the designee of the minority leader.
  Ms. KELLY of Illinois. Mr. Speaker, at this time, I yield to my 
distinguished colleague from New Jersey, Congressman Donald Payne.
  Mr. PAYNE. Mr. Speaker, I want to thank my coanchor, Robin Kelly, 
Congresswoman from Illinois, for being involved in this Special Order 
tonight.
  Thanks also to the members of the Congressional Black Caucus who are 
here tonight on such an important topic.
  Mr. Speaker, I would like to thank the people at home who are tuning 
in to watch this. It is truly an honor to speak to them directly in 
their homes, to fight on their behalf and to advance our shared 
priorities. That is why we are here tonight and every Monday night that 
the House is in session--to address the diverse issues affecting 
African American communities throughout our Nation and to let you know 
that we are here, fighting for you every single day.
  Mr. Speaker, this month is National Minority Health Month. It is a 
chance to evaluate the state of black health, a chance to address 
health disparities affecting racial minorities, and a chance to speak 
to efforts to advance health equity. Today, African American and other 
minority populations lag behind in numerous health areas, including in 
the access to quality care, in timelines of care, and in health 
outcomes. These disparities have devastating impacts on individuals and 
families but also on our communities and our society as a whole.
  There are numerous factors that contribute to the health disparities 
throughout New Jersey's 10th Congressional District and throughout our 
Nation as well--poverty, environmental threats, inadequate access to 
health care, and educational inequities. These are such interconnected 
issues that a piecemeal plan to fixing the problem will not work. A 
comprehensive approach--one that focuses on providing access to quality 
care for all, creating good jobs that provide a decent living, and 
increasing educational opportunities for low-income communities--is 
only one way to eliminate the health disparities once and for all.
  With that, Mr. Speaker, I would like to get to the members of the CBC 
who are here, and I turn it over right now to the gentlewoman from 
Illinois, the Honorable Robin Kelly, who has been holding down the fort 
while I have been dealing with my health issues.


                             General Leave

  Ms. KELLY of Illinois. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and to include extraneous material on the subject of my Special 
Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Illinois?
  There was no objection.
  Ms. KELLY of Illinois. I thank the distinguished gentleman from the 
Garden State, my good friend, Donald Payne. I am glad he is back and in 
better health in order to lead this Congressional Black Caucus Special 
Order hour on the state of black health.
  Mr. Speaker, it has been the refrain of so many people of all races 
across the country, the refrain of ``black lives matter.'' We have 
gathered here this evening because black lives do matter. Whether we 
are talking about issues of justice or of economic opportunity or of 
the health of our Nation, black lives matter. The topic of tonight's 
Special Order hour is: The State of Black Health--a CBC Assessment 
during National Minority Health Month.
  Each April, we observe National Minority Health Month in order to 
raise awareness about the gaping health disparities that impact 
communities of color across the Nation. Many of us have been personally 
affected by the physical and emotional tolls that conditions like 
obesity, diabetes, kidney disease, breast and prostate cancer, and HIV/
AIDS have brought on ourselves and our loved ones and neighbors.
  Last month marked the 50th anniversary of the Selma to Montgomery 
marches--the generation-defining events that led to the passage of the 
1965 Voting Rights Act. Like the right to vote, health care is a 
fundamental civil right that our leaders, health professionals, and 
communities must fight to protect. The Affordable Care Act was a 
critical step in the march toward health equity, but there is still 
much more to be done.
  Dr. Martin Luther King expressed this a half century ago when he 
said:

[[Page 4815]]

``Of all of the forms of inequality, injustice in health care is the 
most shocking and inhumane.''
  I couldn't agree more, and it has been the work of the CBC and of the 
Congressional Black Health Braintrust, which I chair, to advance the 
critical phrase of the human rights and civil rights struggle--``health 
equity.''
  This year, the CBC's Health Braintrust will focus on three core 
principles: strengthening our communities, improving health access, and 
marching toward a healthier future. The disparities facing minority 
communities in rural areas across the country are too numerous to name. 
To that end, the Congressional Black Caucus Health Braintrust will work 
vigorously to address the gaps that exist when it comes to reducing 
heart disease, kidney disease, lung ailments, stroke, oral health, 
lupus, child nutrition, HIV/AIDS, mental health disorders, gun violence 
as a public health threat, and other chronic and infectious diseases.
  I am glad that, during tonight's hour, we will be focused on 
strengthening our public health infrastructure and on developing 
community-oriented, multidisciplinary approaches to public health, 
which will close the national health disparity gap.

                              {time}  1945

  This National Minority Health Month the CBC will work to expand 
access to health care, early health education, and medical investment 
so that we can make our communities healthier and reduce the prevalence 
of diseases that disproportionately cut minority lives short.
  Again, I thank my coanchor for the next hour.
  Mr. PAYNE. Mr. Speaker, I would like to thank the gentlelady from 
Illinois (Ms. Kelly), who has done a tremendous job and has stepped 
into the gap left by the leaving of one of our former colleagues, Donna 
Christensen from the Virgin Islands. Ms. Kelly has stepped up to fill 
the position at the Health Braintrust. She has been a fighter in this 
area prior to coming to the Congress and has continued to demonstrate 
her leadership along these lines.
  At this point in time, it is my honor to hear from a member of the 
CBC who has been a leader, seasoned in so many areas and aspects, and 
has been a real mentor and a role model for me as I come here and try 
to fight for the American people every day, as he does for his 
constituents in Illinois, the Honorable Danny Davis.
  Mr. DANNY K. DAVIS of Illinois. Mr. Speaker, I want to thank my 
colleague, Mr. Payne, for the leadership that he provides, and I am 
delighted to be here with my colleagues as we talk about one of the 
most pernicious problems that exists in our country, and that is the 
tremendous disparity that exists among minorities--African Americans, 
Latinas, and Native Americans--when it comes to health and health care.
  Millions of racial and ethnic minorities have been and continue to be 
disproportionately suffering. Health disparities among minorities have 
been neglected for many decades in this Nation, and as a result, 
millions of racial and ethnic minority Americans continue to lack 
access to reliable and quality health care. They are often suffering 
more from comorbidities and poor health outcomes and are more likely to 
die prematurely from preventible causes compared to their white 
counterparts.
  Examples of these pervasive health disparities include the following:
  The infant mortality rate for African Americans and American Indian/
Alaska Natives are more than two times higher than that for whites;
  African Americans with heart disease are three times more likely to 
be operated on by high-risk surgeons than their white counterparts with 
heart disease;
  Hispanic Latina women have the highest incidence rate for cancers of 
the cervix, 1.6 times higher than that for white women, with a cervical 
cancer death rate that is 1.4 times higher than for white women;
  Puerto Ricans have an asthma prevalence rate over 2.2 times higher 
than non-Hispanic whites, and over 1.8 times higher than non-Hispanic 
blacks;
  Together, African Americans and Hispanics account for 27 percent of 
the total U.S. population yet account for 62 percent of all new HIV 
infections;
  American Indian/Alaska Natives have diabetes rates that are nearly 
three times higher than the overall rate;
  Of the more than 1 million people infected with chronic hepatitis B 
in the United States, half are Asian Americans and Pacific Islanders.
  Of course, one of the bright spots in healthcare delivery in this 
Nation now is the Affordable Care Act. Minorities make up about 30 
percent of the population but are 50 percent of the uninsured. 
Currently, the ACA, since its enactment, has allowed health insurance 
coverage for 16.4 million Americans who were not insured prior to this 
law.
  Another bright spot is community health centers, which are 
celebrating their 50th year. The first of these centers was actually 
approved and funded, the first one being a project between Tufts 
University in Boston, Massachusetts, and Bolivar County, Mississippi. 
It was called the Tufts-Delta Project. Since that time, they now are 
providing quality health care to more than 23 million low- and 
moderate-income individuals throughout the Nation.
  Of course, one of the great needs is the need for health education 
and the recognition that, as people learn how to better care for 
themselves and to make more effective use of the resources that are 
available, not only do we save money, but we also save lives.
  I was amazed, as people spoke against the Affordable Care Act, where, 
for the first time in their lives, many individuals were going to have 
access to a regular primary care physician so they didn't have to go to 
the emergency room of hospitals and get what is called episodic care. 
So while the disparities are great, we know that progress is perhaps 
even greater.
  I end with being at a church just the other day where we were having 
something called organ transplant Sunday, and the minister of this 
particular church had had two heart transplants and a kidney 
transplant. He preached every Sunday and owned a construction company 
that he ran. That is why we need to make sure that we put adequate 
resources into research and the funding of new approaches and new 
techniques.
  I want to thank my colleagues for this evening, for the opportunity 
to talk about not only the great needs, but also to talk about some of 
the progress that is being made.
  I thank the gentleman from New Jersey, my colleague, Mr. Payne.
  Mr. PAYNE. Mr. Speaker, I would like to thank the gentleman from 
Illinois (Mr. Danny Davis), who, as I stated in my opening remarks 
about him, has been a deliberate and conscious fighter for not only his 
constituents, but Americans that find themselves facing these 
disparities all around the Nation.
  Next it is my honor to hear from the gentlelady from Alabama, the 
Honorable Terri Sewell, who had a wonderful participation in her 
district last month of the 50th anniversary of the Edmund Pettus 
Bridge, where many of my colleagues were able to go down and celebrate 
that great victory in this Nation's history, and I was sorry I couldn't 
be there, but I watched from afar and was very delighted to see such an 
outpouring of respect for a moment in our history that can never be 
forgotten, and we can never let the clock be turned back, as we say.
  Ms. SEWELL of Alabama. Thank you so much. I want to commend my 
colleagues from Illinois and New Jersey for having this wonderful CBC 
hour on minority health and the disparities that exist.
  I want to talk for a minute about how we in Congress have tried to 
address these disparities. You know, our Nation celebrated the fifth 
anniversary of the Affordable Care Act in March. This anniversary 
marked the historic progress our Nation has made towards making health 
care not just a privilege, but a right for every American.
  The ACA has significantly affected the minority population by trying 
to close the gap on the disparity by giving

[[Page 4816]]

access to affordable healthcare insurance for all Americans. Thanks to 
the ACA, health insurers can no longer deny coverage to individuals 
because of preexisting conditions, and women no longer have to pay 
higher premiums than men. Because of this law, millions of Americans 
can finally afford to go to the doctor, and families no longer risk 
losing their home savings and all that they have if a family member 
gets sick.
  For those who already had insurance, the ACA has meant new savings 
and new protections. This has even been true in my home State of 
Alabama, a State that did not choose to enact a healthcare exchange, a 
State that did not expand Medicaid. During the most recent enrollment 
period, more than 171,000 Alabamians enrolled in quality healthcare 
coverage at a price that they could afford. Over 1.1 million Alabamians 
with private health insurance now have access to free preventive 
services, and Alabamians with Medicare have saved more than $240 
million in prescription drug costs. In 2014 alone, nearly 90,000 
Alabamians saved an average of $931 for prescriptions. Yes, even in my 
State of Alabama, which chose not to enact a healthcare exchange and 
not to expand Medicaid, the ACA is working.
  These are more than just numbers. Greater access to healthcare 
insurance leads to a healthier population, which is good news not only 
for Alabamians, but for all Americans. The ACA, indeed, works. That is 
why I have proudly defended the ACA against numerous attacks to 
undermine or repeal the law. Bipartisanship is possible. Members from 
both sides of the aisle in both Chambers must work together to 
strengthen our healthcare system and to ensure that all Americans have 
access to quality, affordable healthcare insurance.
  In March, I was proud that 392 of us in the House of Representatives 
agreed on a permanent fix to the flawed Medicare physician payment 
system and an extension to the Children's Health Insurance Program, 
otherwise known as CHIP. This bipartisan agreement marked a historic 
victory for our children of this Nation. It also was a victory for our 
seniors, working class families, and healthcare providers. We must 
continue to work together to ensure the healthcare system is working 
for all of us.
  Unfortunately, for many working poor individuals and families, access 
to quality health care is still out of their reach. An estimated 
191,000 Alabamians, for example, are uninsured because our Governor has 
refused to expand Medicaid. Let me repeat that. 191,000 Alabamians 
would benefit if our Governor would expand Medicaid in the State of 
Alabama. These individuals pay their taxes, work hard, and contribute 
to their communities. Our government should assist them in return. 
Governor Robert Bentley recently created the Alabama Health Care 
Improvement Task Force to examine ways to increase access to health 
care in rural Alabama.

                              {time}  2000

  I welcome my Governor's establishment of this task force. I know that 
when this task force meets, it will recommend expanding Medicaid.
  My hope is that we will put partisan politics aside in my great State 
of Alabama and look to what is in the best interest of all the people. 
Clearly, 191,000 Alabamians fall in that gap, those who currently 
cannot get healthcare insurance because this State would refuse to 
expand Medicaid.
  I find it ironic, Mr. Speaker, that my Governor would choose to 
recommend expanding taxes. Increasing taxes is his current proposal on 
the floor in the statehouse in order to meet the shortfall that exists 
in my State.
  Let's just think about that. My Governor would rather increase taxes 
than to accept money from the Federal Government to expand Medicaid--
how shortsighted.
  No State that refuses to expand Medicaid has been better off without 
it. Without the expansion, the dramatic healthcare needs of Alabama's 
working poor will remain unmet; and rural hospitals, many of which I 
represent, will face growing financial challenges that will undoubtedly 
lead to reduced services.
  According to a 2013 study conducted by the Culverhouse College of 
Commerce at the University of Alabama, the Medicaid expansion would 
create $28 billion in overall business activity in the State of 
Alabama. There has not been another economic development investment in 
the State of Alabama that would bring the State more than 30,000 new 
jobs annually.
  A 2012 study conducted by the University of Alabama at Birmingham 
School of Public Health found that Medicaid expansion in our State 
would generate $20 billion in new economic activity and a $925 million 
increase in State tax revenues--yes, revenues to our State.
  Expanding Medicaid is clearly not only a moral imperative, but I 
would say to you that it is an economic imperative in my State. With 
each day that our State delays expansion, more Alabamians are unable to 
work due to unrelated health conditions. More rural hospitals have to 
cut services because of uncompensated care provided in their emergency 
rooms.
  With each day that my State delays expanding, Alabamians continue to 
forego the immense economic benefit that results from this investment. 
The greatest casualty, Mr. Speaker, are the most vulnerable Americans, 
the most vulnerable in our society: the poor, the working poor, the 
unemployed, the uninsured.
  It is unacceptable that the State of Alabama has not chosen to expand 
Medicaid. We owe it to Alabama taxpayers to expand Medicaid now.
  I want to commend my colleagues, Representatives Payne and Kelly, for 
choosing to talk about the effects of health care on minority 
populations. I would add that in this day and age, when we have a law--
the Affordable Care Act--that stands ready and willing to help 
Americans help themselves--after all, what we are saying is we are 
giving access to affordable healthcare insurance, insurance that they 
have to pay for, insurance that they can get subsidized if they are the 
working poor--we deserve it as Americans.
  In this great country, no one should go without health care, no one, 
especially those who are the most vulnerable in our society.
  I hope that through talking about the disparities that exist in 
minority health, we also remember that this great institution did do 
something that would help decrease the disparity. We chose to pass the 
Affordable Care Act, and every time, we have defended it against 
repeal.
  It is time that States like the State of Alabama get with the 
program. It is time States like Alabama expand Medicaid and that we 
choose our people over politics. Partisan politics should not rule the 
day; instead, we should care more about the people we represent than 
the partisan politics of each of our parties.
  I thank my colleagues for continuing the fight. The CBC Special Order 
hour is very important. It highlights not only what is important to 
minority communities--because what is important to minority communities 
is important to all vulnerable communities in America.
  I want to thank my colleagues for continuing this great tradition. I 
want to thank them for choosing to talk about health care and the 
disparities that exist in this country.
  I want to urge all of the Alabama lawmakers who are listening to my 
voice, the State lawmakers who are in Montgomery today, that we need to 
work together to expand Medicaid in the State of Alabama. The medical 
case is there. The economic case is there. The moral case is there.
  Let's do what is right for all Alabamians, and let's expand Medicaid 
today.
  Mr. PAYNE. Mr. Speaker, I thank the gentlewoman from Alabama for her 
eloquent remarks on the topic of the evening. Irrespective of where you 
are in this Nation, these issues are a common thread in communities 
throughout this Nation.
  I am not surprised that the gentlewoman from Alabama, Representative 
Sewell, is able to talk about the same

[[Page 4817]]

issues that we are able to talk about in New Jersey, Illinois, 
California, Florida, and across this Nation, across this great land.
  At this time, I would like to hear from the gentlewoman from Ohio 
(Mrs. Beatty), an outstanding Member of the United States House of 
Representatives. In just her second term, she has demonstrated her 
superior leadership skills. She is a member of my class, the ``class'' 
of the class.
  Mrs. BEATTY. I thank my colleagues, Congressman Donald Payne and 
Congresswoman Robin Kelly, for leading this evening's critical 
discussion on ``The State of Black Health: A Congressional Black Caucus 
Assessment During National Minority Health Month.''
  Mr. Speaker, it is no surprise that we are here today because, 
certainly, we have had many firsthand experiences to know the 
disparities that exist across all Americans but, more specifically, 
across African American communities.
  To you, Mr. Payne, thank you for having the foresight to come 
tonight; and to you, Congresswoman Kelly, thank you for taking a 
leadership position in helping us share with the Nation the value and 
the importance of protecting all lives but giving information to the 
Nation about the state of black health.
  It is imperative that we continue to address health disparities that 
affect racial minorities and work together on the efforts to advance 
health equity.
  Since July 1971, the Congressional Black Caucus has sponsored 
national conferences and held brain trusts on black health. It is so 
timely that we have this discussion as we observe National Minority 
Health Month.
  Tonight is a call to action, a charge for all of us to unite towards 
a common goal of improving the health of our communities. Everyone in 
America should be able to live a healthy life, regardless of the color 
of their skin.
  Mr. Speaker, the good news is the overall health of an American has 
improved over the past few decades. This is, in part, due to the 
increased focus on preventive medicine and dynamic new advances in 
medical technology.
  However, not all Americans have benefited equally from healthcare 
improvements. Since the enactment of the Affordable Care Act, millions 
of Americans now have access to quality, affordable coverage.
  According to the American Medical Association, recent studies have 
shown that despite the steady improvement in overall health of the 
United States, racial and ethnic minorities experience a lower quality 
of health services and are less likely to receive routine medical 
procedures and have higher rates of morbidity and mortality than 
nonminorities.
  Disparities in health care exist even when controlling for gender, 
condition, age, and socioeconomic status. For example, cardiovascular 
diseases account for the largest proportion of inequality in life 
expectancy between African Americans and non-Hispanic whites.
  According to the American Cancer Society, African American women have 
a 44 percent higher death rate from breast cancer, despite having a 
mammography screening rate that is nearly the same rate for white 
women.
  According to the Centers for Disease Control, the CDC, the infant 
death rate among African Americans is still more than double that of 
whites.
  Mr. Speaker, tonight, you are going to hear my colleagues and I 
discuss much data and statistics because I am from the great State of 
Ohio and Ohio ranks 47th in the Nation in infant mortality, with black 
infants dying at twice the rate of white infants.
  According to a 2015 study conducted by the Kaiser Family Foundation, 
in Ohio, on average, 14.5 black infants die per every 1,000 live 
births, while 6.3 white infants die.
  Ohio community leaders and the Greater Columbus Infant Mortality Task 
Force are working hard to lower Franklin County's infant mortality rate 
and the infant mortality rate in all of Ohio. Tonight, I salute them 
for their research, for their education, and for their consistency to 
save lives. The statistics are staggering, and we can and must do more 
to lower and eliminate them.
  The societal burden of healthcare disparities in America manifest in 
multiple and major ways. For example, a 2014 study by the Joint Center 
for Political and Economic Studies concluded that ``the combined costs 
of health inequalities and premature death in the United States were 
$1.24 trillion.'' That $1.24 trillion is the cost between 2003 and 
2006.
  That is why, on March 23, 2010, when President Barack Obama signed 
the Affordable Care Act, it was a monumental step that has helped us 
address the overwhelming statistics and health disparities within our 
community. I proudly supported the Affordable Care Act because lives 
matter. All lives matter. Black lives matter.
  Now, we have comprehensive healthcare reform that improves access to 
affordable health coverage and guarantees that the most vulnerable in 
our communities have access to care. By improving access to quality 
health care for all Americans, the Affordable Care Act helps reduce 
health disparities.
  How does the Affordable Care Act do this? This law invests in 
prevention and wellness, gives individuals more control over their 
care, and expands initiatives to increase racial and ethnic diversity 
in healthcare professions by strengthening cultural competency training 
for all healthcare providers and improving communications between 
providers and patients.
  The Affordable Care Act represents the most significant Federal 
effort to reduce disparities in this country's history.
  Congressman Payne and Congresswoman Kelly, again, I salute you. I am 
going to repeat that because it is so important for us to let the 
Nation know that the Affordable Care Act represents the most 
significant Federal effort to reduce disparities in this country's 
history.
  The Affordable Care Act also increases funding for community health 
centers which serve an estimated one in three low-income people and one 
in four low-income minority residents.
  There are over 43 community health centers, Mr. Speaker, in Ohio, 
including many in my district: Columbus Neighborhood Health Centers, 
Heart of Ohio Family Health Centers, and Lower Lights Christian Health 
Centers.
  These community health centers provide outstanding primary care, 
dental, behavioral health, and pharmacy services in our most 
underserved areas. In 2013, community health centers provided care to 
over 550,000 Ohioans and recorded over 2 million patient visits.
  We have come a long way, Madam Speaker, but there is still much more 
for us to do. All people should have the opportunity to reach their 
fullest potential for health. We must continue to move forward to 
combat health disparities, build healthier communities, and create a 
stronger country. In order to have a successful Nation, I believe we 
must have a healthy Nation.
  Let me leave you with something a national figure once said:

       If you neglect to recharge a battery, it dies. If you run 
     full speed ahead without stopping for water, you lose 
     momentum to finish the race.

  Let us make sure that all Americans can finish the race.

                              {time}  2015

  Mr. PAYNE. Madam Speaker, I would like to thank the gentlelady from 
Ohio. As I stated in my introduction of her, she has just demonstrated 
an outstanding leadership in our class that is second to none, and we 
can always depend on her to bring some clear thought to these issues at 
hand, so we would like to thank her once again.
  Madam Speaker, tomorrow there will be a press conference at 1:30 with 
Representatives Caroline Maloney and G. K. Butterfield to discuss the 
new JEC report on persistent economic challenges in black communities. 
The report is bleak. There is not a lot of good news in this report.
  Nearly one in seven Americans identify themselves as African 
American. The third-largest racial ethnic group in the United States, 
African Americans have made significant social and economic progress 
since the passage of the Civil Rights Act of 1964; however, the black 
community continues to face enormous challenges.

[[Page 4818]]

  Economic data reveals startling inequities. By many of the most 
important measures of economic well-being, blacks lag far behind the 
majority white population. And that is just the overview of the report. 
That is just the start.
  I hope the people watching at home and my colleagues in earshot of me 
will be there tomorrow to support our colleagues at 1:30 at the HVC 
Studio A.
  I would like to give my colleague, Representative Kelly, the 
opportunity to provide us more information on the issue at hand. As was 
mentioned, the Affordable Care Act, something that has passed this 
Congress, and there have been many attempts to thwart it and repeal it, 
but the majority is never successful at doing that because people 
understand what this legislation has meant to this Nation.
  You see, it makes sense for more people to have quality affordable 
health care, and that has been the issue. The first word in the act, 
``affordable,'' has been prohibitive for many Americans to have the 
health care that they need and desire.
  But this legislation has made it available to 16 million more people 
in this country. Sixteen million people have benefited from this piece 
of legislation that is continually under attack.
  Actually, it is 16 million and one, because I have heard a 
candidate--the first person to announce they are running for President 
of the United States in 2016, who is a Senator, who hails from the 
great State of Texas--say that with him running, his wife will lose, 
will stop working at her job, dedicate herself to this campaign, so his 
health care was under her benefits.
  Well, guess what? In a kind of coy little shrewd way, he said, Well, 
you know, now I will take the mantle of getting health care for my 
family.
  You mean the Affordable Care Act, sir? The issue you railed about 
constantly for years since you have come to the Senate?
  Oh, well that is different.
  It is absolutely incredible, when I sat there and watched him try to 
dance around that, that he is now in the exchange. It was a sight to 
see.
  But I will get off of that and let my colleague from Illinois provide 
us some information.
  Ms. KELLY of Illinois. Thank you, Congressman Payne.
  Something I want to speak about is oral health. As we discuss the 
state of black America, I want to address a topic that is so often left 
out of the public health discourse, and that is the issue of oral 
health in America.
  Earlier this year, the CBC Health Braintrust recognized National 
Children's Dental Health Month, and back in February I had the 
opportunity to go around my district in a mobile dental van to observe 
local dentists performing free oral health screenings around the 
community.
  These types of effort matter, and oral health is a critical piece to 
overall health wellness. The sad fact is that all across our Nation, 
many communities are experiencing serious oral health crises.
  Far too many people in urban, suburban, and rural America are lacking 
access to dental care, despite the efforts of committed dental 
professionals and social service organizations.
  We must recognize that access to dental health care across the 
country is not equal. Each year, nearly 50 million Americans, including 
16 million low-income children in underserved communities, go without 
the oral health services they need.
  As we continue the national discussion on improving health care and 
reducing health disparities in America, it is important that oral 
health be central to the conversation.
  When officials discuss health care and wellness, they should remember 
that the mouth is connected to the rest of the body. This seems to be 
forgotten in the current dialogue about improving health outcomes for 
all.
  This year I introduced H.R. 539, the Action for Dental Health Act, 
which allows organizations to qualify for Health and Human Service oral 
health grants to support activities that improve oral health education 
and dental disease prevention.
  This includes developing and expanding outreach programs that will 
facilitate establishing dental homes for children and adults, including 
the elderly, blind and disabled.
  This bipartisan legislation will target crucial Federal dollars to 
State and local dental organizations to provide proven oral health care 
services in a manner that effectively addresses the barriers to dental 
care many Americans face. It will have a significant impact on many 
underserved communities.
  I think the majority of my colleagues know that regular visits to the 
dentist do more than keep your smile attractive. They can tell a lot 
about your overall health, including whether or not you may be 
developing a disease like diabetes or if you are at risk for a stroke.
  As the CBC takes on the critical task of creating healthier 
communities by breaking down barriers, oral health is a subject that 
must be addressed. This will ultimately help reduce unnecessary health-
care costs by minimizing and eliminating dental diseases in their early 
stages.
  As I mentioned earlier, I recently visited a new mobile dental van 
operated by a hospital in an underserved community in my district that 
had a stop at the hospital's Women, Infant, and Children's Center. They 
had a pediatric dentist on hand to provide babies and toddlers with 
their first dental exams.
  I saw firsthand the critical need for dental care, not only for these 
young children, but for their parents. This highlighted all too well 
the gaps in dental care that are particularly prevalent in minority 
communities.
  Viewing the care and service these dental professionals displayed to 
kids, many of whom had never been to a dentist, reminded me of kids 
like Deamonte Driver.
  You may recall, he was the 12-year old boy from Maryland who died 
from an untreated tooth infection that spread lethal bacteria to his 
brain. An untreated tooth condition that could have been resolved with 
a routine extraction cost this boy his life. How is that possible in 
the most innovative, wealthy Nation in the world?
  I think we should be doing more to support volunteer dental projects 
in underserved communities and improve oral health education, with a 
particular focus on early oral health education and care for children. 
We all know the link between good dental care and overall health has 
been well established.
  As we look for ways to raise a healthier generation of children, 
increasing access and removing barriers to dental care must be at the 
forefront. Through legislation like H.R. 539, the Action for Dental 
Health Act, I am working to increase access to dental care and build 
healthier communities. In improving the state of black health and the 
state of American health, I ask that we lift up the issue of oral 
health, and ask that my colleagues take the first step by cosponsoring 
H.R. 539.
  Mr. PAYNE. Madam Speaker, I thank the gentlelady from Illinois. That 
is so true. And as you stood there and stated those issues, that is 
something that we have known for quite some time, how oral care impacts 
so many other parts of your health--and as you mentioned, could really 
show you the onset of diabetes.
  I mention diabetes, Madam Speaker, because I have been out for 
several weeks now with a foot infection. And it got pretty severe and 
had to be operated on. But what has complicated the circumstance with 
my foot is me being a diabetic, a very noncompliant diabetic, a 
diabetic who did not take it seriously, did not take the medicines that 
I should have for years.
  This circumstance with my foot made it all so very clear what needed 
to be done. The circumstance frightened me into doing everything that I 
am supposed to now, so you are looking at a compliant diabetic. But it 
is crucial, and the diabetes is what has complicated the healing of my 
foot.
  Now, I am a very fortunate person in this country. I am living an 
American Dream that I did not realize would happen to me because of 
another issue of my father losing his bout with colorectal cancer. He 
was the Member prior to me, and I took his place.

[[Page 4819]]

  But we were fortunate. We have always had good health care. We are 
talking about the disparities and the inequities in this Nation for 
people who are not in the positions that Representative Kelly, myself, 
and other well-to-do Americans are who have health care that keeps them 
alive.
  Now, whether you use it or not is really up to you. But we are 
afforded that opportunity to get great health care.
  We are talking about people who want health care but cannot afford it 
and find themselves in emergency rooms as their visit to the doctor. 
They have to wait until they are very ill and go to the emergency room, 
which is how they get their health care. That costs this Nation 
millions and billions of dollars.
  But what the Affordable Care Act has done is given a lot of these 
people the opportunity to get pre-screenings and pro-care prior to 
showing up at the emergency room.
  So whether people realize it or not, you end up paying for these 
people who cannot afford their own health care in your premium, because 
someone is going to cover it. The insurance companies aren't going to 
just cover it. The hospitals aren't, so we pay it in our premiums.
  So as you get more people their own health care, it drives the cost 
down. It will drive the cost down in this Nation, and we will all 
benefit from more people being healthier. That is what the Affordable 
Care Act is about. That is what it does. That is what it does.

                              {time}  2030

  I am so fortunate to live in this Nation, to be able to represent the 
10th Congressional District of the State of New Jersey, and to stand 
here and fight for not only the people of the 10th District of New 
Jersey, but every American that deserves an equal opportunity. That is 
what it is about.
  It is not about favor; it is about the opportunity, the equal 
opportunity. And we see these disparities, iniquities in health care, 
in economics all across the board, all across this Nation.
  It is incumbent upon us as the Congressional Black Caucus to speak up 
for the residents that we represent, children and infants.
  You know, even in the 21st century, health disparities are stark, 
especially in African American communities, where life expectancies are 
lower and infant mortality rates are higher. Children of color who live 
below the poverty line are much more likely to suffer from asthma, 
develop ADHD, and contract diseases because they can't afford 
vaccinations. It is the situation across the board. Cancer, African 
Americans have the highest death rate and the shortest survival rate of 
any racial ethnic group in the United States. And it just goes on and 
on.
  It is important that we get the message out. And we will continue to 
fight with Representative Robin Kelly, head of the Health Braintrust. I 
know the work that she will do on behalf of the American people.
  So, Madam Speaker, with that, I would just like to thank Ms. Kelly 
for the opportunity to speak on what I feel is a dire, dire situation 
in this country, the inequity in health disparities.
  Ms. KELLY of Illinois. Thank you, Congressman Payne. Welcome back. 
And I am glad you are taking care of yourself.
  Madam Speaker, again, I thank my colleagues for taking the time 
during National Minority Health Awareness Month to assess the very 
critical state of black health in America.
  As stated earlier, the health disparities facing communities of color 
are too significant to adequately address in just an hour. As a recent 
CDC Health Disparities Report demonstrated:
  Blacks diagnosed with HIV are less likely than any other groups to be 
linked to care, retained in care, receive treatment, and achieve 
adequate viral suppression;
  Although black Americans represent only 12 percent of the U.S. 
population, they accounted for 44 percent of new HIV infections and 
represented 49 percent of all deaths with HIV in 2010. Furthermore, 
blacks also accounted for 49 percent of new AIDS diagnoses in 2011;
  According to the U.S. Census Bureau 2010 Population Estimates, 84 
percent of all reported tuberculosis cases occurred in racial and 
ethnic minorities. African Americans accounted for 40 percent of TB 
cases amongst U.S.-born persons.
  These facts account for a few of the health disparities affecting the 
state of black health.
  The Congressional Black Caucus Health Braintrust is committed to 
strengthening our Nation's public health infrastructure and developing 
community-oriented, multidisciplinary approaches to public health. We 
will continue to work vigorously to address health gaps existing in the 
black community, empower communities, and improve health access in 
efforts to march toward a healthier future.
  Black lives matter. The state of black health matters, and we are 
confident that if we all join together, we can alleviate health 
disparities facing minority communities across this Nation.
  I thank my colleagues and my cochair, the Honorable Donald Payne, 
Jr., for this hour of discussion, this hour of opportunity, and this 
hour of change.
  Madam Speaker, I yield back the balance of my time.
  Ms. EDDIE BERNICE JOHNSON of Texas. Madam Speaker, I rise in support 
of the CBC Special Order Hour, ``The State of Black Health: A CBC 
Assessment During National Minority Health Month.'' Unfortunately, 
during a time when the best and most promising health innovation and 
treatments exist, many individuals in our population face disparities 
and inequalities in health access, delivery, and outcomes.
  Since April is National Minority Health Month, we must highlight 
these existing disparities and enact policies that focus on eliminating 
inequalities and improving the nation's health at large. The future of 
our nation's health mostly depends on the effectiveness of federal, 
state, and local policies. Traditionally, African Americans and Latinos 
face the worst health disparities in this country and in my home state 
of Texas.
  Generally, the death rate for blacks is higher than whites for heart 
disease, stroke, cancer, influenza and pneumonia, diabetes, HIV/AIDS, 
and homicide. In 2010, about two of five Latino adults and one in four 
black adults were uninsured. While behavioral risk and environmental 
factors are certainly at play for much of our population, the lack of 
health care access and especially access to preventive health services 
in the black and Latino communities increases the inequalities in each 
category.
  Currently, the adult obesity rate for blacks is 47.8 percent, 42.5 
percent for Latinos, and 32.6 percent for whites. Broken down further, 
56.6 percent of black females are obese while 37.1 percent of black 
males are obese. The black population is the most obese among whites 
and Latinos in all categories except for black males which is led by 
Latinos. Obesity takes much of the blame for negative long-term health 
impacts such as high blood pressure, heart disease, stroke, and 
diabetes.
  While the Affordable Care Act has certainly helped to improve access 
to preventive services within minority communities, much can be done to 
improve the aforementioned inequalities. The Centers for Disease 
Control and the U.S. Department of Health and Human Services Office of 
Minority Health have laid out several initiatives to promote health 
equity and close the disparity gap between minorities and white 
Americans. We must support the social, economic, and environmental 
policies that the CDC and OMH have recommended in order to achieve 
health equity and eliminate disparities.
  Ms. FUDGE. Madam Speaker, I want to thank my colleagues Congressmen 
Payne and Kelly for leading the Congressional Black Caucus Special 
Order Hour.
  My Congressional district in Ohio includes much of Cuyahoga County. A 
few years ago, the county analyzed the relationship between a 
resident's life-expectancy and neighborhood, with incredible, but not 
surprising results.
  The study found that people who lived in Hough, a low-income and 
predominantly African-American neighborhood in Cleveland, could expect 
to live 24 years less than someone who resided in Lyndhurst, an 
affluent, predominantly white suburb of the city, less than 10 miles 
away.
  While Hough and Lyndhurst are extreme examples, they accurately 
represent national trends: African Americans live, on average, four 
years less than their white peers.
  It is unacceptable that the American health care system, which 
attracts students, physicians and patients from across the world, does

[[Page 4820]]

not serve all the citizens of this country equally.
  Sadly, the consequences of health disparities have a major impact on 
our nation's children.
  Students who attend predominantly minority schools often do not have 
access to fresh fruits and vegetables, places to exercise, or many of 
the other resources we know are necessary for a healthy lifestyle.
  It is our responsibility as Members of Congress to ensure our 
constituents have the opportunity to be healthy, regardless of how much 
they make, where they live, or what they look like.
  I am committed to working with my colleagues in Congress, the 
Administration, local and state governments, and private partners to 
make good on that obligation.
  Ms. LEE. Madam Speaker, first, let me thank Congresswoman Robin Kelly 
and Congressman Donald Payne, Jr. for hosting this important Special 
Order. I appreciate your leadership in organizing this important 
discussion on the state of Black Health in America.
  Madam Speaker, every April, we observe National Minority Health 
Awareness Month. This year is particularly significant as we mark 30 
years since the groundbreaking Health and Human Services Task Force on 
Black and Minority Health report. This report sparked the first serious 
discussion in Washington on addressing the deep racial health 
disparities that exist in this country.
  This year also marks 50 years since the creation of Medicare and 
Medicaid--programs that have kept and continue to keep Americans 
healthy.
  We are also celebrating the fifth year anniversary of the passage of 
the Affordable Care Act--the most significant legislation to improve 
the health of all Americans in more than a generation.
  These legislative achievements continue moving us closer to health 
equity for all--however, major health disparities still exist.
  The zip code in which you are born still determines your likely life 
expectancy.
  Gross disparities exist from zip code to zip code--even within the 
same city or county.
  So today, I rise to join my colleagues in the Congressional Black 
Caucus to bring to light the state of Black health in America and call 
for more action to address persistent and lingering disparities in 
health access, treatment and care.
  Since the passage of The Affordable Care Act, access to care has 
dramatically expanded in communities of color. The uninsured rate has 
declined 7.3 percent in the African American community. And more people 
have access to affordable, quality healthcare--all thanks to the 
Affordable Care Act.
  When we were crafting the Affordable Care Act, I had the privilege of 
serving as Chair of the Congressional Black Caucus.
  And let me tell you, we worked day and night with our colleagues in 
the Congressional Hispanic Caucus and Congressional Asian Pacific 
American Caucus, to push Congress and the Administration to craft the 
best possible bill.
  Since its passage, the Affordable Care Act has improved the American 
health care system: Healthcare is now more affordable and accessible 
than ever
  Women can no longer be discriminated against because they are a 
woman, have a pre-existing condition--such as HIV/AIDS--or have been 
the victim of domestic violence;
  Young people can stay on their parent's health insurance until they 
are 26; and
  People with serious conditions, like cancer, no longer face the real 
fear of hitting their lifetime cap and being denied life-saving 
treatment.
  The ACA also expands the capacity of the healthcare delivery system 
to better serve those at risk for and living with HIV/AIDS.
  These are the facts. The Affordable Care Act has dramatically 
increased access to preventative care for women, low-income 
communities, and people of color.
  Despite rabble-rousing and grandstanding from the right, this law is 
saving lives--every, day, in communities across America--from Maine to 
my district in the East Bay.
  During the last enrollment period, 16.4 million Americans obtained 
health insurance, and more than half a million came from my home state 
of California.
  Make no mistake--the Affordable Care Act is working.
  African Americans and Latinos, historically underinsured or uninsured 
groups, have seen the greatest declines in their uninsured rates. This 
is especially good news for African Americans who are living with HIV, 
where the key to halting the epidemic is access to affordable and 
quality care.
  With this increase in coverage, we are beginning to close the gap in 
racial and ethnic health disparities and access to care.
  However, much work remains to truly realize health equity in America.
  Right now--in America, the richest and most powerful country in the 
world--African Americans still suffer from disproportionately high 
numbers of preventable deaths, disparities in access to quality health 
care, and underrepresentation within the medical community.
  African Americans have the highest mortality rate of any racial and 
ethnic group from cancer.
  Furthermore, African-Americans are 40% more likely to die from a 
stroke than whites, and 30% more likely to die from heart disease than 
whites.
  And while African Americans are only 13% of the U.S. population, they 
account for nearly half of all new HIV infections. African Americans 
also account for the highest HIV-related deaths and HIV death rates.
  Madam Speaker--this is unacceptable.
  In an age where technology and innovation are paving the way to new 
medical breakthroughs, these persistent disparities in healthcare 
cannot be allowed to continue.
  That is why today, I urge my colleagues: Let's work together and 
commit ourselves to passing legislation that will end racial and ethnic 
disparities and achieve health equity.
  The Affordable Care Act was a good start but more is needed.
  For years, the Congressional tri-caucus has championed this effort by 
introducing The Health Equity and Accountability Act (HEAA). 
Congresswoman Robin Kelly will have the honor in introducing this 
important legislation this Congress and I am proud to co-lead this 
effort as co-chair of the CAPAC Health Task Force.
  This important legislation builds on the Affordable Care Act and puts 
us on track to eliminate health disparities in our country.
  The Health Equity and Accountability Act would address incidences of 
terminal and chronic diseases that disproportionally affect communities 
of color, including cancer, diabetes, heart disease and HIV/AIDS.
  So, in recognition of National Minority Health Awareness Month, I 
urge my colleagues to support this important bill in order to truly 
achieve health equity for all.
  Madam Speaker, the state of black health in America is improving, but 
much work remains before us.
  As our drum major for justice, Dr. King, told us, ``of all the forms 
of inequality, injustice in health care is the most shocking and 
inhumane.''
  I urge my colleagues to join us in securing health equity for all.
  Ms. JACKSON LEE. Madam Speaker, National Minority Health Month is a 
very important time to bring awareness to the many health concerns 
facing minority communities.
  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. Certainly, the Affordable Care Act, which I co-
sponsored and worked on has brought a new quality of life and access to 
healthcare for millions of Americans including minorities.
  I thank all of my CBC colleagues who 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 some of the 
greatest impediments to the health and wellness of the African-American 
community and other minority communities.
  The first challenge is reversing the dangerous trend of increasing 
obesity in juveniles and young adults. Cancer, diabetes and hepatitis 
are of great importance as well as combating the scourge of HIV/AIDS.
  Finally, we must confront the leading cause of death of young 
African-American males between the ages of 15-24; that cause is not 
disease or accidental death, but homicide.


                                OBESITY

  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.
  In 2007, 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.''

[[Page 4821]]

  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 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, 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% in 1980 survey to 32.9% 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% to 13.9%; for those aged 6-11 years, prevalence increased from 
6.5% to 18.8%; and for those aged 12-19 years, prevalence increased 
from 5.0% to 17.4%.
  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-American males.
  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.


                                 Cancer

  Certain groups in the United States are not doing as well as others 
when it comes to preventing and surviving cancer.
  Many such disparities are apparent among certain minority populations 
such as African Americans and Hispanics.
  The reasons why cancer adversely affects these groups are largely 
related to issues such as poverty, access to health care, and other 
socioeconomic factors.
  The cancer death rate among African American men is 27% higher 
compared to non-Hispanic white men.
  The death rate for African American women is 11% higher compared to 
non-Hispanic white women.
  African Americans have the highest incidence rates of colorectal 
cancer of any racial or ethnic group.
  Hispanics have higher rates of cervical, liver, and stomach cancers 
than non-Hispanic whites.
  Liver cancer incidence and death rates among Asian/Pacific Islanders 
are double those among non-Hispanic whites.


                                Diabetes

  About 19 percent of all non-Hispanic black Americans age 20 or older 
(about 5 million people) have diabetes, the highest rate of any ethnic 
group.
  Among Hispanic adults, more than 2.5 million or about 11 percent of 
the population have diabetes; 14 percent of American Indians and Alaska 
Natives are living with the disease.
  Compared with non-Hispanic white adults, the risk of diabetes is 18 
percent higher in Asian-Americans, 66 percent higher in Hispanics/
Latinos, and 77 percent higher in non-Hispanic African-Americans.


                               Hepatitis

  In 2002, 50 percent of those infected with Hepatitis B were Asian 
Americans and Pacific Islanders.
  Black teenagers and young adults become infected with Hepatitis B 
three to four times more often than those who are white.
  One recent study has found that black people have a higher incidence 
of Hepatitis C infection than white people.


                                HIV/AIDS

  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.
  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).
  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.


                       GUN VIOLENCE AND HOMICIDE

  The final health challenge confronting the African-American 
community, and African-American males in particular, involves the issue 
of gun violence and homicide.
  This must be a priority health issue for our community. Over 600,000 
Americans are victimized in handgun crimes each year, and the African-
American community is among the hardest hit.
  It was only a little over a week ago that one of my constituents was, 
caught in a cross fire that ended his life.
  Neither the mind nor the heart can contemplate a cause that could 
lead a human being to inflict such injury and destruction on fellow 
human beings.
  Since 1978, on average, 33 young black males between the ages of 15 
and 24 are murdered every six days. Three-quarters of these victims are 
killed by firearms.
  In 1997, firearm homicide was the number one cause of death for 
African-American men ages 15-34, as well as the leading cause of death 
for all African-American 15-24 year olds. The firearm death rate for 
African-Americans was 2.6 times that of whites.
  According to the Centers for Disease Control, the firearms suicide 
rate amongst African-American youths aged 10-19 more than doubled over 
a 15 year period. Although African-Americans have had a historically 
lower rate of suicide than whites, the rate for African-Americans 15-19 
has reached that of white youths aged 15-19.
  A young African-American male is 10 times more likely to be murdered 
than a young white male. The homicide rate among African-American men 
aged 15 to 24 rose by 66 percent from 1984 to 1987, according to the 
Centers for Disease Control.
  Ninety-five percent of this increase was due to firearm-related 
murders. For African-American males, aged 15 to 19, firearm homicides 
have increased 158 percent from 1985 to 1993. In 1998, 94 percent of 
the African-American murder victims were slain by African-American 
offenders.
  In 1997, African-American males accounted for 45 percent of all 
homicide victims, while they only account for 6 percent of the entire 
population.
  It is scandalous that a 15-year-old urban African-American male faces 
a probability of being murdered before reaching his 45th birthday that 
ranges from almost 8.5 percent in the District of Columbia to less than 
2 percent in Brooklyn.
  By comparison, the probability of being murdered by age 45 is a mere 
three-tenths of 1 percent for all white males.
  Firearms have become the predominant method of suicide for African-
Americans aged 10-19 years, accounting for over 66 percent of suicides.
  In Florida, for example, African-American males have an almost eight 
times greater chance of dying in a firearm-related homicide than white 
males. In addition, the firearm-related homicide death rate for 
African-American females is greater than white males and over four 
times greater than white females.
  Nearly 50 percent of all homicide perpetrators give some type of 
prior warning signal such as a threat or suicide note. Among the

[[Page 4822]]

students who commit a school-associated homicide, 20 percent were known 
to have been victims of bullying and 12 percent were known to have 
expressed suicidal thoughts or engage in suicidal behavior.
  I have been working tirelessly in Congress to end gun violence by 
introducing legislation to assist local governments and school 
administrators in devising preventive measures to reduce school-
associated violent deaths.
  I have introduced sensible legislation to assist law enforcement 
departments, social service agencies, and school officials detect and 
deter gun violence.
  In devising such preventive measures, at a minimum, we must focus on:
  Encouraging efforts to reduce crowding, increase supervision, and 
institute plans/policies to handle disputes during transition times 
that may reduce the likelihood of potential conflicts and injuries.
  Taking threats seriously and letting students know who and where to 
go when they learn of a threat to anyone at the school and encouraging 
parents, educators, and mentors to take an active role in helping 
troubled children and teens.
  Taking talk of suicide seriously and identifying risk factors for 
suicidal behavior when trying to prevent violence toward self and 
others.
  Developing prevention programs designed to help teachers and other 
school staff recognize and respond to incidences of bullying between 
students.
  Ensuring that each school has a security plan and that it is being 
enforced and that school staff are trained and prepared to implement 
and execute the plan.
  Again, thank you all for your commitment to working to find workable 
solutions to the heath and wellness challenges facing our communities. 
I look forward to working with you in the months ahead to achieve our 
mutual goals.

                          ____________________