[House Report 116-550]
[From the U.S. Government Publishing Office]


116th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                     {      116-550

======================================================================



 
      SOUTH ASIAN HEART HEALTH AWARENESS AND RESEARCH ACT OF 2020

                                _______
                                

 September 29, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 3131]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 3131) to amend the Public Health Service Act to 
provide for research and improvement of cardiovascular health 
among the South Asian population of the United States, and for 
other purposes, having considered the same, reports favorably 
thereon with an amendment and recommends that the bill as 
amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................2
 II. Background and Need for the Legislation..........................3
III. Committee Hearings...............................................3
 IV. Committee Consideration..........................................4
  V. Committee Votes..................................................4
 VI. Oversight Findings...............................................4
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures4
VIII.Federal Mandates Statement.......................................5

 IX. Statement of General Performance Goals and Objectives............5
  X. Duplication of Federal Programs..................................5
 XI. Committee Cost Estimate..........................................5
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......5
XIII.Advisory Committee Statement.....................................5

XIV. Applicability to Legislative Branch..............................5
 XV. Section-by-Section Analysis of the Legislation...................5
XVI. Changes in Existing Law Made by the Bill, as Reported............6

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``South Asian Heart Health Awareness and 
Research Act of 2020''.

SEC. 2. HEART HEALTH PROMOTION GRANTS.

  Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is 
amended by inserting after section 317U (42 U.S.C. 247b-23) the 
following new section:

``SEC. 317V. HEART HEALTH PROMOTION GRANTS.

  ``(a) In General.--The Secretary shall make grants to States for the 
purpose of promoting awareness of the increasing prevalence of heart 
disease, including, where appropriate, its relationship to type 2 
diabetes, in communities disproportionately affected by heart disease 
such as South Asian communities in the United States.
  ``(b) Use of Funds.--A State that receives a grant under subsection 
(a) shall use such grant funds--
          ``(1) to develop culturally appropriate materials on 
        evidence-based topics such as nutrition education, optimal diet 
        plans, and programs for regular exercise;
          ``(2) to support heart health promotion activities of 
        community organizations that work with or serve communities 
        disproportionately affected by heart disease, such as South 
        Asian communities in the United States; or
          ``(3) to support conferences or workshops on research 
        practices, methodology, and design to include more members of 
        communities disproportionately affected by heart disease, such 
        as South Asian communities in the United States, in scientific 
        studies.
  ``(c) Annual Report to Congress.--Not later than 180 days after the 
date of the enactment of the South Asian Heart Health Awareness and 
Research Act of 2020, and annually thereafter, the Director shall 
submit to Congress a report on outreach efforts and data relating to 
heart disease in communities disproportionately affected by heart 
disease, such as South Asian communities in the United States.
  ``(d) Authorization of Appropriations.--For purposes of carrying out 
this section, there is authorized to be appropriated $1,000,000 for 
each of fiscal years 2020 through 2024.''.

SEC. 3. HEART HEALTH RESEARCH.

  Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et 
seq.) is amended by adding at the end the following new section:

``SEC. 409K. HEART HEALTH RESEARCH.

  ``(a) In General.--The Secretary may--
          ``(1) conduct or support research and related activities 
        regarding cardiovascular disease, type 2 diabetes, and other 
        heart health-related ailments among at-risk populations, 
        including South Asian communities in the United States; and
          ``(2) establish an Internet clearinghouse to catalog existing 
        evidence-based heart health research and treatment options for 
        communities disproportionately affected by heart disease, such 
        as South Asian communities in the United States, to prevent, 
        treat, or reverse heart disease and diabetes.
  ``(b) Authorization of Appropriations.--For purposes of carrying out 
this section, there is authorized to be appropriated $1,000,000 for 
each of fiscal years 2020 through 2024.''.

                         I. Purpose and Summary

    H.R. 3131, the ``South Asian Heart Health Awareness and 
Research Act of 2020'', was introduced on June 5, 2019, by 
Representatives Pramila Jayapal (D-WA), Joe Wilson (R-SC), 
Brian Fitzpatrick (R-PA), Betty McCollum (D-MN), Raul Grijalva 
(D-AZ), Ro Khanna (D-CA), Tulsi Gabbard (D-HI), Adam Smith (D-
WA), Grace Meng (D-NY), Christopher Smith (R-NJ), Bonnie Watson 
Coleman (D-NJ), Bill Foster (D-IL), Ami Bera (D-CA), Adriano 
Espaillat (D-NY), Sheila Jackson Lee (D-TX), Raja 
Krishnamoorthi (D-IL), and Janice Schakowsky (D-IL). The bill 
authorizes the Secretary of Health and Human Services (the 
Secretary) to award heart health promotion grants to States for 
heart health awareness initiatives, educational materials, and 
training workshops for communities disproportionately affected 
by heart disease. It also authorizes the Secretary to conduct 
or support research regarding cardiovascular disease, type 2 
diabetes, and other heart health-related ailments among at-risk 
populations, including the South Asian populations. The 
Secretary may also establish research catalogs for existing 
heart health research and treatment options.

              II. Background and Need for the Legislation

    Heart disease is the leading cause of death in the United 
States, and a person's risk of heart disease death differs 
dramatically by their race and ethnicity.\1\ Overall, racial 
and ethnic minorities have an elevated risk of morbidity and 
mortality due to heart disease.\2\ Racial and ethnic minorities 
confront more barriers to heart health care than their White 
counterparts, including higher comorbidity rates, less 
culturally competent care, and fewer proactive heart health 
interventions.\3\
---------------------------------------------------------------------------
    \1\Centers for Disease Control and Prevention, Health, United 
States (April 2020) (www.cdc.gov/nchs/hus/spotlight/
HeartDiseaseSpotlight_2019_0404.pdf).
    \2\Lindsay R. Pool, et al., Trends in Racial/Ethnic Disparities in 
Cardiovascular Health Among US Adults From 1999-2012, Journal of the 
American Heart Association (Sep. 22, 2017).
    \3\Garth Graham, Disparities in cardiovascular disease risk in the 
United States, Current Cardiology Review (Aug. 2015).
---------------------------------------------------------------------------
    It is clear that social and structural determinants of 
health affect heart health, but it also appears that biology 
may play a role.\4\ The average lifespan of African Americans 
is significantly shorter than White Americans, mostly because 
of heart disease and stroke, which contributed to more than two 
million years of life lost among African Americans between 1999 
and 2010.\5\ Cardiovascular disease is also the second leading 
cause of death for Hispanics.\6\ And South Asians represent 
approximately 25 percent of the world's population--yet they 
account for 60 percent of the world's heart disease 
patients.\7\
---------------------------------------------------------------------------
    \4\Salim S. Virani, et al., Heart disease and stroke statistics--
2020 update: a report from the American Heart Association, Circulation 
(Jan. 29, 2020).
    \5\Mercedes R. Carnethon, et al., Cardiovascular Health in African 
Americans: A Scientific Statement From the American Heart Association, 
Circulation (Oct. 23, 2017).
    \6\P. C. Balfour, et al., Cardiovascular Disease in Hispanics/
Latinos in the United States, Journal of Latina/o Psychology (2016).
    \7\S Yusuf, et al., Global burden of cardiovascular diseases: Part 
II: variations in cardiovascular disease by specific ethnic groups and 
geographic regions and prevention strategies, Circulation (Dec. 4, 
2001).
---------------------------------------------------------------------------
    In November 2019, the American Heart Association and other 
medical groups issued updated cholesterol guidelines that, for 
the first time, urged doctors to consider ethnicity when 
determining a patient's cardiovascular risk and treatment 
options.\8\
---------------------------------------------------------------------------
    \8\Ethnicity a `risk-enhancing' factor under new cholesterol 
guidelines, American Heart Association News (Jan. 11, 2019).
---------------------------------------------------------------------------
    H.R. 3131 makes additional funding available for States who 
wish to increase heart health promotion, awareness, and 
training for communities disproportionately affected by heart 
disease. The bill also supports heart health research for 
communities disproportionately affected by heart disease.

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 3131:
    The Subcommittee on Health held a hearing on Wednesday, 
June 17, 2020, entitled, ``Heath Care Inequality: Confronting 
Racial and Ethnic Disparities in COVID-19 and the Health Care 
System.'' The Subcommittee received testimony from the 
following witnesses:
           Rhea Boyd, M.D., M.P.H., Pediatrician and 
        Child Health Advocate, Palo Alto Medical Foundation
           Oliver T. Brooks, M.D., President, National 
        Medical Association
           Avik S. A. Roy, President, The Foundation 
        for Research on Equal Opportunity

                      IV. Committee Consideration

    Representative Jayapal (D-WA), along with 16 original 
cosponsors, introduced H.R. 3131, the ``South Asian Heart 
Health Awareness and Research Act of 2020'', on June 5, 2019, 
and the bill was referred to the Committee on Energy and 
Commerce. The bill was then referred to the Subcommittee on 
Health on June 6, 2019. A legislative hearing was held by the 
Subcommittee on June 17, 2020.
    On September 9, 2020, the Subcommittee on Health was 
discharged from further consideration of H.R. 3131, as the full 
Committee on Energy and Commerce called the bill up for 
consideration. The full Committee met in virtual open markup 
session on September 9, 2020, pursuant to notice, to consider 
H.R. 3131. During consideration of the bill, an amendment in 
the nature of a substitute offered by Ms. Schakowsky of 
Illinois was agreed to by a voice vote. Upon conclusion of 
consideration of the bill, the full Committee agreed to a 
motion on final passage by Mr. Pallone, Chairman of the 
committee, to order H.R. 3131 reported favorably to the House, 
amended, by a voice vote, a quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
3131, including the motion on final passage.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to improve 
heart health promotion and research in communities 
disproportionately affected by heart disease such as South 
Asian communities in the United States.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 3131 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 3131 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``South Asian Heart Health Awareness and Research Act of 
2020''.

Sec. 2. Heart Health Promotion Grants

    Section 2 amends title III of the Public Health Service Act 
by inserting a new section to direct the Secretary to award 
grants to States to promote awareness of the increasing 
prevalence of heart disease and its relation to type 2 
diabetes. The grants shall be used to expand awareness in 
certain communities by developing culturally appropriate 
materials on evidence-based topics related to heart health, 
supporting community organizations that address heart health, 
or supporting training opportunities for members of communities 
disproportionately affected by heart disease. An annual report 
on outreach efforts and data relating to heart disease in 
disproportionately affected communities is required to be 
submitted to Congress, with the first report due within 180 
days of enactment.
    Section 2 includes an authorization of $1,000,000 for each 
of fiscal years 2020 through 2024.

Sec. 3. Heart Health Research

    Section 3 amends part B of title IV of the Public Health 
Service Act to authorize the Secretary to conduct or support 
research regarding cardiovascular disease, type 2 diabetes, and 
other heart health-related ailments among at-risk populations, 
as well to establish an Internet clearinghouse to catalog 
existing evidence-based heart health research and treatment 
options.
    Section 3 includes an authorization of $1,000,000 for each 
of fiscal years 2020 through 2024.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 317V. HEART HEALTH PROMOTION GRANTS.

  (a) In General.--The Secretary shall make grants to States 
for the purpose of promoting awareness of the increasing 
prevalence of heart disease, including, where appropriate, its 
relationship to type 2 diabetes, in communities 
disproportionately affected by heart disease such as South 
Asian communities in the United States.
  (b) Use of Funds.--A State that receives a grant under 
subsection (a) shall use such grant funds--
          (1) to develop culturally appropriate materials on 
        evidence-based topics such as nutrition education, 
        optimal diet plans, and programs for regular exercise;
          (2) to support heart health promotion activities of 
        community organizations that work with or serve 
        communities disproportionately affected by heart 
        disease, such as South Asian communities in the United 
        States; or
          (3) to support conferences or workshops on research 
        practices, methodology, and design to include more 
        members of communities disproportionately affected by 
        heart disease, such as South Asian communities in the 
        United States, in scientific studies.
  (c) Annual Report to Congress.--Not later than 180 days after 
the date of the enactment of the South Asian Heart Health 
Awareness and Research Act of 2020, and annually thereafter, 
the Director shall submit to Congress a report on outreach 
efforts and data relating to heart disease in communities 
disproportionately affected by heart disease, such as South 
Asian communities in the United States.
  (d) Authorization of Appropriations.--For purposes of 
carrying out this section, there is authorized to be 
appropriated $1,000,000 for each of fiscal years 2020 through 
2024.

           *       *       *       *       *       *       *


TITLE IV--NATIONAL RESEARCH INSTITUTES

           *       *       *       *       *       *       *



Part B--General Provisions Respecting National Research Institutes

           *       *       *       *       *       *       *



SEC. 409K. HEART HEALTH RESEARCH.

  (a) In General.--The Secretary may--
          (1) conduct or support research and related 
        activities regarding cardiovascular disease, type 2 
        diabetes, and other heart health-related ailments among 
        at-risk populations, including South Asian communities 
        in the United States; and
          (2) establish an Internet clearinghouse to catalog 
        existing evidence-based heart health research and 
        treatment options for communities disproportionately 
        affected by heart disease, such as South Asian 
        communities in the United States, to prevent, treat, or 
        reverse heart disease and diabetes.
  (b) Authorization of Appropriations.--For purposes of 
carrying out this section, there is authorized to be 
appropriated $1,000,000 for each of fiscal years 2020 through 
2024.

           *       *       *       *       *       *       *


                                  [all]