Anti-Racism in Public Health Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 666 To amend the Public Health Service Act to provide for public health research and investment into understanding and eliminating structural racism and police violence. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 1, 2021 Ms. PRESSLEY (for herself, Ms. LEE of California, Ms. CASTOR of Florida, Mr. NADLER, Mrs. WATSON COLEMAN, Mr. TAKANO, Mr. DANNY K. DAVIS of Illinois, Ms. JACKSON LEE, Mr. HIGGINS of New York, Mr. COOPER, Ms. TLAIB, Ms. OCASIO-CORTEZ, Mr. SIRES, Mr. VARGAS, Ms. ROYBAL-ALLARD, Mr. RUSH, Mr. HASTINGS, Ms. NORTON, Ms. WIL- LIAMS of Georgia, Mr. BOWMAN, Ms. JAYAPAL, Ms. VELA´ZQUEZ, Mrs. BEATTY, Ms. BUSH, Ms. MENG, Mr. BLUMENAUER, Mr. DESAULNIER, Mr. RUPPERSBERGER, Mr. ESPAILLAT, Ms. SEWELL, Mr. PAYNE, Ms. OMAR, Mr. SARBANES, Ms. MATSUI, Mr. SMITH of Washington, Mr. CAR- SON, Ms. CLARK of Massachusetts, Mr. COHEN, Ms. CHU, and Mr. TORRES of New York) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to provide for public health research and investment into understanding and eliminating structural racism and police violence. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 666 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Anti-Racism in Public 2 Health Act of 2021’’. 3 SEC. 2. FINDINGS. 4 Congress makes the following findings: 5 (1) For centuries, structural racism, defined by 6 the National Museum of African American History 7 and Culture as an ‘‘overarching system of racial bias 8 across institutions and society,’’ in the United States 9 has negatively affected communities of color, espe- 10 cially Black, Latinx, Asian American, Pacific Is- 11 lander, and American Indian and Alaska Native peo- 12 ple, to expand and reinforce White supremacy. 13 (2) Structural racism determines the conditions 14 in which people are born, grow, work, live, and age 15 and determine people’s access to quality housing, 16 education, food, transportation, and political power, 17 and other social determinants of health. 18 (3) Structural racism serves as a major barrier 19 to achieving health equity and eliminating racial and 20 ethnic inequities in health outcomes that exist at 21 alarming rates and are determined by a wider set of 22 forces and systems. 23 (4) Due to structural racism in the United 24 States, people of color are more likely to suffer from 25 chronic health conditions (such as heart disease, dia- 26 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 666 IH betes, asthma, hepatitis, and hypertension) and in- 1 fectious diseases (such as HIV/AIDS, and COVID– 2 19) compared to their White counterparts. 3 (5) Due to structural racism in maternal health 4 care in the United States, Black and American In- 5 dian and Alaska Native infants are more than twice 6 as likely to die than White infants, Black women are 7 3 to 4 times more likely to die from pregnancy-re- 8 lated causes than White women, and American In- 9 dian and Alaska Native women are 5 times more 10 likely to die from pregnancy-related causes than 11 White women. This trend persists even when adjust- 12 ing for income and education. 13 (6) Due to structural racism in the United 14 States, Non-Hispanic Black women have the highest 15 rates for 22 of 25 severe morbidity indicators used 16 by the Center for Disease Control and Prevention 17 (CDC). 18 (7) Due to structural racism in the United 19 States, people of color comprise a disproportionate 20 percentage of persons with disabilities in the United 21 States. 22 (8) Due to structural racism in the United 23 States, Black men are up to three and a half times 24 as likely to be killed by police as White men, and 1 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 666 IH in every 1,000 Black men will die as a result of po- 1 lice violence. Policing has adverse effects on mental 2 health in Black communities. 3 (9) Due to the confluence of structural racism 4 and factors such as gender, class, and sexual ori- 5 entation or gender identity, commonly referred to as 6 intersectionality, Black and Latinx transgender 7 women are more likely to die due to violence and 8 homicide than their White counterparts. 9 (10) Due to structural racism, inequitable ac- 10 cess to quality health care and longterm services and 11 supports also disproportionately burdens commu- 12 nities of color; people of color and immigrants are 13 less likely to be insured and are more likely to live 14 in medically underserved areas. 15 (11) Due to structural racism, older adults of 16 color are also more likely to be admitted to nursing 17 homes and assisted living facilities and to reside in 18 those of poor quality, and when older adults of color 19 do receive home and community based services, Med- 20 icaid spends less money on their services and they 21 are more likely to be hospitalized than older White 22 adults. 23 (12) In addition, the Federal Government’s fail- 24 ure to honor the unique political status of American 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 666 IH Indian and Alaska Native people, to respect the in- 1 herent sovereignty of Tribal Nations, and to uphold 2 its trust and treaty obligations to Tribal Nations 3 and American Indian and Alaska Native people, is 4 an ongoing and unjust manifestation of centuries of 5 oppression, with the consequence of adverse health 6 outcomes for Native peoples. 7 (13) The COVID–19 pandemic has exposed the 8 devastating impact of structural racism on the 9 United States ability to ensure equitable health out- 10 comes for people of color, and made these commu- 11 nities more likely to suffer from severe outcomes due 12 to the coronavirus infection. 13 (14) Racial and ethnic inequity in public health 14 is a result of systematic, personally mediated, and 15 internalized racism and racist public and private 16 policies and practices, and dismantling structural 17 racism is integral to addressing public health. 18 SEC. 3. DEFINITIONS. 19 In this Act: 20 (1) ANTIRACISM.—The term ‘‘antiracism’’ is a 21 collection of antiracist policies that lead to racial eq- 22 uity, and are substantiated by antiracist ideas. 23 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 666 IH (2) ANTIRACIST.—The term ‘‘antiracist’’ is any 1 measure that produces or sustains racial equity be- 2 tween racial groups. 3 SEC. 4. PUBLIC HEALTH RESEARCH AND INVESTMENT IN 4 DISMANTLING STRUCTURAL RACISM. 5 Part B of title III of the Public Health Service Act 6 (42 U.S.C. 243 et seq.) is amended by adding at the end 7 the following: 8 ‘‘SEC. 320B. NATIONAL CENTER ON ANTIRACISM AND 9 HEALTH. 10 ‘‘(a) IN GENERAL.— 11 ‘‘(1) NATIONAL CENTER.—There is established 12 within the Centers for Disease Control and Preven- 13 tion a center to be known as the ‘National Center 14 on Antiracism and Health’ (referred to in this sec- 15 tion as the ‘Center’). The Director of the Centers for 16 Disease Control and Prevention shall appoint a di- 17 rector to head the Center who has experience living 18 in and working with racial and ethnic minority com- 19 munities. The Center shall promote public health 20 by— 21 ‘‘(A) declaring racism a public health crisis 22 and naming racism as an historical and present 23 threat to the physical and mental health and 24 well-being of the United States and world; 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 666 IH ‘‘(B) aiming to develop new knowledge in 1 the science and practice of antiracism, including 2 by identifying the mechanisms by which racism 3 operates in the provision of health care and in 4 systems that impact health and well-being; 5 ‘‘(C) transferring that knowledge into 6 practice, including by developing interventions 7 that dismantle the mechanisms of racism and 8 replace such mechanisms with equitable struc- 9 tures, policies, practices, norms, and values so 10 that a healthy society can be realized; and 11 ‘‘(D) contributing to a national and global 12 conversation regarding the impacts of racism on 13 the health and well-being of the United States 14 and world. 15 ‘‘(2) GENERAL DUTIES.—The Secretary, acting 16 through the Center, shall undertake activities to 17 carry out the mission of the Center as described in 18 paragraph (1), such as the following: 19 ‘‘(A) Conduct research into, collect, ana- 20 lyze and make publicly available data on, and 21 provide leadership and coordination for the 22 science and practice of antiracism, the public 23 health impacts of structural racism, and the ef- 24 fectiveness of intervention strategies to address 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 666 IH these impacts. Topics of research and data col- 1 lection under this subparagraph may include 2 identifying and understanding— 3 ‘‘(i) policies and practices that have a 4 disparate impact on the health and well- 5 being of communities of color; 6 ‘‘(ii) the public health impacts of im- 7 plicit racial bias, White supremacy, weath- 8 ering, xenophobia, discrimination, and 9 prejudice; 10 ‘‘(iii) the social determinants of health 11 resulting from structural racism, including 12 poverty, housing, employment, political 13 participation, and environmental factors; 14 and 15 ‘‘(iv) the intersection of racism and 16 other systems of oppression, including as 17 related to age, sexual orientation, gender 18 identity, and disability status. 19 ‘‘(B) Award noncompetitive grants and co- 20 operative agreements to eligible public and non- 21 profit private entities, including State, local, 22 territorial, and Tribal health agencies and orga- 23 nizations, for the research and collection, anal- 24 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 666 IH ysis, and reporting of data on the topics de- 1 scribed in subparagraph (A). 2 ‘‘(C) Establish, through grants or coopera- 3 tive agreements, at least 3 regional centers of 4 excellence, located in racial and ethnic minority 5 communities, in antiracism for the purpose of 6 developing new knowledge in the science and 7 practice of antiracism in health by researching, 8 understanding, and identifying the mechanisms 9 by which racism operates in the health space, 10 racial and ethnic inequities in health care ac- 11 cess and outcomes, the history of successful 12 antiracist movements in health, and other 13 antiracist public health work. 14 ‘‘(D) Establish a clearinghouse within the 15 Centers for Disease Control and Prevention for 16 the collection and storage of data generated 17 under the programs implemented under this 18 section for which there is not an otherwise ex- 19 isting surveillance system at the Centers for 20 Disease Control and Prevention. Such data 21 shall— 22 ‘‘(i) be comprehensive and disaggre- 23 gated, to the extent practicable, by includ- 24 ing racial, ethnic, primary language, sex, 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 666 IH gender identity, sexual orientation, age, so- 1 cioeconomic status, and disability dispari- 2 ties; 3 ‘‘(ii) be made publicly available; 4 ‘‘(iii) protect the privacy of individuals 5 whose information is included in such data; 6 and 7 ‘‘(iv) comply with privacy protections 8 under the regulations promulgated under 9 section 264(c) of the Health Insurance 10 Portability and Accountability Act of 1996. 11 ‘‘(E) Provide information and education to 12 the public on the public health impacts of struc- 13 tural racism and on antiracist public health 14 interventions. 15 ‘‘(F) Consult with other Centers and Na- 16 tional Institutes within the Centers for Disease 17 Control and Prevention, including the Office of 18 Minority Health and Health Equity and the 19 Center for State, Tribal, Local, and Territorial 20 Support, to ensure that scientific and pro- 21 grammatic activities initiated by the agency 22 consider structural racism in their designs, 23 conceptualizations, and executions, which shall 24 include— 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 666 IH ‘‘(i) putting measures of racism in 1 population-based surveys; 2 ‘‘(ii) establishing a Federal Advisory 3 Committee on racism and health for the 4 Centers for Disease Control and Preven- 5 tion; 6 ‘‘(iii) developing training programs, 7 curricula, and seminars for the purposes of 8 training public health professionals and re- 9 searchers around issues of race, racism, 10 and antiracism; 11 ‘‘(iv) providing standards and best 12 practices for programming and grant re- 13 cipient compliance with Federal data col- 14 lection standards, including section 4302 15 of the Patient Protection and Affordable 16 Care Act; and 17 ‘‘(v) establishing leadership and stake- 18 holder councils with experts and leaders in 19 racism and public health disparities. 20 ‘‘(G) Coordinate with the Indian Health 21 Service and with the Centers for Disease Con- 22 trol and Prevention’s Tribal Advisory Com- 23 mittee to ensure meaningful Tribal consulta- 24 tion, the gathering of information from Tribal 25 VerDate Sep 11 2014 18:56 Feb 21, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H666.IH H666 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 666 IH authorities, and respect for Tribal data sov- 1 ereignty. 2 ‘‘(H) Engage in government to government 3 consultation with Indian Tribes and Tribal or- 4 ganizations. 5 ‘‘(I) At least every 2 years, produce and 6 publicly post on the Centers for Disease Control 7 and Prevention’s website a report on antiracist 8 activities completed by the Center, which may 9 include newly identified antiracist public health 10 practices. 11 ‘‘(b) AUTHORIZATION OF APPROPR [Text truncated for display. Full text available on Congress.gov.]