Anti-Racism in Public Health Act of 2021

II 117TH CONGRESS 1ST SESSION S. 162 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 SENATE OF THE UNITED STATES FEBRUARY 2, 2021 Ms. WARREN (for herself, Ms. HIRONO, Mr. MERKLEY, Ms. SMITH, and Mr. MARKEY) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 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 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Anti-Racism in Public 4 Health Act of 2021’’. 5 SEC. 2. FINDINGS. 6 Congress makes the following findings: 7 (1) For centuries, structural racism, defined by 8 the National Museum of African American History 9 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 162 IS and Culture as an ‘‘overarching system of racial bias 1 across institutions and society’’, in the United States 2 has negatively affected communities of color, espe- 3 cially Black, Latinx, Asian American, Pacific Is- 4 lander, and American Indian and Alaska Native peo- 5 ple, to expand and reinforce White supremacy. 6 (2) Structural racism determines the conditions 7 in which people are born, grow, work, live, and age 8 and determine people’s access to quality housing, 9 education, food, transportation, and political power, 10 and other social determinants of health. 11 (3) Structural racism serves as a major barrier 12 to achieving health equity and eliminating racial and 13 ethnic inequities in health outcomes that exist at 14 alarming rates and are determined by a wider set of 15 forces and systems. 16 (4) Due to structural racism in the United 17 States, people of color are more likely to suffer from 18 chronic health conditions (such as heart disease, dia- 19 betes, asthma, hepatitis, and hypertension) and in- 20 fectious diseases (such as HIV/AIDS, and COVID– 21 19) compared to their White counterparts. 22 (5) Due to structural racism in maternal health 23 care in the United States, Black and American In- 24 dian and Alaska Native infants are more than twice 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 162 IS as likely to die than White infants, Black women are 1 3 to 4 times more likely to die from pregnancy-re- 2 lated causes than White women, and American In- 3 dian and Alaska Native women are 5 times more 4 likely to die from pregnancy-related causes than 5 White women. This trend persists even when adjust- 6 ing for income and education. 7 (6) Due to structural racism in the United 8 States, Non-Hispanic Black women have the highest 9 rates for 22 of 25 severe morbidity indicators used 10 by the Center for Disease Control and Prevention 11 (CDC). 12 (7) Due to structural racism in the United 13 States, people of color comprise a disproportionate 14 percentage of persons with disabilities in the United 15 States. 16 (8) Due to structural racism in the United 17 States, Black men are up to three and a half times 18 as likely to be killed by police as White men, and 1 19 in every 1,000 Black men will die as a result of po- 20 lice violence. Policing has adverse effects on mental 21 health in Black communities. 22 (9) Due to the confluence of structural racism 23 and factors such as gender, class, and sexual ori- 24 entation or gender identity, commonly referred to as 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 162 IS intersectionality, Black and Latinx transgender 1 women are more likely to die due to violence and 2 homicide than their White counterparts. 3 (10) Due to structural racism, inequitable ac- 4 cess to quality health care and long-term services 5 and supports also disproportionately burdens com- 6 munities of color; people of color and immigrants are 7 less likely to be insured and are more likely to live 8 in medically underserved areas. 9 (11) Due to structural racism, older adults of 10 color are also more likely to be admitted to nursing 11 homes and assisted living facilities and to reside in 12 those of poor quality, and when older adults of color 13 do receive home and community based services, Med- 14 icaid spends less money on their services and they 15 are more likely to be hospitalized than older White 16 adults. 17 (12) In addition, the Federal Government’s fail- 18 ure to honor the unique political status of American 19 Indian and Alaska Native people, to respect the in- 20 herent sovereignty of Tribal Nations, and to uphold 21 its trust and treaty obligations to Tribal Nations 22 and American Indian and Alaska Native people, is 23 an ongoing and unjust manifestation of centuries of 24 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 162 IS oppression, with the consequence of adverse health 1 outcomes for Native peoples. 2 (13) The COVID–19 pandemic has exposed the 3 devastating impact of structural racism on the 4 United States ability to ensure equitable health out- 5 comes for people of color, and made these commu- 6 nities more likely to suffer from severe outcomes due 7 to the coronavirus infection. 8 (14) Racial and ethnic inequity in public health 9 is a result of systematic, personally mediated, and 10 internalized racism and racist public and private 11 policies and practices, and dismantling structural 12 racism is integral to addressing public health. 13 SEC. 3. DEFINITIONS. 14 In this Act: 15 (1) ANTIRACISM.—The term ‘‘antiracism’’ is a 16 collection of antiracist policies that lead to racial eq- 17 uity, and are substantiated by antiracist ideas. 18 (2) ANTIRACIST.—The term ‘‘antiracist’’ is any 19 measure that produces or sustains racial equity be- 20 tween racial groups. 21 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 162 IS SEC. 4. PUBLIC HEALTH RESEARCH AND INVESTMENT IN 1 DISMANTLING STRUCTURAL RACISM. 2 Part B of title III of the Public Health Service Act 3 (42 U.S.C. 243 et seq.) is amended by adding at the end 4 the following: 5 ‘‘SEC. 320B. NATIONAL CENTER ON ANTIRACISM AND 6 HEALTH. 7 ‘‘(a) IN GENERAL.— 8 ‘‘(1) NATIONAL CENTER.—There is established 9 within the Centers for Disease Control and Preven- 10 tion a center to be known as the ‘National Center 11 on Antiracism and Health’ (referred to in this sec- 12 tion as the ‘Center’). The Director of the Centers for 13 Disease Control and Prevention shall appoint a di- 14 rector to head the Center who has experience living 15 in and working with racial and ethnic minority com- 16 munities. The Center shall promote public health 17 by— 18 ‘‘(A) declaring racism a public health crisis 19 and naming racism as an historical and present 20 threat to the physical and mental health and 21 well-being of the United States and world; 22 ‘‘(B) aiming to develop new knowledge in 23 the science and practice of antiracism, including 24 by identifying the mechanisms by which racism 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 162 IS operates in the provision of health care and in 1 systems that impact health and well-being; 2 ‘‘(C) transferring that knowledge into 3 practice, including by developing interventions 4 that dismantle the mechanisms of racism and 5 replace such mechanisms with equitable struc- 6 tures, policies, practices, norms, and values so 7 that a healthy society can be realized; and 8 ‘‘(D) contributing to a national and global 9 conversation regarding the impacts of racism on 10 the health and well-being of the United States 11 and world. 12 ‘‘(2) GENERAL DUTIES.—The Secretary, acting 13 through the Center, shall undertake activities to 14 carry out the mission of the Center as described in 15 paragraph (1), such as the following: 16 ‘‘(A) Conduct research into, collect, ana- 17 lyze and make publicly available data on, and 18 provide leadership and coordination for the 19 science and practice of antiracism, the public 20 health impacts of structural racism, and the ef- 21 fectiveness of intervention strategies to address 22 these impacts. Topics of research and data col- 23 lection under this subparagraph may include 24 identifying and understanding— 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 162 IS ‘‘(i) policies and practices that have a 1 disparate impact on the health and well- 2 being of communities of color; 3 ‘‘(ii) the public health impacts of im- 4 plicit racial bias, White supremacy, weath- 5 ering, xenophobia, discrimination, and 6 prejudice; 7 ‘‘(iii) the social determinants of health 8 resulting from structural racism, including 9 poverty, housing, employment, political 10 participation, and environmental factors; 11 and 12 ‘‘(iv) the intersection of racism and 13 other systems of oppression, including as 14 related to age, sexual orientation, gender 15 identity, and disability status. 16 ‘‘(B) Award noncompetitive grants and co- 17 operative agreements to eligible public and non- 18 profit private entities, including State, local, 19 territorial, and Tribal health agencies and orga- 20 nizations, for the research and collection, anal- 21 ysis, and reporting of data on the topics de- 22 scribed in subparagraph (A). 23 ‘‘(C) Establish, through grants or coopera- 24 tive agreements, at least 3 regional centers of 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 162 IS excellence, located in racial and ethnic minority 1 communities, in antiracism for the purpose of 2 developing new knowledge in the science and 3 practice of antiracism in health by researching, 4 understanding, and identifying the mechanisms 5 by which racism operates in the health space, 6 racial and ethnic inequities in health care ac- 7 cess and outcomes, the history of successful 8 antiracist movements in health, and other 9 antiracist public health work. 10 ‘‘(D) Establish a clearinghouse within the 11 Centers for Disease Control and Prevention for 12 the collection and storage of data generated 13 under the programs implemented under this 14 section for which there is not an otherwise ex- 15 isting surveillance system at the Centers for 16 Disease Control and Prevention. Such data 17 shall— 18 ‘‘(i) be comprehensive and 19 disaggregated, to the extent practicable, by 20 including racial, ethnic, primary language, 21 sex, gender identity, sexual orientation, 22 age, socioeconomic status, and disability 23 disparities; 24 ‘‘(ii) be made publicly available; 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 162 IS ‘‘(iii) protect the privacy of individuals 1 whose information is included in such data; 2 and 3 ‘‘(iv) comply with privacy protections 4 under the regulations promulgated under 5 section 264(c) of the Health Insurance 6 Portability and Accountability Act of 1996. 7 ‘‘(E) Provide information and education to 8 the public on the public health impacts of struc- 9 tural racism and on antiracist public health 10 interventions. 11 ‘‘(F) Consult with other Centers and Na- 12 tional Institutes within the Centers for Disease 13 Control and Prevention, including the Office of 14 Minority Health and Health Equity and the 15 Center for State, Tribal, Local, and Territorial 16 Support, to ensure that scientific and pro- 17 grammatic activities initiated by the agency 18 consider structural racism in their designs, 19 conceptualizations, and executions, which shall 20 include— 21 ‘‘(i) putting measures of racism in 22 population-based surveys; 23 ‘‘(ii) establishing a Federal Advisory 24 Committee on racism and health for the 25 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 162 IS Centers for Disease Control and Preven- 1 tion; 2 ‘‘(iii) developing training programs, 3 curricula, and seminars for the purposes of 4 training public health professionals and re- 5 searchers around issues of race, racism, 6 and antiracism; 7 ‘‘(iv) providing standards and best 8 practices for programming and grant re- 9 cipient compliance with Federal data col- 10 lection standards, including section 4302 11 of the Patient Protection and Affordable 12 Care Act; and 13 ‘‘(v) establishing leadership and stake- 14 holder councils with experts and leaders in 15 racism and public health disparities. 16 ‘‘(G) Coordinate with the Indian Health 17 Service and with the Centers for Disease Con- 18 trol and Prevention’s Tribal Advisory Com- 19 mittee to ensure meaningful Tribal consulta- 20 tion, the gathering of information from Tribal 21 authorities, and respect for Tribal data sov- 22 ereignty. 23 VerDate Sep 11 2014 23:02 Feb 14, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S162.IS S162 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 162 IS ‘‘(H) Engage in government to government 1 consultation with Indian Tribes and Tribal or- 2 ganizations. 3 ‘‘(I) At least every 2 years, produce and 4 publicly post on the Centers for Disease Control 5 and Prevention’s website a report on antiracist 6 activities completed by the Center, which may 7 include newly identified antiracist public health 8 practices. 9 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 10 is authorized to be appropriated such sums as may be nec- 11 essary to carry out this section.’’. 12 SEC. 5. PUBLIC HEALTH RESEARCH AND INVESTMENT IN 13 POLICE VIOLENCE. 14 (a) IN GENERAL.—The Secretary of Health and 15 Human Services shall establish within the National Center 16 for Injury Prevention and Control of the Centers for Dis- 17 ease Control and Prevention (referred to in this section 18 as the ‘‘Center’’) a law enforcement violence prevention 19 program. 20 (b) GENERAL DUTIES.—In implementing the pro- 21 gram under subsec [Text truncated for display. Full text available on Congress.gov.]