Health Equity and MENA Community Inclusion Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 2730 To amend the Public Health Service Act to include Middle Easterners and North Africans in the statutory definition of a ‘‘racial and ethnic minority group’’, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 19, 2023 Ms. TLAIB (for herself, Mrs. DINGELL, Ms. ESHOO, and Ms. KELLY of Illi- nois) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to include Middle Easterners and North Africans in the statutory definition of a ‘‘racial and ethnic minority group’’, and for other purposes. 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 ‘‘Health Equity and 4 Middle Eastern and North African Community Inclusion 5 Act of 2023’’ or the ‘‘Health Equity and MENA Commu- 6 nity Inclusion Act of 2023’’. 7 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 2730 IH SEC. 2. DEFINITION. 1 In this Act, the terms ‘‘Middle Eastern and North 2 African’’ or ‘‘MENA’’, with respect to individuals or popu- 3 lations, includes individuals and populations who identify 4 with one or more nationalities or ethnic groups originating 5 in a country (or portion thereof) in the Middle Eastern 6 and North African region (such as Lebanese, Iranians, 7 Egyptians, Moroccans, Yemenis, Chaldeans, Imazighen, 8 Kurds, Palestinians, and Yazidis). 9 SEC. 3. FINDINGS. 10 Congress finds the following: 11 (1) Through the establishment of the Office of 12 Minority Health (OMH) in 1986, the Department of 13 Health and Human Services has developed health 14 policies and programs that eliminate health dispari- 15 ties and improve the health of racial and ethnic mi- 16 nority populations. 17 (2) Congress has funded the OMH to develop 18 and implement health care service programs that ad- 19 dress physical activity and nutrition, clinical condi- 20 tions, individual social needs, and the social deter- 21 minants of health for ‘‘racial and ethnic minority 22 groups’’. 23 (3) Before the amendments made by this Act, 24 section 1707(g)(1) of the Public Health Service Act 25 (42 U.S.C. 300u–6(g)(1))— 26 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 2730 IH (A) defined the term ‘‘racial and ethnic mi- 1 nority group’’ (for whom the OMH works to 2 improve health outcomes and eliminate health 3 disparities) to exclude Middle Easterners and 4 North Africans; and 5 (B) thereby prevented MENA populations 6 from accessing critical resources intended to as- 7 sist historically marginalized communities. 8 (4) Independent researchers and private sector 9 research initiatives have found significant health dis- 10 parities between MENA individuals and the non- 11 Hispanic White population, as well as significant 12 overlap between the health outcomes and health con- 13 ditions of MENA individuals and those of other ra- 14 cial and ethnic minority groups. 15 (5) Poor health outcomes are often connected to 16 impoverishment in other aspects of life and are exac- 17 erbated by additional barriers to access high-quality 18 health coverage, whether in terms of language, eligi- 19 bility, health literacy, or discrimination at the point- 20 of-service. 21 (6) A recent study published in Proceedings of 22 the National Academy of Sciences suggested that 23 MENA individuals are not perceived as White and 24 do not perceive themselves as White. 25 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 2730 IH (7) Research on the health outcomes and health 1 conditions of MENA individuals is troubling and 2 suggests that efforts must be made on the Federal 3 level to disaggregate the demographic data of 4 MENA individuals from the demographic data of in- 5 dividuals in the non-Hispanic White category and 6 fully understand the social determinants of health 7 for health disparities and outcomes experienced by 8 MENA individuals. 9 (8) Under the current Federal standards for 10 data on race and ethnicity, demographic data on 11 MENA individuals is aggregated into the same cat- 12 egory as demographic data on individuals of Euro- 13 pean ancestry, which limits the ability of the Federal 14 Government to understand the factors that con- 15 tribute to health outcomes for MENA individuals. 16 (9) The Federal standards for data on race and 17 ethnicity effectively obscure the reality of minority 18 health and health disparities by aggregating demo- 19 graphic health data on MENA individuals with that 20 Europeans. 21 (10) MENA individuals are not included among 22 the groups for whom the OMH works to improve 23 health outcomes and eliminate health disparities, 24 which further limits the opportunity of MENA indi- 25 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 2730 IH viduals to access programs designed to address their 1 experiences and health conditions. 2 (11) The OMH could better assess and elimi- 3 nate health disparities by conducting a comprehen- 4 sive study of the health of MENA individuals and 5 recognizing MENA individuals as a racial and ethnic 6 minority group. 7 SEC. 4. INCLUSION OF MIDDLE EASTERNERS AND NORTH 8 AFRICANS IN DEFINITION OF RACIAL AND 9 ETHNIC MINORITY GROUPS. 10 (a) IN GENERAL.—Section 1707(g)(1) of the Public 11 Health Service Act (42 U.S.C. 300u–6(g)(1)) is amended 12 by striking ‘‘and Hispanics’’ and inserting ‘‘Hispanics, 13 and Middle Easterners and North Africans’’. 14 (b) SENSE OF CONGRESS.—It is the sense of Con- 15 gress that subsection (a) should be implemented so as to 16 ensure that— 17 (1) the definition of a ‘‘racial and ethnic minor- 18 ity group’’ in section 1707(g)(1) of the Public 19 Health Service Act (42 U.S.C. 300u–6(g)(1)), as 20 amended by subsection (a), is applied in the imple- 21 mentation and execution of Federal programs and 22 activities that reference such definition; and 23 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 2730 IH (2) no racial and ethnic minority group served 1 by such programs and activities is negatively im- 2 pacted by subsection (a). 3 (c) UNDEFINED REFERENCES.—Not later than 2 4 years after the date of enactment of this Act, the Sec- 5 retary of Health and Human Services shall— 6 (1) identify all regulations, guidance, orders, 7 and documents of the Department of Health and 8 Human Services for establishment or implementa- 9 tion of a health care or public health program, activ- 10 ity, or survey that— 11 (A) use the term ‘‘racial and ethnic minor- 12 ity group’’ or similar terminology; but 13 (B) do not define such term or termi- 14 nology; and 15 (2) take such actions as may be necessary to 16 clarify whether the definition of ‘‘racial and ethnic 17 minority group’’ in section 1707(g)(1) of the Public 18 Health Service Act (42 U.S.C. 300u–6(g)(1)), as 19 amended by subsection (a), applies to such term or 20 terminology. 21 (d) REPORT TO CONGRESS.—Not later than 2 years 22 after the date of enactment of this Act, the Secretary of 23 Health and Human Services shall submit a report to the 24 Congress on the implementation of this section. 25 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 2730 IH SEC. 5. REPORT ON THE HEALTH OF THE MIDDLE EASTERN 1 AND NORTH AFRICAN POPULATION. 2 (a) STUDY REQUIRED.—The Secretary of Health and 3 Human Services (in this section referred to as the ‘‘Sec- 4 retary’’) shall conduct or support a comprehensive study 5 regarding the unique health patterns and outcomes of 6 MENA populations. 7 (b) REQUIREMENTS FOR STUDY.—The comprehen- 8 sive study under subsection (a) shall include an enumera- 9 tion of MENA populations across the United States, 10 disaggregated by subpopulation, and with respect to each 11 such population and subpopulation— 12 (1) the rates of— 13 (A) obesity, diabetes, sickle cell anemia, 14 stroke, asthma, pneumonia, lung cancer, HIV/ 15 AIDS, HPV, high cholesterol, high blood pres- 16 sure, chronic heart, lung, and kidney disease; 17 (B) morbidity and mortality, including the 18 rates of morbidity and mortality associated with 19 the health conditions listed in subparagraph 20 (A); 21 (C) mental health and substance use dis- 22 orders; and 23 (D) domestic violence, dating violence, sex- 24 ual assault, sexual harassment, and stalking; 25 (2) analysis of— 26 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 2730 IH (A) the rates described in paragraph (1); 1 (B) the leading causes of pregnancy-associ- 2 ated morbidity and mortality; and 3 (C) access to health care facilities and the 4 associated outcomes of care; 5 (3) analysis, enumeration, or quantification of 6 any other health or health-related parameters the 7 Secretary may deem necessary; and 8 (4) analysis of the relationship between the 9 health factors, outcomes, and conditions described in 10 paragraphs (1) through (3) and the implementation 11 of Federal health programs. 12 (c) CONSULTATION.—The Secretary shall— 13 (1) carry out this section in consultation, as ap- 14 propriate, with the Director of the Census Bureau, 15 the Director of the Centers for Disease Control and 16 Prevention, the Director of the National Institutes 17 of Health, the Assistant Secretary for Mental Health 18 and Substance Use, and other stakeholders (includ- 19 ing community-based organizations); and 20 (2) determine through such consultation the 21 subpopulations to be used for purposes of 22 disaggregation of data pursuant to subsection (b). 23 VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 2730 IH (d) DEADLINE.—The Secretary shall conclude the 1 comprehensive study under this section not later than two 2 years after the enactment of this Act. 3 (e) ONLINE PORTAL.—Upon conclusion of the com- 4 prehensive study under this section, the Secretary shall 5 establish a public online portal to catalogue the results of 6 the study, its underlying data, and information in the re- 7 port submitted pursuant to subsection (f). 8 (f) REPORT.—Not later than 30 days after the con- 9 clusion of the comprehensive study under this section, the 10 Secretary shall submit to Congress a report describing— 11 (1) the results of the study; and 12 (2) the rulemakings and other actions the agen- 13 cies described in subsection (c)(1) can undertake to 14 more equitably include MENA individuals in their 15 programs. 16 (g) PRIVACY.—The Secretary shall not include any 17 personally identifiable information on the online portal 18 under subsection (e) or in the report under subsection (f). 19 Æ VerDate Sep 11 2014 01:02 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H2730.IH H2730 pbinns on DSKJLVW7X2PROD with $$_JOB