,,iv  #aaf? ,,congress  #b;d ,session   
,h4 ,,res4 #ajfi  ,,9 ,,! ,,h\se ,,(    
,,repres5tatives  ,july #bi1 #bjbj,mrs4 
,hayes 7= h]self & ,mr4 ,crd5as7        
submitt$ ! foll[+ resolution2 :i* 0     
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ! ,judici>y1 = a p]iod to be         
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,,resolution  ,decl>+ racism a 
public heal? crisis4  ,:]eas s9ce !     
,nation's f\nd+1 ! ,unit$ ,/ates has _h 
a long/&+ hi/ory & legacy ( racism1     
mi/reatm5t1 & discrim9ation aga9/       
,african ,am]icans1 ,lat9os1 ,native    
,am]icans1 & o!r p ( color2 ,:]eas !    
,unit$ ,/ates ratifi$ ov] #cej treaties 
) sov]eign indig5\s communities1 has    
brok5 ! promises made 9 su* treaties1 & 
has hi/orically fail$ to c>ry out its   
tru/ responsibilities to ,native        
,am]icans1 includ+ ,am]ican ,indians1   
,alaska ,natives1 & ,native ,hawaiians1 

z made evid5t by ! *ronic & p]vasive    
und]fund+ ( ! ,indian ,heal? ,s]vice &  
,tribal1 ,urban ,indian1 & ,native      
,hawaiian heal? c>e1 ! va/ heal? &      
socioeconomic disp>ities fac$ by ,native
 ,am]ican p1 & ! inaccessibility ( _m   
,f$]al public heal? & social programs 9 
,native ,am]ican communities2 ,:]eas p (
 ,mexican & ,pu]to ,rican desc5t1 :o    
became ,am]icans ?r\gh conque/1 7       
subject to1 b nev] full memb]s ( !      
polity ( ! ,unit$ ,/ates & exp]i5c$     
widespread discrim9ation 9 employm5t1   
h\s+1 education1 & heal? c>e2 ,:]eas !  
immoral p>adox ( slav]y & fre$om is an  
indelible wrong trac$ ?r\gh\t !         
,nation's hi/ory1 z ,african ,am]icans  
liv$ "u ! oppressive in/itution ( slav]y
 f #afai ?r\gh #ahfe1 endur$ ! practices
 & laws ( segregation dur+ ! ,jim ,cr[  
,era1 & cont9ue to face ! ramifications 
( sy/emic racism ?r\gh unju/ &          
discrim9atory /ructures & policies2     
,:]eas be=e ! enactm5t ( ! ,m$ic>e      
program1 ! ,unit$ ,/ates heal? c>e sy/em

 0 highly segregat$1 &1 z late z !      
mid-#aifjs1 hospitals1 cl9ics1 &        
doctors' (fices ?r\gh\t ,nor!rn & ,s\!rn
 ,/ates compli$ ) ,jim ,cr[ laws & 7    
completely segregat$ by race--leav+     
,black communities ) little to no access
 to heal? c>e s]vices2 ,:]eas betwe5    
#aief & #aifg1 ! ,national ,association 
= ! ,advancem5t ( ,color$ ,p 7,,naacp7  
,legal ,def5se & ,education ,fund       
litigat$ a s]ies ( c\rt cases to        
elim9ate discrim9ation 9 hospitals &    
pr(essional associations2 ,:]eas ! l&m>k
 case ,simk9s v4 ,moses ,h4 ,cone       
,memorial ,hospital1 #cbc ,f4#b;d #iei  
7#aifc71 *all5g$ ! ,f$]al ,gov]nm5t's   
use ( public funds to exp&1 support1 &  
su/a9 segregat$ hospital c>e1 & provid$ 
ju/ification = title ,,vi ( ! #aifd     
,civil ,rights ,act & ! ,m$ic>e hospital
 c]tification program--e/abli%+ ,m$ic>e 
hospital racial integration guidel9es t 
appli$ to e hospital t p>ticipat$ 9 !   
,f$]al program2 ,:]eas 9 #aifg1         
,presid5t ,lyndon ,b4 ,johnson e/abli%$ 

! ,national ,advisory ,commission on    
,civil ,disord]s1 :i* conclud$ t ,:ite  
racism is responsible = ! p]vasive      
discrim9ation & segregation 9 employm5t1
 education1 & h\s+1 result+ 9 deep5$    
racial division & cont9u$ exclusion (   
,black communities f ! b5efits (        
economic progress2 ,:]eas language      
m9orities1 includ+ ,lat9os1 ,asian      
,am]icans1 & ,pacific ,isl&]s1 7 n      
assur$ non-discrim9atory access to      
f$]ally fund$ s]vices1 includ+ heal?    
s]vices1 until ! sign+ ( ,executive     
,ord] #acaff 9 #bjjj2 ,:]eas ! ,pati5t  
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh7 includ$         
provisions to exp& ! ,m$icaid program   
&--= ! fir/ "t 9 ! ,unit$               
,/ates--e/abli%$ a ,f$]al prohibition   
aga9/ discrim9ation on ! basis ( race1  
color1 national orig91 sex1 age1 or     
disability 9 c]ta9 heal? programs1      
build+ on o!r ,f$]al civil rights laws2 
,:]eas ! ,pati5t ,protection & ,af=dable
 ,c>e ,act requir$ report+ to ,congress 

on heal? disp>ities bas$ on race1 color1
 national orig91 sex1 age1 or           
disability2 ,:]eas sev]al ,f$]al        
programs h be5 e/abli%$ to address "s1 b
 n all1 ( ! heal? outcomes t are        
disproportionately exp]i5c$ by          
communities ( color1 includ+ sickle cell
 disease1 tub]culosis1 infant mortality1
 & ,,hiv_/,,aids2 ,:]eas ! ,national    
,c5t] = ,*ronic ,disease ,prev5tion &   
,heal? ,promotion works to raise aw>5ess
 ( heal? disp>ities fac$ by m9ority     
populations 9 ! ,unit$ ,/ates1 su* z    
,native ,am]icans1 ,asian ,am]icans1    
,black ,am]icans1 & ,lat9o ,am]icans1   
aim+ to r$uce risk factors = gr\ps      
affect$ by su* heal? disp>ities2 ,:]eas 
! ,unit$ ,/ates heal? c>e sy/em & o!r   
economic & social /ructures rema9       
fraught ) racism & racial1 e?nic1 sex   
7includ+ sexual ori5tation & g5d]       
id5tity71 & class biases t lead to heal?
 inequity & heal? disp>ities2 ,:]eas    
life expectancy rates = ,black & ,native
 ,am]ican p 9 ! ,unit$ ,/ates are       

significantly l[] ?an ^? ( ,:ite p 9 !  
,unit$ ,/ates2 ,:]eas disp>ities 9 heal?
 outcomes are exac]bat$ = ,,lgbtqia p ( 
color2 ,:]eas disp>ities 9 heal?        
outcomes are wors5$ = p ( color )       
disabilities due to bias & inequitable  
access to heal? c>e2 ,:]eas sev]al      
,/ates ) high] p]c5tages ( ,black1      
,lat9o1 & ,native ,am]ican populations h
 n exp&$ _! ,m$icaid programs pursuant  
to subclause 7,,viii7 ( section         
#aijb7;a77#aj77;,a77i7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#aj77;,a77i77--cont9u+ to    
dis5fran*ise m9ority communities f      
access to heal? c>e2 ,:]eas #af ,/ates h
 fail$ to take advantage ( ! ,f$]al     
option to exp& access to ! ,m$icaid     
program "u title ,,xix ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 & ! ,*ildr5's ,heal? ,insurance   
,program "u title ,,xxi ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #acig;aa  
et seq47 to lawfully resid+ immigrant   
*ildr5 )9 ! fir/ #e ye>s ( lawful /atus1

 & #bf ,/ates h fail$ to d s = simil>ly 
situat$ pregnant wom52 ,:]eas betwe5    
#bjaf & #bjah1 ! *ild un9sur$ rate      
increas$ f #d4g p]c5t to #e4b p]c5t & ! 
,lat9o *ild un9sur$ rate increas$ f #g4g
 p]c5t to #h4a p]c5t1 & *ildr5 ( color  
are f> m likely to be un9sur$ ?an ,:ite 
*ildr52 ,:]eas a climate ( fe> &        
confusion = immigrant families due to ! 
public *>ge rule disc\rages su* families
 f enroll+ eligible *ildr5 9 ! ,m$icaid 
program & ! ,*ildr5's ,heal? ,insurance 
,program2 ,:]eas ,pacific ,isl&]s f !   
,freely ,associat$ ,/ates exp]i5ce      
unique heal? disp>ities result+ f ,unit$
 ,/ates nucle> weapons te/s on _! home  
isl&s1 b su* p h be5 categorically d5i$ 
access to ,m$icaid & o!r ,f$]al heal?   
b5efits2 ,:]eas ! ,unit$ ,/ates has     
hi/orically facilitat$ outsid] /atus    
t[>d ,asian ,am]icans & ,pacific        
,isl&]s1 su* z ! au?orization ( !       
int]nm5t ( ,japanese ,am]icans dur+ ,_w 
,w> ,,ii1 :i* result$ 9 pr(\nd economic1
 social1 & psy*ological burd5s = ! p    

impact$2 ,:]eas ! hi/ory & p]si/5ce (   
raci/ & non-sci5tific m$ical beliefs are
 associat$ ) ongo+ racial disp>ities 9  
treatm5t & heal? outcomes2 ,:]eas       
implicit racial & e?nic biases )9 !     
heal? c>e sy/em h an impact on ! quality
 ( c>e exp]i5c$ by communities ( color1 
su* z ! und]treatm5t ( pa9 9 ,black     
pati5ts2 ,:]eas ! hi/orical context (   
une?ical practices & abuses exp]i5c$ by 
,black pati5ts & rese>* p>ticipants1 su*
 z ! ,tuskegee ,syphilis ,/udy1 s]ve z  
symbols ( ! ,black community's mi/ru/ ( 
! m$ical sy/em2 ,:]eas wom5 ( color     
cont9ue to face attacks1 docum5t$       
?r\gh\t hi/ory1 on _! pr5atal1 mat]nal1 
& reproductive heal? & rights2 ,:]eas   
enslav$ ,black wom5 7 =c$ to endure     
egregi\sly une?ical & cruel treatm5t1 z 
subjects ( insidi\s m$ical exp]im5ts1 to
 advance mod]n gynecology2 ,:]eas ?r\gh 
! late #aifjs & e>ly #aihjs1 physicians 
r\t9ely /]iliz$ p ( color1 p]=m+        
excessive & m$ically unnecess>y         
proc$ures on pati5ts ( color )\t _!     

in=m$ cons5t2 ,:]eas ,black & ,native   
,am]ican wom5 are #b to #d times m      
likely ?an ,:ite wom5 to suff] sev]e    
mat]nal morbidity or die (              
pregnancy-relat$ complications1 &       
implicit racial biases & l[] quality c>e
 are contribut+ factors to ! heal? c>e  
disp>ities t lead to ^! outcomes2 ,:]eas
 ,black & ,native ,am]ican infants are  
twice z likely to die z ,:ite infants1 &
 ! ,black infant mortality rate 9 !     
,unit$ ,/ates is high] ?an 9 #ig        
c\ntries worldwide2 ,:]eas rese>*]s h   
develop$ ! analytical framework ( wea!r+
 to describe h[ ! con/ant /ress ( racism
 leads to poor heal? outcomes = ,black  
,am]icans2 ,:]eas ! daily exp]i5ce (    
racism is associat$ ) /ress1 depression1
 & anxiety1 & may cause physiological   
reactivity or contribute to *ronic heal?
 conditions2 ,:]eas racism is l9k$ to   
m5tal heal? *all5ges = *ildr5 &         
adolesc5ts2 ,:]eas *ildr5 ( color are   
ov]repres5t$ 9 ! ,unit$ ,/ates *ild     
welf>e sy/em1 & up to #hj p]c5t ( *ildr5

 9 fo/] c>e ent] ,/ate cu/ody )         
significant m5tal heal? *all5ges2 ,:]eas
 disp>ities 9 educational access &      
atta9m5t1 along ) racism exp]i5c$ 9 !   
educational sett+1 affect ! trajectory (
 academic a*ievem5t = *ildr5 &          
adolesc5ts1 & ultimately impact heal? & 
racial inequities 9 s*ool discipl9e1 :i*
 has long-t]m consequ5ces = *ildr52     
,:]eas racism & segregation 9 ! ,unit$  
,/ates contribute to poor heal? outcomes
 by segregat+ ,black1 ,lat9o1 & ,native 
,am]ican communities f opportunity2     
,:]eas = decades1 discrim9atory h\s+    
practices1 su* z r$l9+1 sy/emically     
exclud$ p ( color f h\s+1 robb+ !m (    
capital 9 ! =m ( l[-co/1 /able mortgages
 & opportunities to build weal?1 & !    
,f$]al ,gov]nm5t us$ its f9ancial p[] to
 segregate r5t]s 9 newly built public   
h\s+2 ,:]eas environm5tal inju/ices1 su*
 z proximity & exposure to toxic wa/e or
 haz>d\s air pollutants1 cont9ue to h>m 
! heal? ( communities ( color1 l[-income
 communities1 & ,indig5\s communities   

ar\nd ! ,nation2 ,:]eas social          
inequities su* z diff]+ access to       
quality heal? c>e1 heal?y food & safe   
dr9k+ wat]1 safe neighborhoods1         
education1 job security1 & reliable     
transportation affect heal? risks &     
outcomes2 ,:]eas dur+ ! ,,covid-#ai     
p&emic1 ! effects ( racism &            
discrim9ation are se5 9 ,,covid-#ai     
infection1 hospitalization1 & mortality 
rates--disproportionately high among    
,black1 ,lat9o1 & ,native ,am]ican      
populations comp>$ to ! ov]all          
population--exac]bat+ heal? disp>ities &
 highlight+ b>ri]s to c>e = ,black1     
,lat9o1 & ,native ,am]ican pati5ts      
across ! ,unit$ ,/ates2 ,:]eas because (
 racial & e?nic disp>ities1 p ( color   
are m likely to h pre-exi/+1 prev5table1
 & *ronic conditions1 :i* lead to high] 
,,covid-#ai morbidity & mortality rates2
 ,:]eas p ( color are ov]repres5t$ 9 !  
numb] ( p 9 ! ,unit$ ,/ates liv+ "u poor
 air quality conditions1 :i* c increase 
! likelihood ( ,,covid- #ai morbidity & 

mortality2 ,:]eas ! ,,covid-#ai p&emic  
has wors5$ b>ri]s = ,black1 ,lat9o1 &   
,native ,am]ican h\seholds t suff] f    
disproportionately high] rates ( food   
insecurity2 ,:]eas ,black & ,lat9o      
work]s make up a disproportionate numb] 
( front l9e work]s1 are less likely to  
receive paid sick leave or h ! ability  
to "w f home1 & h be5 exclud$ f _m =ms (
 relief readily available to o!r gr\ps2 
,:]eas p ( color are disproportionately 
impact$ by ! crim9al ju/ice &           
immigration en=cem5t sy/ems & face a    
high] risk ( contract+ ,,covid-#ai )9   
prison populations & det5tion c5t]s due 
to ! ov]-inc>c]ation ( p ( color2 ,:]eas
 dur+ ! ,,covid-#ai p&emic1 an increas$ 
use ( anti-,asian rhetoric has result$ 9
 ,asian ,am]icans be+ h>ass$1 assault$1 
& scapegoat$ = ! p&emic2 ,:]eas         
communities ( color cont9ue to be> !    
burd5s ( inequitable social1 economic1 &
 crim9al ju/ice policies1 practices1 &  
inve/m5ts t cause deep disp>ities1 hurt1
 h>m1 dang]1 & mi/ru/2 ,:]eas ov] #dj   

p]c5t ( ,lat9os report be+ discrim9at$  
aga9/ or h>ass$ because !y are _! race2 
,:]eas approximately #bd p]c5t ( !      
,lat9o population 9 ! ,unit$ ,/ates     
id5tifies z ,afro-,lat9o & is ?us       
pot5tially subject to bo? race &        
national orig9 discrim9ation2 ,:]eas    
because ( racism1 ,black p 9 ! ,unit$   
,/ates %>e a unique set ( *all5ges &    
exp]i5ces t require height5$ levels (   
aw>5ess & risk :ile p]=m+ ev]yday       
tasks--su* z jogg+ 9 neighborhoods1     
driv+ :ile ,black1 or play+ 9 a p>k--t  
are n exp]i5c$ by o!r populations2      
,:]eas ,black p 9 ! ,unit$ ,/ates are #c
 times m likely to be kill$ by police   
?an ,:ite p 9 ! ,unit$ ,/ates1 & police 
viol5ce is ! #f? lead+ cause ( dea? = "y
 ,black m52 ,:]eas ! police brutality & 
viol5ce exp]i5c$ by ,black p 9 ! ,unit$ 
,/ates adv]sely impacts m5tal heal?     
among ,black communities2 ,:]eas ,black 
communities l$ ! ,nation 9 m\rn+ !      
kill+s ( ,ahmaud ,arb]y1 ,breonna       
,taylor1 ,george ,floyd1 ,elijah        

,mc,clain1 & c\ntless o!r ,black        
,am]icans--call+ = ju/ice & long-t]m    
*anges to dismantle sy/ems ( oppression2
 ,:]eas ?r\gh\t our ,nation's hi/ory1 p 
( color h be5 at ! =efront ( civil      
rights movem5ts = ess5tial fre$oms1     
human rights1 & equal protection =      
m>g9aliz$ gr\ps & cont9ue to fight =    
racial & economic ju/ice today2 ,:]eas a
 public heal? issue is def9$ z meet+ !  
foll[+ #d crit]ia-- 7#a7 ! condition    
affects _m p1 is se5 z a ?reat to !     
public1 & is cont9u+ to increase2  7#b7 
! condition is di/ribut$ unfairly2  7#c7
 prev5tive measures c\ld r$uce ! effects
 ( ! condition2 &  7#d7 ^? prev5tive    
measures are n yet 9 place2 ,:]eas      
racism meets ! crit]ia ( a public heal? 
crisis1 & public heal? exp]ts agree2    
,:]eas a ,f$]al public heal? crisis     
decl>ation w\ld def9e racism z a        
p]vasive heal? issue & al]ts ! ,nation  
to ! ne$ to enact imm$iate & effective  
cross-gov]nm5tal ef=ts to address ! root
 causes ( in/itutional racism & _!      

d[n/ream impacts2 & ,:]eas su*          
decl>ation requires ! response ( !      
,gov]nm5t to engage significant res\rces
 to emp[] ^? communities t are impact$3 
,n[1 !re=e1 be x ,t ! ,h\se (           
,repres5tatives-- 7#a7 supports !       
resolutions draft$1 introduc$1 & adopt$ 
by cities & localities across ! ,nation 
decl>+ racism a public heal? crisis2    
7#b7 decl>es racism a public heal?      
crisis 9 ! ,unit$ ,/ates2  7#c7 commits 
to-- 7,a7 e/abli%+ a nationwide /rategy 
to address heal? disp>ities & inequity  
across all sectors 9 ! ,unit$ ,/ates2   
7,b7 dismantl+ sy/emic practices &      
policies t p]petuate racism 9 ! ,unit$  
,/ates2  7,c7 advanc+ re=ms to address  
ye>s ( neglectful & apa!tic policies t h
 l$ to poor heal? outcomes = communities
 ( color 9 ! ,unit$ ,/ates2 &  7,d7     
promot+ ef=ts to address ! social       
det]m9ants ( heal?--especially = ,black1
 ,lat9o1 & ,native ,am]ican p1 & o!r p (
 color 9 ! ,unit$ ,/ates2 &  7#d7 *>ges 
! ,nation ) mov+ =w>d ) urg5cy to ensure

 t ! ,unit$ ,/ates /&s firmly 9 honor+  
its moral purpose ( advanc+ !           
self-evid5t tru?s t all p are creat$    
equal1 t !y are end[$ ) c]ta9 unali5able
 rights1 & t among ^! are life1 lib]ty1 
& ! pursuit ( happ9ess4