,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #fgfg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #af1         
#bjbe,ms4 ,tlaib 7= h]self1 ,mrs4       
,d+ell1 ,ms4 ,kelly ( ,ill9ois1 ,ms4    
,/ansbury1 ,ms4 ,b>ragn1 ,mr4 ,c>son1   
,ms4 ,cl>ke ( ,new ,york1 ,mr4 ,correa1 
,mr4 ,g>ca ( ,ill9ois1 ,mr4 ,goldman (  
,new ,york1 ,ms4 ,norton1 ,mr4 ,johnson 
( ,georgia1 ,ms4 ,lee ( ,p5nsylvania1   
,ms4 ,mc,collum1 ,ms4 ,ocasio-,cortez1  
,ms4 ,p\1 ,ms4 ,s*ak[sky1 & ,ms4 ,simon7
 introduc$ ! foll[+ bill2 :i* 0 ref]r$  
to ! ,committee on ,en]gy & ,comm]ce  ,a
 ,,bill  ,to am5d ! ,public ,heal?      
,s]vice ,act to include ,middle ,ea/]n &
 ,nor? ,african 7,,m5a7 individuals 9 ! 
/atutory def9ition ( a racial & e?nic   
m9ority gr\p1 to direct ! ,secret>y (   
,heal? & ,human ,s]vices to conduct a   
compreh5sive /udy ( ,,m5a population    
heal?1 & = o!r purposes4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,heal?  
,equity & ,middle ,ea/]n & ,nor?        
,african ,community ,inclusion ,act (   

#bjbe or ! ,heal? ,equity & ,,m5a       
,community ,inclusion ,act ( #bjbe4  #b4
 ,def9ition ,9 ?is ,act1 ! t]ms ,middle 
,ea/]n & ,nor? ,african or ,,m5a1 )     
respect to individuals or populations1  
includes individuals or populations :o  
id5tify ) or belong to "o or m          
nationalities or e?nic gr\ps orig9at+ 9 
a c\ntry 7or portion !re(7 9 ! ,middle  
,ea/]n & ,nor? ,african region 7su* z   
,lebanese1 ,iranians1 ,egyptians1       
,moroccans1 ,yem5is1 ,*aldeans1         
,imazigh51 ,kurds1 ,pale/9ians1 &       
,yazidis74  #c4 ,f9d+s ,congress f9ds ! 
foll[+3 7#a7 ,on ,m>* #bh1 #bjbd1 !     
,(fice ( ,managem5t & ,budget =mally    
recogniz$ ,middle ,ea/]n & ,nor?        
,african populations 9 ,/ati/ical       
,policy ,directive ,numb] #ae 79 ?is    
section ref]r$ to z ,,spd #ae71 :i*     
e/abli%$1 s9ce its issuance 9 #aigg1 !  
m9imum /&>ds = ! collection1 managem5t1 
& pres5tation ( data on race & e?nicity4
  7#b7 ,9 #aihe1 ! ,secret>y ( ,heal? & 
,human ,s]vices produc$ a ,report on    

,black & ,m9ority ,heal?1 :i* analyz$   
p]si/5t heal? diff]5ces betwe5 ! g5]al  
population & ! non-,:ite populations    
recogniz$ 9 ,,spd #ae & s]v$ z ! basis =
 ! f\ndation ( ! ,(fice ( ,m9ority      
,heal? 79 ?is section ref]r$ to z !     
,,omh74  7#c7 ,?r\gh ! e/abli%m5t ( !   
,,omh 9 #aihf1 ! ,secret>y ( ,heal? &   
,human ,s]vices has develop$ heal?      
policies & programs t elim9ate heal?    
disp>ities & improve ! heal? ( racial & 
e?nic m9ority populations4  7#d7        
,congress has fund$ ! ,,omh to ensure   
improv$ heal? /atus ( racial & e?nic    
m9orities1 & to develop measures to     
evaluate ! effectiv5ess ( activities    
aim$ at r$uc+ heal? disp>ities &        
support+ ! local community4 ,!          
activities ( ! ,,omh h address$ heal?   
disp>ities1 includ+ ) respect to        
physical activity & nutrition1 cl9ical  
conditions1 individual social ne$s1 & ! 
social det]m9ants ( heal? = racial &    
e?nic m9ority gr\ps4  7#e7 ,be=e !      
am5dm5ts made by ?is ,act1 section      

#agjg7;g77#a7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a77  
def9$ ! t]m racial & e?nic m9ority gr\p 
7= :om ! ,,omh works to improve heal?   
outcomes & elim9ate heal? disp>ities7 to
 exclude ,middle ,ea/]n]s & ,nor?       
,africans1 & !reby prev5t$ ,,m5a        
populations f access+ critical res\rces 
int5d$ to assi/ hi/orically m>g9aliz$   
communities4  7#f7 ,indep5d5t rese>*]s &
 private sector rese>* initiatives h    
f\nd significant heal? disp>ities betwe5
 ,,m5a individuals & ! non-,hispanic    
,:ite population1 z well z significant  
ov]lap betwe5 ! heal? outcomes & heal?  
conditions ( ,,m5a individuals & ^? (   
o!r racial & e?nic m9ority gr\ps4  7#g7 
,poor heal? outcomes are (t5 connect$ to
 impov]i%m5t 9 o!r aspects ( life & are 
exac]bat$ by additional b>ri]s to access
 high-quality heal? cov]age1 :e!r 9 t]ms
 ( language1 eligibility1 heal? lit]acy1
 or discrim9ation at ! po9t-(-s]vice4   
7#h7 ,a rec5t /udy publi%$ 9 ! j\rnal1  
,proce$+s ( ! ,national ,academy (      

,sci5ces1 sugge/$ t ,,m5a individuals   
are n p]ceiv$ z ,:ite & d n p]ceive     
!mselves z ,:ite4  7#i7 ,rese>* on !    
heal? outcomes & heal? conditions (     
,,m5a individuals is tr\bl+ & sugge/s t 
ef=ts mu/ be made on ! ,f$]al level to  
disaggregate ! demographic data ( ,,m5a 
individuals f ! demographic data (      
individuals 9 ! non-,hispanic ,:ite     
category & fully und]/& ! social        
det]m9ants ( heal? = heal? disp>ities & 
outcomes exp]i5c$ by ,,m5a individuals4 
7#aj7 ,,m5a individuals are n includ$   
among ! gr\ps = :om ! ,,omh works to    
improve heal? outcomes & elim9ate heal? 
disp>ities1 :i* fur!r limits !          
opportunity ( ,,m5a individuals to      
access programs design$ to address _!   
exp]i5ces & heal? conditions4  7#aa7 ,! 
,,omh c\ld bett] assess & elim9ate heal?
 disp>ities by conduct+ a compreh5sive  
/udy ( ! heal? ( ,,m5a individuals &    
recogniz+ ,,m5a individuals z a racial &
 e?nic m9ority gr\p4  #d4 ,inclusion (  
,middle ,ea/]n]s & ,nor? ,africans 9    

def9ition ( racial & e?nic m9ority gr\ps
  7a7 ,9 g5]al ,section #agjg7;g77#a7 ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #cjju-#f7;g77#a77 is am5d$ by 
/rik+ ,blacks2 & ,hispanics & ins]t+    
,blacks or ,african ,am]icans2          
,hispanics2 & ,middle ,ea/]n]s & ,nor?  
,africans4  7b7 ,s5se ( ,congress ,x is 
! s5se ( ,congress t subsection 7a7 %\ld
 be implem5t$ s z to ensure t-- 7#a7 !  
def9ition ( a racial & e?nic m9ority    
gr\p 9 section #agjg7;g77#a7 ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#cjju-#f7;g77#a771 z am5d$ by subsection
 7a71 is appli$ 9 ! implem5tation &     
execution ( ,f$]al programs & activities
 t ref]5ce su* def9ition2 &  7#b7 no    
racial or e?nic m9ority gr\p s]v$ by su*
 programs & activities is negatively    
impact$ by ! am5dm5t made by subsection 
7a74  7c7 ,undef9$ ref]5ces ,n lat] ?an 
#b ye>s aft] ! date ( enactm5t ( ?is    
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices %all-- 7#a7 id5tify all        
regulations1 guidance1 ord]s1 & docum5ts

 ( ! ,dep>tm5t ( ,heal? & ,human        
,s]vices = e/abli%m5t or implem5tation (
 a heal? c>e or public heal? program1   
activity1 or survey t-- 7,a7 use ! t]m  
racial & e?nic m9ority gr\p or simil>   
t]m9ology2 &  7,b7 d n def9e su* t]m or 
t]m9ology2 &  7#b7 take su* actions z   
may be necess>y to cl>ify :e!r !        
def9ition ( racial & e?nic m9ority gr\p 
9 section #agjg7;g77#a7 ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjju-#f7;g77#a771 z am5d$ by subsection
 7a71 applies to su* t]m or t]m9ology4  
7d7 ,report to ,congress ,n lat] ?an #b 
ye>s aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all submit to ,congress a report on !  
implem5tation ( ?is section4  #e4       
,report on heal? ( ,middle ,ea/]n &     
,nor? ,african population  7a7 ,/udy    
requir$ ,! ,secret>y ( ,heal? & ,human  
,s]vices 7ref]r$ to 9 ?is section z !   
,secret>y7 %all conduct or support a    
compreh5sive /udy reg>d+ ! unique heal? 
patt]ns & outcomes ( ,,m5a populations4 

7b7 ,requirem5ts = /udy ,! compreh5sive 
/udy "u subsection 7a7 %all include an  
enum]ation ( ,,m5a populations across ! 
,unit$ ,/ates1 disaggregat$ by          
subpopulation1 & ) respect to ea* su*   
population & subpopulation-- 7#a7 !     
rates (-- 7,a7 heal? risk factors1      
includ+-- 7i7 behaviors1 su* z tobacco  
use1 excessive alcohol consumption1     
physical inactivity1 & unheal?y diet2   
7ii7 physiological factors1 su* z       
obesity1 diabetes1 high blood pressure1 
high blood sug>1 & high *ole/]ol2  7iii7
 environm5tal factors1 su* z exposure to
 toxic *emicals1 air & wat] pollution1 &
 unsafe work+ conditions1 includ+       
preval5ce ( "w-relat$ injuries2  7iv7   
g5etic factors1 su* z family hi/ory (   
*ronic diseases1 pres5ce ( specific g5e 
mutations1 & racial & e?nic             
pr$isposition to c]ta9 conditions2  7v7 
demographic *>act]i/ics1 su* z age1     
geographic location1 & ,engli% language 
pr(ici5cy2 &  7vi7 social det]m9ants (  
heal?1 su* z h\sehold income1 heal?     

insurance cov]age1 socioeconomic /atus1 
education level1 h\s+ in/ability1       
educational & employm5t opportunities1 &
 access to culturally & l+ui/ically     
appropriate s]vice provid]s2  7,b7      
preval5ce ( *ronic disease or illness1  
includ+-- 7i7 canc]s1 su* z brea/1 lung1
 c]vical1 pro/ate1 colorectal1 liv]1    
/oma*1 & oral canc]2  7ii7 c>diovascul> 
conditions1 su* z he>t disease1 atrial  
fibrillation1 & /roke2  7iii7           
respiratory conditions1 su* z a/hma1    
*ronic ob/ructive pulmon>y disease1 &   
lung disease2  7iv7 musculoskeletal     
conditions1 su* z o/eoporosis & c>pal   
tunnel syndrome2  7v7 neurological      
conditions1 su* z ,p>k9son's disease1   
,alzheim]'s & o!r relat$ dem5tias1      
epilepsy1 & c]ebral palsy2  7vi7        
infecti\s diseases1 su* z ,,hiv_/,,aids1
 hepatitis ,b & ,c1 & tub]culosis2 &    
7vii7 autoimmune diseases1 su* z lupus1 
multiple scl]osis1 ulc]ative colitis1 & 
rheumatoid ar?ritis2  7,c7 preval5ce (  
disability & disord]1 includ+-- 7i7     

vision impairm5ts1 su* z bl9dness & l[  
vision2  7ii7 he>+ conditions1 su* z    
deafness & v>y+ degrees ( he>+ loss2    
7iii7 physical impairm5ts1 su* z        
musculoskeletal conditions1 amputation1 
p>alysis1 repetitive /ra9 injuries1 &   
o!r conditions t affect movem5t or      
require assi/ive devices2  7iv7         
intellectual or developm5tal conditions1
 su* z ,d[n syndrome1 ,prat]-,willi     
syndrome1 ,angelman syndrome1 autism1 & 
att5tion-deficit_/hyp]active disord]    
7,,adhd71 z well z o!r conditions t     
affect cognitive abilities1 le>n+1 &    
adaptive behaviors2  7v7 m5tal or       
behavioral conditions1 su* z depression1
 anxiety1 insomnia1 sleep apnea1 bipol> 
disord]1 s*izophr5ia1 & traumatic bra9  
injury2  7vi7 sub/ance use disord]s1 su*
 z disord]s 9 use ( alcohol1 opioids1   
/imulants1 & cannabis1 & risk factors   
/emm+ f su* disord]s1 su* z liv] damage 
& ga/ro9te/9al issues2  7vii7 g5etic or 
blood disord]s1 su* z sickle cell       
anemia1 ,g#f,,pd defici5cy1 hyp]t5sion1 

& ?alassemia2 &  7viii7 endocr9e        
disord]s1 su* z diabetes1 polycy/ic ov>y
 syndrome 7,,pcos71 & hypo?yroidism2    
7,d7 mat]nal & reproductive heal?       
outcomes1 includ+ mat]nal morbidity &   
mortality1 inf]tility1 & po/p>tum       
depression2  7,e7 nutritional heal?     
outcomes1 includ+ malnutrition1 vitam9  
,d & iron defici5cies1 among o!r vitam9 
defici5cies2  7,f7 *ild & adolesc5t     
heal? outcomes1 su* z p$iatric          
developm5tal delays1 *ildhood obesity1 &
 e>ly-onset *ronic conditions2  7,g7    
d5tal & oral heal? outcomes1 includ+    
too? loss1 gum disease1 & too? decay2   
7,h7 dome/ic viol5ce1 dat+ viol5ce1     
sexual assault1 sexual h>assm5t1 &      
/alk+2 &  7,i7 morbidity & mortality1   
includ+ ! rates ( morbidity & mortality 
associat$ ) ! rates ref]5c$ 9           
subp>agraphs 7,a7 ?r\gh 7,h72  7#b7     
analysis (-- 7,a7 ! factors & conditions
 t contribute mo/ to-- 7i7 ! rates      
describ$ 9 p>agraph 7#a72 &  7ii7 !     
rates by :i* ,,m5a subpopulations       

report$ ! outcomes ref]5c$ 9            
subp>agraphs 7,b7 & 7,c7 z a disease1   
illness1 disord]1 or disability2  7,b7 !
 lead+ causes ( morbidity & mortality & 
pregnancy-associat$ morbidity &         
mortality2  7,c7 ! ext5t to :i* access  
to heal? c>e facilities contributes to !
 associat$ outcomes ( c>e1 includ+ !    
rates describ$ 9 p>agraph 7#a72 &  7,d7 
! disp>ities betwe5 ,,m5a subpopulations
 & betwe5 ! aggregate ,,m5a population &
 o!r racial & e?nic populations 9 !     
rates describ$ 9 p>agraph 7#a72  7#c7   
analysis1 enum]ation1 or quantification 
( any o!r heal? or heal?-relat$ p>amet]s
 ! ,secret>y det]m9es necess>y2 &  7#d7 
analysis ( ! ext5t to :i* any or all ( !
 design1 implem5tation1 & evaluation (  
,f$]al heal? programs contribute to !   
heal? factors1 outcomes1 & conditions   
describ$ 9 p>agraphs 7#a7 ?r\gh 7#c74   
7c7 ,consultation ,! ,secret>y %all--   
7#a7 c>ry out ?is section 9             
consultation1 z appropriate1 ) !        
,director ( ! ,c5sus ,bureau1 !         

,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 ! ,director ( ! ,national
 ,in/itutes ( ,heal?1 ! ,assi/ant       
,secret>y = ,m5tal ,heal? & ,sub/ance   
,use1 & o!r /akehold]s 7includ+         
community-bas$ organizations72 &  7#b7  
det]m9e ?r\gh su* consultation !        
subpopulations to be us$ = purposes (   
disaggregation ( data pursuant to       
subsection 7b74  7d7 ,onl9e portal ,^u  
conclusion ( ! compreh5sive /udy "u ?is 
section1 ! ,secret>y %all e/abli% a     
public onl9e portal to catalogue !      
results ( ! /udy1 its und]ly+ data1 &   
in=mation 9 ! report submitt$ pursuant  
to subsection 7e77#b74  7e7 ,report+    
7#a7 ,int]im report ,n lat] ?an #b ye>s 
aft] ! date ( enactm5t ( ?is ,act1 !    
,secret>y %all submit to ,congress a    
report outl9+ ! *all5ges associat$ )1 & 
progress t[>d implem5t+1 heal? data     
collection = ,,m5a populations z a      
di/9ct category & ! plan = complet+ a   
compreh5sive /udy reg>d+ ! unique heal? 
patt]ns & outcomes ( ,,m5a populations4 

7#b7 ,f9al report ,n lat] ?an #cj days  
aft] ! conclusion ( ! compreh5sive /udy 
"u ?is section1 & n lat] ?an #b ye>s    
aft] ! date ( submission ( ! int]im     
report "u p>agraph 7#a71 ! ,secret>y    
%all submit to ,congress a report       
describ+-- 7,a7 ! results ( ! /udy      
conduct$ "u ?is section2 &  7,b7 !      
rulemak+s & o!r actions ! ag5cies       
describ$ 9 subsection 7c77#a7 c und]take
 to m equitably include ,,m5a           
individuals 9 _! programs1 includ+ :e!r 
& to :at ext5t additional res\rces are  
ne$$ to increase rates ( response among 
,,m5a populations to ,f$]al heal?       
surveys4  7f7 ,privacy  7#a7 ,9 g5]al ,9
 c>ry+ out ! compreh5sive /udy "u ?is   
section1 ! ,secret>y %all implem5t robu/
 privacy protections to safegu>d !      
p]sonal data ( ! individuals involv$4   
7#b7 ,m9imum protections ,! privacy     
protections ref]r$ to 9 p>agraph 7#a7   
include ! foll[+3 7,a7 ,p]sonally       
id5tifiable in=mation1 su* z names or   
addresses1 %all n be collect$ :5        

unnecess>y = ! purposes ( ! /udy4  7,b7 
,any p]sonally id5tifiable in=mation t  
is collect$ %all be securely de/roy$ ^u 
completion ( ! int5d$ use ( su*         
in=mation4  7,c7 ,all privacy           
protections & data h&l+ proc$ures %all  
be cle>ly communicat$ to any individuals
 :o may be subjects ( ! /udy1 includ+   
?r\gh in=m$ cons5t if applicable4  7#c7 
,prohibition on inclusion ( ,,pii 9     
onl9e portal or reports ,! ,secret>y    
%all n include any p]sonally id5tifiable
 in=mation on ! onl9e portal "u         
subsection 7d7 or 9 ! reports "u        
subsection 7e74  7g7 ,violations ,any   
p]son :o1 by virtue ( an (ficial        
position or affiliation ) ! ,secret>y-- 
7#a7 has possession (1 or access to1 any
 record conta9+ individually id5tifiable
 in=mation ! disclosure ( :i* is        
prohibit$ by or "u ?is section2 &  7#b7 
kn[+ly discloses su* a record to any    
p]son or ag5cy n entitl$ to receive !   
record1  %all be guilty ( a misdemeanor 
& f9$ n m ?an #be1jjj4  7h7 ,p]sonally  

id5tifiable in=mation def9$ ,9 ?is      
section1 ! t]m p]sonally id5tifiable    
in=mation means individually id5tify+   
in=mation = or ab\t an individual1      
includ+ in=mation likely to disclose !  
location or specific id5tity ( a        
p>ticipat+ individual1 reg>dless ( :e!r 
! in=mation is encod$1 encrypt$1 ha%$1  
or o!rwise protect$1 includ+-- 7#a7 a   
fir/ & la/ "n2  7#b7 a home or o!r      
physical address2  7#c7 contact         
in=mation 7includ+ a po/al1 email or    
int]net protocol address1 or telephone  
or facsimile numb]72  7#d7 a social     
security numb]1 driv] lic5se numb]1     
passport numb]1 or /ud5t id5tification  
numb]2 &  7#e7 any o!r in=mation1       
includ+ date ( bir?1 racial or e?nic    
backgr\nd1 or religi\s affiliation1 t   
w\ld s]ve to id5tify any individual4    
7i7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ su* sums 
z may be necess>y to c>ry out ?is       
section4