,,iii #aaith ,,congress #ast ,session ,s4 ,,res4 #fg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #f 7legislative day1 ,february #e71 #bjbe,mr4 ,booker 7for himself1 ,mr4 ,padilla1 ,ms4 ,hirono1 ,mr4 ,blumenthal1 ,mr4 ,kim1 ,ms4 ,baldwin1 and ,mr4 ,wyden7 submitted the following resolution2 which was referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,,resolution ,declaring racism a public health crisis4 ,whereas a public health crisis is an issue-- 7#a7 that affects many people1 is a threat to the public1 and is ongoing2 7#b7 that is unfairly distributed among different populations1 disproportionately impacting health outcomes1 access to health care1 and life expectancy2 7#c7 the effects of which could be reduced by preventive measures2 and 7#d7 for which those preventive measures are not yet in place2 ,whereas public health experts agree that significant racial inequities exist in the prevalence1 severity1 and mortality rates of various health conditions in the ,united ,states2 ,whereas examples of significant racial inequities include that-- 7#a7 life expectancies for ,black1 ,american ,indian1 and ,alaska ,native people in the ,united ,states are #d to #aj years lower than those of non-,hispanic ,white people in the ,united ,states2 7#b7 ,black1 ,american ,indian1 and ,alaska ,native women are #b to #d times more likely than ,white women to suffer severe maternal morbidity and have the highest rates of pregnancy-related mortality2 7#c7 ,black1 ,native ,hawaiian1 ,pacific ,islander1 ,american ,indian1 and ,alaska ,native infants are #b to #c times more likely to die than ,white infants2 7#d7 the ,black infant mortality rate in the ,united ,states is higher than the infant mortality rates recorded in #bg of the #cf democratic countries with market-based economies that are members of the ,organization for ,economic ,co-operation and ,development2 7#e7 ,hispanic women have a #ea percent higher incidence1 and are #cj percent more likely to die from1 cervical cancer compared to non-,hispanic ,white women2 7#f7 ,asian ,americans are the only racial group in the ,united ,states who experience cancer as the leading cause of death and have the highest rates of lung cancer among never-smoking women2 7#g7 ,native ,hawaiians and ,pacific ,islanders are #b4e-times more likely to die from diabetes than non-,hispanic ,white women2 7#h7 ,native ,hawaiians suffer from coronary heart disease1 stroke1 heart failure1 cancer1 and diabetes at a #c times greater rate than other ethnic populations in ,hawaii1 and become afflicted with those diseases a decade earlier in their lives compared with other ethnic populations2 and 7#i7 during the ,,covid-#ai pandemic1 ,black1 ,hispanic or ,latino1 ,asian ,american1 ,native ,hawaiian1 ,pacific ,islander1 and ,native ,american communities experienced disproportionately high rates of ,,covid-#ai infection1 hospitalization1 and mortality compared to the ,white population of the ,united ,states2 ,whereas inequities in health outcomes are exacerbated for people of color who are ,,lgbtqia2 ,whereas inequities in health outcomes are exacerbated for people of color who have disabilities2 ,whereas1 historically1 explanations for health inequities have focused on false genetic science1 such as eugenics2 ,whereas1 historically1 explanations for health inequities have focused on incomplete social scientific analyses that narrowly focus on individual behavior to highlight ostensible deficiencies within racial and ethnic minority groups2 ,whereas modern public health officials recognize the broader social context in which health inequities emerge and acknowledge the impact of historical and contemporary racism on health2 ,whereas racism is recognized in modern public health discourse as #a of many social determinants of health1 which-- 7#a7 are a broad range of nonmedical factors that can enhance or hinder quality of life and influence health outcomes2 7#b7 are the conditions in which people are born1 grow1 work1 live1 and age1 and include the wider set of forces and systems shaping the conditions of daily life2 7#c7 include factors such as housing1 employment1 education1 health care1 food1 transportation1 social support1 poverty1 crime1 violence1 segregation1 and environmental toxins2 7#d7 are linked to a lack of opportunity and resources to protect1 improve1 and maintain health2 and 7#e7 taken together1 create health inequities that stem from unfair and unjust systems1 policies1 and practices1 and limit access to the opportunities and resources needed to live the healthiest life possible2 ,whereas1 since its founding1 the ,united ,states has had a longstanding history and legacy of racism1 mistreatment1 and discrimination that has perpetuated health inequities for members of racial and ethnic minority groups2 ,whereas that history and legacy of racism1 mistreatment1 and discrimination includes-- 7#a7 the immoral paradox of freedom and slavery1 which is an atrocity that can be traced throughout the history of the ,united ,states1 as ,african ,americans lived under the oppressive institution of slavery from #afai through #ahfe1 endured the practices and laws of segregation during the ,jim ,crow era1 and continue to face the ramifications of systemic racism through unjust and discriminatory structures and policies2 7#b7 the failure of the ,united ,states to carry out the responsibilities and promises made in more than #cgj treaties ratified with sovereign indigenous communities1 including ,american ,indians1 ,alaska ,natives1 ,native ,hawaiians1 and ,pacific ,islanders1 as made evident by the chronic and pervasive underfunding of the ,indian ,health ,service and ,native ,hawaiian health care1 the vast health and socioeconomic inequities faced by ,american ,indian and ,alaska ,native people1 and the inaccessibility of many ,federal public health and social programs in ,native ,american communities2 7#c7 the enactment of immigration laws in the ,united ,states that scapegoated ,asians1 separated families1 and branded ,asians as perpetual outsiders1 such as-- 7,a7 the ,act entitled ,an ,act supplementary to the ,acts in relation to immigration1 approved ,march #c1 #ahge 7commonly known as the ,page ,act of #ahge7 7#ah ,stat4 #dgg1 chapter #ada71 which effectively prohibited the entry of ,east ,asian women into the ,united ,states2 7,b7 the ,act entitled ,an ,act to execute certain treaty stipulations relating to ,chinese1 approved ,may #f1 #ahhb 7commonly known as the ,chinese ,exclusion ,act7 7#bb ,stat4 #eh1 chapter #abf71 which banned thousands of ,chinese-born laborers1 who were essential in the completion of the transcontinental railroad and development of the ,west ,coast of the ,united ,states2 and 7,c7 the ,act entitled ,an ,act to regulate the immigration of aliens to1 and the residence of aliens in1 the ,united ,states1 approved ,february #e1 #aiag 7commonly known as the ,immigration ,act of #aiag7 7#ci ,stat4 #hgd1 chapter #bi71 which barred all immigrants from the ,asiatic zone and prevented the migration of individuals from ,south ,asia1 ,southeast ,asia1 and ,east ,asia2 7#d7 during the ,great ,depression ,era1 the deportation of approximately #a1hjj1jjj individuals based on their ,mexican ethnic identity1 although approximately #fj percent of the deported individuals were citizens of the ,united ,states1 and the targeting of individuals of ,mexican descent for repatriation due to scapegoating efforts1 which blamed those individuals for stealing jobs from real ,americans2 and 7#e7 in #aidb1 the issuance of ,executive ,order #ijff which began the forced evacuation and detention of ,japanese ,american ,west ,coast residents1 placing #gj1jjj citizens of the ,united ,states into relocation centers2 ,whereas1 in #aifg1 ,president ,lyndon ,b4 ,johnson established the ,national ,advisory ,commission on ,civil ,disorders1 which concluded that ,white racism is responsible for the pervasive discrimination and segregation in employment1 education1 and housing1 causing deepened racial division and the continued exclusion of ,black communities from the benefits of economic progress2 ,whereas overt racism was embedded in the development of medical science and medical training during the #ahth1 #aith1 and #bjth centuries1 causing disproportionate physical and psychological harm to members of racial and ethnic minority groups1 including-- 7#a7 the unethical practices and abuses experienced by ,black patients and research participants1 such as the ,tuskegee ,study of ,untreated ,syphilis in the ,negro ,male1 which serve as the foundation for the mistrust the ,black community has for the medical system2 and 7#b7 the egregiously unethical and cruel treatment of enslaved ,black women who were forced to be the subject of insidious medical experiments to advance modern gynecology1 including those perpetuated by the so-called father of gynecology1 ,j4 ,marion ,sims2 ,whereas structural racism cemented historical racial and ethnic inequities in access to resources and opportunities1 contributing to worse health outcomes2 ,whereas examples of structural racism include-- 7#a7 before the enactment of the ,medicare program1 the ,united ,states health care system was highly segregated1 and1 as late as the mid-#aifjs1 hospitals1 clinics1 and doctors' offices throughout the northern and southern ,united ,states complied with ,jim ,crow laws and were completely segregated by race1 leaving ,black communities with little to no access to health care services2 7#b7 the landmark case ,simkins v4 ,moses ,h4 ,cone ,memorial ,hospital1 #cbc ,f4#b;d #iei 7#dth ,cir4 #aifc71 which challenged the use of public funds by the ,federal ,government to expand1 support1 and sustain segregated hospital care and provided justification for title ,,vi of the ,civil ,rights ,act of #aifd 7#db ,u4,s4,c4 #bjjj;d et seq47 and the ,medicare hospital certification program by establishing ,medicare hospital racial integration guidelines that applied to every hospital that participated in the ,federal program2 7#c7 that ,pacific ,islanders from the ,freely ,associated ,states experience unique health inequities resulting from ,united ,states nuclear weapons tests on their home islands while they have been categorically denied access to ,medicaid and other ,federal health benefits2 7#d7 that language minorities1 including ,spanish-speaking1 ,chinese-speaking1 and ,tagalog-speaking people in the ,united ,states1 were not assured nondiscriminatory access to federally funded services1 including health services1 until the signing of ,executive ,order #acaff 7#db ,u4,s4,c4 #bjjj;d-#a note2 relating to improving access to services for persons with limited ,english proficiency7 in #bjjj2 7#e7 that the ,,covid-#ai pandemic exacerbated economic1 health1 housing1 and food security barriers for ,black1 ,hispanic or ,latino1 ,asian ,american1 ,native ,hawaiian1 ,pacific ,islander1 and ,native ,american households1 which already suffer from disproportionately higher rates of food insecurity2 and 7#f7 that members of the ,black1 ,native ,american1 ,alaska ,native1 ,asian ,american1 ,native ,hawaiian1 ,pacific ,islander1 and ,hispanic or ,latino communities are disproportionately impacted by the criminal justice and immigration enforcement systems and face a higher risk of contracting ,,covid-#ai within prison populations and detention centers due to the over-incarceration of members of those communities2 ,whereas subtle or implicit racism in all sectors of the medical service profession continues to cause disproportionate physical and psychological harm to members of racial and ethnic minority groups2 ,whereas examples of subtle or implicit racism in the medical service profession include that-- 7#a7 the history and persistence of racist and nonscientific medical beliefs1 which are associated with ongoing racial inequities in treatment and health outcomes2 7#b7 implicit racial and ethnic biases within the health care system1 which have an explicit impact on the quality of care experienced by members of racial and ethnic minority groups1 such as the undertreatment of pain in ,black patients2 7#c7 nearly #a_/e of ,hispanic or ,latino ,americans avoid medical care due to concern about being discriminated against or treated poorly2 7#d7 the ,united ,states health care system and other economic and social structures remain fraught with biases based on race1 ethnicity1 sex 7including sexual orientation and gender identity71 and class that lead to health inequities2 7#e7 women of color1 including ,black1 ,native ,american1 ,hispanic or ,latina1 ,asian ,american1 ,native ,hawaiian1 and ,pacific ,islander women1 have faced and continue to face attacks on their prenatal1 maternal1 and reproductive health and rights2 and 7#f7 through the early #aihjs1 physicians routinely sterilized members of racial and ethnic minority groups1 specifically ,american ,indian and ,alaska ,native women 7with #a_/d of childbearing-aged ,american ,indian and ,alaska ,native women being sterilized by the ,indian ,health ,service7 and ,african-,american and ,latina women1 performing excessive and medically unnecessary procedures without their informed consent2 ,whereas structural racism perpetuates racial and ethnic inequities in the social determinants of health1 which produces unintended negative health outcomes for members of racial and ethnic minority groups2 ,whereas examples of that structural racism include-- 7#a7 that there are fewer pharmacies1 medical practices1 and hospitals in predominantly ,black and ,hispanic or ,latino neighborhoods1 compared to ,white or more diverse neighborhoods2 7#b7 that environmental hazards1 such as toxic waste facilities1 garbage dumps1 and other sources of airborne pollutants1 are disproportionately located in predominantly ,black1 ,hispanic or ,latino1 ,asian ,american1 ,native ,hawaiian1 ,pacific ,islander1 and low-income communities1 resulting in poor air quality conditions1 which can increase the likelihood of chronic respiratory illness and premature death from particle pollution2 7#c7 that employed ,black adults are #aj percent less likely to have employer-sponsored health insurance than employed ,white adults because of racial segregation in occupation sectors and the types of organizations in which they work2 7#d7 that #a in #d ,american ,indian and ,alaska ,native people lack health insurance and that ,native ,hawaiians1 ,pacific ,islanders1 and certain groups of nonelderly ,asian ,american adults have lower levels of insurance than ,white adults2 7#e7 that several ,states with higher percentages of ,black1 ,hispanic or ,latino1 ,american ,indian1 and ,alaska ,native populations have not expanded their ,medicaid programs1 continuing to disenfranchise minority communities from access to health care as of the date of adoption of this resolution2 7#f7 discriminatory housing practices1 such as redlining1 which have1 for decades1 systemically excluded members of racial and ethnic minority groups from housing by robbing them of capital in the form of low-cost1 stable mortgages and opportunities to build wealth1 and the use of financial power by the ,federal ,government to segregate renters in public housing2 7#g7 social inequities1 such as differing access to quality health care1 healthy food and safe drinking water1 safe and affordable neighborhoods1 education1 job security1 and reliable transportation1 which affect health risks and outcomes2 7#h7 exclusionary disciplinary practices 7such as detention and suspension7 in primary education and even early education settings1 which disproportionately affect children from racial and ethnic minority backgrounds1 particularly ,black children2 and 7#i7 that1 as much as #fj percent of the health of a person in the ,united ,states can be determined by their ,,zip ,code2 ,whereas structural racism perpetuates ongoing knowledge gaps in data1 research1 and development1 which produces unintended negative health outcomes for members of racial and ethnic minority groups2 ,whereas examples of that structural racism include that-- 7#a7 most participants in clinical trials are ,white1 so there is insufficient data to develop evidence-based recommendations for people from racial and ethnic minority groups2 7#b7 medical research equipment and medical devices are typically developed by majority-,white teams and therefore can have racial blind spots unintentionally built into their design1 rendering them less effective for people from racial and ethnic minority groups1 such as-- 7,a7 electroencephalogram electrodes used in neuroimaging research do not collect reliable data when used on scalps with thick1 curly hair2 and 7,b7 pulse oximeters produce less accurate oxygen saturation readings when used on fingertips with darker skin2 7#c7 a lack of images depicting darker skin in medical textbooks1 literature1 and journals contributes to higher rates of underdiagnosis or misdiagnosis in patients with darker skin2 and 7#d7 many health-related studies fail to include data on ,american ,indians1 ,alaska ,natives1 ,asian ,americans1 ,native ,hawaiians1 or ,pacific ,islanders1 or do not disaggregate data among those groups1 leading to their invisibility in health data and unjust resource allocation and policies2 ,whereas racism produces unjust outcomes and treatment for members of racial and ethnic minority groups1 with such negative experiences serving as stressors that over time have a negative impact on physical health 7leading1 for example1 to high blood pressure or hypertension7 and mental health 7leading1 for example1 to anxiety or depression72 ,whereas there is evidence that racial and ethnic minority groups continue to face discrimination in the ,united ,states1 examples of which include that-- 7#a7 social scientists have documented racial microaggressions in contemporary ,united ,states society1 including-- 7,a7 assumptions that members of racial and ethnic minority groups are not citizens of the ,united ,states2 7,b7 assumptions of lesser intelligence2 7,c7 statements that convey color-blindness or denial of the importance of race2 7,d7 assumptions of criminality or dangerousness2 7,e7 denial of individual racism2 7,f7 promotion of the myth of meritocracy2 7,g7 assumptions that the cultural background and communication styles of an individual are pathological2 7,h7 treatment as a second-class citizen2 and 7,i7 environmental messages of being unwelcome or devalued2 7#b7 compared to ,white ,americans1 ,black ,americans are #e times more likely to report experiencing discrimination when interacting with the police1 ,hispanic or ,latino ,americans and ,native ,americans are nearly #c times as likely1 and ,asian ,americans1 ,native ,hawaiians1 and ,pacific ,islanders are nearly twice as likely2 7#c7 #db percent of employees in the ,united ,states have experienced or witnessed racism in the workplace2 7#d7 ,muslims1 ,south ,asians1 and ,sikhs were unjustly targeted for profiling1 surveillance1 arrest1 discrimination1 harassment1 assault1 and murder after #i_/aa2 7#e7 xenophobic rhetoric1 including anti-immigrant rhetoric and the scapegoating of people of ,east ,asian and ,southeast ,asian descent for the ,,covid-#ai pandemic1 resulted in a surge of hate against ,asian ,americans1 ,native ,hawaiians1 and ,pacific ,islanders1 including increased harassment1 discrimination1 bullying1 vandalism1 and assault2 7#f7 nearly #a_/b of ,asian ,americans1 ,native ,hawaiians1 and ,pacific ,islanders throughout the ,united ,states have experienced discrimination or unfair treatment that may be illegal and the majority of victims of discrimination name race or related characteristics as the reason for the discrimination2 and 7#g7 more than #ej percent of ,hispanic or ,latino adults experience at least #a form of discrimination due to their racial or ethnic heritage1 such as being treated as if they were not smart1 criticized for speaking ,spanish1 told to return to their country1 called offensive names1 or unfairly stopped by the police2 ,whereas ,black people in the ,united ,states experience overt and direct forms of violence that1 when not fatal1 can cause severe physical or psychological harm2 ,whereas examples of such forms of violence include-- 7#a7 that ,black people are confronted and threatened by armed citizens while performing everyday tasks1 such as jogging in neighborhoods1 driving1 or playing in a park2 7#b7 that ,black people are #c times more likely to be killed by police than ,white people1 and police violence is the sixth leading cause of death for young ,black men2 7#c7 the killings of ,tamir ,rice1 ,ahmaud ,arbery1 ,breonna ,taylor1 ,george ,floyd1 ,elijah ,mc,clain1 ,jayland ,walker1 ,jeenan ,anderson1 ,timothy ,mc,cree ,johnson1 ,jordan ,neely1 and countless other ,black ,americans by law enforcement2 7#d7 that it took the ,united ,states #ff years after the senseless and brutal murder of #ad-year-old ,emmett ,till to make lynching a ,federal crime2 7#e7 that1 since #bjae1 mass shootings around the country1 such as in ,buffalo1 ,new ,york1 and ,charleston1 ,south ,carolina1 serve as reminders of the unresolved history of racism in the ,united ,states and highlight the threats ,black people must take into consideration when going about their daily lives1 both when outside their communities and within those communities2 and 7#f7 the threat of brutality and violence adversely impacting mental health among ,black communities2 ,whereas ,american ,indians and ,alaska ,natives experience historical trauma1 systemic oppression1 and cultural genocide that1 even when not fatal1 can cause severe physical or psychological harm2 ,whereas examples of such forms of violence include-- 7#a7 forced relocation1 termination1 and assimilation policies1 such as boarding schools1 that contributed to health disparities and legacies of trauma inflicted on indigenous people2 7#b7 the ,army attempting cultural genocide by instigating numerous massacres1 including the mass execution of #ch ,dakota men in ,minnesota1 and the murder of #cjj ,lakota people at the ,battle of ,wounded ,knee1 to eradicate ,american ,indians and ,alaska ,natives2 7#c7 murder being the third leading cause of death for ,native women1 and #d_/e of indigenous women experiencing violence in their lifetime2 7#d7 that1 since #bjaf1 there have been #e1gab cases of missing and murdered indigenous women and people across the ,united ,states1 including #ejf cases in #ga urban cities and #aec cases missing from law enforcement databases1 with those missing cases likely undercounting the actual number of cases due to the underreporting of cases within ,american ,indian and ,alaska ,native communities2 7#e7 that the overall death rate from suicide among ,american ,indians and ,alaska ,natives is #bj percent higher compared to non-,hispanic ,white populations2 and 7#f7 cycles of violence that have overburdened indigenous communities to respond to increased levels of violence1 including gender-based violence1 human trafficking1 suicide1 and homicide with minimal resources2 ,whereas ,american ,indian1 ,alaska ,natives1 ,hispanics or ,latinos1 ,asian ,americans1 ,native ,hawaiians1 and ,pacific ,islanders experience racially motivated kidnapping1 murders1 and mass violence1 such as shootings in ,oak ,creek1 ,wisconsin1 ,el ,paso and ,allen1 ,texas1 ,atlanta1 ,georgia1 and ,indianapolis1 ,indiana1 that1 even when not fatal1 can cause severe physical or psychological harm2 ,whereas1 throughout the history of the ,united ,states1 members of racial and ethnic minority groups have been at the forefront of civil rights movements for essential freedoms1 human rights1 and equal protection for marginalized groups and continue to fight for racial1 environmental1 and economic justice today2 ,whereas racial inequities in health continue to persist because of historical and contemporary racism2 ,whereas public health experts agree that racism meets the criteria of a public health crisis because-- 7#a7 the condition affects many people1 is seen as a threat to the public1 and is continuing to increase2 7#b7 the condition is distributed unfairly2 7#c7 preventive measures could reduce the effects of the condition2 and 7#d7 those preventive measures are not yet in place2 ,whereas the ,centers for ,disease ,control and ,prevention-- 7#a7 declared racism a serious threat to public health2 and 7#b7 acknowledged the need for additional research and investments to address that serious threat2 ,whereas a ,federal public health crisis declaration proclaims racism as a pervasive health issue and alerts the people of the ,united ,states to the need to enact immediate and effective cross-governmental efforts to address the root causes of structural racism and the downstream impacts of that racism2 and ,whereas such a declaration requires the response of governments to engage significant resources to empower the communities that are impacted3 ,now1 therefore1 be it ,that the ,senate-- 7#a7 supports the resolutions drafted1 introduced1 and adopted by cities and localities across the ,united ,states declaring racism a public health crisis2 7#b7 declares racism a public health crisis in the ,united ,states2 7#c7 commits to-- 7,a7 establishing a nationwide strategy to address health disparities and inequities across all sectors in society2 7,b7 dismantling systemic practices and policies that perpetuate racism2 7,c7 advancing reforms to address years of neglectful and apathetic policies that have led to poor health outcomes for members of racial and ethnic minority groups2 and 7,d7 promoting efforts to address the social determinants of health for all racial and ethnic minority groups in the ,united ,states2 and 7#d7 places a charge on the people of the ,united ,states to move forward with urgency to ensure that the ,united ,states stands firmly in honoring its moral purpose of advancing the self-evident truths that all people are created equal1 that they are endowed with certain unalienable rights1 and that among these are life1 liberty1 and the pursuit of happiness4