,,iii  #aai? ,,congress  #a/ ,session   
,s4 ,,res4 #fg  ,,9 ,,! ,,s5ate ,,( ,,! 
,,unit$ ,,/ates  ,febru>y #f            
7legislative day1 ,febru>y #e71         
#bjbe,mr4 ,book] 7= himself1 ,mr4       
,padilla1 ,ms4 ,hirono1 ,mr4 ,blum5?al1 
,mr4 ,kim1 ,ms4 ,baldw91 & ,mr4 ,wyd57  
submitt$ ! foll[+ resolution2 :i* 0     
ref]r$ to ! ,committee on ,heal?1       
,education1 ,labor1 & ,p5sions          
,,resolution  ,decl>+ racism a public   
heal? crisis4  ,:]eas a public heal?    
crisis is an issue-- 7#a7 t affects _m  
p1 is a ?reat to ! public1 & is ongo+2  
7#b7 t is unfairly di/ribut$ among      
diff]5t populations1 disproportionately 
impact+ heal? outcomes1 access to heal? 
c>e1 & life expectancy2  7#c7 ! effects 
( :i* c\ld be r$uc$ by prev5tive        
measures2 &  7#d7 = :i* ^? prev5tive    
measures are n yet 9 place2 ,:]eas      
public heal? exp]ts agree t significant 
racial inequities exi/ 9 ! preval5ce1   
sev]ity1 & mortality rates ( v>i\s heal?
 conditions 9 ! ,unit$ ,/ates2 ,:]eas   

examples ( significant racial inequities
 include t-- 7#a7 life expectancies =   
,black1 ,am]ican ,indian1 & ,alaska     
,native p 9 ! ,unit$ ,/ates are #d to   
#aj ye>s l[] ?an ^? ( non-,hispanic     
,:ite p 9 ! ,unit$ ,/ates2  7#b7 ,black1
 ,am]ican ,indian1 & ,alaska ,native    
wom5 are #b to #d times m likely ?an    
,:ite wom5 to suff] sev]e mat]nal       
morbidity & h ! highe/ rates (          
pregnancy-relat$ mortality2  7#c7       
,black1 ,native ,hawaiian1 ,pacific     
,isl&]1 ,am]ican ,indian1 & ,alaska     
,native infants are #b to #c times m    
likely to die ?an ,:ite infants2  7#d7 !
 ,black infant mortality rate 9 ! ,unit$
 ,/ates is high] ?an ! infant mortality 
rates record$ 9 #bg ( ! #cf democratic  
c\ntries ) m>ket-bas$ economies t are   
memb]s ( ! ,organization = ,economic    
,co-op]ation & ,developm5t2  7#e7       
,hispanic wom5 h a #ea p]c5t high]      
incid5ce1 & are #cj p]c5t m likely to   
die f1 c]vical canc] comp>$ to          
non-,hispanic ,:ite wom52  7#f7 ,asian  

,am]icans are ! only racial gr\p 9 !    
,unit$ ,/ates :o exp]i5ce canc] z !     
lead+ cause ( dea? & h ! highe/ rates ( 
lung canc] among nev]-smok+ wom52  7#g7 
,native ,hawaiians & ,pacific ,isl&]s   
are #b4e-times m likely to die f        
diabetes ?an non-,hispanic ,:ite wom52  
7#h7 ,native ,hawaiians suff] f coron>y 
he>t disease1 /roke1 he>t failure1      
canc]1 & diabetes at a #c times great]  
rate ?an o!r e?nic populations 9        
,hawaii1 & become afflict$ ) ^? diseases
 a decade e>li] 9 _! lives comp>$ ) o!r 
e?nic populations2 &  7#i7 dur+ !       
,,covid-#ai p&emic1 ,black1 ,hispanic or
 ,lat9o1 ,asian ,am]ican1 ,native       
,hawaiian1 ,pacific ,isl&]1 & ,native   
,am]ican communities exp]i5c$           
disproportionately high rates (         
,,covid-#ai infection1 hospitalization1 
& mortality comp>$ to ! ,:ite population
 ( ! ,unit$ ,/ates2 ,:]eas inequities 9 
heal? outcomes are exac]bat$ = p ( color
 :o are ,,lgbtqia2 ,:]eas inequities 9  
heal? outcomes are exac]bat$ = p ( color

 :o h disabilities2 ,:]eas1 hi/orically1
 explanations = heal? inequities h      
focus$ on false g5etic sci5ce1 su* z    
eug5ics2 ,:]eas1 hi/orically1           
explanations = heal? inequities h focus$
 on incomplete social sci5tific analyses
 t n>r[ly focus on individual behavior  
to highlight o/5sible defici5cies )9    
racial & e?nic m9ority gr\ps2 ,:]eas    
mod]n public heal? (ficials recognize ! 
broad] social context 9 :i* heal?       
inequities em]ge & ackn[l$ge ! impact ( 
hi/orical & contempor>y racism on heal?2
 ,:]eas racism is recogniz$ 9 mod]n     
public heal? disc\rse z #a ( _m social  
det]m9ants ( heal?1 :i*-- 7#a7 are a    
broad range ( nonm$ical factors t c     
enhance or h9d] quality ( life &        
influ5ce heal? outcomes2  7#b7 are !    
conditions 9 :i* p are born1 gr[1 "w1   
live1 & age1 & include ! wid] set ( =ces
 & sy/ems %ap+ ! conditions ( daily     
life2  7#c7 include factors su* z h\s+1 
employm5t1 education1 heal? c>e1 food1  
transportation1 social support1 pov]ty1 

crime1 viol5ce1 segregation1 &          
environm5tal tox9s2  7#d7 are l9k$ to a 
lack ( opportunity & res\rces to        
protect1 improve1 & ma9ta9 heal?2 &     
7#e7 tak5 toge!r1 create heal?          
inequities t /em f unfair & unju/       
sy/ems1 policies1 & practices1 & limit  
access to ! opportunities & res\rces    
ne$$ to live ! heal?ie/ life possible2  
,:]eas1 s9ce its f\nd+1 ! ,unit$ ,/ates 
has _h a long/&+ hi/ory & legacy (      
racism1 mi/reatm5t1 & discrim9ation t   
has p]petuat$ heal? inequities = memb]s 
( racial & e?nic m9ority gr\ps2 ,:]eas t
 hi/ory & legacy ( racism1 mi/reatm5t1 &
 discrim9ation includes-- 7#a7 ! immoral
 p>adox ( fre$om & slav]y1 :i* is an    
atrocity t c be trac$ ?r\gh\t ! hi/ory (
 ! ,unit$ ,/ates1 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     

7#b7 ! failure ( ! ,unit$ ,/ates to c>ry
 out ! responsibilities & promises made 
9 m ?an #cgj treaties ratifi$ ) sov]eign
 indig5\s communities1 includ+ ,am]ican 
,indians1 ,alaska ,natives1 ,native     
,hawaiians1 & ,pacific ,isl&]s1 z made  
evid5t by ! *ronic & p]vasive und]fund+ 
( ! ,indian ,heal? ,s]vice & ,native    
,hawaiian heal? c>e1 ! va/ heal? &      
socioeconomic inequities fac$ by        
,am]ican ,indian & ,alaska ,native p1 & 
! inaccessibility ( _m ,f$]al public    
heal? & social programs 9 ,native       
,am]ican communities2  7#c7 ! enactm5t (
 immigration laws 9 ! ,unit$ ,/ates t   
scapegoat$ ,asians1 sep>at$ families1 & 
br&$ ,asians z p]petual outsid]s1 su*   
z-- 7,a7 ! ,act entitl$ ,an ,act        
supplem5t>y to ! ,acts 9 relation to    
immigration1 approv$ ,m>* #c1 #ahge     
7commonly kn[n z ! ,page ,act ( #ahge7  
7#ah ,/at4 #dgg1 *apt] #ada71 :i*       
effectively prohibit$ ! entry ( ,ea/    
,asian wom5 into ! ,unit$ ,/ates2  7,b7 
! ,act entitl$ ,an ,act to execute c]ta9

 treaty /ipulations relat+ to ,*9ese1   
approv$ ,may #f1 #ahhb 7commonly kn[n z 
! ,*9ese ,exclusion ,act7 7#bb ,/at4    
#eh1 *apt] #abf71 :i* bann$ ?\s&s (     
,*9ese-born labor]s1 :o 7 ess5tial 9 !  
completion ( ! transcont95tal railroad &
 developm5t ( ! ,we/ ,coa/ ( ! ,unit$   
,/ates2 &  7,c7 ! ,act entitl$ ,an ,act 
to regulate ! immigration ( ali5s to1 & 
! resid5ce ( ali5s 91 ! ,unit$ ,/ates1  
approv$ ,febru>y #e1 #aiag 7commonly    
kn[n z ! ,immigration ,act ( #aiag7 7#ci
 ,/at4 #hgd1 *apt] #bi71 :i* b>r$ all   
immigrants f ! ,asiatic zone & prev5t$ !
 migration ( individuals f ,s\? ,asia1  
,s\!a/ ,asia1 & ,ea/ ,asia2  7#d7 dur+ !
 ,great ,depression ,era1 ! deportation 
( approximately #a1hjj1jjj individuals  
bas$ on _! ,mexican e?nic id5tity1      
al?\gh approximately #fj p]c5t ( !      
deport$ individuals 7 citiz5s ( ! ,unit$
 ,/ates1 & ! t>get+ ( individuals (     
,mexican desc5t = repatriation due to   
scapegoat+ ef=ts1 :i* blam$ ^?          
individuals = /eal+ jobs f real         

,am]icans2 &  7#e7 9 #aidb1 ! issuance (
 ,executive ,ord] #ijff :i* began ! =c$ 
evacuation & det5tion ( ,japanese       
,am]ican ,we/ ,coa/ resid5ts1 plac+     
#gj1jjj citiz5s ( ! ,unit$ ,/ates into  
relocation c5t]s2 ,:]eas1 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 caus+ deep5$ racial 
division & ! cont9u$ exclusion ( ,black 
communities f ! b5efits ( economic      
progress2 ,:]eas ov]t racism 0 emb$d$ 9 
! developm5t ( m$ical sci5ce & m$ical   
tra9+ dur+ ! #ah?1 #ai?1 & #bj?         
c5turies1 caus+ disproportionate        
physical & psy*ological h>m to memb]s ( 
racial & e?nic m9ority gr\ps1 includ+-- 
7#a7 ! une?ical practices & abuses      
exp]i5c$ by ,black pati5ts & rese>*     
p>ticipants1 su* z ! ,tuskegee ,/udy (  
,untreat$ ,syphilis 9 ! ,negro ,male1   
:i* s]ve z ! f\ndation = ! mi/ru/ !     

,black community has = ! m$ical sy/em2 &
  7#b7 ! egregi\sly une?ical & cruel    
treatm5t ( enslav$ ,black wom5 :o 7 =c$ 
to be ! subject ( insidi\s m$ical       
exp]im5ts to advance mod]n gynecology1  
includ+ ^? p]petuat$ by ! s-call$ fa!r (
 gynecology1 ,j4 ,m>ion ,sims2 ,:]eas   
/ructural racism cem5t$ hi/orical racial
 & e?nic inequities 9 access to res\rces
 & opportunities1 contribut+ to worse   
heal? outcomes2 ,:]eas examples (       
/ructural racism include-- 7#a7 be=e !  
enactm5t ( ! ,m$ic>e program1 ! ,unit$  
,/ates heal? c>e sy/em 0 highly         
segregat$1 &1 z late z ! mid-#aifjs1    
hospitals1 cl9ics1 & doctors' (fices    
?r\gh\t ! nor!rn & s\!rn ,unit$ ,/ates  
compli$ ) ,jim ,cr[ laws & 7 completely 
segregat$ by race1 leav+ ,black         
communities ) little to no access to    
heal? c>e s]vices2  7#b7 ! l&m>k case   
,simk9s v4 ,moses ,h4 ,cone ,memorial   
,hospital1 #cbc ,f4#b;d #iei 7#d? ,cir4 
#aifc71 :i* *all5g$ ! use ( public funds
 by ! ,f$]al ,gov]nm5t to exp&1 support1

 & su/a9 segregat$ hospital c>e &       
provid$ ju/ification = title ,,vi ( !   
,civil ,rights ,act ( #aifd 7#db        
,u4,s4,c4 #bjjj;d et seq47 & ! ,m$ic>e  
hospital c]tification program by        
e/abli%+ ,m$ic>e hospital racial        
integration guidel9es t appli$ to e     
hospital t p>ticipat$ 9 ! ,f$]al        
program2  7#c7 t ,pacific ,isl&]s f !   
,freely ,associat$ ,/ates exp]i5ce      
unique heal? inequities result+ f ,unit$
 ,/ates nucle> weapons te/s on _! home  
isl&s :ile !y h be5 categorically d5i$  
access to ,m$icaid & o!r ,f$]al heal?   
b5efits2  7#d7 t language m9orities1    
includ+ ,spani%-speak+1 ,*9ese-speak+1 &
 ,tagalog-speak+ p 9 ! ,unit$ ,/ates1 7 
n assur$ nondiscrim9atory access to     
f$]ally fund$ s]vices1 includ+ heal?    
s]vices1 until ! sign+ ( ,executive     
,ord] #acaff 7#db ,u4,s4,c4 #bjjj;d-#a  
note2 relat+ to improv+ access to       
s]vices = p]sons ) limit$ ,engli%       
pr(ici5cy7 9 #bjjj2  7#e7 t !           
,,covid-#ai p&emic exac]bat$ economic1  

heal?1 h\s+1 & food security b>ri]s =   
,black1 ,hispanic or ,lat9o1 ,asian     
,am]ican1 ,native ,hawaiian1 ,pacific   
,isl&]1 & ,native ,am]ican h\seholds1   
:i* already suff] f disproportionately  
high] rates ( food insecurity2 &  7#f7 t
 memb]s ( ! ,black1 ,native ,am]ican1   
,alaska ,native1 ,asian ,am]ican1       
,native ,hawaiian1 ,pacific ,isl&]1 &   
,hispanic or ,lat9o communities 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 
( memb]s ( ^? communities2 ,:]eas subtle
 or implicit racism 9 all sectors ( !   
m$ical s]vice pr(ession cont9ues to     
cause disproportionate physical &       
psy*ological h>m to memb]s ( racial &   
e?nic m9ority gr\ps2 ,:]eas examples (  
subtle or implicit racism 9 ! m$ical    
s]vice pr(ession include t-- 7#a7 !     
hi/ory & p]si/5ce ( raci/ & nonsci5tific
 m$ical beliefs1 :i* are associat$ )    

ongo+ racial inequities 9 treatm5t &    
heal? outcomes2  7#b7 implicit racial & 
e?nic biases )9 ! heal? c>e sy/em1 :i* h
 an explicit impact on ! quality ( c>e  
exp]i5c$ by memb]s ( racial & e?nic     
m9ority gr\ps1 su* z ! und]treatm5t (   
pa9 9 ,black pati5ts2  7#c7 ne>ly #a_/e 
( ,hispanic or ,lat9o ,am]icans avoid   
m$ical c>e due to conc]n ab\t be+       
discrim9at$ aga9/ or treat$ poorly2     
7#d7 ! ,unit$ ,/ates heal? c>e sy/em &  
o!r economic & social /ructures rema9   
fraught ) biases bas$ on race1 e?nicity1
 sex 7includ+ sexual ori5tation & g5d]  
id5tity71 & class t lead to heal?       
inequities2  7#e7 wom5 ( color1 includ+ 
,black1 ,native ,am]ican1 ,hispanic or  
,lat9a1 ,asian ,am]ican1 ,native        
,hawaiian1 & ,pacific ,isl&] wom51 h    
fac$ & cont9ue to face attacks on _!    
pr5atal1 mat]nal1 & reproductive heal? &
 rights2 &  7#f7 ?r\gh ! e>ly #aihjs1   
physicians r\t9ely /]iliz$ memb]s (     
racial & e?nic m9ority gr\ps1           
specifically ,am]ican ,indian & ,alaska 

,native wom5 7) #a_/d ( *ildbe>+-ag$    
,am]ican ,indian & ,alaska ,native wom5 
be+ /]iliz$ by ! ,indian ,heal? ,s]vice7
 & ,african-,am]ican & ,lat9a wom51     
p]=m+ excessive & m$ically unnecess>y   
proc$ures )\t _! in=m$ cons5t2 ,:]eas   
/ructural racism p]petuates racial &    
e?nic inequities 9 ! social det]m9ants (
 heal?1 :i* produces un9t5d$ negative   
heal? outcomes = memb]s ( racial & e?nic
 m9ority gr\ps2 ,:]eas examples ( t     
/ructural racism include-- 7#a7 t !re   
are few] ph>macies1 m$ical practices1 & 
hospitals 9 pr$om9antly ,black &        
,hispanic or ,lat9o neighborhoods1      
comp>$ to ,:ite or m div]se             
neighborhoods2  7#b7 t environm5tal     
haz>ds1 su* z toxic wa/e facilities1    
g>bage dumps1 & o!r s\rces ( airborne   
pollutants1 are disproportionately      
locat$ 9 pr$om9antly ,black1 ,hispanic  
or ,lat9o1 ,asian ,am]ican1 ,native     
,hawaiian1 ,pacific ,isl&]1 & l[-income 
communities1 result+ 9 poor air quality 
conditions1 :i* c increase ! likelihood 

( *ronic respiratory illness & premature
 dea? f p>ticle pollution2  7#c7 t      
employ$ ,black adults are #aj p]c5t less
 likely to h employ]-sponsor$ heal?     
insurance ?an employ$ ,:ite adults      
because ( racial segregation 9          
occupation sectors & ! types (          
organizations 9 :i* !y "w2  7#d7 t #a 9 
#d ,am]ican ,indian & ,alaska ,native p 
lack heal? insurance & t ,native        
,hawaiians1 ,pacific ,isl&]s1 & c]ta9   
gr\ps ( noneld]ly ,asian ,am]ican adults
 h l[] levels ( insurance ?an ,:ite     
adults2  7#e7 t sev]al ,/ates ) high]   
p]c5tages ( ,black1 ,hispanic or ,lat9o1
 ,am]ican ,indian1 & ,alaska ,native    
populations h n exp&$ _! ,m$icaid       
programs1 cont9u+ to dis5fran*ise       
m9ority communities f access to heal?   
c>e z ( ! date ( adoption ( ?is         
resolution2  7#f7 discrim9atory h\s+    
practices1 su* z r$l9+1 :i* h1 =        
decades1 sy/emically exclud$ memb]s (   
racial & e?nic m9ority gr\ps f h\s+ by  
robb+ !m ( capital 9 ! =m ( l[-co/1     

/able mortgages & opportunities to build
 weal?1 & ! use ( f9ancial p[] by !     
,f$]al ,gov]nm5t to segregate r5t]s 9   
public h\s+2  7#g7 social inequities1   
su* z diff]+ access to quality heal?    
c>e1 heal?y food & safe dr9k+ wat]1 safe
 & af=dable neighborhoods1 education1   
job security1 & reliable transportation1
 :i* affect heal? risks & outcomes2     
7#h7 exclusion>y discipl9>y practices   
7su* z det5tion & susp5sion7 9 prim>y   
education & ev5 e>ly education sett+s1  
:i* disproportionately affect *ildr5 f  
racial & e?nic m9ority backgr\nds1      
p>ticul>ly ,black *ildr52 &  7#i7 t1 z  
mu* z #fj p]c5t ( ! heal? ( a p]son 9 ! 
,unit$ ,/ates c be det]m9$ by _! ,,zip  
,code2 ,:]eas /ructural racism          
p]petuates ongo+ k gaps 9 data1 rese>*1 
& developm5t1 :i* produces un9t5d$      
negative heal? outcomes = memb]s (      
racial & e?nic m9ority gr\ps2 ,:]eas    
examples ( t /ructural racism include   
t-- 7#a7 mo/ p>ticipants 9 cl9ical      
trials are ,:ite1 s !re is insuffici5t  

data to develop evid5ce-bas$            
recomm5dations = p f racial & e?nic     
m9ority gr\ps2  7#b7 m$ical rese>*      
equipm5t & m$ical devices are typically 
develop$ by majority-,:ite teams & !re=e
 c h racial bl9d spots un9t5tionally    
built into _! design1 r5d]+ !m less     
effective = p f racial & e?nic m9ority  
gr\ps1 su* z-- 7,a7 electro5cephalogram 
electrodes us$ 9 neuroimag+ rese>* d n  
collect reliable data :5 us$ on scalps )
 ?ick1 curly hair2 &  7,b7 pulse        
oximet]s produce less accurate oxyg5    
saturation read+s :5 us$ on f+]tips )   
d>k] sk92  7#c7 a lack ( images depict+ 
d>k] sk9 9 m$ical textbooks1 lit]ature1 
& j\rnals contributes to high] rates (  
und]diagnosis or misdiagnosis 9 pati5ts 
) d>k] sk92 &  7#d7 _m heal?-relat$     
/udies fail to include data on ,am]ican 
,indians1 ,alaska ,natives1 ,asian      
,am]icans1 ,native ,hawaiians1 or       
,pacific ,isl&]s1 or d n disaggregate   
data among ^? gr\ps1 lead+ to _!        
invisibility 9 heal? data & unju/       

res\rce allocation & policies2 ,:]eas   
racism produces unju/ outcomes &        
treatm5t = memb]s ( racial & e?nic      
m9ority gr\ps1 ) su* negative exp]i5ces 
s]v+ z /ressors t ov] "t h a negative   
impact on physical heal? 7lead+1 =      
example1 to high blood pressure or      
hyp]t5sion7 & m5tal heal? 7lead+1 =     
example1 to anxiety or depression72     
,:]eas !re is evid5ce t racial & e?nic  
m9ority gr\ps cont9ue to face           
discrim9ation 9 ! ,unit$ ,/ates1        
examples ( :i* include t-- 7#a7 social  
sci5ti/s h docum5t$ racial              
microaggressions 9 contempor>y ,unit$   
,/ates society1 includ+-- 7,a7          
assumptions t memb]s ( racial & e?nic   
m9ority gr\ps are n citiz5s ( ! ,unit$  
,/ates2  7,b7 assumptions ( less]       
intellig5ce2  7,c7 /atem5ts t convey    
color-bl9dness or d5ial ( ! importance (
 race2  7,d7 assumptions ( crim9ality or
 dang]\sness2  7,e7 d5ial ( individual  
racism2  7,f7 promotion ( ! my? (       
m]itocracy2  7,g7 assumptions t !       

cultural backgr\nd & communication /yles
 ( an individual are pa?ological2  7,h7 
treatm5t z a second-class citiz52 &     
7,i7 environm5tal messages ( be+        
unwelcome or devalu$2  7#b7 comp>$ to   
,:ite ,am]icans1 ,black ,am]icans are #e
 times m likely to report exp]i5c+      
discrim9ation :5 int]act+ ) ! police1   
,hispanic or ,lat9o ,am]icans & ,native 
,am]icans are ne>ly #c times z likely1 &
 ,asian ,am]icans1 ,native ,hawaiians1 &
 ,pacific ,isl&]s are ne>ly twice z     
likely2  7#c7 #db p]c5t ( employees 9 ! 
,unit$ ,/ates h exp]i5c$ or witness$    
racism 9 ! workplace2  7#d7 ,muslims1   
,s\? ,asians1 & ,sikhs 7 unju/ly t>get$ 
= pr(il+1 surveillance1 arre/1          
discrim9ation1 h>assm5t1 assault1 &     
murd] aft] #i_/aa2  7#e7 x5ophobic      
rhetoric1 includ+ anti-immigrant        
rhetoric & ! scapegoat+ ( p ( ,ea/      
,asian & ,s\!a/ ,asian desc5t = !       
,,covid-#ai p&emic1 result$ 9 a surge ( 
hate aga9/ ,asian ,am]icans1 ,native    
,hawaiians1 & ,pacific ,isl&]s1 includ+ 

increas$ h>assm5t1 discrim9ation1       
bully+1 v&alism1 & assault2  7#f7 ne>ly 
#a_/b ( ,asian ,am]icans1 ,native       
,hawaiians1 & ,pacific ,isl&]s ?r\gh\t !
 ,unit$ ,/ates h exp]i5c$ discrim9ation 
or unfair treatm5t t may be illegal & ! 
majority ( victims ( discrim9ation "n   
race or relat$ *>act]i/ics z ! reason = 
! discrim9ation2 &  7#g7 m ?an #ej p]c5t
 ( ,hispanic or ,lat9o adults exp]i5ce  
at lea/ #a =m ( discrim9ation due to _! 
racial or e?nic h]itage1 su* z be+      
treat$ z if !y 7 n sm>t1 criticiz$ =    
speak+ ,spani%1 told to return to _!    
c\ntry1 call$ (f5sive names1 or unfairly
 /opp$ by ! police2 ,:]eas ,black p 9 ! 
,unit$ ,/ates exp]i5ce ov]t & direct =ms
 ( viol5ce t1 :5 n fatal1 c cause sev]e 
physical or psy*ological h>m2 ,:]eas    
examples ( su* =ms ( viol5ce include--  
7#a7 t ,black p are confront$ & ?reat5$ 
by arm$ citiz5s :ile p]=m+ ev]yday      
tasks1 su* z jogg+ 9 neighborhoods1     
driv+1 or play+ 9 a p>k2  7#b7 t ,black 
p are #c times m likely to be kill$ by  

police ?an ,:ite p1 & police viol5ce is 
! six? lead+ cause ( dea? = "y ,black   
m52  7#c7 ! kill+s ( ,tamir ,rice1      
,ahmaud ,arb]y1 ,breonna ,taylor1       
,george ,floyd1 ,elijah ,mc,clain1      
,jayl& ,walk]1 ,je5an ,&]son1 ,timo?y   
,mc,cree ,johnson1 ,jordan ,neely1 &    
c\ntless o!r ,black ,am]icans by law    
en=cem5t2  7#d7 t x took ! ,unit$ ,/ates
 #ff ye>s aft] ! s5seless & brutal murd]
 ( #ad-ye>-old ,emmett ,till to make    
lyn*+ a ,f$]al crime2  7#e7 t1 s9ce     
#bjae1 mass %oot+s ar\nd ! c\ntry1 su* z
 9 ,buffalo1 ,new ,york1 & ,*>le/on1    
,s\? ,c>ol9a1 s]ve z rem9d]s ( !        
unresolv$ hi/ory ( racism 9 ! ,unit$    
,/ates & highlight ! ?reats ,black p mu/
 take into consid]ation :5 go+ ab\t _!  
daily lives1 bo? :5 outside _!          
communities & )9 ^? communities2 &  7#f7
 ! ?reat ( brutality & viol5ce adv]sely 
impact+ m5tal heal? among ,black        
communities2 ,:]eas ,am]ican ,indians & 
,alaska ,natives exp]i5ce hi/orical     
trauma1 sy/emic oppression1 & cultural  

g5ocide t1 ev5 :5 n fatal1 c cause sev]e
 physical or psy*ological h>m2 ,:]eas   
examples ( su* =ms ( viol5ce include--  
7#a7 =c$ relocation1 t]m9ation1 &       
assimilation policies1 su* z bo>d+      
s*ools1 t contribut$ to heal? disp>ities
 & legacies ( trauma inflict$ on        
indig5\s p2  7#b7 ! ,army attempt+      
cultural g5ocide by in/igat+ num]\s     
massacres1 includ+ ! mass execution (   
#ch ,dakota m5 9 ,m9nesota1 & ! murd] ( 
#cjj ,lakota p at ! ,battle ( ,w\nd$    
,knee1 to eradicate ,am]ican ,indians & 
,alaska ,natives2  7#c7 murd] be+ ! ?ird
 lead+ cause ( dea? = ,native wom51 &   
#d_/e ( indig5\s wom5 exp]i5c+ viol5ce 9
 _! lifetime2  7#d7 t1 s9ce #bjaf1 !re h
 be5 #e1gab cases ( miss+ & murd]$      
indig5\s wom5 & p across ! ,unit$       
,/ates1 includ+ #ejf cases 9 #ga urban  
cities & #aec cases miss+ f law en=cem5t
 databases1 ) ^? miss+ cases likely     
und]c\nt+ ! actual numb] ( cases due to 
! und]report+ ( cases )9 ,am]ican       
,indian & ,alaska ,native communities2  

7#e7 t ! ov]all dea? rate f suicide     
among ,am]ican ,indians & ,alaska       
,natives is #bj p]c5t high] comp>$ to   
non-,hispanic ,:ite populations2 &  7#f7
 cycles ( viol5ce t h ov]burd5$ indig5\s
 communities to respond to increas$     
levels ( viol5ce1 includ+ g5d]-bas$     
viol5ce1 human traffick+1 suicide1 &    
homicide ) m9imal res\rces2 ,:]eas      
,am]ican ,indian1 ,alaska ,natives1     
,hispanics or ,lat9os1 ,asian ,am]icans1
 ,native ,hawaiians1 & ,pacific ,isl&]s 
exp]i5ce racially motivat$ kidnapp+1    
murd]s1 & mass viol5ce1 su* z %oot+s 9  
,oak ,creek1 ,wiscons91 ,el ,paso &     
,all51 ,texas1 ,atlanta1 ,georgia1 &    
,indianapolis1 ,indiana1 t1 ev5 :5 n    
fatal1 c cause sev]e physical or        
psy*ological h>m2 ,:]eas1 ?r\gh\t !     
hi/ory ( ! ,unit$ ,/ates1 memb]s (      
racial & e?nic m9ority gr\ps h be5 at ! 
=efront ( civil rights movem5ts =       
ess5tial fre$oms1 human rights1 & equal 
protection = m>g9aliz$ gr\ps & cont9ue  
to fight = racial1 environm5tal1 &      

economic ju/ice today2 ,:]eas racial    
inequities 9 heal? cont9ue to p]si/     
because ( hi/orical & contempor>y       
racism2 ,:]eas public heal? exp]ts agree
 t racism meets ! crit]ia ( a public    
heal? crisis because-- 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$uce ! effects
 ( ! condition2 &  7#d7 ^? prev5tive    
measures are n yet 9 place2 ,:]eas !    
,c5t]s = ,disease ,control &            
,prev5tion-- 7#a7 decl>$ racism a s]i\s 
?reat to public heal?2 &  7#b7 ackn[l$g$
 ! ne$ = additional rese>* & inve/m5ts  
to address t s]i\s ?reat2 ,:]eas a      
,f$]al public heal? crisis decl>ation   
proclaims racism z a p]vasive heal?     
issue & al]ts ! p ( ! ,unit$ ,/ates to !
 ne$ to enact imm$iate & effective      
cross-gov]nm5tal ef=ts to address ! root
 causes ( /ructural racism & ! d[n/ream 
impacts ( t racism2 & ,:]eas su* a      
decl>ation requires ! response (        

gov]nm5ts to engage significant res\rces
 to emp[] ! communities t are impact$3  
,n[1 !re=e1 be x ,t ! ,s5ate-- 7#a7     
supports ! resolutions draft$1          
introduc$1 & adopt$ by cities &         
localities across ! ,unit$ ,/ates 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 & inequities across   
all sectors 9 society2  7,b7 dismantl+  
sy/emic practices & policies t p]petuate
 racism2  7,c7 advanc+ re=ms to address 
ye>s ( neglectful & apa!tic policies t h
 l$ to poor heal? outcomes = memb]s (   
racial & e?nic m9ority gr\ps2 &  7,d7   
promot+ ef=ts to address ! social       
det]m9ants ( heal? = all racial & e?nic 
m9ority gr\ps 9 ! ,unit$ ,/ates2 &  7#d7
 places a *>ge on ! p ( ! ,unit$ ,/ates 
to move =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