III
119THCONGRESS
1
STSESSION S. RES. 67
Declaring racism a public health crisis.
IN THE SENATE OF THE UNITED STATES
FEBRUARY6 (legislative day, FEBRUARY5), 2025
Mr. B
OOKER(for himself, Mr. PADILLA, Ms. HIRONO, Mr. BLUMENTHAL, Mr.
K
IM, Ms. BALDWIN, and Mr. WYDEN) submitted the following resolution;
which was referred to the Committee on Health, Education, Labor, and
Pensions
RESOLUTION
Declaring racism a public health crisis.
Whereas a public health crisis is an issue—
(1) that affects many people, is a threat to the pub-
lic, and is ongoing;
(2) that is unfairly distributed among different pop-
ulations, disproportionately impacting health outcomes,
access to health care, and life expectancy;
(3) the effects of which could be reduced by preven-
tive measures; and
(4) for which those preventive measures are not yet
in place;
Whereas public health experts agree that significant racial in-
equities exist in the prevalence, severity, and mortality
rates of various health conditions in the United States;
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Whereas examples of significant racial inequities include
that—
(1) life expectancies for Black, American Indian,
and Alaska Native people in the United States are 4 to
10 years lower than those of non-Hispanic White people
in the United States;
(2) Black, American Indian, and Alaska Native
women are 2 to 4 times more likely than White women
to suffer severe maternal morbidity and have the highest
rates of pregnancy-related mortality;
(3) Black, Native Hawaiian, Pacific Islander, Amer-
ican Indian, and Alaska Native infants are 2
1
⁄2to 3
times more likely to die than White infants;
(4) the Black infant mortality rate in the United
States is higher than the infant mortality rates recorded
in 27 of the 36 democratic countries with market-based
economies that are members of the Organization for Eco-
nomic Co-operation and Development;
(5) Hispanic women have a 51 percent higher inci-
dence, and are 30 percent more likely to die from, cer-
vical cancer compared to non-Hispanic White women;
(6) 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 women;
(7) Native Hawaiians and Pacific Islanders are 2.5-
times more likely to die from diabetes than non-Hispanic
White women;
(8) Native Hawaiians suffer from coronary heart
disease, stroke, heart failure, cancer, and diabetes at a 3
times greater rate than other ethnic populations in Ha-
waii, and become afflicted with those diseases a decade
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earlier in their lives compared with other ethnic popu-
lations; and
(9) during the COVID–19 pandemic, Black, His-
panic or Latino, Asian American, Native Hawaiian, Pa-
cific Islander, and Native American communities experi-
enced disproportionately high rates of COVID–19 infec-
tion, hospitalization, and mortality compared to the
White population of the United States;
Whereas inequities in health outcomes are exacerbated for
people of color who are LGBTQIA+;
Whereas inequities in health outcomes are exacerbated for
people of color who have disabilities;
Whereas, historically, explanations for health inequities have
focused on false genetic science, such as eugenics;
Whereas, historically, explanations for health inequities have
focused on incomplete social scientific analyses that nar-
rowly focus on individual behavior to highlight ostensible
deficiencies within racial and ethnic minority groups;
Whereas modern public health officials recognize the broader
social context in which health inequities emerge and ac-
knowledge the impact of historical and contemporary rac-
ism on health;
Whereas racism is recognized in modern public health dis-
course as 1 of many social determinants of health,
which—
(1) are a broad range of nonmedical factors that can
enhance or hinder quality of life and influence health out-
comes;
(2) are the conditions in which people are born,
grow, work, live, and age, and include the wider set of
forces and systems shaping the conditions of daily life;
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(3) include factors such as housing, employment,
education, health care, food, transportation, social sup-
port, poverty, crime, violence, segregation, and environ-
mental toxins;
(4) are linked to a lack of opportunity and resources
to protect, improve, and maintain health; and
(5) taken together, create health inequities that stem
from unfair and unjust systems, policies, and practices,
and limit access to the opportunities and resources need-
ed to live the healthiest life possible;
Whereas, since its founding, the United States has had a
longstanding history and legacy of racism, mistreatment,
and discrimination that has perpetuated health inequities
for members of racial and ethnic minority groups;
Whereas that history and legacy of racism, mistreatment, and
discrimination includes—
(1) the immoral paradox of freedom and slavery,
which is an atrocity that can be traced throughout the
history of the United States, as African Americans lived
under the oppressive institution of slavery from 1619
through 1865, endured the practices and laws of segrega-
tion during the Jim Crow era, and continue to face the
ramifications of systemic racism through unjust and dis-
criminatory structures and policies;
(2) the failure of the United States to carry out the
responsibilities and promises made in more than 370
treaties ratified with sovereign indigenous communities,
including American Indians, Alaska Natives, Native Ha-
waiians, and Pacific Islanders, as made evident by the
chronic and pervasive underfunding of the Indian Health
Service and Native Hawaiian health care, the vast health
and socioeconomic inequities faced by American Indian
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and Alaska Native people, and the inaccessibility of many
Federal public health and social programs in Native
American communities;
(3) the enactment of immigration laws in the United
States that scapegoated Asians, separated families, and
branded Asians as perpetual outsiders, such as—
(A) the Act entitled ‘‘An Act supplementary to
the Acts in relation to immigration’’, approved
March 3, 1875 (commonly known as the ‘‘Page Act
of 1875’’) (18 Stat. 477, chapter 141), which effec-
tively prohibited the entry of East Asian women into
the United States;
(B) the Act entitled ‘‘An Act to execute certain
treaty stipulations relating to Chinese’’, approved
May 6, 1882 (commonly known as the ‘‘Chinese Ex-
clusion Act’’) (22 Stat. 58, chapter 126), which
banned thousands of Chinese-born laborers, who
were essential in the completion of the trans-
continental railroad and development of the West
Coast of the United States; and
(C) the Act entitled ‘‘An Act to regulate the im-
migration of aliens to, and the residence of aliens in,
the United States’’, approved February 5, 1917
(commonly known as the ‘‘Immigration Act of
1917’’) (39 Stat. 874, chapter 29), which barred all
immigrants from the ‘‘Asiatic zone’’ and prevented
the migration of individuals from South Asia, South-
east Asia, and East Asia;
(4) during the Great Depression Era, the deporta-
tion of approximately 1,800,000 individuals based on
their Mexican ethnic identity, although approximately 60
percent of the deported individuals were citizens of the
United States, and the targeting of individuals of Mexi-
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can descent for ‘‘repatriation’’ due to scapegoating ef-
forts, which blamed those individuals for ‘‘stealing’’ jobs
from ‘‘real’’ Americans; and
(5) in 1942, the issuance of Executive Order 9066
which began the forced evacuation and detention of Japa-
nese American West Coast residents, placing 70,000 citi-
zens of the United States into ‘‘relocation centers’’;
Whereas, in 1967, President Lyndon B. Johnson established
the National Advisory Commission on Civil Disorders,
which concluded that White racism is responsible for the
pervasive discrimination and segregation in employment,
education, and housing, causing deepened racial division
and the continued exclusion of Black communities from
the benefits of economic progress;
Whereas overt racism was embedded in the development of
medical science and medical training during the 18th,
19th, and 20th centuries, causing disproportionate phys-
ical and psychological harm to members of racial and
ethnic minority groups, including—
(1) the unethical practices and abuses experienced
by Black patients and research participants, such as the
Tuskegee Study of Untreated Syphilis in the Negro Male,
which serve as the foundation for the mistrust the Black
community has for the medical system; and
(2) the egregiously unethical and cruel treatment of
enslaved Black women who were forced to be the subject
of insidious medical experiments to advance modern gyn-
ecology, including those perpetuated by the so-called ‘‘fa-
ther of gynecology’’, J. Marion Sims;
Whereas structural racism cemented historical racial and eth-
nic inequities in access to resources and opportunities,
contributing to worse health outcomes;
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Whereas examples of structural racism include—
(1) before the enactment of the Medicare program,
the United States health care system was highly seg-
regated, and, as late as the mid-1960s, hospitals, clinics,
and doctors’ offices throughout the northern and south-
ern United States complied with Jim Crow laws and were
completely segregated by race, leaving Black communities
with little to no access to health care services;
(2) the landmark case Simkins v. Moses H. Cone
Memorial Hospital, 323 F.2d 959 (4th Cir. 1963), which
challenged the use of public funds by the Federal Govern-
ment to expand, support, and sustain segregated hospital
care and provided justification for title VI of the Civil
Rights Act of 1964 (42 U.S.C. 2000d et seq.) and the
Medicare hospital certification program by establishing
Medicare hospital racial integration guidelines that ap-
plied to every hospital that participated in the Federal
program;
(3) that Pacific Islanders from the Freely Associated
States experience unique health inequities resulting from
United States nuclear weapons tests on their home is-
lands while they have been categorically denied access to
Medicaid and other Federal health benefits;
(4) that language minorities, including Spanish-
speaking, Chinese-speaking, and Tagalog-speaking people
in the United States, were not assured nondiscriminatory
access to federally funded services, including health serv-
ices, until the signing of Executive Order 13166 (42
U.S.C. 2000d–1 note; relating to improving access to
services for persons with limited English proficiency) in
2000;
(5) that the COVID–19 pandemic exacerbated eco-
nomic, health, housing, and food security barriers for
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Black, Hispanic or Latino, Asian American, Native Ha-
waiian, Pacific Islander, and Native American house-
holds, which already suffer from disproportionately high-
er rates of food insecurity; and
(6) that members of the Black, Native American,
Alaska Native, Asian American, Native Hawaiian, Pacific
Islander, and Hispanic or Latino communities are dis-
proportionately impacted by the criminal justice and im-
migration enforcement systems and face a higher risk of
contracting COVID–19 within prison populations and de-
tention centers due to the over-incarceration of members
of those communities;
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 groups;
Whereas examples of subtle or implicit racism in the medical
service profession include that—
(1) the history and persistence of racist and nonsci-
entific medical beliefs, which are associated with ongoing
racial inequities in treatment and health outcomes;
(2) implicit racial and ethnic biases within the
health care system, which have an explicit impact on the
quality of care experienced by members of racial and eth-
nic minority groups, such as the undertreatment of pain
in Black patients;
(3) nearly
1
⁄5of Hispanic or Latino Americans avoid
medical care due to concern about being discriminated
against or treated poorly;
(4) the United States health care system and other
economic and social structures remain fraught with bi-
ases based on race, ethnicity, sex (including sexual ori-
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entation and gender identity), and class that lead to
health inequities;
(5) women of color, including Black, Native Amer-
ican, Hispanic or Latina, Asian American, Native Hawai-
ian, and Pacific Islander women, have faced and continue
to face attacks on their prenatal, maternal, and reproduc-
tive health and rights; and
(6) through the early 1980s, physicians routinely
sterilized members of racial and ethnic minority groups,
specifically American Indian and Alaska Native women
(with
1
⁄4of childbearing-aged American Indian and Alas-
ka Native women being sterilized by the Indian Health
Service) and African-American and Latina women, per-
forming excessive and medically unnecessary procedures
without their informed consent;
Whereas structural racism perpetuates racial and ethnic in-
equities in the social determinants of health, which pro-
duces unintended negative health outcomes for members
of racial and ethnic minority groups;
Whereas examples of that structural racism include—
(1) that there are fewer pharmacies, medical prac-
tices, and hospitals in predominantly Black and Hispanic
or Latino neighborhoods, compared to White or more di-
verse neighborhoods;
(2) that environmental hazards, such as toxic waste
facilities, garbage dumps, and other sources of airborne
pollutants, are disproportionately located in predomi-
nantly Black, Hispanic or Latino, Asian American, Na-
tive Hawaiian, Pacific Islander, and low-income commu-
nities, resulting in poor air quality conditions, which can
increase the likelihood of chronic respiratory illness and
premature death from particle pollution;
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(3) that employed Black adults are 10 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 work;
(4) that 1 in 4 American Indian and Alaska Native
people lack health insurance and that Native Hawaiians,
Pacific Islanders, and certain groups of nonelderly Asian
American adults have lower levels of insurance than
White adults;
(5) that several States with higher percentages of
Black, Hispanic or Latino, American Indian, and Alaska
Native populations have not expanded their Medicaid pro-
grams, continuing to disenfranchise minority commu-
nities from access to health care as of the date of adop-
tion of this resolution;
(6) discriminatory housing practices, such as red-
lining, which have, for decades, systemically excluded
members of racial and ethnic minority groups from hous-
ing by robbing them of capital in the form of low-cost,
stable mortgages and opportunities to build wealth, and
the use of financial power by the Federal Government to
segregate renters in public housing;
(7) social inequities, such as differing access to qual-
ity health care, healthy food and safe drinking water,
safe and affordable neighborhoods, education, job secu-
rity, and reliable transportation, which affect health risks
and outcomes;
(8) exclusionary disciplinary practices (such as de-
tention and suspension) in primary education and even
early education settings, which disproportionately affect
children from racial and ethnic minority backgrounds,
particularly Black children; and
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(9) that, as much as 60 percent of the health of a
person in the United States can be determined by their
ZIP Code;
Whereas structural racism perpetuates ongoing knowledge
gaps in data, research, and development, which produces
unintended negative health outcomes for members of ra-
cial and ethnic minority groups;
Whereas examples of that structural racism include that—
(1) most participants in clinical trials are White, so
there is insufficient data to develop evidence-based rec-
ommendations for people from racial and ethnic minority
groups;
(2) medical research equipment and medical devices
are typically developed by majority-White teams and
therefore can have racial blind spots unintentionally built
into their design, rendering them less effective for people
from racial and ethnic minority groups, such as—
(A) electroencephalogram electrodes used in
neuroimaging research do not collect reliable data
when used on scalps with thick, curly hair; and
(B) pulse oximeters produce less accurate oxy-
gen saturation readings when used on fingertips
with darker skin;
(3) a lack of images depicting darker skin in medical
textbooks, literature, and journals contributes to higher
rates of underdiagnosis or misdiagnosis in patients with
darker skin; and
(4) many health-related studies fail to include data
on American Indians, Alaska Natives, Asian Americans,
Native Hawaiians, or Pacific Islanders, or do not
disaggregate data among those groups, leading to their
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invisibility in health data and unjust resource allocation
and policies;
Whereas racism produces unjust outcomes and treatment for
members of racial and ethnic minority groups, with such
negative experiences serving as stressors that over time
have a negative impact on physical health (leading, for
example, to high blood pressure or hypertension) and
mental health (leading, for example, to anxiety or depres-
sion);
Whereas there is evidence that racial and ethnic minority
groups continue to face discrimination in the United
States, examples of which include that—
(1) social scientists have documented racial micro-
aggressions in contemporary United States society, in-
cluding—
(A) assumptions that members of racial and
ethnic minority groups are not citizens of the United
States;
(B) assumptions of lesser intelligence;
(C) statements that convey color-blindness or
denial of the importance of race;
(D) assumptions of criminality or dangerous-
ness;
(E) denial of individual racism;
(F) promotion of the myth of meritocracy;
(G) assumptions that the cultural background
and communication styles of an individual are patho-
logical;
(H) treatment as a second-class citizen; and
(I) environmental messages of being unwelcome
or devalued;
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(2) compared to White Americans, Black Americans
are 5 times more likely to report experiencing discrimina-
tion when interacting with the police, Hispanic or Latino
Americans and Native Americans are nearly 3 times as
likely, and Asian Americans, Native Hawaiians, and Pa-
cific Islanders are nearly twice as likely;
(3) 42 percent of employees in the United States
have experienced or witnessed racism in the workplace;
(4) Muslims, South Asians, and Sikhs were unjustly
targeted for profiling, surveillance, arrest, discrimination,
harassment, assault, and murder after 9/11;
(5) xenophobic rhetoric, including anti-immigrant
rhetoric and the scapegoating of people of East Asian
and Southeast Asian descent for the COVID–19 pan-
demic, resulted in a surge of hate against Asian Ameri-
cans, Native Hawaiians, and Pacific Islanders, including
increased harassment, discrimination, bullying, van-
dalism, and assault;
(6) nearly
1
⁄2of Asian Americans, Native Hawaiians,
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
discrimination; and
(7) more than 50 percent of Hispanic or Latino
adults experience at least 1 form of discrimination due to
their racial or ethnic heritage, such as being treated as
if they were not smart, criticized for speaking Spanish,
told to return to their country, called offensive names, or
unfairly stopped by the police;
Whereas Black people in the United States experience overt
and direct forms of violence that, when not fatal, can
cause severe physical or psychological harm;
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Whereas examples of such forms of violence include—
(1) that Black people are confronted and threatened
by armed citizens while performing everyday tasks, such
as jogging in neighborhoods, driving, or playing in a
park;
(2) that Black people are 3 times more likely to be
killed by police than White people, and police violence is
the sixth leading cause of death for young Black men;
(3) the killings of Tamir Rice, Ahmaud Arbery,
Breonna Taylor, George Floyd, Elijah McClain, Jayland
Walker, Jeenan Anderson, Timothy McCree Johnson,
Jordan Neely, and countless other Black Americans by
law enforcement;
(4) that it took the United States 66 years after the
senseless and brutal murder of 14-year-old Emmett Till
to make lynching a Federal crime;
(5) that, since 2015, mass shootings around the
country, such as in Buffalo, New York, and Charleston,
South Carolina, serve as reminders of the unresolved his-
tory of racism in the United States and highlight the
threats Black people must take into consideration when
going about their daily lives, both when outside their
communities and within those communities; and
(6) the threat of brutality and violence adversely im-
pacting mental health among Black communities;
Whereas American Indians and Alaska Natives experience
historical trauma, systemic oppression, and cultural geno-
cide that, even when not fatal, can cause severe physical
or psychological harm;
Whereas examples of such forms of violence include—
(1) forced relocation, termination, and assimilation
policies, such as boarding schools, that contributed to
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health disparities and legacies of trauma inflicted on in-
digenous people;
(2) the Army attempting cultural genocide by insti-
gating numerous massacres, including the mass execution
of 38 Dakota men in Minnesota, and the murder of 300
Lakota people at the Battle of Wounded Knee, to eradi-
cate American Indians and Alaska Natives;
(3) murder being the third leading cause of death
for Native women, and
4
⁄5of indigenous women experi-
encing violence in their lifetime;
(4) that, since 2016, there have been 5,712 cases of
missing and murdered indigenous women and people
across the United States, including 506 cases in 71
urban cities and 153 cases missing from law enforcement
databases, with those missing cases likely undercounting
the actual number of cases due to the underreporting of
cases within American Indian and Alaska Native commu-
nities;
(5) that the overall death rate from suicide among
American Indians and Alaska Natives is 20 percent high-
er compared to non-Hispanic White populations; and
(6) cycles of violence that have overburdened indige-
nous communities to respond to increased levels of vio-
lence, including gender-based violence, human trafficking,
suicide, and homicide with minimal resources;
Whereas American Indian, Alaska Natives, Hispanics or
Latinos, Asian Americans, Native Hawaiians, and Pacific
Islanders experience racially motivated kidnapping, mur-
ders, and mass violence, such as shootings in Oak Creek,
Wisconsin, El Paso and Allen, Texas, Atlanta, Georgia,
and Indianapolis, Indiana, that, even when not fatal, can
cause severe physical or psychological harm;
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Whereas, throughout the history of the United States, mem-
bers of racial and ethnic minority groups have been at
the forefront of civil rights movements for essential free-
doms, human rights, and equal protection for
marginalized groups and continue to fight for racial, en-
vironmental, and economic justice today;
Whereas racial inequities in health continue to persist be-
cause of historical and contemporary racism;
Whereas public health experts agree that racism meets the
criteria of a public health crisis because—
(1) the condition affects many people, is seen as a
threat to the public, and is continuing to increase;
(2) the condition is distributed unfairly;
(3) preventive measures could reduce the effects of
the condition; and
(4) those preventive measures are not yet in place;
Whereas the Centers for Disease Control and Prevention—
(1) declared racism a serious threat to public health;
and
(2) acknowledged the need for additional research
and investments to address that serious threat;
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 racism; and
Whereas such a declaration requires the response of govern-
ments to engage significant resources to empower the
communities that are impacted: Now, therefore, be it
Resolved, That the Senate— 1
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(1) supports the resolutions drafted, introduced, 1
and adopted by cities and localities across the 2
United States declaring racism a public health crisis; 3
(2) declares racism a public health crisis in the 4
United States; 5
(3) commits to— 6
(A) establishing a nationwide strategy to 7
address health disparities and inequities across 8
all sectors in society; 9
(B) dismantling systemic practices and 10
policies that perpetuate racism; 11
(C) advancing reforms to address years of 12
neglectful and apathetic policies that have led 13
to poor health outcomes for members of racial 14
and ethnic minority groups; and 15
(D) promoting efforts to address the social 16
determinants of health for all racial and ethnic 17
minority groups in the United States; and 18
(4) places a charge on the people of the United 19
States to move forward with urgency to ensure that 20
the United States stands firmly in honoring its 21
moral purpose of advancing the self-evident truths 22
that all people are created equal, that they are en-23
dowed with certain unalienable rights, and that 24
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among these are life, liberty, and the pursuit of hap-1
piness. 2
Æ
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