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Public Statements

Statements on Introduced Bills and Joint Resolutions

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Date:
Location: Washington, DC

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - September 29, 2006)

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Mr. OBAMA. Mr. President, I rise today to join my colleague from South Carolina, Senator Jim DeMint, in introducing the Education Opportunity Act.

We often hear that many students who graduate from high school are not ready for the academic rigors of college. This is especially problematic for students from low-income families. For these students to succeed in the transition to college, they must have opportunity, and a continuity of classroom experiences that prepare them for success. Academic rigor in a high school curriculum is essential in establishing the momentum necessary for a student to progress toward a bachelor's degree.

The unfortunate fact is that not all students have access to a challenging high school curriculum. Low-income students are often disadvantaged by a lack of rigorous courses in their high school, especially in subjects such as the advanced mathematics courses that are so important for college success. Universities and community colleges have increasingly provided such courses to high school students. But the cost of such classes can be a barrier to low-income students, who are the very students most likely to be enrolled in high schools that provide the most limited access to challenging college preparatory curricula.

This legislation will provide a program for grant support to allow thousands of students with limited exposure to college-level programs in their high schools to earn college credit at their local university or community college. I urge my colleagues to join us in extending opportunities for college success to deserving low-income high school students.

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Mr. OBAMA. Mr. President, for forty years the civil rights activist Fannie Lou Hamer rallied the Nation with her statement ``I am sick and tired, of being sick and tired.'' She would be disheartened to know the extent to which her words are still resonating with millions of Americans today. Whether we are talking about African Americans, Latinos, Asians or American Indians, the fact is that minorities continue to suffer a greater burden of disease and die prematurely. African Americans are one-third more likely than all other Americans to die from cancer, and have the highest rate of new HIV infection. One in 3 Latinos has no insurance coverage. Fifty percent of Americans suffering from chronic hepatitis B are Asian. And among many American Indian tribes, the rate of diabetes has hit epidemic proportions, with rates near 50 percent in certain tribes. The state of minority health in this Nation is deplorable, and by many measures, is getting worse.

Researchers have contributed a substantial body of work that has increased our understanding of the factors contributing to poor health. Higher rates of uninsurance are one such factor. Racial and ethnic minorities, particularly African Americans and Latinos, are significantly more likely to be uninsured. This lack of access to care leads to delayed or foregone care, and according to the Institute of Medicine, is the 6th leading cause of death in this Nation for adults aged 25-64. But equally disturbing, an overwhelming number of studies have shown that regardless of insurance status, minorities are more likely to receive low quality health care, and as a consequence, suffer worse health outcomes.

The Institute of Medicine's 2002 historic report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, documented persistent and pervasive disparities in health care for minority groups, even after adjusting for differences in insurance status and socioeconomic factors. The American Journal of Public Health has reported that more than 886,000 deaths could have been prevented from 1991 to 2000 if African Americans had received the same level of health care as whites. In contrast, the same study estimates that technological improvements in medicine--including better drugs, devices and procedures--prevented only 176,633 deaths during the same period.

African Americans are not the only minorities getting worse care. Data has shown, for example, that compared to white Americans, Mexican Americans receive 38 percent fewer heart medications, and American Indians get recommended care for only 40 percent of quality measures. The bottom line is that although the level of health care quality is mediocre at best for all Americans, it is much worse for minority groups. And this is unacceptable.

For these reasons, I am joining my colleagues Senator FRIST and Senator KENNEDY in introducing the Minority Health Improvement and Health Disparity Elimination Act. This critical legislation has a number of important provisions to help address the dismal health status of minority and other underserved populations. First, this bill strengthens education and training in cultural competence and communication, which is the cornerstone of quality health care for all patients. It also reauthorizes the pipeline programs in Title VII of the Public Health Service Act, which seek to increase diversity in the health professions. We all know that the door to opportunity is only half open for minority students in the health professions. The percentage of minority health professionals is shockingly low--African Americans, Hispanics and American Indians account for one-third of the Nation's population but less than 10 percent of the Nation's doctors, less than 5 percent of dentists and only 12 percent of nurses. We can do better, and we must.

Lack of workforce diversity has serious implications for both access and quality of health care. Minority physicians are significantly more likely to treat low-income patients, and their patients are disproportionately minority. Studies have also shown that minority physicians provide higher quality of care to minority patients, who are more satisfied with their care and more likely to follow their doctor's recommendations.

Second, this bill expands and supports a number of initiatives to increase access to quality care. Specifically, the legislation authorizes demonstration projects to help address health disparities in the U.S.-Mexico border region, increase health coverage and continuity of coverage, identify and implement effective disease management strategies, train community health workers, and increase enrollment of minorities in clinical trials. The REACH program at the Centers for Disease Control and Prevention, and the Health Disparity Collaboratives at the Bureau of Primary Health Care are authorized in statute. And I am pleased that the Community Health Initiative has also been authorized. This new environmental public health program is modeled after the Health Action Zones in the Healthy Communities Act, S. 2047, that I introduced a year ago, and guides and strengthens community efforts to improve health in comprehensive and sustained fashion.

A third area of focus is expansion and acceleration of data collection and research across the agencies, including the Agency for Healthcare Research and Quality and the National Institutes of Health, with special emphasis on translational research. The tremendous advances in medical science and health technology, which have benefited millions of Americans, have remained out of reach for too many minorities, and translational research will help to remedy this problem. The National Center on Minority Health and Health Disparities, which has a leadership role in establishing the disparities research strategic plan at the National Institutes of Health, is reauthorized, and a new advisory committee has been established at the Food and Drug Administration, to focus on pharmacogenomics and its safe and appropriate application in minority populations.

Last but not least, I want to highlight that the bill reauthorizes the Office of Minority Health and Health Disparity Elimination. This Office has been critical in providing the leadership, expertise and guidance for health improvement activities within the agencies of the Department of Health and Human Services, and has helped to ensure coordination, collaboration and integration of such efforts as well.

In conclusion, I want to note that this is the first bipartisan effort on minority health and health disparities since 2000, when the Congress passed the last minority health bill. That bill accelerated the research that documented the full scope and magnitude of disparities in health and health care in this Nation, and more importantly, helped us understand why these disparities occur. But it is time for the next step. We've got to translate the knowledge we have gained into practical and effective interventions that will improve minority health and eliminate disparities, and this bill will help us do just that.

I urge my colleagues to join me in cosponsoring and passing this critical legislation. Regardless of how you measure it--whether by needless suffering, lost productivity, financial costs, or lives lost--disparities in health and health care are a tremendous problem and moral imperative for our Nation, and one that is within our power to address right now. On behalf of the millions of Americans who continue to be sick and tired of being sick and tired, I ask you to join me in voting yes to pass this bill.

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