[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 789 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 789
To amend the Public Health Service Act to establish an Office of Men's
Health, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 31, 2007
Mr. Towns (for himself, Mrs. Christensen, Mr. Conyers, and Ms. Lee)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish an Office of Men's
Health, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Office of Men's Health Act of
2007''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Introduction.--Men's health in the United States is in
a state of crisis revealing a breadth of health inequities that
warrant national attention. This crisis has led to the need for
an Office of Men's Health within the Department of Health and
Human Services that coordinates the development of effective
strategies and interventions designed to improve the health
determinants as well as reduce and eliminate the widespread
chronic diseases and health conditions that negatively affect
the health of American men.
(A) According to Healthy People 2010, social
determinants of health include education, housing,
labor, justice, transportation, agriculture, and the
environment.
(B) Improving the social determinants that affect
men's health could substantially improve their health
and well-being, as well as the health and well-being of
their families and communities over time.
(2) Women's health.--While the men's health crisis concerns
most if not all men, it also jeopardizes the lives of
individuals in their families and social networks, particularly
women. Women bear the direct and indirect caregiving burden for
the family when male counterparts are unavailable due to
declining health or premature death. Consequently, women's
overall well-being and health are threatened by conditions that
compromise the health and shorten the lives of their male loved
ones.
(3) Gender-related health inequities.--Significant gender
disparities exist in health that should be addressed to improve
the overall health profile of the Nation. While the average
life expectancy for the general population is 77.9 years of
age, women on average live six years longer than men. In some
cases, the life expectancy for men is 20 years less than women,
especially within communities of color.
(A) Overall, men have higher death rates for the
top 10 leading causes of death than women, including
heart disease, cancer, chronic lower respiratory
disease, unintentional injuries, suicide, chronic liver
disease, homicide, and HIV/AIDS.
(B) In addition, men have a cardiovascular disease
death rate 1.5 times higher than women, a lung cancer
mortality rate 1.8 times higher than women, and an HIV/
AIDS death rate that is roughly 3 times higher than
women.
(C) Studies confirm that men are more likely than
women to have less healthy lifestyles, less likely to
seek and obtain needed medical attention, more likely
to engage in risky behaviors, and less likely to
recognize the value of and adhere to preventive health
care practices than women.
(D) Men are at least 25 percent less likely than
women to visit a doctor, and are significantly less
likely to have regular physician checkups and obtain
preventive screening tests for serious acute and
chronic diseases.
(4) Racial and ethnic health inequalities.--Racial and
ethnic inequalities exist in men's health with grave
consequences for our most vulnerable populations.
(A) African American men have the highest incidence
and mortality rates of many forms of cancer, have the
highest levels of high blood pressure in the world, and
are twice as likely as White men to have diabetes, thus
detrimentally affecting their health status and
dramatically reducing their life expectancy.
(B) The life expectancy for African American men is
not only the lowest among all men, but is lower than
that for African American women. Black urban men have
the shortest life expectancy (66.7 years of age),
followed by Southern rural Black men, at 67.7 years of
age.
(C) African American men are more likely to suffer
serious side effects from chronic diseases and have
higher mortality rates from heart disease and obesity
than any other racial or ethnic group.
(D) African American men generally access medical
facilities in later disease stages, thus reducing their
chances for adequate treatment and recovery and
increasing the cost of care. This affects mortality
rates in a wide range of chronic diseases, including
testicular disease and end-stage renal disease related
to diabetes.
(E) American Indian and African American men, 15 to
29 years of age, have higher overall death rates than
Hispanic, White, and Asian American men of the same age
group.
(F) Since 2001, the only men of color for whom HIV
disease is a major cause of death are African Americans
(fourth ranked) and Latinos (tenth ranked).
(G) Diabetes mellitus is the fifth ranked cause of
death for American Indian and Alaska Native men, the
sixth ranked cause among Latino men and White men, and
the seventh ranked cause among Asian and Pacific
Islander men and African American men.
(5) Oral health.--Oral diseases are prevalent among men of
color, particularly African Americans. Men suffer
disproportionately from oral diseases, many of which can be
treated and prevented with appropriate diagnosis and care.
(A) More than 50 percent of African American men
have untreated dental decay compared to only 28 percent
of White men.
(B) African American men have the highest incidence
of oral cancer and the lowest survival rates of any
group.
(6) Mental health.--Mental health is often ignored in
discussions and intervention strategies related to men's
health. However, mental health is an indispensable component of
personal health and well-being. Mental health defines and
affects interpersonal relationships, the ability to adapt and
cope with adversity, and an individual's relationship to his
family, community, and society. The mental health status of men
is a growing concern for this country and can have significant
health consequences. From 1980-1995, the suicide rate among
African American males ages 10 to 14 increased 233 percent,
compared to 120 percent of comparable non-Hispanic White men.
Additionally, research indicates that suicide death rates are
more than four times higher among men than women.
(7) National impact.--Nationally, the men's health crisis
has a profound and often detrimental impact not only on the
health, well-being, and productivity of men, but also on the
strength and viability of the communities in which they live,
work, and do business.
(A) This health crisis has had a negative impact on
the national economy. As a consequence, substantial
additional burdens have been placed upon a significant
portion of our Nation's labor force.
(B) The current men's health crisis is a major
concern for the private sector, labor unions, health
providers, and government--from local governments to
the Federal Government. Both the private sector and the
public sector experience substantial additional costs
related to absorbing the burden of health disparities
related to men. These disparities are exacerbated even
further in terms of men who are unable to afford or
gain access to reliable and appropriate care in their
communities and men of color who bear a dual burden
related to ethnicity and gender.
(C) The inequities in men's health are a core
concern for employers, particularly those offering
health benefits to employees and their dependants.
(i) Men's health issues challenge
employers' efforts to contain the direct and
indirect costs associated with providing health
care insurance for employees.
(ii) Disparities in men's health,
particularly in communities of color, leave men
in the workforce in poorer health and at
greater risk for the most costly chronic and
acute conditions. These communities are
especially at risk for increased rates of
absenteeism and lower rates of productivity for
health-only reasons.
(8) Health insurance.--Access to medical care in this
country is largely predicated upon having health insurance
coverage. Dramatically higher rates of uninsured men of color
have had major consequences for the health of our Nation, our
States, and our communities. This lack of health insurance
creates barriers to access to appropriate health care services
and treatments and may have a profound impact on the health
status and health outcomes of men, their families, and their
communities. Health insurance is a primary source of health
care for both prevention services and treatment of illnesses.
Overall, racial and ethnic minority men are disproportionately
more likely than White men to be uninsured, as well as to
suffer from chronic and acute conditions, and die prematurely
from often preventable conditions during their most productive
life years.
(A) More than half (56 percent) of all Hispanic
men, about 45 percent of all American Indian and Alaska
Native men, 47 percent of all Native Hawaiian and
Pacific Islander men, and 38 percent of all African
American men, 18 to 29 years of age, were uninsured in
2004, compared to 26 percent of all White men in the
same age group.
(B) In 2004, the percentage of all uninsured men of
color, 30 to 44 years of age, was higher than that of
white men of the same age group. The percentage of
uninsured Hispanic men, ages 30 to 44 was more than two
and a half times higher than that of White men in the
same age group. American Indian and Alaska Native men
of the same age group had uninsured rates that were two
times higher than White men.
(9) Health literacy and education.--Providing a culturally
competent and ethnically diverse health care workforce is
likely to improve quality of health care and health outcomes
for men. Additionally, finding ways to better educate men,
their families, and health care providers about the importance
of early detection of male health problems can result in
reducing rates of mortality for male-specific diseases, as well
as improve the health of America's men and its overall economic
well-being.
(A) A majority of men of color, most notably those
with lower levels of education, have difficulty
understanding medical information. Men of color have
reported limited medical literacy. More than half of
African American (54 percent), Hispanic (59 percent),
and Asian (63 percent) men reported that they did not
find information from their doctor's office easy to
understand. Others reported a similar difficulty
understanding the information written on prescription
bottles.
(B) Asian, Pacific Islander, and Latino men, the
men for whom English is more likely to be a second
language, most frequently reported dissatisfaction with
the quality of care received from health care
providers.
(10) Prison health.--The rates for incarcerated men of
color are generally much higher than for White men. Men of
color also enter the prison population suffering from a wider
range of primary and chronic diseases. Men of color, who are
ex-offenders, also return to low-income communities with the
fewest health resources. The unmet health needs of these men
threaten scarce public resources by placing additional burdens
on the health infrastructure of a wide range of urban and rural
communities.
(A) In 2005, the percentage of African American and
Hispanic men who were incarcerated was significantly
higher than the incarceration rate for White men.
(i) Many of these inmates suffer with HIV/
AIDS, hepatitis, and tuberculosis and various
chronic diseases such as diabetes,
hypertension, and asthma.
(ii) Even more male inmates suffer from
undiagnosed or untreated mental illness.
(B) These disproportionate rates of chronic disease
and conditions have a tremendous affect on many low-
income communities, both urban and rural.
SEC. 3. ESTABLISHMENT OF OFFICE OF MEN'S HEALTH.
Title XVII of the Public Health Service Act (42 U.S.C. 300 et seq.)
is amended by adding at the end the following section:
``SEC. 1711. ESTABLISHMENT OF THE OFFICE OF MEN'S HEALTH.
``(a) Establishment.--The Secretary of Health and Human Services
shall establish within the Department of Health and Human Services an
office to be known as the Office of Men's Health, which shall be headed
by a director appointed by the Secretary.
``(b) Personnel.--The Secretary, acting through the Director of the
Office of Men's Health, shall recruit and hire qualified personnel for
the Office, including members of racial and ethnic minority populations
with relevant expertise in men's health issues.
``(c) Coordination With Federal Health Agencies.--The Secretary,
acting through the Director of the Office of Men's Health, shall
collaborate with all relevant agencies and offices of the Federal
Government, including the Institute of Medicine, the National Center
for Health Statistics, and the National Center on Minority Health and
Health Disparities at the National Institutes of Health, the Office of
Minority Health, the Substance Abuse and Mental Health Services
Administration, the Indian Health Service, the Agency for Healthcare
Research and Quality, and others to identify and report on men's health
data, including health disparities for chronic diseases and health
conditions related to men of color.
``(d) Definition.--In this section, the term `racial and ethnic
minority populations' means American Indian or Alaska Native, Asian,
Black or African American, Hispanic or Latino, and Native Hawaiian or
other Pacific Islander populations.''.
SEC. 4. GRANTS.
(a) Authorization.--The Secretary of Health and Human Services
shall make grants to institutions of higher education for the purpose
of--
(1) conducting conferences on men's health;
(2) conducting public education campaigns to reduce health
disparities relating to men's health;
(3) evaluating the effectiveness of government and public
sector resources that focus on men's health; and
(4) reporting on the gaps and problems that men of color
have in utilizing health resources in a city or county.
(b) Priority.--In evaluating grant proposals under this section,
the Secretary of Health and Human Services shall give priority to
proposals from Historically Black Colleges or Universities (HBCU) and
proposals from historically Hispanic, Native American, or other ethnic
colleges and universities.
(c) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $50,000,000 for fiscal year 2008
and each subsequent fiscal year.
SEC. 5. REPORTING.
(a) IOM Study on Men's Health.--
(1) In general.--The Secretary of Health and Human Services
shall enter into an agreement with the Institute of Medicine of
the National Academy of Sciences--
(A) to conduct a comprehensive study on men's
health; and
(B) to submit to the Congress a report on the
results of such study, to be entitled ``Report to the
Nation on Men's Health''.
(2) Contents.--The study conducted under this subsection
shall be a fair and impartial review of the state of men's
health in the United States (including the District of
Columbia, the Commonwealth of Puerto Rico, the United States
Virgin Islands, Guam, American Samoa, the Commonwealth of the
Northern Mariana Islands, the Republic of the Marshall Islands,
the Federated States of Micronesia, the Republic of Palau, and
any other territory or possession of the United States) and
shall--
(A) include information on racial and ethnic
minority men and a focus on African American, Hispanic,
Native American, and Asian and Pacific Island men and
their health disparities;
(B) describe the activities and accomplishments of
the Office of Men's Health;
(C) include statistics and information that
indicate men's health in standard and customary health
categories with commonly used health indices;
(D) provide, in addition to commonly used health
indices, the status of social determinants of men's
health;
(E) include all relevant qualitative materials that
indicate the state of men's health, including
statistical studies, qualitative evaluations, findings,
and program evaluations of current programs and
initiatives of the Department of Health and Human
Services;
(F) draw from both primary and secondary research
resources from local, State, and Federal agencies; and
(G) include updated information relative to the
Institute of Medicine's study entitled ``Unequal
Treatment: Confronting Racial and Ethnic Disparities in
Healthcare''.
(3) Panel of independent experts.--
(A) Establishment.--The agreement under paragraph
(1) shall provide for the establishment of a panel of
independent experts (in this paragraph referred to as
the ``panel'') to assist in the conduct of the study
under this subsection by reviewing and providing
guidance on appropriate outcomes and assessments for
men's health and health disparities of men of color.
(B) Composition.--The agreement under paragraph (1)
shall provide for appropriate representation on the
panel from the racial and ethnic groups covered by the
study under this subsection.
(b) Annual Reporting.--Subsequent to the submission of the report
required by subsection (a)(1)(B), the Secretary of Health and Human
Services, acting through the National Institutes of Health and the
Director of the Office of Men's Health, shall submit an annual report
to the Congress that--
(1) includes the same extent of information on men's health
as is included in the Secretary's annual reporting to the
Congress on women's health; and
(2) uses analytical tools similar to those used in such
reporting on women's health.
(c) National Healthcare Disparities Report.--In each report
submitted under section 903(a)(6) of the Public Health Service Act (42
U.S.C. 299a-1(a)(6)), the Director of the Agency for Healthcare
Research and Quality shall include analysis of available data on
racial, ethnic, and geographic disparities in men's health, including
rates for uninsured populations, heart disease, cancer, chronic lower
respiratory disease, unintentional injuries, mental health and suicide,
oral and dental health, chronic liver disease, and HIV/AIDS.
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