Fighting for Inclusion: H.R. 2730 and Health Equity for MENA Americans
By: Matthew Jamil
Executive Summary
In the United States, people of Middle Eastern and North African (MENA) descent lack representation in many areas, including healthcare. This lack of representation in healthcare can lead to many negative effects on MENA people’s physical well-being, as they can be predisposed to various health issues. In supporting the Health Equity and MENA Community Inclusion Act of 2023, H.R. 2730, a bill that would mandate MENA to be a racial category in medical settings, these negative effects can be avoided by giving MENA individuals representation and delivering more equitable healthcare for members of the community.
Legislative History
People have been immigrating to the United States from the Middle East and North Africa for a long time, but most notably, a large wave of MENA immigrants arrived in the late 19th century as a result of Detroit’s massive automotive boost. It is now estimated that over three million MENA Americans live in the United States, but none of them are officially considered Middle Eastern or North African in the context of the census, or in many cases, in healthcare settings. Although MENA is a large and diverse category, it is underrepresented and virtually ignored, especially in healthcare. This lack of representation and the categorization of MENA people as being “white” in healthcare has resulted in poor research and care for MENA individuals. This has led to a lack of knowledge about how MENA people might be predisposed to various medical conditions, resulting in inadequate care in some cases. A recent study has determined that the following health risks can disproportionately impact MENA people:
Prone to excessive tobacco and alcohol use.
Lacking vaccine knowledge compared to other ethnic groups causes fewer MENA people to become vaccinated and more to get sick.
High risk for diabetes compared to other racial groups.
Higher chance of having mental health problems due to racism, generational trauma, stigma, etc.
Higher risk for late-stage breast cancer, thyroid cancer, lung cancer, prostate cancer, and bladder cancer compared to other racial groups.
Higher risk for cardiovascular and heart diseases.
These health risks carry a significant weight. If MENA people were considered a racial category in healthcare settings, then medical professionals would be able to spot some of these increased health risks sooner, thus delivering proper and equitable care to all patients. For example, during the COVID-19 pandemic, the Centers for Disease Control (CDC) was able to determine that Native Americans were at a higher risk for COVID-19 because they are considered a racial category. Because healthcare providers knew this information, they were able to provide Native Americans with extra resources during the pandemic. Additionally, by recognizing MENA as its own category, further and more widespread research can be conducted on more health conditions, helping to address the data shortage for this demographic.
H.R. 2730 aims to solve this healthcare problem by amending the Public Health Service Act to include Middle Eastern and North African as a racial and ethnic group. Currently, MENA people are categorized as white, which can have various negative effects on their health as mentioned throughout this section. Creating a distinct category for MENA individuals would allow healthcare professionals to:
Treat MENA people while taking into account conditions they might be predisposed to.
Expand research on different health risks that MENA people might be at risk for.
Increase education to MENA people about various health conditions they are at risk of.
H.R. 2730 is an amendment to the Public Health Service Act of 1944, which broadly aims to provide the opportunity for the government to intervene in public health concerns. It is a critical piece of policy that helps to promote the overall health of the population. The Public Health Service Act of 1944 has been amended numerous times to add to the very important nature of the original act.
H.R. 2730 was proposed in April 2023 by Democratic Congresswoman Rashida Tlaib from Michigan’s 12th District. It has since been referred to the House Energy and Commerce Committee for further debate. If the bill makes it out of committee, it will be brought to the House floor for further debate.
The bill has been cosponsored by seven different members of Congress, but this is not nearly as much support as it needs in order to make it out of committee. As of February 3, 2025, the co-sponsors are Debbie Dingell (D-MI-6), Anna Eshoo (D-CA-16), Robin Kelly (D-IL-2), Luis Correa (D-CA-46), Janice Schakowsky (D-IL-19), Katie Porter (D-CA-46), Daniel Kildee (D-MI-8), Alexandria Ocasio-Cortez (D-NY-14), Betty McCollum (D-MN-4), Lori Trahan (D-MA-3), Eleanor Holmes Norton (D-DC), Jesus G. Chuy Garcia (D-IL-4). Most of the members of Congress who support this bill represent districts with high numbers of people who come from Arab ancestry according to the U.S. Census Bureau. All of the supporters of the bill also happen to be Democrats, which is especially interesting when considering that many Republicans represent large groups of people who identify as Middle Eastern or North African. No member of Congress has directly verbalized their opposition to the bill, but there are many political and historical reasons why Republicans and other members of Congress might oppose the bill:
Many members of Congress might be busy with their heavy workload, pushing this bill to the side.
Some members of Congress do not represent a population that has a significant number of MENA individuals and do not see the bill as something that can help their constituents.
In 1909, a group of Middle Eastern Christians won a landmark case that labeled them as white, so that they could avoid racial stereotypes. Their key argument was that if they were Middle Eastern, then so was Jesus, as they come from the same place. White supremacists latched on to this concept, which has also prevented MENA from being represented as a category of race. Some members of Congress might feel the need to uphold the results that came out of this case.
These reasons are apparent, extremely complex, and deeply rooted in systemic issues within the federal government. The reasons why people directly oppose this bill cannot be unveiled until this bill gets more traction in the House, which is what will be discussed in the following section.
To conclude, H.R. 2730 aims to limit inequity for Middle Eastern and North African people in healthcare by ensuring that they are represented as a racial category. This will allow medical professionals to easily identify certain health risks in MENA people, increase education efforts on these health risks, and increase research efforts. While this bill is relatively unsupported, it has some support from members of Congress who represent MENA populations. This bill has no direct opposition, but there is some systemic and historical evidence that can explain why resistance is occurring.
Stakeholders
The people who are most impacted by H.R. 2730 are, of course, Middle Eastern and North African Americans, making them a key interest group. MENA people want to have equitable treatment in healthcare, and this bill would deliver that. As a result, the seven members of Congress who support this bill represent districts that have high MENA populations. This can be for a number of reasons. It is possible that they actually care about the issue and want to help their constituents, or they care about the issue for the sake of garnering votes. Nonetheless, their support for the bill is crucial for the further advancement of equitable healthcare for MENA individuals.
Alternatively, there are various groups that support MENA individuals directly such as the Arab American Civic Council (AACC), the Arab Community Center for Economic and Social Services (ACCESS), and the National Arab American Institute. These groups do policy work and are an additional opportunity to garner support for the bill. The AACC has expressed direct support for H.R. 2730, stating that it is a vital step in addressing concerns of equity for MENA people in healthcare.
Two key interest groups of this bill are research institutions and healthcare professionals. By designating MENA as a racial category, research institutions will be able to better understand risks associated with MENA people’s health and will be better able to recommend solutions to various health problems that might arise. Additionally, healthcare professionals will be able to acknowledge the potential health risks of their MENA patients and provide them with adequate care. The interests of these two groups are rooted in a desire for equitable access to healthcare and overall care for people’s health.
All of the above interest groups assert large amounts of political influence. MENA constituents have the right to be heard by their elected officials. Although no polls have been completed surrounding this issue, many MENA people have voiced their concerns regarding misrepresentation on the Census, which has similar root causes to this issue. Research institutions such as the Centers for Disease Control and the World Health Organization also have some political influence in this case, as they are medical professionals and members of Congress mostly are not. Additionally, the American Medical Association, one of the largest lobbying groups representing doctors, has a significant influence on health policy. In the past, they have supported bills addressing medical racism and inequity, and are committed to providing equitable access to healthcare for all. They most certainly have a way of expressing their opinions on the bill to lawmakers in an influential manner. In this way, members of Congress should trust MENA people’s concerns and medical professionals’ opinions when it comes to considering whether or not this bill is beneficial.
As mentioned previously, seven Democrats support H.R. 2730, which is currently stuck in the House Energy and Commerce Committee. Representative Rashida Tlaib, the main sponsor of this bill, does not sit on the Energy and Commerce Committee and thus does not have much more influence when it comes to getting this bill on the House floor. It is most crucial to take action at this stage of the bill as if it does not get voted out of committee, then it will likely die. For this bill to be successful, the following needs to happen:
Members in the House Energy and Commerce Committee begin to talk about the bill and rally support for it.
The bill garners bipartisan support from Republicans in this committee, as it is currently only supported by some Democrats in the House.
The bill is voted on in committee and sent to the House floor for further debate if it receives a majority vote in favor of the bill.
In simple terms, this is what needs to be done to ensure equitable access to healthcare for MENA individuals, but the strategies that are needed to get to this point are much more complicated. The next section will discuss political strategies that can be implemented to help get this bill passed into law.
Political Strategy
In order to accomplish the goals mentioned in the previous section, a secure political strategy needs to be established. This strategy will enable other members of Congress to get on board with H.R. 2730, and will hopefully garner public support for the bill as well. The following steps should be enacted to ensure that this bill receives the proper attention:
A mix of lobbying organizations and grassroots efforts will target members of Congress who represent large numbers of MENA individuals, especially those who are on the Energy and Commerce Committee.
Members of Congress who already support this bill will continue to spread the word to other members of Congress.
Polls, likely funded by lobbying groups like the American Medical Association, the Arab American Civic Council, and ACCESS will record public interest from MENA communities about H.R. 2730, which will hopefully make Congress see this issue as one that impacts a lot of people.
Research will be used to demonstrate the ways in which MENA people can be disproportionately impacted by various health issues, further showing the importance of this legislation.
This political strategy is loose and broad as it is contingent on various factors. In order to convince a majority of Congress to support this bill, it is first necessary to convince those who might have a deeper stake in this issue. There are two ways to interpret this. Firstly, we can look at the members of Congress who are on the Energy and Commerce Committee. This would enable those who have jurisdiction over the bill to be better informed about it. To be more specific, we can also target members of the Energy and Commerce Committee who represent large numbers of MENA people. Broadly speaking, California, Michigan, and New York have the largest numbers of MENA individuals, but many other specific places have large populations as well. By targeting these individuals, it is more likely that they will become involved, as this bill directly affects their constituents and, in other words, their votes.
Members of Congress who already support this bill will be the primary source of assistance when it comes to spreading the word about this bill, but the use of lobbying organizations can and should be used if the right opportunity arises. Additionally, grassroots campaigns such as the Arab American Civic Council, ACCESS, and the National Arab American Institute would be helpful in spreading awareness of this issue and bill in MENA communities.
In order to convince members of Congress that this is a serious issue that is worth their attention, it is important that quality data and research is used. The first, and most important, piece of research that is needed is evidence that MENA people are disproportionately impacted by various health conditions. There have already been small studies on this that would be a great start. It is harder to find this data, as MENA people are not represented in healthcare, which is one of the solutions that this bill is trying to solve. The second piece of data that needs to be collected is polls from MENA communities that show they care about this issue. This would help to establish this as an issue that voters care about, hopefully giving it a sense of urgency on Capitol Hill.
Discussion
H.R. 2730 is a pivotal piece of legislation that is crucial for the well-being and health of Middle Eastern and North African people in the United States. Without MENA representation in healthcare, MENA people are susceptible to not receiving adequate care and being underresearched compared to other ethnic and racial groups. To put it broadly, this legislation will result in equitable outcomes for MENA people in the following ways:
It will allow medical personnel to be able to treat MENA individuals while taking into consideration the health issues that they might be predisposed to.
It will open up pathways for further research on MENA communities to determine any health risks associated with MENA people.
It will increase education efforts for MENA people who might not understand a variety of health risks.
In these ways, this bill will create equity for MENA individuals by representing them in healthcare. This would be an important milestone in the betterment of the MENA community's health and well-being.
Delivering equity to underserved communities should be the driving force in getting Congress to pass this piece of legislation. Despite this, many members of Congress might feel as if they already have the MENA vote secured and thus do not have to focus on any policy regarding them. This phenomenon, known as electoral capture, is especially true in districts with large MENA populations. As it is currently, MENA people do not have the opportunity to have equitable access to healthcare because they are not even acknowledged in most of these settings and are ignored by their elected officials. This is not the fault of MENA people, but rather the fault of a system that does not believe in their existence. There is a so-called opportunity gap in this situation, where the “problem is not in the abilities” of MENA people, “but in the disparate opportunities” they are given for representation.
Beyond healthcare, a lack of representation in science as a whole can have significant psychological impacts on MENA individuals. By not being represented in these forms, MENA people can feel a sense of otherness and not belonging. They can feel pressured to fit into the “white” category that they are often put in. The thought that they have to identify with the same people who so often push racism on MENA people can be extremely triggering. This can result in MENA people struggling with their identity and even cause them to feel a sense of embarrassment or shame as a result.
These psychological consequences are the opposite result of what this bill aims to fix. This bill aims to solve healthcare problems through representation, but without the bill, more of these healthcare problems ewould xist. In this way, “Representation opens the door for more opportunities, voices and journeys to be heard” resulting in MENA people feeling more confident that they are valued in American society. Congress should value that people feel heard and valued in the United States, especially their constituents.
If H.R. 2730 is not passed, Congress is not only harming the health of MENA people but also upholding generations of systemic and institutionalized racism. This category of racism relies on an active anti-MENA mentality that attempts to make people feel othered, as certain functions of society are built against them. In not passing this legislation, Congress is failing to provide its constituents with the proper resources needed to receive adequate care in a medical setting. Congress has a duty to serve the needs of the people they represent, and by staying neutral on this issue, they are actively contributing to institutional racism, and doing their constituents a disservice.
A large reason why this issue of a lack of MENA representation in healthcare exists is because of a lack of funding. Whether it is good or bad, money is a contributing factor in getting an issue on the policy agenda in Congress. The fact that MENA people are underserved already means that they certainly do not have the proper funds to take charge of this issue. Additionally, this bill is fighting for equitable representation and access to healthcare, and nobody should have to pay money to fight for the right to be heard. In not paying attention to bills like these, politicians are establishing their priority in money rather than the wellness of their constituents.
To summarize, in passing the Health Equity and MENA Community Inclusion Act, H.R. 2730, Congress would be accomplishing the following:
Delivering equity for MENA individuals in healthcare settings.
Reduce the risk of negative psychological effects on MENA individuals due to a lack of representation.
Reduce the amount of institutionalized racism pushed by the federal government.
Bring attention to a policy issue that would otherwise require a large amount of funding.
In this way, Congress is helping to serve a community that is largely underrepresented in the sphere of American politics. Congress has an ethical obligation to serve the American people regardless of race or ethnicity. Congress has a moral imperative to address issues of systemic oppression against Middle Eastern and North African people in the United States, and H.R. 2730 would do just that.
With all of this in mind, it is with the utmost urgency that I recommend Congress passes the Health Equity and MENA Community Inclusion Act in order to deliver equity and quality care to MENA communities nationwide.
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