[Federal Register Volume 60, Number 145 (Friday, July 28, 1995)]
[Notices]
[Pages 38844-38847]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-18579]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Announcement 562]
Analytic Studies to Elaborate the Impact of Race, Ethnicity, and
Socioeconomic Status Upon the Health of Minority Populations
Introduction
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 1995 funds for cooperative agreements
to conduct analytic studies to elaborate the impact of race, ethnicity,
and socioeconomic status (SES) upon the health of minority populations
in the United States. Research sponsored by this announcement will
focus on the performance of special studies and analyses of existing
data to:
1. Identify the critical features of SES which determine health,
delineate the mechanisms and processes whereby social stratification
produces disease, and specify the psychological and interpersonal
processes that can intensify or mitigate the effects of social
structure on health behaviors, access to care, and health outcomes;
2. Explore the need for more accurate descriptions of racial and
ethnic status to monitor the differential impact of health policy
changes and system reform on minority subpopulations; and,
3. Increase understanding of the impact of ethnicity on health by
identifying the ways in which SES, cultural factors, and racial/ethnic
variables and discrimination impact on health behaviors, access to
health care, and health outcomes.
The ``Disadvantaged Minority Health Improvement Act of 1990''
(Pub.L. 101-527) which established the Minority Health Statistics
Grants Program and subsequent reauthorizing legislation contained in
the ``Preventive Health Amendments of 1993'' (Pub.L. 103-183),
recognized the need for improved and refined data to monitor and focus
on the differences in health status between and among minority
populations.
The Public Health Service (PHS) is committed to achieving the
health promotion and disease prevention objectives of ``Healthy People
2000,'' a PHS-led national activity to reduce morbidity and mortality
and improve the quality of life. This announcement is related to the
priority area of Surveillance and Data Systems. (For ordering a copy of
``Healthy People 2000,'' see the section ``Where to Obtain Additional
Information.'')
Authority
This program is authorized under section 306(m) of the Public
Health Service Act [42 U.S.C. 242k(m)] as amended.
Smoke-Free Workplace
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products,
and Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking
in certain facilities that receive Federal funds in which education,
library, day care, health care, and early childhood development
services are provided to children.
Eligible Applicants
Applications may be submitted by nonprofit organizations and
institutions, and governments and their agencies. Thus, universities,
colleges, research institutions, hospitals, other public and private
nonprofit organizations, State and local governments or their bona fide
agents, federally recognized Indian tribal governments, Indian tribes
or Indian tribal organizations, are eligible to apply.
Availability of Funds
Approximately $500,000 will be available in FY 1995 to fund
approximately 3 to 7 awards ranging from $50,000 to $200,000. It is
expected that the average award will be $150,000. It is expected that
the awards will begin on or about September 30, 1995, and will be made
for a 12-month budget period within a project period of up to 3 years.
Funding estimates may vary and are subject to change. Applications
requesting funds greater than an upper limit of $250,000 total costs
for any 12-month budget period will be returned to the applicant
without review. Continuation awards within the project period will be
made on the basis of satisfactory progress and the availability of
funds.
Purpose
The purpose of this program announcement is to support special
studies and analyses that will elucidate the impact of race/ethnicity
and SES upon the health of minority populations in the United States.
Research priorities for race/ethnicity and SES have been divided
into several categories. Genetics is an important variable; however, it
diverts attention from the more influential social and environmental
differences which have erroneously been attributed as race differences.
Implicit in these priorities are a number of methodological and
analytical issues, such as finding and
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sampling small groups as well as developing new statistical techniques
to analyze new and existing data, which need to be addressed in order
to investigate these issues:
Special Studies
Special studies of minority population to examine changes
in behavior, wealth, generational (e.g., immigration); historical
(e.g., political, social); population migration (within the United
States/in and out of the United States); family structure, and
lengthening life span.
Focused studies on rare populations to address a need for
a national origin and generational research, and supplemental race and
ethnic descriptors in addition to other identifiers (e.g., the concept
of underserved populations can help to eliminate racial lumping).
Critical synthesis of past theoretical and empirical
research on race and ethnicity and SES.
Studies of the impact of migration, acculturation, and
other processes on the health status of minority groups and subgroups.
Studies of the appropriateness, reliability, and validity
of health measures for particular ethnic groups, taking into
consideration values, beliefs, and externally-imposed factors that need
to be addressed.
Identify and define the intervening mechanisms that link
SES with health service utilization and health status.
Identify and use additional measures of SES on race and
ethnicity classification--including measures of family structure and
living arrangements, new measures of economic status (e.g., wealth, per
capita income), acculturation, residence, labor force participation
(including females), religion/spirituality, alienation, SES in early
life.
Conduct comprehensive studies of stress in family,
residential, and occupational environments including financial strain
and exposure to discrimination.
Studies of populations currently in transition.
Study the use of alternative health resources which
supplant traditional resources.
Conduct research designed to understand and improve self-
reporting of race and ethnicity, including:
--how minority populations self-identify and report (cognitive process,
etc.),
--effects of mixed parentage, and
--effects of self-identification or self-reporting of persons of
biracial or multiracial background.
Test the reliability of race and ethnic information on
vital and medical records (self-reports vs. proxy reports with a focus
on mortality statistics and underreporting).
Conduct research on capturing racial and ethnic
information via provider records.
Conduct special studies and/or analyses to understand the
health of racial and ethnic populations where there are known data gaps
including:
--the effect of age, gender, generation, education, birthplace, on
health status;
--social, economic, environmental (social and physical) and
psychological factors affecting health status;
--mental health and stress;
--sources of medical care, prevention care, and payment mechanisms;
--cultural factors affecting health status (e.g., acculturation,
assimilation, etc.); and
--alternative health care vs. health status outcome.
Conduct research to develop additional or enhanced
predictors of health status that can explain observed differences
between race and ethnic populations, including SES status measures such
as:
--generational status
--measures of family structure and living arrangements
--wealth
--per capita income
--labor force participation (including women)
--SES in early life
--income to needs comparisons
--other variables such as: cultural, environmental, and societal.
Develop and test analytical approaches to better
understand the relationship between race, ethnicity, and SES as they
pertain to or affect health outcomes.
Studies to examine the relationship between self
actualization, self-esteem, social support and health status or
perceived health status among racial/ethnic groups.
Studies to address environmental equity issues, including
psycho/social environments.
Program Requirements
In conducting activities to achieve the purpose of this program,
the recipient will be responsible for the activities under A.
(Recipient Activities), and CDC will be responsible for the activities
listed under B. (CDC Activities).
A. Recipient Activities
Where applicable recipients will involve community-based
organizations, members of the minority population under study, and
researchers from universities or private nonprofit organizations
throughout the research process. Involvement in these activities may
include research design, implementation, analysis, and dissemination of
research results. The applicant must address why the involvement of any
of the above-referenced groups is not relevant to the proposed project.
In addition, all recipients are expected to determine whether their
proposed projects meet the criteria of the Protection of Human Subjects
(45 CFR Part 46) requiring review by an institutional review board
(IRB). If an IRB review is required and the applicant does not have the
capacity to perform an IRB review, the applicant is strongly encouraged
to enter into a partnership with universities or other organizations
with the capacity to conduct an IRB review.
Each recipient will address the activities in one or both of the
following areas, as appropriate:
1. Special studies or analyses
a. Identify a problem or population where there is a unique
opportunity to conduct analytic studies or there are gaps in existing
information as identified through the research literature, ``Healthy
People 2000,'' and/or references cited in the ``Where to Obtain
Additional Information'' section.
b. Identify and define available sources of information and
assistance for performing special studies or analyses (e.g., NCHS and
other Federal organizations, State/local health departments,
universities, survey research organizations, existing Centers of
Excellence, community-based organizations, etc.).
c. Develop the research design, implementation and analytic plans
for the conduct of special studies or analysis. Applicants should
consider the professional acceptability of their methodologic approach
(peer review journals/statistical standards, etc.), specific
expectations of methods used, comparability to national data sources,
and generalizability to other groups or subgroups.
d. Execute the planned study.
e. Disseminate research findings in publications, reports, etc.,
and within the respective community.
B. CDC Activities
1. Assist in the refinement of analytic and research plans.
[[Page 38846]]
2. Make available other information and technical assistance from
government sources, as appropriate.
3. Provide liaison with other government agencies, as appropriate.
4. Provide technical assistance on individual analytic and research
projects, including those conducted by sub-grantees, as appropriate.
Evaluation Criteria
Applications will undergo an initial peer review evaluation
according to the following criteria:
1. The likelihood that new knowledge gained will subsequently
contribute to improvement of the ability of the scientific community to
identify and meet the data needs of the future. Factors to be
considered include: uniqueness of the project objectives and their
consistency with program priorities; and the generalizability of the
project findings. (25 points)
2. Understanding the technical and substantive issues and the
research priorities the project proposes to address; clarity,
feasibility, and practicality of the goals and objectives of the
project as well as the plan to meet them. (20 points)
3. Soundness, practicality, and feasibility of the technical
approach to the work, including how the tasks are to be carried out,
anticipated problems and proposed solutions; conformance with accepted
scientific standards, principles and techniques; and the feasibility
and appropriateness of the proposed evaluation plan and mechanism. (20
points)
4. Substantial involvement of community-based organizations and
indigenous populations in the research project; links to existing
research networks and infrastructures at the local, State and/or
national level. (20 points)
5. Capabilities of the proposed investigators, including
qualifications, relevant experience in the content and execution of the
proposed project, and adequacy of project management to keep project on
track and on schedule. (15 points)
A second-level program review will be conducted by senior Federal
staff on applications referred from the initial review. All referred
applications will be evaluated on an individual basis according to the
criteria below:
1. The results of the objective review.
2. Balance in addressing the various racial and ethnic groups and
geographic areas.
3. Non-duplication of currently-supported research activities.
4. Generalizability and comparability of research results.
5. Match with available technical assistance.
6. Impact on program budget.
Awards will be made based on merit and priority score ranking by
the peer review, program review by senior Federal staff, and the
availability of funds.
Executive Order 12372 Review
This program is not subject to the Executive Order 12372 review.
Public Health System Reporting Requirements
This program is not subject to the Public Health System Reporting
Requirements.
Catalog of Federal Domestic Assistance Number
The Catalog of Federal Domestic Assistance Number is 93.283.
Other Requirements
Paperwork Reduction Act
Projects that involve the collection of information from 10 or more
individuals and funded by the cooperative agreement will be subject to
review by the Office of Management and Budget (OMB) under the Paperwork
Reduction Act.
Human Subjects
If the proposed project involves research on human subjects, the
applicant must comply with the Department of Health and Human Services'
Regulations, 45 CFR Part 46, regarding the protection of human
subjects. Assurance must be provided to demonstrate that the project
will be subject to initial and continuing review by an appropriate
institutional review committee. In addition to other applicable
committees, Indian Health Services (IHS) institutional review
committees also must review the project if any component of IHS will be
involved or will support the research. If any American Indian community
is involved, its tribal government must also approve that portion of
the project applicable to it. The applicant will be responsible for
providing assurance in accordance with the appropriate guidelines and
form provided in the application kit.
Letters of Intent
Although it is not a prerequisite to apply, potential applicants
are encouraged to submit a non-binding letter of intent to the Grants
Management Officer (whose address is given in the section titled
``Application Submission and Deadline''). It should be postmarked on or
before August 15, 1995. The letter should include a brief summary of
the research proposal and the names and addresses of the principal
investigators. This letter does not influence review or funding
decisions. Rather, it enables CDC to effectively plan for the review.
Application Submission and Deadline
The original and five copies of the application PHS form 398 (OMB
Number 0925-0001) or PHS form 5161-1 (OMB Number 0937-0189) must be
submitted to Henry S. Cassell, III, Grants Management Officer, Grants
Management Branch, Procurement and Grants Office, Centers for Disease
Control and Prevention (CDC), 255 East Paces Ferry Road, NE., Room 300,
Mailstop E-16, Atlanta, Georgia 30305, on or before August 31, 1995.
(Note: local governments may use PHS form 5161-1; however, PHS form 398
is preferred. If using PHS form 5161-1, submit an original and two
copies to the address stated above.)
1. Deadline: Applications shall be considered as meeting the
deadline if they are:
(a) Received on or before the deadline date; or
(b) Sent on or before the deadline date and received in time for
submission to the objective review group.
(Applicants must request a legibly dated U.S. Postal Service
postmark or obtain a legibly dated receipt from a commercial carrier or
U.S. Postal Service. Private metered postmarks shall not be acceptable
as proof of timely mailing.)
2. Late Applications: Applications which do not meet the criteria
in 1.(a) or 1.(b) above are considered late applications. Late
applications will not be considered in the current competition and will
be returned to the applicant.
Where to Obtain Additional Information
A complete program description, information on application
procedures, an application package and business management assistance
may be obtained from: David Elswick, Grants Management Specialist,
Grants Management Branch, Procurement and Grants Office, Centers for
Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE.,
Room 300, Mailstop E-13, Atlanta, Georgia 30305, telephone (404)842-
6521.
Programmatic technical assistance may be obtained from Audrey L.
Burwell, Grants Coordinator, National Center for Health Statistics,
Room 1100, 6525 Belcrest Road, Hyattsville, Maryland 20782, telephone
(301)436-
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7062 (E-mail address: [email protected]).
Please refer to Announcement Number 562 when requesting information
and submitting an application.
Potential applicants may obtain a copy of ``Healthy People 2000''
(Full Report; Stock No. 017-001-00474-0) or ``Healthy People 2000''
(Summary Report; Stock No. 017-001-00473-1) referenced in the
``Introduction'' through the Superintendent of Documents, Government
Printing Office, Washington, DC 20402-9325, telephone (202)512-1800.
Information regarding the ``Directory of Minority Health Data
Resources of the Public Health Service'' may be obtained from an
information specialist at the Office of Minority Health Resource
Center, P.O. Box 3733, Washington, DC 20013-7337, telephone 1-800- 444-
6472.
Information regarding the ``1992 NCVHS Annual Report and the
Minority Health Statistics Grants Program Factsheet'', ``Setting a
Research Agenda: Challenges for the Minority Health Statistics Grants
Program'', and ``Race and Ethnic standards for Federal Statistics and
Administrative Reporting'' may be obtained from Sara Lewis, Program
Analyst, National Center for Health Statistics, Room 1100, 6525
Belcrest Road, Hyattsville, Maryland 20782, telephone (301)436-7062 (E-
mail address: [email protected]).
Dated: July 24, 1995.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for
Disease Control and Prevention (CDC).
[FR Doc. 95-18579 Filed 7-27-95; 8:45 am]
BILLING CODE 4163-18-P
