[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-

[[Page 38847]]
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