CENTERS FOR POPULATION HEALTH AND HEALTH DISPARITIES
 
RELEASE DATE:  April 1, 2002 (see NOT-ES-02-012)
 
RFA:  ES-02-009
 
National Institute of Environmental Health Sciences (NIEHS) 
 (http://www.niehs.nih.gov/)
National Cancer Institute (NCI)
 (http://cancer.gov/)
National Institute on Aging (NIA)
 (http://www.nia.nih.gov/)
Office of Behavioral and Social Sciences Research (OBSSR) 
 (http://obssr.od.nih.gov/)

LETTER OF INTENT RECEIPT DATE:  July 29, 2002

APPLICATION RECEIPT DATE:  August 29, 2002
 
THIS RFA CONTAINS THE FOLLOWING INFORMATION

o Purpose of this RFA
o Research Objectives
o Mechanism(s) of Support 
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Special Requirements 
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations
o References

PURPOSE OF THIS RFA

The purpose of Centers for Population Health and Health Disparities (CPHHD) 
is to support inter-disciplinary research leading to an understanding and 
reduction of health disparities in domestic populations.  Applicants are 
invited to propose multi-level, integrated research projects that will 
elucidate the complex interactions of the social and physical environment, 
mediating behavioral factors, and biologic pathways which determine health 
and disease.  CPHHD are expected to create an environment conducive to 
interdisciplinary and reciprocally beneficial collaborations among biomedical 
scientists, social scientists and affected communities with the common goal 
of improving population health and reducing health disparities.  

For the purposes of this proposed Centers Program, the physical environment 
includes the natural environment and built structures, as well as physical, 
chemical, and biological agents (e.g., radiation, pesticides, infectious 
agents, food supply, and pharmacological agents) to which individuals are 
exposed.  The social environment includes individual, institutional, and 
community-level characteristics [e.g., socioeconomic status (SES), education, 
coping resources and support systems, residential factors, institutional and 
political forces, racial discrimination, and familial and cultural factors].

This RFA draws on the recommendations contained in the strategic plans of the 
sponsoring National Institutes of Health (NIH) institutes concerning health 
disparities [1], those submitted to NIH from the conference entitled "Toward 
Higher Levels of Analysis: Progress and Promise in Research on Social and 
Cultural Dimensions of Health" [2], and those highlighted by numerous recent 
National Academy of Sciences and Institute of Medicine Reports [3-11].

This is a trans-NIH RFA sponsored jointly by the National Institute of 
Environmental Health Sciences (NIEHS), the National Cancer Institute (NCI), 
the National Institute on Aging (NIA, and the Office of Behavioral and Social 
Science Research (OBSSR).  Applicants are encouraged to propose research 
across disease outcomes or health-related issues relevant for these 
Institutes. 

RESEARCH OBJECTIVES

Background    

Remarkable advances in understanding human biology and its interaction with 
behavior and social factors have been made in recent decades.  The mapping of 
the human genome will undoubtedly provide a platform for further discovery 
and progress in disease prevention, early detection, diagnosis, treatment, 
and for increasing active life expectancy.  However, these discoveries will 
not reach their full potential without an effective long-term strategy for 
gaining knowledge and preventing disease at the population level [12].  This 
strategy must integrate research in the natural sciences with that in the 
behavioral and social sciences to create a more comprehensive understanding 
of disease pathways from a molecular to a societal level [3], and lead to 
effective measures to prevent disease occurrence and progression, and to 
enhance well-being in all population subgroups, especially those at higher 
risk.

A. Social Determinants of Health

Social determinants refer to factors in the social, cultural, and physical 
environment that interact to influence population health [8,12-13].  Most 
frequently, the impact of the social environment is represented by some 
measure of socioeconomic status.  For almost any measure of SES, a gradient 
in health has been described wherein those at the bottom of the social scale 
fare worse than those at the top [14].  There is no threshold at which SES 
begins to exert an influence, but rather an incremental decrease in morbidity 
and mortality as one ascends the social ladder.  Science cannot fully explain 
this observation.

The disparity in health between socioeconomically disadvantaged individuals 
and those more advantaged has existed for centuries and continues to this 
day.  Disparities are most apparent and closely associated among populations 
with varying levels of socioeconomic status (SES).  The most striking health 
disparities result in shorter life expectancy, as well as higher rates of 
most cancers, some birth defects, infant mortality, asthma, diabetes, 
dementia, impaired functional and cognitive abilities, behavioral and 
affective disorders, and cardiovascular disease.  Disparate health outcomes 
in specific populations will require multi-level analyses to identify and 
describe the mechanisms by which social determinants of health interact with 
the physical environment to influence these adverse health outcomes.

Socioeconomic status has been most often characterized by the complex 
interplay between income, education and occupation.  Other concepts have been 
developed to reflect the influence of societal resources on health.  Social 
capital, for example, refers to the network of societal institutions and 
relationships that together have a positive influence on the function of 
communities and individuals [5,8].  Examples include membership in 
faith-based organizations, civic organizations, neighborhood organizations, 
extended family relationships, and other social networks.  Units of social 
capital for communities could include the overall affluence of the community, 
the quality and condition of schools, neighborhood housing, and quality of 
recreational facilities.  There is a paucity of data concerning the 
interaction between social capital and SES in the causation of health 
disparities, and whether intervening upon social capital is feasible and has 
a potential for improving outcomes and reducing disparities.
 
Psychosocial factors may also help explain the observed relationship between 
SES and health.  For example, health and/or illness may depend less on the 
immediate physical effects of inferior material conditions than of the social 
meanings attached to those conditions, e.g., how people feel about their 
circumstances and how they feel about themselves.  However, psychosocial 
factors are themselves strongly patterned by socioeconomic and other societal 
conditions.  Therefore, considering physical infrastructure rather than its 
psychosocial consequences may be similarly valuable from a public policy 
perspective.  For example, regions with wide economic disparity tend to have 
inadequate investment in human capital and have more adverse health outcomes.  
The relationships between psychosocial factors, social capital and health 
need further study, and targets for effective and feasible interventions need 
to be identified.

Social gradients have been observed for overall mortality and disease-
specific mortality, including cardiovascular diseases and exemplified by 
longitudinal studies of British civil servants [15].  In addition, a 
longitudinal study of Atherosclerosis Risk in the Communities (ARIC) has 
recently reported that even after controlling for personal income, education, 
and occupation, living in a disadvantaged neighborhood is associated with an 
increased incidence of coronary heart disease (CHD).  Although far less well 
studied than cardiovascular disease, inverse gradients in overall and 
specific cancer mortality can also be observed in relation to various 
measures of SES [16].  However, there are important and interesting 
exceptions to this general observation, such as the case of breast cancer 
diagnosis, where the gradient is reversed such that those in the highest SES 
group are at highest risk of developing the disease.  This highlights the 
fact that the relationship between cancer as a group of diseases, and social 
gradients can differ depending on the particular cancer.  Consequently, 
studies of relationships between cancer and environmental variables 
contributing to social disparities may lead to important insights into the 
role of societal factors in health.  

For most chronic diseases and functional disabilities, more research is 
needed to understand the mechanisms by which SES affects health.  An 
excellent example of the interaction between social and physical environments 
in determining children's health status is asthma.  Statistics show that 
asthma prevalence and severity disproportionately affect socially 
disadvantaged populations, including African Americans, Mexican Americans, 
and residents of low-income inner-city neighborhoods. Although racial and 
ethnic differences in asthma prevalence are small nationally, African 
Americans have substantially higher rates of asthma mortality, 
hospitalization, and emergency department visits than Caucasians. Differences 
in indoor allergen (e.g. cockroach, dust mite and mold) sensitivity are 
consistent with racial differences in asthma morbidity. Similar recent 
results suggest that all children living in an urban setting (in contrast to 
rural setting) are at increased risk for asthma, regardless of race, ethnicity 
or low family income. Along with other data, these findings suggest that 
racial and ethnic disparities in housing, community environmental quality, or 
both may play a role in determining national patterns of asthma morbidity.  
Hence, there is an urgent need to address the complex relationship between 
both social and physical environments as major influences of asthma and other 
disorders affecting children. Other examples include Alzheimer's Disease, the 
dementias, and cognitive impairment at older ages, where the relationship 
between SES and these conditions is unresolved.

Cardiovascular disease is the leading cause of death worldwide.  Recent 
studies have demonstrated that living in a disadvantaged neighborhood is 
associated with an increased incidence of Coronary Heart Disease (CHD), even 
after controlling for measures of SES, e.g., personal income, education, and 
occupation.  Additionally, this association remains intact after adjustment 
for CHD risk factors including smoking, hypertension, and body mass index.  A 
social gradient has been observed for both blacks and whites with indications 
that environment is as important as genetics; SES characteristics of 
communities are related to the incidence of CHD and strategies for CHD 
prevention will need to consider community level SES in addition to 
individual-centered approaches.

B. Bio-behavioral Mechanisms 

Although the mechanisms through which the social environment affects the 
biology of health and disease are not well understood, several such 
influences on neural, cognitive, endocrine and immune functions have been 
described.  One theory, which is particularly relevant to cardiovascular 
diseases, suggests that cumulative wear and tear due to an organism's 
repeated need to adapt to external and internal stress, or allostatic load, 
may be an important link between the psychosocial environment and health, 
especially when demands are excessive or physiologic responses inefficient 
[3].  In a longitudinal study of older Americans, lower allostatic load was 
linked to better physical and mental functioning and reduced probability of 
developing cardiovascular disease over time.  However, it is not known 
whether it is possible to intervene on allostatic load, and whether such 
interventions will decrease somatic disease outcome.

A bio-behavioral model of environmental stress and the disease course for 
cancer is still being developed, but parallels in principle the relationships 
postulated for other diseases: long term stresses from the social environment 
lead not only to adjustment difficulties related to cancer after it is 
diagnosed, but may have also influenced pre-clinical biological processes 
leading to incident cancer.  Responses to stress are regulated by 
neuro-endocrine mechanisms, yet individual experience defines the content and 
conditions that give rise to particular responses.  Thus, the context of 
human experience, the social environment, plays an influential role in the 
state of the biological environment.  Specific mechanisms linking stress to 
down- regulation of natural killer cell activity (believed important to host 
anti-cancer defenses), to DNA damage and repair, and the inhibition of 
apoptosis are also under study. 

Mechanisms by which the social environment may contribute to sensitivity or 
resistance to infectious diseases are under investigation.  Previous studies 
using animal models have demonstrated that animals occupying lower ranks in 
the dominance hierarchies of a colony are more susceptible to viral 
infections after exposure to viral pathogens compared to animals of higher 
rank.  These studies and others validate the utilization of animal models in 
studies examining social status/rank and physical exposures.  

Age is a risk factor for many diseases, partly because disease reflects a 
developmental process that takes time to manifest clinically, and partly 
because of normal age changes in the ability of the organism to respond to 
stress, to recover from injury, and in the function of homeostatic 
mechanisms.  Thus, it is important that risks conferred by social environment 
are studied within the context of age effects.  

The biologic pathways through which social determinants affect disease and 
functional outcomes remain to be determined.  The answers will not be found 
by inquiry limited solely to biological or individual behavioral approaches.   
A broader perspective is required that integrates the social and biologic 
sciences to study diseases, chronic morbidity and disability in populations. 
Responses to stress are regulated by neuro-endocrine mechanisms.  An 
interdisciplinary setting is essential so that biomedical, clinical, 
behavioral and social scientists can work together using a shared conceptual 
framework that integrates discipline-specific theories, concepts, and 
approaches to address common problems [17, 18].

Objectives and Scope    

The purpose of the RFA is to support interdisciplinary research leading to 
understanding and reduction of health disparities in domestic populations.  
To achieve this goal CPHHD will support three or more thematically linked 
research projects, facility cores that support two or more projects, an 
administrative core, and pilot projects.  CPHHD will present opportunities to 
concurrently study biological, behavioral, psychological, cultural and social 
precursors of disease. 

A key objective is to generate a research program that embraces the concept 
of 'multiple levels of analysis' [1] in health sciences to examine factors 
operating at the social/environmental, behavioral/psychological, and 
biological (organ system, cellular, and molecular) levels.  Centers should 
propose mechanistic and intervention studies across multiple levels of 
analysis and across diseases and conditions relevant to the mission of the 
sponsoring Institutes.

The theme of a proposed CPHHD may be organized to examine:

o A single condition for which a significant disparity in morbidity and/or 
mortality between populations has been demonstrated (e.g., obesity, infant 
mortality, low birth weight, diabetes, CHD, asthma, cancer), its relationship 
to multiple social and physical environmental determinants and their 
mechanistic pathways; or

o A particular category of social environmental determinant (e.g., food 
supply, urban crowding, built environment, social support) and mechanistic 
pathways by which it affects multiple health outcomes for which disparities 
have been demonstrated between populations.

Although not required, applicants are encouraged to take advantage of defined 
geographic areas of study and existing high-quality population-based disease 
registries in developing these investigations. 

This RFA supports research across multiple levels of analysis.  Applicants 
must develop a thematic focus that can be carried across population(s), 
behavior, and biologic pathways for the diseases or conditions under study.  
At least two of the following levels must be addressed in proposed research 
projects.

A. Social/Environmental Level

More needs to be learned about the effects of social networks, social 
capital, racism and other forms of social injustice at the population level 
on risk factor behaviors, disease incidence, and stage of disease at 
diagnosis.  This includes the influence of social policies, the impact of 
social hierarchies, and factors related to control in the workplace.

Population health models [9] are needed for investigations that include: the 
community as a unit of analysis; measurements of cumulative social, physical 
and behavioral antecedents or exposures; the characteristics of "healthy 
communities" and health-promoting environments; characteristics of "toxic" 
community environments and interventions to remedy these conditions; 
protective factors and mechanisms promoting positive health outcomes and 
disease prevention; human resilience, resistance to disease, and factors 
supporting positive health behaviors.

The role of the health care system in contributing to disparities in disease 
outcomes is important, but will be supported by this RFA only when integrated 
with studies of social and physical environmental factors.  The relative 
impact of the health care system may be compared to underlying social and 
behavior characteristics of the population prior to diagnosis of disease. 
Although the focus of this RFA is on domestic populations, international 
comparisons of health systems combined with other sociocultural, economic or 
physical environmental factors may shed light on determinants relevant to 
domestic populations and are within the scope of this announcement.  

Studies of multi-generational patterns of social and physical exposures and 
their mediating biological and behavioral pathways on relevant health 
outcomes are encouraged.  Analytic studies that elucidate the links between 
social relationships and gene expression [3], and longitudinal studies that 
link cumulative social relationship profiles with biological and 
pathophysiologic effects may be pursued.

Examples of activities relevant to the sponsoring Institutes include but are 
not limited to:

o Examining differential social gradients for specific cancer sites and the 
contribution of known risk factors to these gradients.

o Identifying and elucidating pathways by which the built environment, which 
includes physical aspects such as streets, sidewalks, transportation systems, 
buildings, architecture, land use planning, signage and landscaping, exerts 
influence on persons with functional disabilities, and on diverse health 
outcomes such as infant morbidity and mortality, asthma, perturbations of the 
immune system, degenerative or developmental neurological disorders, 
cognitive disorders, behavioral disorders, sensory impairment, and 
cardiovascular disease.

o Elucidating the role of the social and physical environments and behavioral 
and biologic pathways in explaining the persistent disparities in cervical 
cancer mortality.  What is the interplay of social norms and culture in the 
sexual transmission of the human papilloma virus, the practice of pelvic 
examinations and Pap smears, and societal barriers to adequate treatment?

o Evaluating whether social class or other social factors affect the 
availability and efficacy of therapeutic interventions for diseases such as 
sickle cell disease, which predominately affect specific population 
subgroups.

o Increasing emphasis on the collection of biomarkers in epidemiological 
studies of social relationships and health. 

o Examining the consequences of retirement on health and functioning.
Investigating the effects of public versus private retirement programs,
income security of future retirees, and labor supply and demand for older
workers on health disparities in elderly populations.

o Characterizing differentials in income and wealth accumulation for 
sub-populations (such as elderly, racial and ethnic minorities, pre-
retirement workers), and identifying the sources of these differentials and 
their impacts on health status.

B.  Behavioral/Psychological Level

Individual risk behaviors (including poor diet, lack of exercise, smoking, 
alcohol abuse, saving and non-saving behaviors among the elderly) may be 
critical factors in the etiology and progression of chronic diseases.  
However, for purposes of this RFA and to advance our understanding of 
population health, applicants should focus on the factors that affect health 
disparities among population subgroups, rather than solely focus on high-risk 
individuals.  The effectiveness of many interventions is related to social 
factors that determine group behaviors, such as affordability of drugs/foods, 
communication, trust, and cultural beliefs.  Study of response to lifestyle 
and pharmacological interventions will be considered to be within the scope 
of this RFA only if studied in relationship to the context of social, 
cultural, or physical environmental influences on health at a population 
level.  Likewise, studies of tobacco use and cancer will be considered within 
the scope of this RFA only when placed in the context of the multiple 
determinants of cancer and other diseases and when they use a multi-level 
analytic approach (social and physical environment, behavioral, and 
biological).

Examples of relevant activities that involve this level of analysis include:

o Elucidation of the pathways invoked by protective factors and mechanisms 
that act at a population level to result in positive health behavior and 
outcomes, such as the substantially lower incidence of certain cancers in 
Asian and Hispanic populations.

o The extent to which the population prevalence of known risk factors such as 
tobacco use, altered cognitive function, suboptimal diet, low physical 
activity, personality, and inadequate screening practices explain observed 
social gradients in disease incidence, morbidity, and mortality, and 
disability.

C. Biological Levels

The biologic pathways through which social determinants might affect disease 
incidence, severity and outcomes may be studied in diseases for which a 
significant disparity exists.  How do factors in biologic pathways, which 
include genetic, endocrine, and immunologic variables, interact with 
behavioral, psychological, and social influences prior to and after the 
diagnosis?  For example, substantial age and racial/ethnic differences have 
been noted in variability in biological response to certain drugs and 
nutrients (e.g. dietary salt, chemotherapeutics, beta-agonists, beta-
blockers, ACE inhibitors), and effectiveness of many interventions is related 
to social and behavioral factors, such as access to and quality of care, 
affordability of drugs/foods, communication, trust, cultural beliefs.  
Applicants are encouraged to propose studies that examine: genetic 
susceptibility in relation to social characteristics and exposures, and the 
connection to positive and negative health outcomes; and the relationship 
between social conditions and phenotype.

Examples of activities of relevance to the sponsoring Institutes include but 
are not limited to:

o Employing animal models, including application of methods to examine gene 
mutations and gene expression in relation to social and/or physical 
environmental exposures.   

o Identifying and characterizing the social and environmental factors that 
interact with genetic susceptibility to disease and pathophysiologic factors 
to contribute to variation in the prevalence of cancer, cardiopulmonary 
conditions and other chronic diseases.

o Exploring the biological pathways by which various exposures (e.g., 
polychlorinated biphenyls, mercury, lead)  and social and cultural conditions 
influence neuro-developmental and cognitive outcomes.

o Evaluating genetic factors or pathophysiologic mechanisms by which social 
and physical environments contribute to disparities in the prevalence of, 
asthma, CHD, and diabetes in population subgroups.

o Determining whether social factors are equally involved in differential 
cancer prevalence in various subgroups, and elucidate the implications to 
disparities in health.

o Evaluating the interaction between social, cultural, educational or 
lifestyle factors and genetic variability on cognitive decline and dementia 
in older population subgroups.

o Exploring the role of social/environmental factors in explaining observed 
biological variability in response to heart failure, cancer, asthma or other 
therapies.

D.  Methodological Research

Integration of multiple levels of analysis, as previously described, may 
warrant the refinement of existing methodological approaches or the 
development of novel methodological approaches in the conduct of CPHHD 
research projects.  Methodological research is supported by this RFA to the 
extent that it is requisite to the achievement of specific aims outlined in 
CPHHD applications. 

Research at various levels of analysis could be facilitated by methodologic 
advances in areas such as: 

o Development of methods to improve the assessment of physical, 
social, psychological, behavioral, and cultural environmental exposures.  

o Development of innovative and effective ways to integrate qualitative and 
quantitative research methods needed to investigate the complex, 
multi-layered nature of psychosocial, behavioral, and cultural influences on 
health and functioning.

o Development of statistical methods to delineate relationships among 
behavioral, psychosocial, environmental, and biological levels of
analysis.

o Development of the most useful contextual measures of SES at the level of 
neighborhoods or census tracts, how these measures relate to individual SES, 
and how this relationship varies for different disease outcomes.

o Development of design, implementation, and analysis strategies for 
multi-component interventions which include adaptive tuning of duration 
or intensity to achieve optimal effects.

o Development of standardized approaches to assessing the collective health 
of communities.

DESCRIPTION OF A CENTER

Centers established under this RFA will have in common support for the 
following four basic elements: research projects, shared facility core 
resources, an administration core and pilot projects.  For the purpose of 
this RFA, a Center is defined as an interdisciplinary collaborative 
arrangement among a group of scientists located at the same or different 
institutions, committed to conducting at least three individual but 
interrelated and interdependent research projects that address the goals of 
this RFA.  Plans for interaction among the components within Centers must be 
explicitly described.

A. Research Projects

Each Center will minimally support three meritorious research projects with a 
conceptual theme focusing on social determinants of health, population health 
and significant disparate health outcomes.  At least one of these research 
projects must be a community based participatory research project.  Research 
projects must be inter-disciplinary and address at least two levels of 
analysis (i.e., social, behavioral, biological). Projects will bring together 
the skills of basic, clinical, and public health intervention research 
scientists with other population research scientists, such as 
anthropologists, demographers, economists, epidemiologists, psychologists, 
sociologists, historians, and political scientists to support multiple levels 
of analysis within and/or across research projects supported by Center 
funding.  In addition, CPHHDs will be asked to explicitly describe a plan for 
the promotion and support of interdisciplinary planning, implementation and 
synthesis of research across and within individual projects. 
 
Hypotheses and specific aims developed and described in Center applications 
must demonstrate the thematic, inter-disciplinary and collaborative nature of 
the Center proposal. This requirement is meant to promote inter-disciplinary 
collaboration in the development and design of Center research projects as 
well as continued collaboration throughout the duration of Center support.

B.  Community-based Participatory Research

Each Center must support one project that develops, implements, and evaluates 
a Community-based Participatory Research (CBPR) related to the central theme 
of the Center.  These projects can be proposed in the following areas: 
community-based etiology studies of health concerns; community-based exposure 
assessment; and community based prevention/intervention research.  CPHHD 
applicants are encouraged to propose CBPR intervention research where 
scientifically appropriate. 

It is a requirement of this program that academic researchers work together 
with community-based organizations, broadly defined to include environmental 
justice groups, faith-based organization coalitions, parent-teacher 
associations, or other such groups who have organized around environmental or 
health concerns of the community.  Working with local affiliates of regional 
or national disease-based organizations in identifying research concerns is 
also appropriate.  Applications lacking a demonstrable linkage to a 
community-based or local disease-based organization will be considered 
non-responsive and returned without review to the applicant.

This CBPR project, like all other proposed research projects, must 
specifically address all of the following parameters: (a) scientific basis of 
the proposed research and the hypotheses to be tested; (b) sample size 
needed, power considerations, procedures for sample selection, and 
recruitment and retention of study population; (c) detailed description of a 
research design for the proposed intervention or etiologic or exposure 
assessment study; (d) measurement instruments and their reliability and 
validity, considering both process and outcome evaluation; and (e) data 
management and analysis methods.  In addition, it must include the means of 
establishing effective interaction and collaboration with community members.  
Because this project is intended to be community-based and participatory, the 
application must demonstrate specific, existing linkages to community-based 
organizations and specific involvement of community members in development, 
conduct, and interpretation of the research. 
 
Appropriate activities for CBPR projects include but are not limited to the 
following examples:
 
o Testing of worksite or community-based interventions to promote aggregate 
level changes in weight loss and physical activity in populations whose modal 
characteristics put them at higher risk of cardiovascular disease, cancer and 
other chronic diseases.

o Intervention studies among disadvantaged populations that combine 
individual and community approaches to healthy lifestyles by integrating 
psychosocial interventions with traditional management of cardiovascular 
disease risk factors.

o Design and implementation of community-based participatory prevention 
strategies to promote aggregate-level health by changing social and community 
environments (e.g., regulation of smoking in public places, institutional 
policies). 

o Research that identifies sources of health strengths and resilience, as 
well as health risks, among individuals, families, and communities of low SES 
and racial and ethnic minority groups.

o Application of exposure assessment tools to study pathways through which 
behavioral and social factors affect pregnancy outcomes, low birth weight 
incidence, and infant morbidity/mortality and active life expectancy.

C.  Facility Cores

Centers may support shared core resources common to two or more research 
projects.  Each Center may support facility cores that provide a technique, 
service, or instrumentation to enhance ongoing research efforts.  Examples of 
such facilities are: biostatistics, survey research and data analysis, 
pathology, molecular biology, neuropsychology, and exposure assessment.  
Budgeted Center projects as well as research projects external to the Center 
may have access to facility cores.  The application should provide a total 
operational budget for each facility core together with the percentage of 
support requested from the Center grant.  The application should explain the 
organization and proposed mode of operation of each core, including a plan 
for usage, priority setting, allocation of resources, and any applicable 
charge back system.  Allocation among various components of the Center should 
be balanced and well justified.

D.  Administrative Core

The administrative structure should include, in addition to the Center 
Director, a Co-Director, a business manager, an internal steering committee, 
and an external advisory committee.  The external advisory committee should 
consist of a group of three to five scientists, having expertise appropriate 
for the Center's research focus, plus at least one representative from a 
community-based organization involved in the community-based participatory 
research.  At least two-thirds of the external advisory committee members 
should be from outside the grantee institution.  The membership of the 
advisory committee must be approved by the funding agency post review.  Names 
should not be submitted in the application.  Individuals in senior leadership 
positions should provide intellectual, administrative, and scientific 
leadership for the center and are critical to its overall effectiveness and 
evolution.  These individuals should be in place and committed to a defined 
percent effort.  

The administrative core should promote joint planning and evaluation 
activities as well as collaborations and interactions among different 
research cores of the Center.  The Center must have appropriate and adequate 
management capabilities to conduct research and to evaluate the performance 
of the Center in achieving the goals of the RFA.  Objective criteria for 
evaluation including intermediate markers for the potential impact of the 
science conducted by each Center in improving population health and reducing 
health disparities are required as part of this core.  It is anticipated that 
a Center will devote no more than 10 percent of its budget to the 
administrative core.

Pilot Project Program

Funds can be used to provide support for short-term research projects to 
explore the feasibility of new areas of study and to enable investigators to 
collect preliminary data for other funding mechanisms.  Centers may provide 
up to $200,000 per year in direct costs for pilot projects, which based on 
internal peer review, are deemed to have a high potential to lead to more 
fully developed, competitive research projects.  The process of internal 
peer-review must be specified. General conceptual examples of two proposed 
pilot studies should be given; but details of the content of pilot studies 
are not required.  Scientific merit of pilot projects should be evaluated 
based on the potential to address research gaps in the scientific focus of 
the Center.  Management of the program must include a means of announcing its 
availability, a mechanism of scientific merit review, and a record of 
results.  This record must be available to NIH program directors for review 
post-award and final approval of pilot projects after internal review will be 
made by the NIH program director.

MECHANISM OF SUPPORT

Support of this program will be through the P50 Specialized Centers Grant.  
Applicants are encouraged to discuss this mechanism with the Program 
Representatives named below.  As an applicant you will be solely responsible 
for planning, directing, and executing the proposed project.  This RFA is a 
one-time solicitation.  The anticipated award date is April 1, 2003.

This RFA uses just-in-time concepts.  

FUNDS AVAILABLE

The sponsoring Institutes intend to commit approximately $15,000,000  (NIEHS 
$5 million, NCI $8 million, and NIA $2 million) in FY 2003 to fund 7 to 8 new 
grants in response to this RFA.  An applicant may request a project period of 
up to five years and a budget for direct costs of up to $1.3 million per 
year.  This direct cost maximum includes F&A costs associated with consortial 
arrangements.  Because the nature and scope of the proposed research will 
vary from application to application, it is anticipated that the size and 
duration of each award will also vary.  Although the financial plans of the 
participating Institutes provide support for this program, awards pursuant to 
this RFA are contingent upon the availability of funds and the receipt of a 
sufficient number of meritorious applications. 

ELIGIBLE INSTITUTIONS
 
You may submit an application if your institution has any of the following 
characteristics:

o For-profit or non-profit organizations 
o Public or private institutions, such as universities, colleges, hospitals, 
and laboratories 
o Units of State and local governments
o Eligible agencies of the Federal government  
o Domestic
o Faith-based organizations

Foreign organizations are not eligible to apply for this program, although an 
international partnership with a lead domestic institution is possible.  
Minority individuals, women, and persons with disabilities are encouraged to 
apply as principal investigators. 
 
Applications are encouraged from institutions holding other Center grants in 
population sciences from the National Institutes of Health (NIH), Centers for 
Disease Control (CDC), and foundations, since the skills and capabilities of 
these Centers may synergistically strengthen research on social determinants 
of health disparities.  It is expected that consortia of institutions that 
might include medical schools, environmental health science centers, cancer 
centers, schools of public health and community-based organizations will best 
support interdisciplinary CPHHDs.
 
INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS   

Any individual with the skills, knowledge, and resources necessary to carry 
out the proposed research is invited to work with their institution to 
develop an application for support.  Individuals from underrepresented racial 
and ethnic groups as well as individuals with disabilities are always 
encouraged to apply for NIH programs.   
 
SPECIAL REQUIREMENTS 
 
Interaction among different CPHHDs could contribute significantly to the 
objectives of this initiative.  Centers are encouraged to describe creative 
strategies for fostering inter-center collaborations, and for identifying 
overarching scientific and methodological issues.  CPHHD Principal 
Investigators and each research project and core facility leader from each 
Center will be required to attend an annual meeting in the Washington, DC 
metropolitan area, and Research Triangle Park, NC (in alternating years).  
The travel budget should therefore reflect appropriate allocation for this 
activity.  The purpose of these annual meetings will be to share scientific 
information, assess progress, identify and solve common methodological 
problems, identify new research opportunities and consider possible 
strategies for evaluating progress.
 
WHERE TO SEND INQUIRIES

We encourage inquiries concerning this RFA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into three 
areas: scientific/research, peer review, and financial or grants management 
issues:

o Direct your questions about scientific/research issues to:

Suzanne Heurtin-Roberts, Ph.D. M.S.W.
National Cancer Institute 
Division of Cancer Control and Population Sciences 
6130 Executive Blvd., EPN 4054 
Bethesda, MD  20892 
Telephone:  (301) 594-6655 
FAX:  (301) 435-7547
Email:  sheurtin@mail.nih.gov

Frederick L. Tyson, Ph.D.
Scientific Program Administrator
Chemical Exposures and Molecular Biology Branch
National Institute of Environmental Health Science
P.O. Box 12233
111 T.W. Alexander Drive (EC-21)
Research Triangle Park, NC 27709
Telephone:  (919) 541-0176
FAX:  (919) 316-4606
Email:  tyson2@niehs.nih.gov 

Georgeanne E. Patmios, M.A.
National Institute on Aging
Behavioral and Social Research Program
7201 Wisconsin Avenue
Gateway Building, Suite 533
Bethesda, MD  20892-7936
Bethesda, MD 20892-7936
Telephone:  (301) 496-3138
FAX: (301) 402-0051 
Email: patmios@nih.gov

o Direct your questions about peer review issues to:

Linda K. Bass, Ph.D.
Scientific Review Administrator
Scientific Review Branch
National Institute of Environmental Health Sciences
P.O. Box 12233 (EC-30)
111 T.W. Alexander Drive
79 T.W. Alexander Drive, Bldg 4401, Room 3172 (express/courier service)
Research Triangle Park, NC 27709 
Telephone:  (919) 541-1307
FAX:  (919) 541-2503
Email:  bass@niehs.nih.gov 

o Direct your questions about financial or grants management matters to:

Ms. Carolyn K. Mason
Deputy, Grants Management Officer
Grants Management Branch
National Institute of Environmental Health Sciences
P.O. Box 12233 (EC-22)
111 T.W. Alexander Drive
Research Triangle Park, NC 27709 
Telephone:  (919) 541-1373
FAX:  (919) 541-2860
Email:  mason6@niehs.nih.gov

Ms. Crystal Wolfrey
Grants Administration Branch
National Cancer Institute
6120 Executive Boulevard, Suite 243
Rockville, MD 20852 (for express courier service)
Phone:  (301) 496-8634
Fax:  (301) 496-8601
Email: crystal.wolfrey@nih.gov

Ms. Carol Lander
Grants and Contracts Management Office
National Institute on Aging
7201 Wisconsin Avenue, Suite 2N212, MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 496-1472
FAX:  (301) 402-3672
Email: landerC@nia.nih.gov

LETTER OF INTENT
 
Prospective applicants are asked to submit a letter of intent that includes 
the following information:

o Descriptive title of the proposed research
o Name, address, and telephone number of the Principal Investigator
o Names of other key personnel 
o Participating institutions
o Number and title of this RFA 

Although a letter of intent is not required, is not binding, and does not 
enter into the review of a subsequent application, the information that it 
contains allows Participating Institute staff to estimate the potential 
review workload and plan the review.
 
The letter of intent is to be sent by the date listed at the beginning of 
this document.  The letter of intent should be sent to:

Linda K. Bass, Ph.D.
Scientific Review Administrator
Scientific Review Branch
National Institute of Environmental Health Sciences
P.O. Box 12233 (EC-30)
79 T.W. Alexander Drive, Bldg 4401, Room 3172 (express/courier service)
Research Triangle Park, NC 27709 
Telephone:  (919) 541-1307
FAX:  (919) 541-2503
Email:  bass@niehs.nih.gov

PRE-APPLICATION MEETING

Participating Institutes plan to hold a pre-application meeting in the
Summer 2002 to which interested prospective applicants are invited.  Details 
of this meeting will be published in the NIH Guide to Grants and Contracts 
when they become available.

SUBMITTING AN APPLICATION

Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001).  The PHS 398 is available at 
http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive 
format.  For further assistance contact GrantsInfo, Telephone (301) 435-0714, 
Email: GrantsInfo@nih.gov.

USING THE RFA LABEL

The RFA label available in the PHS 398 (rev. 5/2001) application form must be 
affixed to the bottom of the face page of the application.  Type the RFA 
number on the label.  Failure to use this label could result in delayed 
processing of the application such that it may not reach the review committee 
in time for review.  In addition, the RFA title and number must be typed on 
line 2 of the face page of the application form and the YES box must be 
marked. The RFA label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.
 
SENDING AN APPLICATION TO THE NIH

Submit a signed, typewritten original of the application, including the 
Checklist, and three signed, photocopies, in one package to:
 
Center For Scientific Review
National Institutes Of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)
 
At the time of submission, two additional copies of the application must be 
sent to:

Linda K. Bass, Ph.D.
Scientific Review Administrator
Scientific Review Branch
National Institute of Environmental Health Sciences
79 T.W. Alexander Drive, Bldg 4401, Room 3172 (express courier)
Research Triangle Park, NC 27709 
Telephone:  (919) 541-1307
FAX:  (919) 541-2503
Email:  bass@niehs.nih.gov 
 
APPLICATION PROCESSING

Applications must be postmarked by the application receipt date listed in the 
heading of this RFA.  If an application is received after that date, it will 
be returned to the applicant without review.
 
The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application.  The 
CSR will not accept any application that is essentially the same as one 
already reviewed.  This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must 
include an Introduction addressing the previous critique.

PEER REVIEW PROCESS  
 
Upon receipt, applications will be reviewed for completeness by the CSR and 
responsiveness by the NIEHS.  Incomplete and/or non-responsive applications 
will be returned to the applicant without further consideration.

Applications that are complete and responsive to the RFA will be evaluated 
for scientific and technical merit by an appropriate peer review group 
convened by the NIEHS in accordance with the review criteria stated below.  
As part of the initial merit review, all applications will:

o Receive a written critique

o Undergo a process in which only those applications deemed to have the 
highest scientific merit, generally the top half of the applications under 
review, will be discussed and assigned a priority score

o Receive a second level review by the National Advisory Environmental Health 
Sciences Council, the National Cancer Advisory Board, or the National 
Advisory Council on Aging. 
 
REVIEW CRITERIA

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health.  In 
the written comments, reviewers will be asked to discuss the following 
aspects of your application in order to judge the likelihood that the 
proposed research will have a substantial impact on the pursuit of these 
goal. 

A.  Overall Center

Centers must include three or more research projects with a conceptual theme 
focusing on one of the two thematic areas outlined in the RFA.  There must be 
evidence of the potential for a meaningful inter-disciplinary collaboration 
with an integrated identity relevant to population health, the social and 
physical environmental determinants of disease, and health disparities. 

1.  Evaluate the interdisciplinary nature of the proposed research 
activities, integration of the projects around an overarching theme, and 
plans to effectively pursue interdisciplinary research objectives.

2.  Evaluate the plans for active participation of populations such as 
community or tribal groups in the conceptualization, planning, 
implementation, and handling and dissemination of research and findings 
whenever appropriate. 

B.  Research Projects

Reviewers will be asked to evaluate each research project using the criteria 
listed below.  Reviewers are asked to judge the likelihood that the proposed 
research will have a substantial impact on the pursuit of the goals of this 
RFA as implied by the criteria below.  Each criterion will be addressed and 
considered by the reviewers in assigning the overall score for each project:

1.  Significance.  Does this study address an important research objective 
related to social and physical environmental determinants of disease and 
health and disparate health outcomes in domestic populations?  Will this 
study lead to a better understanding of factors influencing population health 
and health disparities?  

2.  Approach.  Are the conceptual research framework, design, methods, and 
analyses adequately developed, well integrated, and appropriate to the aims 
of the project?  Does the applicant acknowledge potential problem areas and 
consider alternative interdisciplinary approaches?  Is there clear evidence 
of significant interdisciplinary interactions in the conception, design, and 
proposed implementation of the project?  How well is collaboration with the 
community documented? Does the project show significant and meaningful 
evidence of attempts to cross and link levels of analysis in the 
conceptualization, design or methods of the project?  Does this attempt show 
promise of being successful and productive?

3.  Innovation.  Does the project show promise in the development of the 
conceptualization of population health and health disparities?  Does the 
project challenge existing paradigms or develop new methods or technologies 
that will move the area of study forward?  Does the study reflect sufficient 
originality, novelty, and innovation to make it highly relevant to the 
overall goals and objectives of CPHHD?

4.  Investigators.  Are all investigators appropriately qualified with 
demonstrated competence to conduct the proposed research?  Is the proposed 
work appropriate to the experience level of the principal investigator and 
other project researchers?  Are the proposed time commitments for all key 
researchers reasonable and appropriately associated with the project?

5.  Environment.  Does the scientific environment in which the work will be 
done contribute to the probability of success?  Do the proposed projects take 
advantage of unique and interdisciplinary features in the scientific 
environment and reach out to useful collaborative arrangements?  Is there 
evidence of adequate institutional support?  Is the project interactive with 
and supportive of other components of the CPHHD conceptually and 
experimentally?  

C.  Community-based Participatory Research (CBPR)

In addition to review criteria for the other research projects, CBPR projects 
will be evaluated on:

1.  Demonstrate extent of community support and liaison.  Rationale for 
selection of the targeted population and documentation of environmental 
health needs and risk factors.  Evidence of access to, interaction with, and 
participation of community members and community leaders in development and 
conduct of the project.  Establishment of collaborative interactions among 
all project participants.  Extent to which the design demonstrates 
sensitivity to cultural and socioeconomic factors in the community.

2.  Demonstration of effective communication channels between researchers and 
community members.  Plans for useful and practical dissemination of project 
activities and findings within the affected community(ies).  Active 
involvement of at least one community based organization is a minimal 
requirement for responsiveness to this RFA.

3.  For intervention projects evaluate the extent to which findings can be 
translated into public health practice and/or policies.  Are links to the 
community within which the research is framed well documented reflecting both 
appropriate levels of support and collaboration?

D.  Facility Cores  

1.  Evaluate overall use of each core by funded by proposed research 
projects. Determine whether projected use is sufficient to warrant 
establishment of the core.  Determine if the usage is balanced and broadly 
based rather than being primarily for the research project(s) of only one or 
a few individuals.

2.  Evaluate the core for its overall importance to research activities in 
the Center. Evaluate whether the core is likely to become of greater or 
lesser importance to center members in the future.  Determine if the facility 
core can contribute to the expansion of research into new areas.
         
3.  Evaluate whether there is sufficient institutional commitment to meet the 
requirements of the core.

4.  Determine if the requests for equipment, supplies, and other items are 
appropriate for the activity of each core.

5.  Evaluate the cost effectiveness and efficiency of use of the core in the 
context of the quality, breadth, and utility of service provided.

6.  Assess the total operational budget of the facility core and the 
percentage of support requested from the Center grant and determine if the 
facility core usage by Center members is proportional to support requested.

7.  Adequacy of qualifications and performance (if applicable) of core 
personnel to conduct high quality, reliable resource operations.

8.  Adequacy of plans for oversight of resources and the prioritization of 
work. 

E.  Administrative Core

1.  Evaluate whether the lines of authority and the administrative structure 
are designed for effective center management.

2.  Evaluate the qualifications, responsibilities, and effectiveness of 
senior leaders. Identify if the percent effort is appropriate.   
             
3.  Evaluate the duties and percent efforts of administrative staff of the 
center in terms of their qualifications and contributions to the specialized 
needs and conduct of the center's research activities.

4. Evaluate the effectiveness of the center's internal planning and 
evaluation activities.  Determine who is involved and the mechanisms used.  
Determine if these activities are documented.  Evaluate how well the 
administrative structure maximizes the Center's capability to take advantage 
of research opportunities. 

F.  Pilot Project Program

1.  Evaluate whether pilot project funds will be used to test innovative 
ideas of particular importance to the development of new ideas within the 
CPHHD.

2.  Evaluate the overall plan for and potential effectiveness of the pilot 
project program in filling gaps in research areas relevant to the scientific 
focus of the CPHHD.

3.  Evaluate the adequacy of the proposed process for continuously reviewing 
and funding a spectrum of pilot projects for their quality, innovativeness, 
interdisciplinary nature and importance to population health and health 
disparities research.

4.  Evaluate the degree to which pilot project funds will be used to 
stimulate projects of an interdisciplinary nature that will promote 
collaborative interactions within the Center.

5.  Evaluate the appropriateness of the budget relative to the scope of the 
proposed pilot project program and potential of the program to generate 
innovative pilot projects on a consistent basis.

G.  Institutional Commitment

1.  Evaluate the effectiveness of the Center as a formal organizational 
component within the institution relative to other organizational components.  
Determine whether the reporting, accountability, and management structure of 
the CPHHD within the institution are equivalent to that of comparable 
organizations within the institution.  Assess the adequacy of institutional 
procedures and plans for monitoring, evaluating, and assuming accountability 
for the general success of the CPHHD.

2.  Evaluate the specific resources provided by the institution such as 
personnel, appropriate facilities, financial support, and other forms of 
support that reflect the level of the institution's commitment to the 
functional stability, continuing development, and success of the Center.

3.  Appraise the adequacy of the institutional infrastructure for assessing 
progress and needs. 

ADDITIONAL REVIEW CRITERIA

In addition to the above criteria, your application will also be reviewed 
with respect to the following:

o PROTECTIONS:  The adequacy of the proposed protection for humans, animals, 
or the environment, to the extent they may be adversely affected by the 
project proposed in the application.

o INCLUSION:  The adequacy of plans to include subjects from both genders, 
all racial and ethnic groups (and subgroups), and children as appropriate for 
the scientific goals of the research.  Plans for the recruitment and 
retention of subjects will also be evaluated.  (See Inclusion Criteria 
included in the section on Federal Citations, below)

o BUDGET:  The reasonableness of the proposed budget and the requested period 
of support in relation to the proposed research.

RECEIPT AND REVIEW SCHEDULE

Letter of Intent Receipt Date:  July 29, 2002
Application Receipt Date:  August 29, 2002
Peer Review Date:  November 2002
Council Review:  January/February 2003
Earliest Anticipated Start Date:  April 1, 2003

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o Scientific merit (as determined by peer review)
o Availability of funds
o Programmatic priorities.
 
REQUIRED FEDERAL CITATIONS 

INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH

It is the policy of the NIH that women and members of minority groups and 
their sub-populations must be included in all NIH-supported clinical research 
projects unless a clear and compelling justification is provided indicating 
that inclusion is inappropriate with respect to the health of the subjects or 
the purpose of the research.  This policy results from the NIH Revitalization 
Act of 1993 (Section 492B of Public Law 103-43).

All investigators proposing clinical research should read the AMENDMENT "NIH 
Guidelines for Inclusion of Women and Minorities as Subjects in Clinical 
Research - Amended, October, 2001," published in the NIH Guide for Grants and 
Contracts on October 9, 2001 (http://grants.nih.gov/grants/guide/notice-
files/NOT-OD-02-001.html); a complete copy of the updated Guidelines are 
available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm 
The amended policy incorporates: the use of an NIH definition of clinical 
research; updated racial and ethnic categories in compliance with the new OMB 
standards; clarification of language governing NIH-defined Phase III clinical 
trials consistent with the new PHS Form 398; and updated roles and 
responsibilities of NIH staff and the extramural community.  The policy 
continues to require for all NIH-defined Phase III clinical trials that: a) 
all applications or proposals and/or protocols must provide a description of 
plans to conduct analyses, as appropriate, to address differences by 
sex/gender and/or racial/ethnic groups, including subgroups if applicable; 
and b) investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

The NIH maintains a policy that children (i.e., individuals under the age of 
21) must be included in all human subjects research, conducted or supported 
by the NIH, unless there are scientific and ethical reasons not to include 
them. This policy applies to all initial (Type 1) applications submitted for 
receipt dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
"NIH Policy and Guidelines" on the inclusion of children as participants in 
research involving human subjects that is available at 
http://grants.nih.gov/grants/funding/children/children.htm. 

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS

NIH policy requires education on the protection of human subject participants 
for all investigators submitting NIH proposals for research involving human 
subjects.  You will find this policy announcement in the NIH Guide for Grants 
and Contracts Announcement, dated June 5, 2000, at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

HUMAN EMBRYONIC STEM CELLS (hESC)

Criteria for federal funding of research on hESCs can be found at 
http://grants.nih.gov/grants/stem_cells.htm and at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html.  Only 
research using hESC lines that are registered in the NIH Human Embryonic Stem 
Cell Registry will be eligible for Federal funding (see http://escr.nih.gov).   
It is the responsibility of the applicant to provide the official NIH 
identifier(s)for the hESC line(s)to be used in the proposed research.  
Applications that do not provide this information will be returned without 
review. 

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT

The Office of Management and Budget (OMB) Circular A-110 has been revised to 
provide public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances.  Data that are (1) first produced in a 
project that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA.  
It is important for applicants to understand the basic scope of this 
amendment.  NIH has provided guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application should 
include a description of the archiving plan in the study design and include 
information about this in the budget justification section of the 
application. In addition, applicants should think about how to structure 
informed consent statements and other human subjects procedures given the 
potential for wider use of data collected under this award.

URLs IN NIH GRANT APPLICATIONS OR APPENDICES

All applications and proposals for NIH funding must be self-contained within 
specified page limitations. Unless otherwise specified in an NIH solicitation, 
Internet addresses (URLs) should not be used to provide information necessary 
to the review because reviewers are under no obligation to view the Internet 
sites. Furthermore, we caution reviewers that their anonymity may be 
compromised when they directly access an Internet site.

HEALTHY PEOPLE 2010

The Public Health Service (PHS) is committed to achieving the health promotion 
and disease prevention objectives of "Healthy People 2010," a PHS-led national 
activity for setting priority areas. This RFA is related to one or more of the 
priority areas.  Potential applicants may obtain a copy of "Healthy People 
2010" at http://www.health.gov/healthypeople.

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No. 
93.113, 93.115 and 93.866, and is not subject to the intergovernmental review 
requirements of Executive Order 12372 or Health Systems Agency review.  
Awards are made under authorization of Sections 301 and 405 of the Public 
Health Service Act as amended (42 USC 241 and 284) and administered under NIH 
grants policies described at http://grants.nih.gov/grants/policy/policy.htm 
and under Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92.

The PHS strongly encourages all grant recipients to provide a smoke-free 
workplace and discourage the use of all tobacco products.  In addition, 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities (or in some cases, any portion of a facility) in which 
regular or routine education, library, day care, health care, or early 
childhood development services are provided to children.  This is consistent 
with the PHS mission to protect and advance the physical and mental health of 
the American people.

REFERENCES

1. Documents on the Institutes' Strategic Plans to Reduce or Eliminate Health 
Disparities are available at: 
http://healthdisparities.nih.gov/working/institutes.html

2. Office of Behavioral and Social Sciences Research. Toward Higher Levels of 
Analysis: Progress and Promise in Research on Social and Cultural Dimensions 
of Health. National Institutes of Health, Bethesda, MD 20892, NIH Publication 
No. 01-5020, September 2001. 
http://obssr.od.nih.gov/Conf_Wkshp/higherlevel/conference.html]

3. New Horizons in Health: An Integrative Approach. Singer BH, Ryff CD, 
Editors. Committee on Future Directions for Behavior and Social Sciences 
Research at the National Institutes of Health, National Research Council, 
2001, National Academy Press, Washington, DC.

4. The Unequal Burden of Cancer: An Assessment of NIH Research and Programs 
for Ethnic Minorities and the Medically Underserved.  Haynes MA, Smedley BD, 
editors, Committee on Cancer Research Among Minorities and the Medically 
Underserved. 1999 Institute of Medicine, National Academy Press, Washington, 
DC.

5. Promoting Health: Intervention Strategies from Social and Behavioral 
Research. Smedley BD, Syme SL, editors.  Committee on Capitalizing on Social 
Science and Behavioral Research to Improve the Public's Health 2000, 
Institute of Medicine, National Academy Press, Washington, DC.

6. Hanna, K., Coussens, C.  Rebuilding the Unity of Health and the 
Environment: A New Vision of Environmental Health for the 21st Century. 
Washington, DC: National Academy Press, 2001.

7. Stoto, M.A., Green, L.W., Bailey, L.A. Linking Research and Public Health 
Practice: A Review of CDC's Program of Centers for Research and Demonstration 
of Health Promotion and Disease Prevention. Washington, DC: National Academy 
Press, 1997.

8. Institute of Medicine. Committee on Health and Behavior: Research, 
Practice and Policy Board on Neuroscience and Behavioral Health.  Health and 
Behavior: The Interplay of Biological, Behavioral, and Societal Influences. 
Washington, DC: National Academy Press, 2001.

9. The Aging Mind: Opportunities in Cognitive Research.  Stern PC and 
Carstensen LL, Editors.  Committee on Future Directions for Cognitive 
Research on Aging, Board on Behavioral, Cognitive, and Sensory Sciences, 
National Research Council, 2000, National Academy Press, Washington, DC. 

10. Cells and Surveys: Should Biological Measures Be Included in Social 
Science Research?  Finch CE, Vaupel JW and Kinsella K, Editors.  Committee on 
Population, National Research Council, 2001, National Academy Press, 
Washington, DC. 

11. Racial and Ethnic Differences in the Health of Older Americans.  Martin 
LG and Soldo BJ, Editors.  Committee on Population, National Research 
Council, 1997, National Academy Press, Washington, DC. 

12. Rose, G.  The Strategy of Preventive Medicine.  New York:  Oxford 
University Press, 1992.

13. Marmot, M., Wilkinson, R.G. Eds.  Social Determinants of Health. 1999. 
Oxford University Press, Oxford.

14. Adler NE, Boyce T, Chesney MA, Cohen S, Folkman S, Kahn RL, Syme SL. 
Socioeconomic status and health: the challenge of the gradient. Amer Psych 
1994;49:15-24.

15. Brunner, E.J., Marmot, M.G., Nanchahal, K., et al. Social Inequality in 
Coronary Risk:  Central Obesity and the Metabolic Syndrome.  Evidence from 
the Whitehall II Study.  Diabetologia 40: 1341-1349, 1997.

16. Faggiano F, Partanen T, Kogevinas M, Boffetta P. Socioeconomic 
differencesin cancer incidence and mortality. In Kogevinas M, Pearce N, 
Susser M, Boffetta P, eds. Social Inequalities and Cancer. IARC Scientific 
Publications No. 138. Lyon, France: International Agency for Research on 
Cancer; 1997:65-176.

17. Kahn RL, Prager DJ. Interdisciplinary collaborations are a scientific and 
social imperative. The Scientist. July 11, 1994, p 12.

18. Abrams DB. Transdisciplinary paradigms for tobacco prevention research. 
Nicotine Tob Res 1999;1:S15-S23.

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