Fellowships, grants, & awards. (Announcements).

Environmental Justice: Partnerships for Communication Program

At every stage of life, people who are economically disadvantaged and/or who live or work in areas and occupations where conditions result in greater exposure to hazardous substances suffer disproportionate levels of morbidity and mortality. Research evidence suggests that certain groups, especially minorities and low-income communities, bear an uneven burden of hazardous environmental and occupational stressors. These socioeconomically disadvantaged people suffer the lowest life expectancy and the highest adverse health consequences of inadequate access to high-quality health care. Additionally, they most often experience the highest degree of exposure to environmental agents and frequently have the least information available about the health consequences of exposure to these agents.

Environmental justice refers to the need to remedy the unequal burden of exposure and disease borne by socioeconomically disadvantaged persons in terms of residential exposure to greater-than-acceptable levels of environmental pollution, exposure to occupational hazards, and fewer civic benefits such as sewerage and water treatment. Geographic location plays an important role in environmental exposure of socioeconomically disadvantaged persons. Health problems may be exacerbated by issues relating to geographic location and consequences of the built environment such as the lack of consistent planning, along with negligent or unregulated policies in land use and zoning, the development and expansion of highways near low-income and indigent neighborhoods, and inadequate transportation facilities. A specific underaddressed area of interest to the NIEHS is the public health challenge arising from the health impact of the built environment. For information on the built environment, see http://www.niehs.nih.gov/translat/news.htm.

The lack of resources for early identification of the effects of toxic agents may lead to an increased disease burden among people who are economically least able to cope with it. Most complex chronic health conditions or diseases have an environmental component in their etiology. An amalgamation of factors results in the exacerbation of these health conditions for low-income and minority populations. Many low-income workers are temporary employees or may be employed in substandard workplaces and therefore may receive inadequate workplace protections and occupational health and safety training. These workers may also face language or cultural barriers at the workplace. When this is the case, the community rather than the workplace may be the preferable place to reach these workers to conduct occupational health outreach and intervention programs. For more on occupational health priorities, see http://www.cdc.gov/niosh/nora.html.

The purpose of the Environmental Justice: Partnerships for Communication Program is to strengthen support in the NIEHS and the National Institute for Occupational Safety and Health (NIOSH) for research toward environmental justice for disadvantaged and underserved populations in the United States. One goal of the NIEHS and NIOSH is to understand the influence of economic and social factors on the health status of individuals exposed to environmental toxicants and occupational hazards and the impact on public health. The intent is to promote health research, education, and intervention programs that address improved ways to serve low-income, immigrant, and minority populations who may be disproportionately exposed to environmental and occupational stressors.

This component of the research program in environmental justice is designed to encourage community outreach, training, research, education, and evaluation efforts that will become the catalyst for reducing exposure to or health impacts from environmental and occupational stressors in underserved populations. The main objective of this request for applications (RFA) is to establish methods for linking members of a community who are directly affected by adverse environmental or occupational conditions with researchers and health care providers, and to create partnerships that can address environmental and occupational health problems and develop appropriate research and policy strategies to protect public health.

With this goal in mind, the NIEHS established the Translational Research Program. This effort supports research and education examining the effects and risks to human health from exposure to physical and social environmental agents. The environmental justice agenda, which falls within the Translational Research Program, is one such endeavor that seeks to minimize and prevent adverse health effects from environmental exposures through public outreach and education coupled with innovative research to develop solutions and have significant impact on public health and policy. For further information on the Translational Research Program, see http://www.niehs.nih.gov/translat/envjust/ envjust.htm.

This current effort in environmental justice research will ensure that the community 1) is aware of basic environmental/occupational health concepts, issues, and resources; 2) has a role in identifying and defining problems and risks related to environmental and occupational exposures and stressors; 3) is included in the dialogue and is integral in shaping research and policy approaches to the problem; and 4) actively participates with researchers and health care providers in developing responses and setting priorities for education and intervention strategies.

The issues identified by research in the field of environmental and occupational health include the following: 1) Inner-city poor often live in homes with high lead levels and may also be exposed to higher levels of air pollution. 2) In the United States, toxic waste sites are more frequent in rural, poor counties. 3) Nuclear facilities and chemical plants are often located in rural areas. 4) Exposure to pesticides is another example where rural, socioeconomically disadvantaged populations are at a greater-than-average risk. 5) Disadvantaged neighborhoods may rely on well water that may be polluted with toxic chemicals. 6) Medical care is often inadequate or unavailable to a significant proportion of socioeconomically disadvantaged and minority people. 7) Lead poisoning and the cognitive and developmental damage associated with exposure to lead occur disproportionately among minorities. 8) High blood pressure and prostate cancer are very common among African Americans. 9) Low birth weight and other problems during pregnancy are common among groups of women who do not have access to good prenatal care. 10) Minority and immigrant workers are employed disproportionately in industries with higher injury and illness rates, such as food processing, textile and garment manufacturing, services (including health care services), construction, and agriculture. 11) Both African-American and Hispanic workers have been shown to be disproportionately impacted by workplace injuries and fatalities. 12) Workers exposed to hazardous substances at workplaces with inadequate cleanup facilities can contaminate their homes with toxic substances.

One aim of this program is to facilitate the development of trust needed for establishing effective partnerships among individuals who are adversely impacted by environmental and occupational hazards in a socioeconomically disadvantaged community, researchers in environmental/ occupational health, and health care providers. The collaborative team should then be able to initiate a research program that incorporates all parties and seeks to reduce exposure to or health impacts from environmental and occupational stressors that may manifest in the workplace or home environment.

It is important to note that, because of the wide range of environmental and/or occupational health problems to be addressed and the diversity of affected communities, applications must be multidisciplinary in nature. At least one member of each of the following three personnel groups must have an active and meaningful role in both the development of the application and the conduct of the proposed project: 1) a research scientist in environmental health sciences (including but not limited to those at NIEHS Environmental Health Sciences Centers, NIEHS Centers for Children's Environmental Health and Disease Prevention Research, and NIOSH Educational and Research Centers and Agricultural Research Centers); 2) a primary health care provider directly involved in a community affected by one or more environmental or occupational hazards; and 3) a community-based organization in an area having an underserved population that is adversely affected by an environmental or occupational hazard. This community-based organization must work directly and regularly with the affected community.

The NIEHS and NIOSH have a significant commitment to the support of programs designed to increase the number of underrepresented minority and female scientists participating in biomedical, environmental, and behavioral research. Therefore, applications from minority individuals and women are encouraged. Since the projects are situated in the community, well-established community-based or faith-based organizations are encouraged to consider their capacity to serve as the primary applicant organization. Due to the complex administrative, programmatic, and financial responsibilities 'associated with this role, such groups should contact program staff for guidance.

Over the past nine years, the NIEHS has supported a variety of environmental justice and community-based participatory research programs. These programs have been very successful in achieving open and honest communication between researchers and community members and have had an impact on the health of the public. Working together, researchers and community leaders have been successful in identifying the disproportionate environmental health risks in certain communities and have formulated viable research agendas. A needed step in this process is gaining participation of community members in efforts to understand the problem as well as gather preliminary health and exposure data. Ongoing projects within the Environmental Justice: Partnerships for Communication Program are committed to enhancing community participation in research studies and facilitating communication among environmental/occupational health researchers, community health care providers, and community members.

The two main objectives of the Environmental Justice: Partnerships for Communication Program are to establish methods for linking members of a community who are directly affected by adverse environmental/occupational conditions with researchers and health care providers, and to enable this partnership to develop appropriate research strategies to address environmental/occupational health problems of concern in order to impact public health and health policy.

Development of such community-based strategies to address these health problems requires approaches that are not typically familiar to environmental, occupational, and medical research communities. Customary approaches to risk assessment and management often neglect the knowledge and experience of at-risk populations and the sociocultural context of environmental/occupational hazards. The distinctive needs of individual communities are only rarely considered in identifying environmental/occupational health problems and devising appropriate disease and pollution prevention tactics. In addition, for occupational health, a community setting may be the workplace where the social and political dynamics are very different from a residential community setting. Occupational health researchers generally construct their exposure assessments based on observations and measurements in the workplace and/or documents provided by the employers. In the residential community setting, many of these exposure sources may be unavailable. Underserved populations are often diverse, fragmented, and isolated, making it difficult to obtain their input and to integrate their concerns in decision-making processes. Assays of the health effects of environmental pollution, as well as regulations based on such assays, are often performed with little or no input from the affected community. The purpose of this program is to institute mechanisms to bridge this communication gap. Once communication and collaboration have been achieved, researchers and community members should then develop a research agenda to identify and assess environmental/occupational risks. Establishing and maintaining trust among all partners is important throughout the process, as it will enhance the capacity to collect preliminary health and exposure data.

Because the ultimate goal of this program is to improve health in these populations and reduce the burden of disease, participation of the affected community is essential for both the identification of health risks and the effective implementation of policies to reduce exposure. Applicants are therefore expected to create equitable partnerships among researchers in environmental/occupational health, health care providers, and representatives of low-income or medically underserved communities affected by environmental health problems.

Types of activities that may be proposed include, but are not limited to, the following: 1) development of efficacious methods for risk communication in low-income and underserved communities unfavorably impacted by environmental/occupational hazards; 2) development of community-based, culturally sensitive educational programs to mitigate adverse health effects from environmental toxicants or occupational hazards in low-income and underserved communities; 3) carrying out community-based training to increase environmental and/or occupational health literacy (i.e., awareness of the public in such neighborhoods); 4) training and educating neighborhood health care professionals in the prevention, diagnosis, and treatment of disorders having an etiology related to exposure to hazardous substances (these providers should have a direct role in assisting a community affected by exposure to an environmental or occupational hazard); 5) developing a research agenda to measure population exposure and/or quantify human health impacts; 6) creating a comprehensive plan for an ongoing evaluation from the inception of the project to its completion, including (but not limited to) assessments of both the partnership among various team members and the impact upon policy and public health; and 7) suggesting recommendations for future activities (beyond the period of current funding) to ensure continued participation of community members in research and service programs addressing environmental injustices.

This RFA will use the NIH Education Research Program grant (R25) award mechanism. This RFA uses the nonmodular budgeting format. Applicants must follow the instructions for nonmodular research grants applications. The anticipated award date is 30 July 2004.

The NIEHS intends to commit approximately $1.67 million in fiscal year 2004 to fund 5-6 new and/or competitive continuation grants in response to this RFA. NIOSH intends to commit approximately $500,000 in fiscal year 2004 to fund 2-3 new grants in response to this RFA. An applicant may request a project period of up to four years and a budget for direct costs of up to $225,000 per year. Indirect costs will be paid at 8% of direct costs less appropriate exclusions.

Community-based organizations are especially encouraged to apply. Applicant institutions may fir into any of the following categories: for-profit or nonprofit organizations; public or private institutions, such as universities, colleges, hospitals, and laboratories; units of state and local government; eligible agencies of the federal government; domestic organizations; or faith-based or community-based organizations. Foreign institutions are not eligible to apply.

Usually, only one award under this RFA will be funded at an institution or organization. Although a single institution or organization must be the applicant, a multi-institutional arrangement (consortium) is possible. Such consortia, entailing active participation by more than one organization, are encouraged if there is clear evidence of close interaction and responsible partnership among the participants. Competitive continuation applications from existing grantees in the NIEHS Environmental Justice: Partnerships for Communication Program in their fourth year of support will be accepted for consideration under this RFA. Such applications must follow PHS 398 guidelines for competitive renewal. Such applicants are strongly encouraged to contact program staff for additional guidance.

The deadline for receipt of letters of intent is 17 September 2003, with 17 October 2003 the deadline for receipt of applications. 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. Complete information on this announcement is located at http://grants.nih.gov/grants/guide/rfa-files/ RFA-ES-03-007.html.

Contact: Shobha Srinivasan, NIEHS, Division of Extramural Research and Training, PO Box 12233, MD EC-21, 111 TW Alexander Dr, Research Triangle Park, NC 27709 USA, 919-541-2506, fax: [phone], e-mail: [e-mail]; or Adele M. Childress, CDC, NIOSH, Office of Extramural Programs, 1600 Clifton Rd NE, Executive Park Bldg 24, Rm 1427, MS E-74, Atlanta, GA 30333 USA, 404-498-2509, fax: [phone], e-mail: [e-mail]. Reference: PA No. PAS-03-092