assessing whether research questions for specific programs are focused on illuminating the particular needs of ethnic minority and medically underserved communities.

The committee found no evidence that NIH calculates total expenditures for research on medically underserved groups, apart from calculations derived for ethnic minority populations. A consistent definition of medically underserved individuals is needed (as discussed above), and calculations of research expenditures for these groups should be based on whether research questions specifically address the unique needs of these populations.

Research on Cancer among Ethnic Minority and Medically Underserved Groups at other ICDS

As noted above, several ICDs are conducting research, either in collaboration with NCI or independently, on cancer among minority and medically underserved populations.

National Institute of Environmental Health Sciences

As noted above, NIEHS supports the second-largest portfolio of cancer-related research at NIH, with overall funding of more than $84 million in FY 1997. Of this amount, NIEHS reports that it allocated $26.7 million to fund 138 extramural projects, including investigator-initiated research, co-funded projects, and Superfund and center grants (described below). Of these, NIEHS reports that 71 awards are relevant to minority and medically underserved populations, in that the awards specifically target minority or low-income communities or the research topic disproportionately affects minority and medically underserved populations. Total expenditures on these awards fell slightly under $9.5 million; eight awards were cosponsored with NCI, with a total of $672,389 expended by NIEHS. Several relevant programs are described below.

Community Outreach and Education Program

NIEHS supports community outreach efforts through the Environmental Health Sciences Center Grants Program, a program of core center support that seeks to address specific regional or community needs through outreach and educational activities. Centers serve to define environmental health issues of greatest concern to communities, with a focus on populations that may be at greatest risk as a result of environmental insults, including children, elderly people, and low-income communities. Centers are encouraged to sponsor local efforts through community organizations



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