RFQ_Package-Final.pdf

U.S. Department of Health & Human Services

National Institutes of Health

NATIONAL INSTITUTE ON MINORITY HEALTH AND

HEALTH DISPARITIES

Request for Quotation

“NIMHD U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Socioeconomic Status, Age and Location

NIH-NIMHD-DIR-ASB-2019-001

Administered by the Office of Acquisitions, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

July 15, 2019

PART I – THE SCHEDULE

THE INFORMATION SET FORTH IN SECTION A – SOLICITATION/CONTRACT FORM, HEREIN CONTAINS IMPORTANT INFORMATION FOR ANY OFFEROR/VENDOR INTERESTED IN RESPONDING TO THIS SOLICITATION. ANY CONTRACT RESULTING FROM THIS SOLICITATION WILL INCLUDE IN ITS SECTION A- SOLICITATION/CONTRACT FORM ACCOUNTING, APPROPRIATION AND GENERAL INFORMATION APPLICABLE TO THE CONTRACT AWARD.

THE CONTRACT SCHEDULE SET FORTH IN SECTION B THROUGH H, HEREIN, CONTAINS CONTRACTUAL INFORMATION PERTINENT TO THIS SOLICITION. IT IS NOT AN EXACT REPRESENTATION OF THE CONTRACT DOCUMENT THAT WILL BE AWARDED AS A RESULT OF THIS SOLICITATION. THE CONTRACT COST OR PRICE AND OTHER CONTRACTUAL PROVISIONS PERTINENT TO THE OFFEROR WILL BE DISCUSSED IN THE NEGOTIATION PROCESS AND WILL BE INCLUDED IN THE RESULTANT CONTRACT. THE ENCLOSED CONTRACT SCHEDULE IS INTENDED TO PROVIDE THE OFFEROR WITH THE NECESSARY INFORMATION TO UNDERSTAND THE TERMS AND CONDITIONS OF THE RESULTANT CONTRACT.

CHAPTER B – CONTINUATION OF SF 1449

SECTION A – EXECUTIVE SUMMARY

A.1. TYPE OF CONTRACT

The National Institute of Minority Health and Health Disparities (NIMHD) at the National Institutes of Health (NIH) intends to award a single Fixed-Price contract from this solicitation for commercial services under Federal Acquisition Regulation (FAR) Part 12 and Part 15.

A.2. CONTRACT TERM

The period of performance of the contract shall not exceed Thirty-Six (36) months. There will be a 12-month Base Period plus two (2) 12-month option periods that the government (NIMHD) shall have the unilateral right to exercise upon its determination of need and availability of funds. It shall also be understood that, in accordance with federal appropriations, in the event there is adequate funding to support an entire 12-month contract period that the contractor/vendor and government shall bilaterally modify the subsequent period of performance prior to the government unilaterally exercising the option period. As part of each performance period there will be an Option to Increase Quantities but shall not extend beyond the performance period of the respective option period. The total contract performance period shall not exceed six (6) months following the expiration of the contract in accordance with FAR Clause 52.216, incorporated by reference in Chapter B, Part 1.

A.3. CONTRACT COVERAGE

The purpose of the resulting contract is for a contractor to provide support services to the U.S. Burden Of Health Disparities Working Group in an effort to produce a landmark comprehensive report.

The support/services shall be expected in the following related Technical Categories (TC):

TC #1: Produce county-level burden of disease estimates by race/ethnicity, sex, socioeconomic status

(SES), and age group for all U.S. counties; and

TC #2: Produce census tract-level (or using a smaller geographic unit of analyses if feasible) burden of disease estimates by race/ethnicity, sex, SES, and age group for approximately four large U.S.

metropolitan areas experiencing a high burden of disease.

(End of Chapter B, Section A)

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

ARTICLE B.1. BRIEF DESCRIPTION OF SUPPLIES OR SERVICES

The Contractor shall provide support services to the U.S. Burden of Health Disparities Working Group in an effort to produce a landmark comprehensive report.

The Vendor shall work independently, and not as an agent of the Government to furnish services, qualified personnel, material, equipment, and facilities not otherwise provided by the Government as described in Section C of the solicitation.

ARTICLE B.2. PRICES/COSTS

a. The resultant contract will be a Fixed-Price contact as contemplated by FAR 16.2. The total fixed price for the Base Period is $ . In the event the subsequent option periods are exercised; the total fixed price of this contract will be $____________________.

b. Upon delivery and acceptance of the item(s) described in SECTION C of this Delivery Order and identified in the schedule of charges below, the Government will pay to the Contractor the unit price(s) set forth below:

SCHEDULE OF CHARGES FOR BASE PERIOD XXXXXXX - XXXXXXX

DESCRIPTION OF TASK/

TECHNICAL CATEGORY

HOURS

(TIME)

PRICE/

COST

Task 1: Systematic Analysis of Data Sources Task 2: Systematically Account for Differences in Data Sources and Biases

Task 3: Optimize and Standardize Indicators Task 4: Estimate All-Cause Mortality, Causes of Death and YLL Task 5: Estimate Prevalence, Incidence and YLD Task 6: Estimate DALYs and HALE Task 7: Estimate Exposures to and the Burden of Risk Factors Task 8: Data Management and Documentation of Data Sources Task 9: Generate Summary Report Task 10: Project Management and Administration Other Direct Costs (ODCs)

TOTAL

c. The contractor will not exceed the Base Period amount of $ without the

Government’s prior review and execution of a subsequent modification, in doing so without consent will be at the risk of the contractor. It is understood that this amount will cover the base period of performance of ____________________ through ______________________.

d. The Contractor will not unilaterally reallocate hours and funds between Technical Categories (Tasks) without submitting a written request for a Contracting Officer’s Authorization (COA). Upon receipt of the Contracting Officer’s consent, the Contractor shall reallocate accordingly.

ARTICLE B.3. OPTION YEAR/PERIOD PRICES

a. Unless the Government exercises its option pursuant to the option clause referenced in ARTICLE I.3.

ADDITIONAL CONTRACT CLAUSES, this contract consists only of the Base Period specified in the Statement of Work as defined in SECTIONS C and F, for the price set forth in ARTICLE B.2.of this contract.

b. Pursuant to FAR Clause 52.217-6/Option for Increased Quantity/FAR Clause 52.217-7/Option for

Increased Quantity-Separately Priced Line Item/FAR Clause 52.217-8/Option to Extend Services/FAR Clause 52.217-9/Option to Extend set forth in ARTICLE I.1. ADDITIONAL CONTRACT CLAUSES of this contract, the Government may, by unilateral contract modification, require the Contractor to perform the Option Period(s) specified in the Statement of Work as defined in SECTIONS C and F of this contract. If the Government exercises this/these option(s), notice must be given before the expiration date of the contract. Specific information regarding the time frame for this notice is set forth in the OPTION PROVISION Article in SECTION H of this contract. The fixed price of this contract will be increased as set forth in paragraph c., below.

c. Upon the delivery and acceptance of the Option Item/Option Items/Option Service/Option Services of the contract and identified in the schedule of charges below, the Government will pay the Contractor.

OPTION FOR INCREASE QUANTITIES FOR BASE PERIOD

DESCRIPTION OF TASK/

TECHNICAL CATEGORY

HOURS

(TIME)

PRICE/

COST

Task 1: Systematic Analysis of Data Sources Task 2: Systematically Account for Differences in Data Sources and Biases

Task 3: Optimize and Standardize Indicators Task 4: Estimate All-Cause Mortality, Causes of Death and YLL Task 5: Estimate Prevalence, Incidence and YLD Task 6: Estimate DALYs and HALE Task 7: Estimate Exposures to and the Burden of Risk Factors Task 8: Data Management and Documentation of Data Sources Task 9: Generate Summary Report Task 10: Project Management and Administration Other Direct Costs (ODCs)

SCHEDULE OF QUANTITIES AND CHARGES FOR FUTURE OPTION PERIODS

OPTION

PERIOD

PERIOD OF

PERFORMANCE

MINIMUM

AMOUNT

OPTION TO

INCREASE

QUANTITIES

MAXIMUM

AMOUNT

Option Period #1 Option Period #2

(End of Chapter B, Section B)

SECTION C – TECHNICAL REQUIREMENTS

ARTICLE C.1. DESCRIPTION, SPECIFICATIONS, WORK STATEMENT

Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government as needed to perform the Statement of Work below:

I. BACKGROUND and INTRODUCTION

Patterns of the health burden in the U.S. vary widely by population characteristics and geographic area. Routine monitoring of these differences by population groups and area can aid health planning and policy efforts that aim to reduce health disparities (e.g., Medicaid expansion programs and distribution of mental health and health care resources). Although reports on the distribution of diseases and risk factors exist by race/ethnicity, sex, education, percent of poverty level, and age (e.g., the National Center for Health Statistics Health, United States 2016 report), they are limited. Limitations include that the estimates provided are for the nation as a whole, rather than at the county-level, often include only Black-White comparisons, and report out using very simple measures of socioeconomic status. Furthermore, their scope is limited to a small set of diseases, injuries and risk factors and they do not report on a comprehensive set of burden of disease measures.

Valuable relatively untapped sources of data about diseases, injuries, risk factors and deaths exist in various surveys and population health monitoring systems that are in the public domain or can be purchased, such as the National Center for Health Statistics (NCHS), and data collected by the Centers for Medicare and Medicaid Services (CMS), the Agency for Health Care Research and Quality (AHRQ), and other government programs. Furthermore, these health data can be linked with other data sources, e.g. U.S. Census Bureau data to generate detailed epidemiologic data for diverse and vulnerable U.S. population groups. Although these programs publish general reports, their resources are insufficient to analyze the numerous datasets collected through these surveys or to develop the detailed and unique analyses required to obtain an in-depth understanding of health disparities in the U.S. based on race/ethnicity, sex, socioeconomic status (SES), age and location.

Through this project, the U.S. Burden of Health Disparities Working Group at NIH aims to generate a landmark and comprehensive report and public platform entitled, U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography. This project would result in a publication that provides valid, accurate, and useful data summaries on the descriptive epidemiology of health disparities in the U.S. The project entails producing detailed county-level estimates of disease burden stratified by race/ethnicity, socioeconomic status (SES), age, and sex for a vast array of diseases, injuries and risk factors. The report would include a broader set of measures of the burden of disease (e.g., disability-adjusted life years and healthy life expectancy). This project would result in a platform for downloadable, publicly available data review and visualization tools for extracting information on these stratified analyses at the county-level for every U.S. county. Ultimately, we would seek to produce publicly available datasets with documentation that could be made available to intramural and extramural researchers for studies of health disparities in the U.S. based on race/ethnicity, sex, SES, age and location.

The National Institute on Minority Health and Health Disparities Division of Intramural Research (NIMHD DIR) plans and directs the Institute’s clinical, behavioral, and population intramural research programs. Our research seeks to understand mechanisms that produce and contribute to health disparities, develop socio-behavioral interventions to reduce these disparities, and promote the health and well-being of racial/ethnic minority populations.

Furthermore, the NIMHD DIR analyzes research efforts and impact to establish intramural research program priorities; collaborates with and coordinates intramural research on minority health and health disparities conducted by the Institutes and Centers to raise awareness of health disparities research; advises the Institute Director and staff on matters of scientific interest to the Institute; and assists with development of the Institute’s Minority Health and Health Disparities Research Strategic Plan and its implementation.

To inform and help prioritize NIMHD DIR efforts in the areas above, we require in-depth analyses and understanding of health disparities in the U.S. that occur on the basis of race/ethnicity, sex, SES, age and location. These analyses require access to and synchronization of numerous sources of data, and epidemiologic, statistical, computer programming, data mining, data visualization expertise and tools that exceed the scope of the NIMHD DIR. The NIMHD DIR will seek to work collaboratively with the Contractor and other NIH entities including the NHLBI Center for Translation Research and Implementation Science and the Minority Health and Health Disparities Population Laboratory, NCI Division of Cancer Epidemiology and Genetics, NIA Division of Behavioral and Social Research, OBSSR, ODP.

These entities have formed a U.S. Burden of Health Disparities Working Group, the group that will oversee this project.

II. SCOPE

The first objective of this 3-year project is to work collaboratively with the Contractor to produce U.S. county-level estimates of the burden of disease stratified by race/ethnicity, SES, sex, and age. NIMHD-DIR seeks to produce a comprehensive report on the state of the U.S. burden of disease, providing detailed assessments of patterns of health status indicators and risk factors by race/ethnicity, sex, SES, age and location, with a public platform for downloading the data and data visualizations.

The second objective of this 3-year project will be to characterize the burden of disease for a subset of the U.S., at a smaller geographic unit than county-level; county-level data can often mask significant health disparities due to the heterogeneity in health indicators occurring within a county. NIMHD DIR and the U.S. Burden of Health Disparities Working Group will work collaboratively with the Contractor to select approximately four major metropolitan areas of the

U.S. where notable health disparities are evident, to produce census tract-level (or by smaller, more homogenous geographic units if feasible) estimates of the burden of disease, stratified by race/ethnicity, sex, SES, and age group.

These two approaches will allow us to examine and compare burden of disease estimates for specific population subgroups produced at the county-level, with estimates based on disaggregated data at a smaller geographic unit of analysis. This project will assist NIH with the identification of potential mechanisms of health disparities, prevention research targets, geographic hot spots of health disparities, potential interventions to reduce disparities, and methodological and data challenges in producing detailed estimates of burden of disease by race/ethnicity, SES, age, and location for men and women. Ultimately, the plan is to routinely generate and maintain these burden of disease estimates to inform national and local efforts to improve minority health and reduce health disparities. It would be useful and in the public interest to produce a transparent dataset, and data review and visualization tools, with supporting documentation that would enable intramural and extramural researchers to conduct further analyses to advance our scientific knowledge with respect to the drivers of health disparities, premature mortality, and disease burden for specific subpopulations or regions of the U.S.

The Contractor shall provide support and services in the following related technical categories:

1. Produce county-level burden of disease estimates by race/ethnicity, sex, SES, and age group for all U.S. counties; and

2. Produce census tract-level (or using a smaller geographic unit of analyses if feasible) burden of disease estimates by race/ethnicity, sex, SES, and age group for approximately four large U.S. metropolitan areas experiencing a high burden of disease.

A. OBJECTIVES

The Government seeks an organization to assist the U.S. Burden of Health Disparities Working Group, consisting of representatives from the NIMHD DIR, NHLBI Center for Translation Research and Implementation Science and the Minority Health and Health Disparities Population Laboratory, NCI Division of Cancer Epidemiology and Genetics, NIA Division of Behavioral and Social Research, Office of Behavioral and Social Science Research, and Office of Disease Prevention. The purpose of this acquisition is to obtain support services needed for this effort. Funding is contributed by each of these collaborators. The requirement consists of the following general tasks:

1) Epidemiological research on how diseases, injuries and risk factors are distributed in the U.S. by race/ethnicity, sex, age, SES and location (e.g., county-level);

2) Biostatistical consultation, including Bayesian statistical modeling;

3) Computational approach and public platform that allows for simultaneous estimation of the burden of disease at the county level by race/ethnicity, gender, and SES for all U.S. counties and that yields robust and valid models/estimates with data visualization tools;

4) Ability to achieve out of sample predictive validity for specific race/ethnic groups for smaller areas where data are sparse;

5) Data Management and processing, file documentation and reports;

6) Epidemiologic, biostatistics, data management/processing, graphic data displays, technical/scientific editor, administrator, publication, SharePoint support for production of the “U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status, and Location” report; and

7) Epidemiologic, biostatistics, data management/data processing, graphic, technical/scientific editor, administrator, publication support for other reports and scientific publications.

The primary objective is to produce a landmark comprehensive report, The U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography Report that will be based on high quality epidemiological statistical analyses and tools, and visual data display tools and a data analysis framework and public platform to support these types of analyses. High quality data management and documentation of data sources and analytic processes are also crucial. A comparative analysis of the relative advantages and disadvantages of producing estimates of the burden of health disparities by county-level versus census-tract level is also important.

Objective 1:

The first objective of this project is to produce county-level estimates of the burden of disease by race/ethnicity, sex, SES, and age group for all U.S. counties (in 2016, there were 3,142 counties/county equivalents in the 50 states and District of Columbia).

These county-level estimates will be provided stratified by race/ethnicity, national origin subpopulation (if available), sex (male/female), major indicators of individual and group-level socioeconomic status (e.g., years of education, census-tract level median income and education and percent employed between ages 18-64 or index measure), and age groups (five-year intervals or other available age groupings), by U.S. county for the most time period for which robust data are available and valid estimates can be produced. Burden of disease measures will include: prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for a comprehensive array of diseases, injuries and risk factors (behavioral, environmental, occupational, and metabolic) to the extent that existing data sources can provide robust estimates for the populations and geographical units specified.

These estimates would be incorporated into available tools/data platform that allow for the review of results and data visualization by population subgroups and geographic areas.

Products of these analyses (i.e., comprehensive report entitled U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography Report and multiple peer-reviewed publications) will draw attention to health disparities in the U.S.

and suggest areas that are in critical need of further studies to elucidate mechanisms of action producing such disparities and effective interventions to prevent or reduce them.

A public platform for downloading data and data visualization tools to advance studies of health disparities is required.

Objective 2:

The second objective is to produce more granular data for several geographic sub-regions of the U.S. which carry a disproportionately high burden of disease. Working with the Contractor, we will identify approximately four major metropolitan areas, allowing for comparisons with geographic areas where minority populations are doing better vs. worse on health metrics, and produce census tract-level (or for smaller, more homogenous geographic units if feasible) estimates of the burden of disease, stratified by race/ethnicity, sex, SES, and age group for each geographic unit. Burden of disease measures will include: prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for a comprehensive array of diseases, injuries and risk factors (behavioral, environmental, occupational, and metabolic) to the extent that existing data sources can provide robust estimates for the subpopulations and geographical units specified. These estimates would be incorporated into available tools that allow for the review of results and data visualization by population subgroups and geographic areas.

This second objective will constitute a pilot study to identify the appropriate methodologies, algorithms, data sources, SES indicators, needed central storage and analytic capacity, and estimated costs associated with generating these types of estimates for smaller geographic units, e.g., census-tract level or smaller. The study will produce a comparative analyses of the relative advantages and disadvantages of producing estimates of the burden of disease for population strata at the aggregated (county-level) versus disaggregated (census-tract level).

Pilot study results will inform future efforts to routinely update and maintain these estimates and extend these analyses. Future extensions might include producing census-tract level estimates of available indicators of the burden of disease (e.g., prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to premature mortality, years lived with disability, and disability-adjusted life-years for available causes and risk factors) for additional regions of the U.S. suffering a high burden of disease or that incorporate other measures relevant for health disparities researchers, e.g., primary language spoken in the home, years lived in the U.S., sexual orientation and gender identity.

B. TECHNICAL REQUIREMENTS

The Contractor shall:

• Independently, and not as an agent of the Government, furnish all the necessary services, qualified personnel, material, and facilities not otherwise provided by the Government, as needed to perform the specific tasks outlined below

• Independently perform all work and furnish all labor, materials, supplies, equipment, and services (except as otherwise specified in the contract)

• Have an understanding of Federal Government policies and procedures and demonstrated ability to meet fast turnaround deadlines

• Have an understanding of Federal Government contracting and billing processes along with experience in cost control management

• Have prior experience working with the Federal Government

• Complete Non-Disclosure Agreement (NDA)

• Have extensive experience in oral and written communication and documentation

C. SPECIFIC TASKS TO BE PERFORMED

TASK PERFORMANCE

Performance of work shall involve the conduct of original epidemiologic research, which is analytical or descriptive of a defined population such as that of the adult population of the United States. This includes:

1) assessment and analysis of data files in the context of contemporary knowledge about these diseases, injuries, and risk factors;

2) preparation of detailed written technical reports on scientific analyses arising from the data files that would be suitable for publication in the peer-reviewed medical literature, including discussion of the pertinent published literature and scientific assessment of analysis results as they relate to current knowledge of diseases, injuries, and risk factors;

3) epidemiologic and statistical consultation in assessment and analysis of a variety of sources of data on diseases, injuries, and risk factors.

Data sources include particularly complex data files derived from surveys of the National Center for Health Statistics, Behavioral Risk Factor Surveillance Survey, Centers for Disease Control and Prevention, U.S. Census files, and other appropriate data files relating to the objectives. The work will be performed in collaboration with scientists of the U.S. Burden of Health Disparities Working Group. Analyses will include conducting a wide range of descriptive and inferential epidemiologic and statistical analyses; Bayesian modeling to generate estimates; provision of biostatistician support in determining the scientific and technical feasibility of specific proposed analyses, considering such factors as complex survey design, sample size, missing data, discrepancies in coding of variables across data sources, etc.; selection of appropriate statistical analytic methods for specific analyses; performing statistical tests of analyses to determine significance of results; testing the validity of modeling results at the county and census-tract levels; and refinement of existing SAS or other appropriate statistical packages and programs such as Python, SAS, SUDAAN or STATA or Geographical Information Systems procedures to perform innovative analyses or to develop other programs not available in standard software packages. Data management and data processing support will include the analysis of complex biomedical datasets; procuring and maintaining complex data files from epidemiologic surveys and other data sources;

development and maintenance and documentation of computer files; merging files and developing specialized working sub files; statistical computer-based analyses; and preparation of technical reports containing details of files procured, new files developed, and file management.

Epidemiological, biostatistician, data management/processing, and project management support will be required for the production of a report documenting the burden of health disparities in the U.S. and will include authorship and editorial responsibilities, and provision of both tabulated and graphically displayed national health data by race/ethnicity, sex, socioeconomic status (SES), age and location. Such support may also be needed for certain data from community/regional surveys.

Technical editing requiring a high level of knowledge of health disparities will be required for review of outlines and chapters. Administrative support will be needed for arranging conference calls, contacting authors, writing conference call minutes, and tracking progress on the U.S. Burden of Health Disparities Report chapters and other scientific publications. Chapters will be word processed, requiring graphic support and Section 508 compliance for tables and figures. The U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography report will be published on the NIMHD website and potentially in the form of a hardcopy. A SharePoint site or other repository will be maintained and updated as chapters and other scientific materials are developed.

Key Personnel

The Contractor shall identify at least the following key personnel:

• Epidemiologists

• Biostatisticians

• Project Manager

DETAILED TECHNICAL REQUIREMENTS OF TASKS TO BE PERFORMED

The following tasks are required to generate the U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography report and associated peer-reviewed scientific publications, data platforms and data visualization tools. Tasks may be modified in collaborations between the Contractor and the U.S. Burden of Disease

Working Group depending on the feasibility of obtaining the required data sources, time and effort required to model the estimates by the population groups requested, and financial considerations. For all tasks identified below, the Contractor shall collaborate with U.S. Burden of Health Disparities Working Group scientists in conducting original scientific research relating to health disparities in the U.S. using large, complex surveys and data files of the NCHS and other data sources provided to the Contractor or procured by the Contractor.

Two epidemiologists and two biostatisticians must be available on the Contractor’s staff or through subcontract. Each of the epidemiologists must have a Ph.D. in epidemiology; or an M.D. degree with training/experience in epidemiology or public health; or a lower level degree with significant experience in chronic disease epidemiology. Each of the epidemiologists must have demonstrated experience in conducting and analyzing complex statistical studies in epidemiologic and public health contexts using large samples, complex data files, and a wide range of univariate and multivariate statistical techniques; experience in writing analytic and statistical reports;

demonstrated ability to work in a consultative mode with other epidemiologic investigators; ability to clearly express themselves orally and in writing; and demonstrated ability to collaborate with computer programmers. Demonstrated experience working with NCHS or similar complex data sets and demonstrated familiarity with Bayesian modeling, Python, SAS or similar statistical analyses software, programming, visual data display tools, and Geographic Information System (GIS) mapping technology are required. The biostatisticians must have experience with methods for analysis of complex sample surveys, statistical weighting of data to account for sample selection probability, Bayesian modeling techniques, geospatial analyses, etc.

Biostatisticians must have demonstrated experience with statistical modeling techniques required to generate robust and valid disease burden estimates at the county and census tract level within population strata, especially in situations where data are not coded consistently across datasets to be linked, e.g., classification of race/ethnicity differs between U.S. Census and death certificate databases.

Performance of work shall involve the conduct of original epidemiologic research, which is analytical or descriptive of a defined population such as that of the adult population of the United States, on the epidemiology and sequelae of the various diseases, injuries and risk factors. These studies may investigate etiologic risk factors and relationships; the sociodemographic distribution of the diseases and conditions; and a variety of outcomes of diseases including medical complications, health care aspects, mortality, and public health impact.

TASK 1: Systematic Analysis of Data Sources

Conduct systematic analyses of published studies and available data sources providing information on the prevalence, incidence, remission, and excess mortality associated with injuries, disease, and risk factors. These may include: e.g., the National Health and Nutrition Examination Surveys, state-level inpatient databases, National Ambulatory Medical Care Survey, National Epidemiological Survey on Alcohol and Related Conditions, National Survey on Drug Use and Health, U.S. Department of Agriculture Continuing Survey of Food Intakes, Marketscan, National Health Interview Survey, Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention Disease Surveillance Reports, other inpatient stays and outpatient encounter claims data, U.S. Census Bureau, and the National Death Index. The Contractor shall identify the most appropriate data sources that can be utilized to fulfill the requirements of this project.

The contractor epidemiologists and biostatisticians shall assess the scientific content of various data sets from extant, ongoing, and new population surveys of the NCHS and other Federal and non-Federal programs to determine which provide information of relevance to U.S. Burden of Health Disparities Working Group. They shall design appropriate analyses of pertinent data files and data sources to address the requirements of the project. Working with NIH scientists, the contractor epidemiologists and biostatisticians will determine if the scientific and public health questions can be answered with identified data sources, based on the quality, quantity, and relevance of the available data.

Once it has been determined that a data source(s) would likely be satisfactory to produce specific estimates of the burden of disease by population groups and location, the Contractor shall develop the specific modeling approaches to be used to achieve the objectives, such as Bayesian modeling, linear mixed effects regression (LMER) or spatiotemporal Gaussian process regression (ST-GPR) to identify optimal predictive models using a variety of fit statistics. It may be necessary for the Contractor to perform preliminary analyses to determine if the extant data can in fact satisfactorily address the scientific questions.

TASK 2: Systematically Account for Differences in Data Sources and Biases

The Contractor shall systematically account for differences in data sources and biases and analyze levels and trends for causes and risk factors within the same computational framework, to maximize comparability across race/ethnicity, age groups, socioeconomic status, locations (counties), and years, by sex. The input data must be standardized to run through the same computational structure and tools. For example, create a methodology for adjusting for bias in health services encounter data from claims data that accounts for prevalence estimates from all diagnoses associated with a claim, not just the primary diagnosis (using ICD-10 codes). A unifying computational framework is needed across the analyses of diseases, injuries and risk factors to allow for comparisons across population groups and geography, as well as to examine trends in indicators. Mortality and incidence data must be matched.

The Contractor shall provide statistical consultation in determining the correct and most efficient approach and the technical feasibility of specific proposed analyses, considering such factors as complex survey design, total sample size, cell size, missing data, etc.; and shall provide consultation to U.S. Burden of Health Disparities Working Group scientists as requested regarding statistical assessment of the complex NCHS data and other data sources. The biostatisticians should have a Ph.D.

in biostatistics with significant experience in biomedical research; demonstrated experience in designing statistical aspects of epidemiologic analyses; ability to collaborate in a consultative mode with epidemiologists; and experience in writing analytic and statistical reports. It is particularly important that the biostatistician/data scientist have experience in working with and conducting statistical testing of complex stratified cluster sample surveys of the NCHS.

TASK 3: Optimize and Standardize Indicators of Race/Ethnicity, Sex, Socioeconomic Status, Age, and Location that can be Derived from Available Datasets

Operationalization of population characteristics of race/ethnicity, sex, SES and age categories vary across datasets and sources and have relative advantages and disadvantages. Death certificates and U.S. Census Bureau utilize different methods for ascertainment of race/ethnicity, which creates analytic challenges. For example, the U.S. Census Bureau collects race and ethnicity data following U.S. Office of Management and Budget (OMB) guidelines, and these data are based upon self-identification. In our diverse country, a growing number of people find the current race and ethnic categories confusing and the proportion of people who do not identify with any of the official OMB race categories have been racially classified as “Some Other Race (SOR).” The SOR category has grown to be the third largest racial group in 2010, with Hispanics/Latinos making up the overwhelming majority of those classified as SOR. In addition, segments of other populations, such as Afro-Caribbean and Middle Eastern or North African populations, did not identify with any of the OMB race categories and identified as SOR.

A number of nuanced individual- and geographic-level indicators and indices can be derived using U.S. Census Data or survey data. These can include measures of education, income, occupation, family and household composition, occupational prestige, resources (e.g., wealth, earnings, home ownership), and absolute and relative poverty. Such variations in the variables used to categorize populations need to be weighed by the contractor epidemiologists in consultation with the U.S. Burden of Health Disparities Working Group. Varying approaches need to be considered in accordance with the purpose of this project to estimate the burden of diseases and risk factors by U.S. population groups and the time/resources required.

Additionally, for Objective 2 above, the Contractor will work with the NIH scientists to select approximately four major metropolitan areas of the U.S. for which the analyses will be replicated for smaller geographical units of analyses than county. The optimum size of the geographic unit (e.g. census-tract) for making robust and comprehensive estimates of the burden of disease will need to be decided. The optimum location of high burden metropolitan areas where racial/ethnic minority populations have worse or better health will need to be selected with analytic support from the Contractor.

TASK 4: Estimate All-Cause Mortality, Causes of Death and Years of Life Lost

The Contractor shall complete a comprehensive analysis by race/ethnicity, sex, age, SES, and location, of mortality, leading causes of death, and years of life lost due to premature mortality (YLL) for a comprehensive array of diseases and injuries. They will create mutually exclusive categories of causes of mortality that can be disaggregated and aggregated. These analyses will be produced at the county-level for all U.S. counties, and at the census tract-level for a subset of the country (to be determined by contractor epidemiologists and U.S. Burden of Health Disparities Working Group). Using the analytical datasets, the contractor biostatisticians shall perform the statistical analyses, usually in Python, SAS, R or related programming languages or programs such as SUDAAN. The biostatisticians shall select appropriate statistical analytic methods for specific analyses and apply these statistical methods to specific analyses, performing appropriate statistical tests of analyses to determine the significance of results or precision of estimates generated. Statistical expertise may also be required for refinement of existing SAS or other appropriate statistical packages and programs such as Python, SAS, SUDAAN or STATA or Geographical Information Systems to perform innovative analyses or to identify or develop other programs and techniques not available in SAS or standard complex survey software.

TASK 5: Estimate Prevalence, Incidence and Years Lived with Disability (YLD)

The Contractor shall complete a comprehensive analysis by race/ethnicity, sex, age, SES, and location, of prevalence, incidence, and years lived with disability (YLDs) for a comprehensive array of diseases and injuries. They will create mutually exclusive categories of causes of morbidity that can be disaggregated and aggregated. These analyses will be produced at the county-level for all U.S. counties, and at the census tract-level for a subset of the country (to be determined by contractor epidemiologists and the U.S. Burden of Health Disparities Working Group). Using the analytical datasets, the contractor biostatisticians shall perform the statistical analyses, usually in Python, SAS, R or related programs such as SUDAAN. The biostatisticians shall select appropriate statistical analytic methods for specific analyses and apply these statistical methods to specific analyses, performing appropriate statistical tests of analyses to determine the significance of results or precision of estimates generate. Statistical consultation may also be required for refinement of existing SAS or other appropriate statistical packages and programs such as Python, SAS, SUDAAN or STATA or Geographical Information Systems to perform innovative analyses or to identify or develop other programs and techniques not available in SAS or standard complex survey software.

TASK 6: Estimate Disability-Adjusted Life-Years (DALYs) and Healthy Life Expectancy

(HALE)

The Contractor shall complete a comprehensive analysis by race/ethnicity, sex, age, SES, and location, of disability-adjusted life-years (DALYs), life expectancy, and healthy life expectancy (HALE) for a comprehensive array of diseases and injuries. Create mutually exclusive categories of causes of mortality and morbidity that can be disaggregated and aggregated. These analyses will be produced at the county-level for all U.S. counties, and at the census tract-level for a subset of the country (to be determined by contractor epidemiologists and U.S. Burden of Health Disparities Working Group). Using the analytical datasets, the contractor biostatisticians shall perform the statistical analyses, usually in Python, SAS, R or related programs such as SUDAAN. The biostatisticians shall select appropriate statistical analytic methods for specific analyses, performing appropriate statistical tests of analyses to determine the significance and precision of results. Statistical consultation may also be required for refinement of existing statistical packages or creation of new programs to perform innovative analyses or to identify or develop other programs and techniques not available in SAS or standard complex survey software.

TASK 7: Estimate Exposures to and the Burden of Risk Factors

The contractor epidemiologists shall identify the risk factors that are the main causes of U.S. morbidity and mortality, e.g. poor diet, smoking, obesity, high blood pressure. The Contractor will conduct comparative risk analysis to estimate the level of risk related to a vast array of behavioral, environmental, occupational, and metabolic risks, as well as clusters of co-occurring risk factors. These analyses will estimate attributable deaths, DALYs, and differences in exposure by race/ethnicity, sex, age, SES, and location. Using the analytical datasets, the contractor biostatisticians shall perform the statistical analyses, usually in Python, SAS, R or related programs such as SUDAAN. The biostatistician shall select appropriate statistical analytic methods for specific analyses and apply these statistical methods to specific analyses, performing appropriate statistical tests of analyses to determine the significance of results or precision of estimates generated. Statistical consultation may also be required for refinement of existing SAS or other appropriate statistical packages and programs such as Python, SAS, SUDAAN or STATA or Geographical Information Systems SAS procedures to perform innovative analyses or to identify or develop other programs and techniques not available in SAS or standard complex survey software.

TASK 8: Data Management and Documentation of Data Sources and Estimation Processes, with Public Platform for Downloading of Data and Data Visualizations

This task concerns the data file management and reporting requirements necessary to support Tasks 1-7. The Contractor shall document each step of the estimation processes, as well as data sources, in accordance with the Guidelines for Accurate and

Transparent Health Estimates Reporting. The Contractor shall create and document all analytical data sets for each project. The Contractor shall procure and maintain complex data files from epidemiologic surveys and other data sources; re-code data to create new variables or scales which are logical functions of existing variables; merge data files; and construct working sub files. If absolutely necessary, files may be mounted, archived, and maintained on the computers of the NIH Center for Information Technology (CIT). However, it is preferable that files be maintained on a local system and data processed through use of personal computers.

The Contractor shall be fully versed in NIH data security issues and policies, HIPAA compliance and Section 508 compliance. The Contractor shall have in place all necessary data security mechanisms to ensure that all data sets are secure and that access to data is consistent with the security requirements of NIH and each individual data set. All expected data processing cannot be specified in this request, as specific needs may arise during the contract period. However, it is anticipated that the major files to be used will be those of NCHS, CMS, National Health and Nutrition Examination Surveys (NHANES), National Health Examination Follow-up Surveys, Hispanic Health and Nutrition Examination Survey (1982-84), Hispanic Community Health Study/Study of Latinos, National Hospital Discharge Surveys, National Ambulatory Medical Care Surveys, National Health Interview Surveys, and U.S.

multiple cause of death mortality files. Other national surveys are also likely to be accessed. Data processing and analysis may also be requested using data files provided to NIMHD by other researchers, based on sources in the published medical literature including NCHS published data, and based on unpublished data from NCHS and other sources. The Contractor may be provided with these primary source data or with their location in which for the latter case the Contractor would obtain the primary source data. The Contractor shall collate, reformat, prepare data sets, and perform data analysis using these sources.

The Contractor shall submit written documented reports of all analyses performed, including preliminary analyses that are used to explore the feasibility of a particular analysis. These written reports shall be communicated by either printed or electronic transmission. The reports shall be thoroughly annotated so that all variables used in the input and output are clearly shown and labeled and easily understood. The program logic shall be included, and the Contractor shall document all statistical procedures performed and appropriate citations for data inputs. The Contractor shall share data files and statistical coding and programming throughout the contract with the U.S. Burden of Health Disparities Working Group at NIH to allow for verification of results prior to publication. The Contractor shall share the public platform demonstrations at least yearly with the Working Group.

TASK 9: Generate Summary Report: U.S. Burden of Health Disparities by Race/Ethnicity, Sex, Age, Socioeconomic Status and Geography and Scientific Publications

THE CONTRACTOR SHALL PROVIDE EPIDEMIOLOGIC, BIOSTATISTICS,

DATA MANAGEMENT/DATA PROCESSING, GRAPHIC,

TECHNICAL/SCIENTIFIC EDITOR, ADMINISTRATOR, PUBLICATION,

SHAREPOINT OR OTHER DOCUMENT REPOSITORY SUPPORT FOR

PRODUCTION OF THE FIRST U.S. BURDEN OF HEALTH DISPARITIES BY

RACE/ETHNICITY, SEX, AGE, SOCIOECONOMIC STATUS AND GEOGRAPHY

REPORT. A FINAL REPORT SHALL BE CREATED, COMPLETE WITH

REFERENCES, TABLES, AND FIGURES SUITABLE FOR SCIENTIFIC AND

HEALTH POLICY AUDIENCES. THIS REPORT WILL SERVE AS THE

PREMIER RESOURCE FOR THE MOST VALID, ACCURATE, AND USEFUL

DATA ON HEALTH DISPARITIES IN THE U.S. THE EPIDEMIOLOGISTS

SHALL PROVIDE AUTHORSHIP AND EDITORIAL RESPONSIBILITIES AND

DEVELOP SUPPORTING TABLES AND GRAPHIC PRESENTATIONS

BASED ON NATIONAL AND POTENTIALLY COMMUNITY/REGIONAL DATA

THAT ADDRESS CHAPTER TOPICS; DEVELOPMENT OF TABLES AND

GRAPHIC PRESENTATIONS WILL SUPPORT BOTH CHAPTERS THAT

THE EPIDEMIOLOGISTS ARE PERSONALLY WRITING (LEAD OR

COAUTHOR) AND THOSE THAT OTHER AUTHORS ARE DEVELOPING.

DATA MANAGEMENT/PROCESSING, AND FILE DEVELOPMENT SHALL

SUPPORT THESE TABULATIONS. BIOSTATISTICAL AND LARGE

COMPLEX SURVEY STATISTICAL CONSULTATION SHALL BE PROVIDED,

AS NEEDED.

Technical editing will require a high level of knowledge of health disparities for review of outlines, chapters and manuscripts. The technical/scientific editor shall review all outlines, chapters, and manuscripts for scientific content, overlap with other chapters, grammar, style of writing, and consistency of style across chapters at multiple time points during the development of the chapters. This editorial review shall be provided in addition to the editorial review provided by outside scientific experts in the health disparities field.

TASK 10: Project Management and Administration

a. Contract Management

The Contractor shall:

• Provide for the overall management, integration and coordination of all contract activities, including the management and coordination of activities carried out under subcontracts;

• Provide a technical and administrative infrastructure to ensure the efficient planning, initiation, implementation and timely…