School of Medicine, University of South Carolina, Columbia, SC, United States.
School of Public Health, University of South Carolina, Columbia, SC, United States.
Front Public Health. 2024 Sep 25;12:1452494. doi: 10.3389/fpubh.2024.1452494. eCollection 2024.
The National Institutes of Health (NIH) is the primary federal agency in the United States (US) that supports biomedical research, training, and clinical trials. NIH funding creates patents and jobs and thus helps the regional and national economy grow. Therefore, NIH funding would be expected to flow equitably to all 50 US states. However, there is a significant geographic disparity in the level of NIH funding received by various states. To that end, in 1993, authorized by Congress, NIH initiated a funding program called the Institutional Development Award (IDeA) to support states, called IDeA states, which received low levels of NIH funding. However, whether this approach has helped reduce the geographic disparity in NIH funding is unclear.
In the current study, we analyzed data on various NIH funding mechanisms awarded to 23 IDeA states vs. 27 non-IDeA states, as identified by NIH. We compared these data to the population size, federal taxes paid, and the number of PhDs and Post-doctoral Fellows(PDFs) trained in IDeA vs. non-IDeA states.
The non-IDeA states received 93.6% of the total NIH funding, whereas IDeA states received only 6.4%. On average, one Institutional Training Grant was received for every 24 PhDs trained in non-IDeA states, while IDeA states received one such grant for every 46 PhDs trained. The non-IDeA states comprised 84.3% of the US population, whereas IDeA states comprised 15.7%. Thus, on a basis, non-IDeA states received $120 from NIH, whereas IDeA states received $45 per person. For every million dollars contributed by the non-IDeA states toward federal taxes, they received $7,903 in NIH funding, while the IDeA States received only $4,617. For FY 2022, the NIH funding created an economic activity of $90.6 Billion in non-IDeA states and only $6.3 billion in IDeA states. When total NIH funding to the states was analyzed for the years 1992, 2002, 2012, and 2022, IDeA states received 4.7% of the total NIH funding in 1992, which increased to 7.2% in 2002 but dropped to 6.8% in 2012 and 6.5% in 2022. This demonstrated that IDeA states' share of NIH funding remained relatively unchanged for the past 20 years.
Eliminating the geographic disparity in NIH funding is crucial for achieving equitable health outcomes across the US, and for the IDeA states to successfully train future generations of physicians and scientists, as well as grow the regional economy. Although the NIH IDeA programs have helped enhance the research capacity in IDeA states, the funding currently constitutes less than 1% of the total NIH budget. Thus, it is critical to increase NIH funding to IDeA states to improve health outcomes for all Americans.
美国国立卫生研究院（NIH）是美国支持生物医学研究、培训和临床试验的主要联邦机构。NIH 的资金创造了专利和就业机会，从而有助于区域和国家经济的增长。因此，预计 NIH 的资金将公平地流向美国的 50 个州。然而，不同州获得的 NIH 资金水平存在显著的地域差异。为此，1993 年，NIH 根据国会授权启动了一项名为机构发展奖（IDeA）的资助计划，以支持获得低水平 NIH 资金的州，即 IDeA 州。然而，这种方法是否有助于减少 NIH 资金的地域差异尚不清楚。
在目前的研究中，我们分析了 NIH 授予 23 个 IDeA 州和 27 个非 IDeA 州的各种 NIH 资助机制的数据。我们将这些数据与人口规模、缴纳的联邦税以及 IDeA 州和非 IDeA 州培养的博士和博士后数量进行了比较。
非 IDeA 州获得了 NIH 总资金的 93.6%，而 IDeA 州仅获得了 6.4%。平均而言，非 IDeA 州每培养 24 名博士就获得一个机构培训拨款，而 IDeA 州每培养 46 名博士就获得一个这样的拨款。非 IDeA 州占美国人口的 84.3%，而 IDeA 州占 15.7%。因此，从人均基础上看，非 IDeA 州从 NIH 获得了 120 美元，而 IDeA 州获得了 45 美元。非 IDeA 州每向联邦纳税 100 万美元，就从 NIH 获得 7903 美元的资金，而 IDeA 州仅获得 4617 美元。2022 财年，NIH 在非 IDeA 州创造了 906 亿美元的经济活动，而在 IDeA 州仅创造了 63 亿美元。当分析 1992 年、2002 年、2012 年和 2022 年各州的 NIH 总资金时，IDeA 州在 1992 年获得了 NIH 总资金的 4.7%，在 2002 年增加到 7.2%，但在 2012 年降至 6.8%，在 2022 年降至 6.5%。这表明，在过去的 20 年里，IDeA 州在 NIH 资金中的份额相对保持不变。
消除 NIH 资金的地域差异对于实现美国医疗保健的公平结果以及 IDeA 州成功培养未来几代医生和科学家以及促进区域经济增长至关重要。尽管 NIH IDeA 计划有助于提高 IDeA 州的研究能力，但目前该计划的资金还不到 NIH 总预算的 1%。因此，必须增加对 IDeA 州的 NIH 资金，以改善所有美国人的健康状况。
