Despite efforts to promote diversity in the biomedical workforce, there remains a lower rate of funding of National Institutes of Health R01 applications submitted by African-American/black (AA/B) scientists relative to white scientists. To identify underlying causes of this funding gap, we analyzed six stages of the application process from 2011 to 2015 and found that disparate outcomes arise at three of the six: decision to discuss, impact score assignment, and a previously unstudied stage, topic choice. Notably, AA/B applicants tend to propose research on topics with lower award rates. These topics include research at the community and population level, as opposed to more fundamental and mechanistic investigations; the latter tend to have higher award rates. Topic choice alone accounts for over 20% of the funding gap after controlling for multiple variables, including the applicant’s prior achievements. Our findings can be used to inform interventions designed to close the funding gap.

Topic choice contributes to the lower rate of NIH awards to African-American/black scientists

Tobacco use by adolescents and young adults poses serious concerns Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age Current cigarette use among adults is highest among persons aged 21 to 25 years The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotineAt the request of the US Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators

Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products

This technical report serves to provide the evidence base for the American Academy of Pediatrics' policy statements "Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke" and "Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke." Tobacco use and involuntary exposure are major preventable causes of morbidity and premature mortality in adults and children. Tobacco dependence almost always starts in childhood or adolescence. Electronic nicotine delivery systems are rapidly gaining popularity among youth, and their significant harms are being documented. In utero tobacco smoke exposure, in addition to increasing the risk of preterm birth, low birth weight, stillbirth, placental abruption, and sudden infant death, has been found to increase the risk of obesity and neurodevelopmental disorders. Actions by pediatricians can help to reduce children's risk of developing tobacco dependence and reduce children's involuntary tobacco smoke exposure. Public policy actions to protect children from tobacco are essential to reduce the toll that the tobacco epidemic takes on our children.

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Protecting Children From Tobacco, Nicotine, and Tobacco Smoke

Importance Advancing the health equity agenda for Asian American, Native Hawaiian, and Pacific Islander (AA/NHPI) individuals has become an intersecting priority for federal agencies. However, the impact of federal investments and legislation to ensure systematic processes and resources to eliminate health disparities in AA/NHPI populations is unclear. Objective To perform a portfolio review of clinical research funded by the National Institutes of Health (NIH) for AA/NHPI populations and determine the level of NIH investment in serving these populations. Design, Setting, and Participants Cross-sectional study in which the NIH Research Portfolio Online Reporting Tools Expenditures and Results system was queried for extramural AA/NHPI-focused clinical research projects conducted in the United States from January 1, 1992, to December 31, 2018. Clinical research funded under research project grants, centers, cooperative awards, research career awards, training grants, and fellowships was included, with an advanced text search for AA/NHPI countries and cultures of origin. Project titles and terms were screened for inclusion and project abstracts were reviewed to verify eligibility. Descriptive analyses were completed. Main Outcomes and Measures Outcomes included NIH funding trends and characteristics of funded projects and organizations. The proportions of AA/NHPI-related funding trends were calculated using 2 denominators, total NIH expenditures and clinical research expenditures. Results There were 5460 records identified, of which 891 studies were reviewed for eligibility. Of these, 529 clinical research studies focused on AA/NHPI participants composed 0.17% of the total NIH budget over 26 years. Projects studying AA/NHPI individuals in addition to other populations were funded across 17 NIH institutes and centers. The top 5 funders collectively contributed almost 60% of the total funding dollars for AA/NHPI projects and were the National Cancer Institute ($231 584 664), National Institute on Aging ($108 365 124), National Heart, Lung, and Blood Institute ($67 232 910), National Institute on Minority Health and Health Disparities ($62 982 901), and National Institute on Mental Health ($60 072 779). Funding of these projects ($775 536 121) made up 0.17% of the overall NIH expenditures ($451 284 075 000) between 1992 and 2018, and 0.18% ($677 479 468) of the NIH research budget after 2000. Funding for AA/NHPI projects significantly increased over time, but the proportion of the total NIH budget has only increased from 0.12% before 2000 to 0.18% after 2000. Of total funding, 60.8% was awarded to research project grants compared with only 5.1% allocated to research career awards, training grants, and fellowships. Conclusions and Relevance Increases in research dollars for AA/NHPI clinical research were not associated with increases in the overall NIH research budget, and underrepresentation of AA/NHPI subgroups still remains. Without overt direction from federal entities and dedicated funds for health disparities research, as well as parallel efforts to increase diversity in the biomedical workforce, investments may continue to languish for AA/NHPI populations.

/pdf/trends-in-clinical-research-including-asian-american-native-3q0s9mp3cv.pdf

Trends in Clinical Research Including Asian American, Native Hawaiian, and Pacific Islander Participants Funded by the US National Institutes of Health, 1992 to 2018

https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X%2815%2970095-1.pdf

The consequences of tobacco tax on household health and finances in rich and poor smokers in China:an extended cost-effectiveness analysis

Introduction We estimated the impact of cigarette prices on youth smoking in 38 countries with the Global Youth Tobacco Survey. Methods We used a 2-part model of cigarette demand. In the first part, we estimated the impact of prices on the decision to smoke. Conditional on smoking, we then estimated the effect of price on the number of cigarettes smoked. We employed 2-way fixed effects to address country-level time-invariant heterogeneity and controlled for an array of local-level variables to address local-level heterogeneity. Results The estimated total price elasticity is -1.5 for a sample that contains both high-income and low- and middle-income countries. Constraining the sample to only low- and middle-income countries, we found a total price elasticity of -2.2, suggesting that smoking among youths in low-income countries is more responsive to cigarette price changes. Conclusion Cigarette price increases are highly effective in reducing smoking prevalence and consumption among youths globally and particularly among youths in low- and middle-income countries.

The effect of prices on cigarette use among youths in the global youth tobacco survey.

Here, we use recent U.S. National Institutes of Health (NIH) data to document trends in the NIH-funded workforce over time. Consistent with previous studies that were initiated by NIH, we find that the number of scientists funded on competing R01-equivalent (R01 Eq.) and research project grants (RPGs) increased 2-5% per year between 2009 and 2016. Primary beneficiaries of this growth were experienced investigators (Exp), whereas the share of funding awarded to early-stage investigators (ESIs) and new investigators (NIs) declined. The decline occurred even after NIH instituted the New and Early-Stage Investigator policy in 2009. When we evaluate the investigator pool, we find that women and racial and ethnic minorities represent a higher percentage of NIs and ESIs relative to Exp. Thus, trends of diminishing support for NIs and ESIs may negatively impact the diversity of the current and future biomedical research workforce. We find some recent gains among women and Hispanics as part of the applicant and awardee pool for both R01 Eq. and RPGs, but significant, large gaps persist among nationally underrepresented racial minorities. Our findings suggest a need to prioritize investments and support of ESIs and NIs, groups in which women and racial and ethnic minorities represent a larger proportion of the applicant pool, to enhance diversity in the NIH-funded workforce.-Nikaj, S., Roychowdhury, D., Lund, P. K., Matthews, M., Pearson, K. Examining trends in the diversity of the U.S. National Institutes of Health participating and funded workforce.

https://faseb.onlinelibrary.wiley.com/doi/pdf/10.1096/fj.201800639

Examining trends in the diversity of the U.S. National Institutes of Health participating and funded workforce

Alcohol consumption and social network ties among adolescents: Evidence from Add Health

PurposeThis analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doublin

Silda Nikaj

Papers

The effect of prices on cigarette use among youths in the global youth tobacco survey.

Examining trends in the diversity of the U.S. National Institutes of Health participating and funded workforce

Alcohol consumption and social network ties among adolescents: Evidence from Add Health

The Impact of Individual Mentored Career Development (K) Awards on the Research Trajectories of Early-Career Scientists.

Reverse mortgages and senior property tax relief