The double bind faced by black research applicants

Last week the National Institutes of Health (NIH) published an analysis finding that the agency is significantly less likely to fund proposals to study health disparities and population health, compared with studies of molecular biology. The reaction of a number of young academics? Well, duh.

[This is an article from The Chronicle of Higher Education, America’s leading higher education publication. It is presented here under an agreement with University World News.]

“I actually wasn’t surprised,” said Margee Louisias, an associate physician at Brigham and Women’s Hospital who wants to study ways to reduce asthma in minority children.

“That’s exactly what I’ve seen in this early stage of my career,” said Utibe Essien, an assistant professor at the University of Pittsburgh’s School of Medicine, who studies racial disparities in who gets the latest treatments for heart disease.

The NIH analysis also revealed a concerning double bind. Not only are health-disparity projects underfunded, but black applicants for the grant type the agency studied, called R01 grants, are disproportionately likely to propose those types of studies.

Meanwhile, white applicants are more likely to propose studying topics – having to do with cells, molecules and genetics – that are among the NIH’s most funded.

In short: black academics, already under-represented in science, are less likely to land grants that are critical to advancing their careers, in part because they tend to want to study interventions that could improve the health of poor Americans of colour.

Getting the message

Early-career scientists said they’re getting the message – from mentors, reviewers and their own observations – that they might have a harder time getting funding in general for the research topics they’re passionate about.

Mya Roberson, a doctoral student in epidemiology at the University of North Carolina at Chapel Hill, is rewriting a grant application that’s been rejected by the Agency for Healthcare Research and Quality, which, like the NIH, is an agency under the Department of Health and Human Services.

Roberson proposed studying black women with breast cancer. In the feedback she received with her rejection, she said: “What had been said, nearly verbatim, is that the major limitation of my study was that it was an all-black study. Without including white women, I would be limited in the interventions I could suggest.”

She declined to share the rejection letter, citing rules about not sharing grant applications that are being resubmitted.

Roberson was frustrated; her sister and aunt are cancer survivors. Black women are about 20% more likely to die of breast cancer than white women are, according to the American Cancer Society, though that gap has narrowed recently. Roberson remains unsure of whether to hold her ground or change her study for the chance to get funding.

Louisias, the physician who wants to study asthma disparities, recalled her mentors telling her that she should apply for funding from private foundations and federal agencies beyond the NIH “because the people in the room may be basic scientists and translational researchers, and they may not get it”.

Wanda Phipatanakul, a professor at Harvard Medical School, is one of those mentors. She told The Chronicle that reviewers who focus on basic science – think experiments on cells and lab animals, not people – may not know what’s feasible in population studies and have biases against them. But she added that it is possible to be funded through the NIH; it just might take a few tries, as it did for her before she built a reputation for her work.

“I started from the ground up,” she said. “I took three times to get my first R01. It’s an uphill battle for everybody.”

Despite the greater success they might have with other funding sources, aspiring population-health scientists said they want NIH grants, which are seen as more prestigious. Depending on the institution where they work, landing one or more R01s may even be a requirement for promotion.

“The NIH, getting a grant from there is seen to be a metric of, ‘You’ve really reached that level of success’,” Louisias said.

The NIH analysis found black applicants face barriers beyond the choice of research topic. For example, while all proposals to study areas such as socio-economic class and health were less likely than average to be funded, black applicants nevertheless had an even harder time getting the green light than whites did. The NIH is studying what role implicit bias plays in its process for peer-reviewing grant applications.

It’s all made early-career scientists feel they need to take extraordinary measures to ensure they can stay in their field. “I have to think so far ahead,” Roberson said. “This study makes me feel like I have to really be on top of it.”

Officials at the NIH said they care about population-health research and diversity among scientists.

“Those topics are clearly extremely important, are in our mission, and are being funded. We would like to see more equivalent rates of funding,” said Hannah Valantine, the NIH’s chief officer for scientific work-force diversity, who worked on the recent NIH study.

In the past few years, efforts by the NIH to link under-represented minority scientists with mentors have helped reduce the black-white funding gap in R01 grants and eliminated it among K grants, which are for scientists with less experience, according to agency numbers.

Scientists, on the other hand, said they’re getting mixed messages. They knew of and appreciated the NIH’s projects aimed at improving diversity among scientists. Yet they chafed at the fact that the NIH’s one institute focused on Americans who systematically suffer from worse health, the National Institute on Minority Health and Health Disparities, is one of the poorest funded by Congress. Of the NIH’s 27 institutes and centres, its budget was ranked 23rd in 2019.

There’s little research on why American scientists might undervalue population-health research, compared with molecular biology, but scholars have theories.

Aimee Medeiros, a historian at the University of California at San Francisco, pointed to the Scientific Revolution as the beginning of the scientific community’s privileging of lab science over real-world observations.

Roberson and Louisias thought lab experiments might seem sexier because that’s the kind of science that leads to new drugs – treatments that might seem like easier solutions than untangling the effects of discrimination and environmental exposures that lead to health disparities.

Nevertheless, the scientists interviewed said they were inspired to study population health, rather than bench science, because they thought it could help make an immediate difference.

Essien, who is a doctor as well as a researcher, said: “I felt like being a physician was much more than the biology and the science of disease, but really what our patients’ lived experiences are, before they even get to us in the clinic.”

Francie Diep is a staff reporter covering money in higher education. Follow her on Twitter @franciediep, or email her at francie.diep@chronicle.com.