Lan N. Đoàn, MPH1; Yumie Takata, PhD2; Kari-Lyn K. Sakuma, PhD, MPH1; et al
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.
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.