How the NIH Is Addressing Structural Racism In Medicine

NIH addresses structural racism

Key Takeaways

  • The National Institute of Health in February launched a program to address structural racism in biomedical science called UNITE.
  • Since the program’s inception, the NIH has sought out community feedback on improving their current initiatives from the scientific community and has dedicated a total of $60 million toward initiatives focused on health disparities. 
  • Research proposals from Black or African American applicants were 13 percentage points less likely to receive NIH funding than whites.

Recognizing that structural racism is a problem across society, leaders of the National Institute of Health (NIH) in February launched the UNITE Initiative, a program promoting diversity, equity, and inclusion in biomedical research.

Since the program’s inception, the NIH has gathered advice from the biomedical science community on the institute's policies and efforts according to Marie A. Bernard, MD, chief officer for scientific workforce diversity at the National Institutes of Health.

“We got more than 1,100 responses. And we’re in the process of evaluating these responses to figure out what we need to be doing beyond the things we’re doing already,” Bernard tells Verywell. 

This initiative comes at a time when health organizations are under fire for a lack of commitment to combatting racism. In February, the Journal of the American Medical Association (JAMA) received scathing backlash after a white doctor and editor questioned whether structural racism exists in medicine during a podcast. The incident ultimately prompted JAMA's editor in chief to step down.

Bernard shares that the NIH has committed a total of $60 million to Common Fund initiatives that focus on health disparities research and health equity. The NIH has also issued a special training on structural racism and its impact on biomedical career development.

What Does UNITE Mean?

UNITE is rolling out these efforts to tackle racism and discrimination through the implementation of five committees:

  • Committee U is responsible for performing a systemic self-evaluation.
  • Committee N focuses on new research on health disparities, minority health, and health equity.
  • Committee I is tasked with changing the NIH organizational culture in order to promote diversity, equity, and inclusion.
  • Committee T seeks to ensure transparency and accountability from all internal and external stakeholders.
  • Committee E performs a systemic evaluation of NIH policies and processes and identify policies or processes that lack diversity and inclusion.

In addition to the committee, the NIH will expand on the Science Education Partnership Award (SEPA) program, a program partnering with kindergarten through 12th grade schools in underserved communities to provide STEM education.

“We talked about expanding the SEPA program to make more outreach to historically Black colleges and universities of Hispanic serving institutions, tribal colleges and universities, and other minority serving institutions,” Bernard says.

NIH Funding Challenges 

A research analysis found that between 2000 to 2006, proposals from Black applicants were 10 percentage points less likely than white applicants to be awarded research project grants from the NIH. Asian applicants were also less likely to receive an award than white applicants, but those differences disappeared when the sample was limited to U.S. citizens. This research underscores the gap in research funding for African American and Asian applicants, says Bernard. 

The biomedical science funding space is "still predominantly white, male, and people who are 50 years of age or older,” Sarah Bauerle Bass, PhD, MPH, the director of the Risk Communication Laboratory in Temple University’s College of Public Health tells Verywell. 

How Diverse Is the NIH Workforce?

The NIH workforce consists of:

  • 54.3% white employees
  • 20.6% Black employees
  • 19.4% Asian employees
  • 3.9% Hispanic or Latino employees
  • 1.0% Two or more races
  • 0.7% American Indian or Alaska Natives
  • 0.1% Native Hawaiian or Pacific Islander

Bass adds that when researchers of color do not receive grant funding, it lowers the amount of creativity within research. “If you’re giving NIH grants to the same people over and over again, [the research] becomes very narrow,” Bass says. “Part of the peer review process is making sure that the peer review has a lot of different voices.” 

While the gap is slowly closing, Bernard adds, there are still far too few applicants of color. “So we have a lot of work yet to do and UNITE is going to be really helpful in examining systems that may be barriers," she says.

To ensure that the NIH is reaching diverse candidates, Bernard says that the organization weaves diversity into the fabric of NIH grant applications. “When you look at a grant, you look at significance, impact, methods, and then separately, you consider diversity,” she says, adding whether an applicant will bring diverse perspectives is built into the scoring system.

What This Means For You

The NIH is accepting comments and suggestions from the scientific and broader community on advancing and strengthening diversity, equity, and inclusion in the biomedical workplace. People can submit their feedback here

The Future Of UNITE

The NIH will host advisory and director meetings in June and December to report on accomplishments and upcoming plans.

While the NIH is working to combat systemic racism within the NIH system and biomedical field, Bernard says that UNITE will only touch one facet of racism. “Structural racism is impacted by all systems, housing, education, finances. Our efforts at UNITE will focus on the systemic problems within biomedicine,” Bernard explains. 

Because systemic racism is a widespread and chronic problem, Bernard implores people to take action. “Individual scientists and institutions can examine what their systems are, endorse and bring about equity for all within their environment,” Bernard says. “And we really look forward to working across the government and beyond to address structural racism.”

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institutes of Health. Ending Structural Racism.

  2. Ginther DK, Schaffer WT, Schnell J, et al. Race, ethnicity, and NIH research awards. Science. 2011;333(6045):1015-1019. doi:10.1126/science.1196783

  3. National Institutes of Health. NIH Workforce Profile

By Kayla Hui, MPH
Kayla Hui, MPH is the health and wellness ecommerce writer at Verywell Health.She earned her master's degree in public health from the Boston University School of Public Health and BA from the University of Wisconsin-Madison.