How the NIH Is Addressing Structural Racism In Medicine

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.

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. 

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.

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.”