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Brief ReportPolicy Briefs

Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards

Brianna J. Cameron, Andrew W. Bazemore and Christopher P. Morley
The Journal of the American Board of Family Medicine September 2016, 29 (5) 531-532; DOI: https://doi.org/10.3122/jabfm.2016.05.160076
Brianna J. Cameron
From Central New York Master of Public Health Alumnus, SUNY Upstate Medical University, Syracuse, NY (BJC); the Robert Graham Center for Policy Studies, Washington, DC (AWB); and the Departments of Family Medicine, Public Health & Preventive Medicine, and Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse (CPM).
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Andrew W. Bazemore
From Central New York Master of Public Health Alumnus, SUNY Upstate Medical University, Syracuse, NY (BJC); the Robert Graham Center for Policy Studies, Washington, DC (AWB); and the Departments of Family Medicine, Public Health & Preventive Medicine, and Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse (CPM).
MD, MPH
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Christopher P. Morley
From Central New York Master of Public Health Alumnus, SUNY Upstate Medical University, Syracuse, NY (BJC); the Robert Graham Center for Policy Studies, Washington, DC (AWB); and the Departments of Family Medicine, Public Health & Preventive Medicine, and Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse (CPM).
PhD, MA
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Abstract

A small proportion of National Institutes of Health and other federal research funding is received by university departments of family medicine, the largest primary care specialty. That limited funding is also concentrated, with roughly a quarter of all National Institutes of Health, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality funding awarded to 3 departments, almost half of that funding coming from 3 agencies, and a recent trend away from funding for new investigators.

  • Awards & Prizes
  • Center for Disease Control & Prevention (U.S.)
  • Family Practice
  • Grants
  • Primary Health Care
  • Research

Previous reports have revealed that Family Medicine (FM) as a specialty receives relatively little federal research funding, despite delivering a wide range of care to a diverse set of patients and populations.1⇓–3 In addition, this limited funding has been shown to be concentrated to a small number of funders and recipient institutions, which can pose a barrier to building research capacity within less established departments of FM (DFMs) and the specialty as a whole.1

We used the National Institutes of Health (NIH) RePORTER tool4 to quantify the number of US Department of Health and Human Services grants, including from the NIH, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention, that were awarded to DFMs over the study period of 2002 to 2014. We specifically sought to determine how NIH FM grants are classified by activity code, academic department, and funding institute or center.4

There seems to be an increasing concentration by department. From 2007 to 2014, 3 departments received one quarter of all grants awarded to DFMs by the NIH—an increase from one fifth during 2002 to 2006. Notably, all 3 of these departments combine FM and public health. Grants were also awarded by a limited number of institutes or funding agencies. Across the 13-year time frame of the study, the top 3 administering institutes or centers funded nearly half of all grants awarded to DFMs (Table 1). The primary administering agency for FM grants is the National Cancer Institute, which funded 28% of NIH grants for FM research over 2011 to 2014, followed by Agency for Healthcare Research and Quality (11%) and the National Heart, Lung, and Blood Institute (8%). In terms of award type, funding for research training awards (K-series) to DFMs has declined, from 22% over 2002 to 2006 to 15% from 2011 to 2014.

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Table 1.

National Institutes of Health Grants Awarded to Departments of Family Medicine from 2002 to 2014, Classified by Activity Code, Department of Family Medicine, and Administering Institute or Center

An already thin stream of research funding from federal agencies also concentrates in a few universities, revealing that most funded DFMs depend on a small number of federal institutes and centers. There may be a number of endogenous factors within the specialty of FM that contribute to the issue, including fewer research fellowships or other training opportunities across the field, as well as a weaker overall research infrastructure in FM. It is also possible that applications for funding from institutions that do not have strong research support simply lack the necessary rigor. Regardless, there seems to be an opportunity to strengthen the primary care research enterprise through university efforts to grow DFM research capacity, increased attention to the importance of primary care research across the federal research community, and efforts to reverse the decline in K-series awards being made to new investigators in DFMs.

Notes

  • This article was externally peer reviewed.

  • Funding: This project was partially supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services under grant D54HP23297, “Academic Administrative Units,” for roughly $2000 (total award amount $154,765; 90% financed with nongovernmental sources), corresponding to the amount of effort dedicated to this project by the lead author (BJC).

  • Conflict of interest: none declared.

  • Disclaimer: This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by, the Health Resources and Services Administration, the U.S. Department of Health and Human Services, or the U.S. government.

  • See Related Commentary on page 525

  • Received for publication February 19, 2016.
  • Revision received May 16, 2016.
  • Accepted for publication May 31, 2016.

References

  1. 1.↵
    1. Lucan SC,
    2. Phillips RL Jr.,
    3. Bazemore AW,
    4. Phillips RL,
    5. Bazemore AW
    . Off the roadmap? Family medicine's grant funding and committee representation at NIH. Ann Fam Med 2008;6:534–42.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Morley CP,
    2. Bazemore AW,
    3. Cameron BJ
    . The impact of administrative academic units (AAU) grants on the family medicine research enterprise in the United States. Fam Med 2016;48:452–8.
    OpenUrlPubMed
  3. 3.↵
    1. Cameron BJ,
    2. Bazemore AW,
    3. Morley CP
    . Lost in translation: NIH funding for family medicine research remains limited. J Am Board Fam Med 2016;29:528–30.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    U.S. Department of Health & Human Services. NIH Research Portfolio Online Reporting Tools (RePORT). NIH RePORTER version 7.10.0. Available from: https://projectreporter.nih.gov/reporter.cfm. Accessed January 5, 2015.
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The Journal of the American Board of Family     Medicine: 29 (5)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 5
September-October 2016
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Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards
Brianna J. Cameron, Andrew W. Bazemore, Christopher P. Morley
The Journal of the American Board of Family Medicine Sep 2016, 29 (5) 531-532; DOI: 10.3122/jabfm.2016.05.160076

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Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards
Brianna J. Cameron, Andrew W. Bazemore, Christopher P. Morley
The Journal of the American Board of Family Medicine Sep 2016, 29 (5) 531-532; DOI: 10.3122/jabfm.2016.05.160076
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