Radiology departments serving racial or ethnic minorities, along with low-income or poorly educated populations, are less likely to receive National Institutes of Health funding, according to research published Tuesday.
Healthcare access disparities and lack of inclusion in clinical research have been “well documented” for marginalized populations, experts wrote in Radiology [1]. But few studies have examined how the NIH prioritizes funding to tackle these issues.
For their study, researchers analyzed all such funding awarded to U.S. radiology departments between 2017 and 2021. They used the 2021 Lown Institute Hospitals Index rankings for inclusivity and community benefit to examine institutions’ patient population and community-benefit spending.
“Our study showed that aggregate NIH funding to radiology departments was negatively correlated with inclusive care as assessed by the Lown Institute Hospitals Index, with departments receiving the most NIH funding serving the lowest share of diverse patients,” corresponding author Randy C. Miles, MD, chief of breast imaging at Denver Health, and colleagues wrote Jan. 23. “Incentives to promote collaboration between well-funded large academic institutions and institutions with a focus on providing equitable care to underserved groups may be required to improve research inclusion,” they added.
A total of 75 radiology departments received NIH funding during the study period, ranging from $195,000 to nearly $217.9 million. Miles and co-authors observed a negative correlation between the amount of research funding received and institutional rankings for serving patients from racial or ethnic minorities, low-income populations, or those with lower levels of education. They also found no connection between the amount of radiology department NIH funding and institutional rankings for charity care spending, community investment, and Medicaid as a proportion of patient revenue.
In a corresponding editorial [2], experts called the latter finding “in some ways not surprising.” Patients’ lack of health insurance, limited access to transportation and poor health literacy may prevent them from seeking care at NIH-funded institutions, which are often well-resourced academic centers. More commonly, they are treated at local healthcare facilities and safety-net hospitals that don’t have large research enterprises.
“To address this disparity, we must look to strengthen relationships between academic medical centers and affiliated community hospitals and with other members and organizations in our communities,” wrote Tejas S. Mehta, MD, and Max P. Rosen, MD, both with the UMass Chan Medical School in Worchester, Massachusetts.
“Beyond the positive clinical impacts that radiology departments have on the communities they serve, fostering a renewed awareness and connection to local communities will yield additional benefit for radiology faculty, learners and staff,” they added later. “As integrated hospital systems continue to expand and a greater percentage of work is performed remotely, radiology is at risk for becoming a ‘transactional’ discipline. By working to reconnect our research efforts with the communities we serve, radiologists will hopefully regain additional meaning from our careers beyond simply measuring our impact in relative value units.”
Read more, including potential study limitations, at the links below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.