Since its inception, the National Institutes of Health (NIH) has possibly spent more dollars on research to cure and treat homosexuality and “gender identity disorder” than to understand and address the concerns of lesbian, gay, and bisexual (LGB) individuals. Previous articles, including the one by Coulter et al.1 from earlier this year, have documented this lack of attention on the real and pressing concerns of these communities extending beyond HIV/AIDS. Our analysis of NIH’s fiscal year 2012 funding portfolio supports the findings of previous publications summarizing the bleak state of funding for LGB health research, providing more detailed information regarding the trends of funding at the institute and center level, for different activity codes, dollar amounts allocated, and study section or review panel.
Of the 78 827 funded projects described in RePORTER at the time of study, only 26 were non-HIV LGB health related; seven were newly funded and 19 were continuing projects. Non-HIV LGB projects represented less than 0.05% of each of the total projects within the 13 activity codes represented (Table 1). The state of research grants is particularly disheartening; only 10 of the 27 221 R01s awarded in fiscal year 2012 represented non-HIV LGB research.
TABLE 1—
Actual and Financial Representation of Non-HIV Lesbian, Gay, and Bisexual (LGB) Projects as Part of Fiscal Year 2012 Overall National Institutes of Health (NIH) Funding Portfolio Listed by Activity Code
| Activity Code | Total NIH Projects, No. | Non-HIV LGB, No. (% of Total) | Total NIH Funding Allocated, $ | Non-HIV LGB Funding, % (% of Total) | Administrating ICs | Study Sections |
| F31 | 1 239 | 2 (0.161) | 40 056 950 | 96 225 (0.24) | NIAAA, NICHD | Health Services Research Review Subcommittee; Special Emphasis Panel [ZRG1-F16-B (20)] |
| F32 | 1 379 | 1 (0.073) | 61 959 993 | 21 405 (0.03) | NICHD | Special Emphasis Panel [ZRG1-PSE-J (50)] |
| K08 | 967 | 1 (0.103) | 130 175 088 | 16 0984 (0.12) | NIMH | ITVC |
| K23 | 1 018 | 2 (0.196) | 150 293 765 | 310 587 (0.21) | NIAAA, NIMH | Health Services Research Review Subcommittee; SRNS |
| K99 | 358 | 1 (0.279) | 36 034 622 | 121 841 (0.34) | NIAAA | Health Services Research Review Subcommittee |
| P30 | 3 688 | 1 (0.027) | — | 104 439 (—) | NIA | Special Emphasis Panel [ZAG1-ZIJ-3(M1)] |
| R01 | 27 221 | 10 (0.037) | 10 599 741 043 | 4 645 315 (0.04) | NIAAA, NICHD, NIDA, NIMH | CIHB; CLHP; PDRP; RPIA; SPIP; Special Emphasis Panel (ZRG1-AARR-F[03]); Special Emphasis Panel (ZRG1-PSE-J [50]); Special Emphasis Panel (ZRG1-PSE-K [02]) |
| R03 | 1 236 | 2 (0.162) | 98 866 819 | 218 650 (0.22) | NICHD | CDRC, Pediatrics Subcommittee |
| R13 | 684 | 1 (0.146) | 13 464 707 | 10 000 (0.07) | NICHD | Pediatrics Subcommittee |
| R15 | 234 | 1 (0.427) | 79 833 929 | 446 056 (0.56) | NIAAA | PDRP |
| R21 | 3 884 | 1 (0.026) | 780 534 600 | 180 383 (0.02) | NICHD | CIHB |
| R25 | 690 | 1 (0.145) | 181 663 617 | 168 483 (0.09) | NICHD | Pediatrics Subcommittee |
| R34 | 276 | 1 (0.362) | 65 593 255 | 307 144 (0.047) | NIMH | SRNS |
| U54 | 2 077 | 1 (0.048) | — | 166 666 (—) | NIMHD | Special Emphasis Panel (ZMD1-RN[09]) |
Note. CDRC = Communication Disorder Review Committee; CIHB = Community Influences on Health Behavior; CLHP = Community-Level Health Promotion Study Section; ICs = institutes and centers; ITVC = Interventions Committee for Disorders Involving Children and Their Families; NIA = National Institute on Aging; NIAAA = National Institute on Alcohol Abuse and Alcoholism; NICHD = National Institute of Child Health and Human Development; NIDA = National Institute on Drug Abuse; NIMH = National Institute of Mental Health; NIMHD = National Institute on Minority Health and Health Disparities; PDRP = Psychosocial Development, Risk and Prevention Study Section; RPIA = Risk, Prevention and Intervention for Addictions Study Section; SPIP = Social Psychology, Personality and Interpersonal Processes Study Section; SRNS = Mental Health Services in Non-Specialty Settings
Of the 27 institutes and centers at NIH, 20 awarded funding to zero non-HIV LGB projects and none devoted more than 0.05% of its funding toward these topics. The National Institute of Child Health and Human Development administered funding to the greatest number of projects (11, 0.31% of its portfolio) while the National Institute on Alcohol Abuse and Alcoholism awarded the greatest percentage of non-HIV LGB projects at 0.49% (six projects). The National Institute on Aging, the National Institute on Deafness and Other Communication Disorders, and the National Institute on Minority Health and Health Disparities each administered funding to only one project.
In eliminating HIV-related studies from our analysis, we hoped to see a more equitable distribution of health topics funded than discovered by Coulter et al.1 NIH lists 237 distinct Research, Condition, and Disease Categorization categories, 43 of which were represented (Table A, available as a supplement to this article at http://www.apha.org). While there is a somewhat wide range of topics covered, it is not deep. Twenty-seven of these spending categories are represented by only one or two studies. Many of the categories related to topics highlighted by the Institute of Medicine report2 as priorities for research, such as cancer, adolescent sexual activity, sexually transmitted infections or herpes, and interventions related to homicide and substance abuse among sexual minority groups are not receiving funding outside of the context of HIV/AIDS.
Our findings suggest that individual LGB health projects may not be underfunded, as the proportion of funding resembles the proportion of projects per activity code. However, well-funded, single projects on a sampling of topics fail to reveal the full picture of LGB health. The historical funding trends have contributed to the de facto definition of LGB health research as HIV research. Current voids of relevant research within institutes and centers, disease categories, and activity codes, now uncovered, are opportunities to contribute to a broader definition of health and addressing the other pressing health concerns of this population.
Acknowledgments
This project was conducted as part of Drexel University’s Opening Doors Health Disparities Research Training Program. Opening Doors is funded by an R25 grant from the National Institute on Minority Health and Health Disparities (R25MD006792).
References
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