This story is part of a series highlighting the research accomplishments of Robert Wood Johnson Foundation (RWJF) grantees from the Human Capital portfolio and the mentors that guide them.

Q: Many people outside of the world of science were surprised by these numbers, were you?

A: “No, I was not surprised at all,” says Thomas LaVeist, PhD, director of the Johns Hopkins Center for Health Disparities Solutions. “But I am impressed that the National Institutes of Health (NIH) conducted this research on their own. They should be commended for that. But, as someone who has reviewed grants for NIH, I can say, anecdotally, that I have seen issues arise in the review process that pointed to this problem. If they analyzed funding by gender, I think they would find similar disparities,” says LaVeist, who is chair of the National Advisory Committee for the RWJF Center for Health Policy at Meharry Medical College. “The numbers were not a surprise to me either,” adds Amani Nuru-Jeter, PhD, a 2003-2005, RWJF Health & Society Scholar. “But it was helpful to have numbers to back-up what many people already suspected to be an issue.”

Q: What are the factors—on the NIH side—that you think are contributing to the disparity in funding?

A: “To begin with, there’s the NIH grant proposal review process itself,” says Debra Joy Perez, PhD, RWJF interim assistant vice president and senior program officer for New Connections: Increasing the Diversity of RWJF Programming. “The study reveals that there are advantages to participating in NIH review committees. The current challenge, however, is that those panels are less likely to have African Americans among the reviewers.” “Having been a part of an NIH review committee,” LaVeist adds. “I do not think that the reviewers are rejecting applicants because of their race, but the reviewers do not place the same value on the types of research questions African American and Latino researchers often choose to work on. There’s a perception that these [disparities studies] issues are not the most important or complex questions. The topics Black and Latino scholars tend to study are not valued so they are given lower scores.”

“My research, for instance, is not focused on clinical outcomes,” Nuru-Jeter says. “Many scholars of color work on issues related to social inequality such as the effects of racism on health. But if we’re asking questions about biological reactivity to race or other forms of social stress in order to examine susceptibility to illness more broadly, where do we send our grant applications? It appears that in order to get large NIH grants, you have to be focused on specific diseases.”

Q: Are there issues outside of NIH that are part of the problem?

A: “Of course, the pipeline is a huge problem,” Perez says. “We are in a crisis right now when it comes to producing Black and Latino PhDs [according to National Center for Education Statistics only 6.5 percent of new PhDs were Black and 3.8 percent were Latino as of 2009].

“And once researchers do obtain PhDs and reach the level in their careers where they can apply for NIH grants, they need a great deal of support from their academic institution to produce a grant proposal. It takes an entire team of people to help researchers apply—mentors, research assistants and other resources are needed. Researchers from African American institutions might not have access to these resources and minority researchers at larger academic centers might have difficulty getting that support as well,” Perez explains. “This is one of the large structural issues that limit minority scholars.”

Q: How can applicants increase their chances of getting funded?

A: "First, you have to realize that the challenges presented by race are not new and they are not going to go away in the short term,” LaVeist says. “If you are a young minority scholar, you may have to be three times as good at your work as other competitors, so be excellent in all that you do. You cannot allow yourself to be deterred by this. You should also continue with the research you are interested in. Minority health is increasingly American health. Our society is a majority of racial minorities and the health profile of the country is increasingly defined by minority health.”

“But, we may have to learn to ask our research questions in different ways,” Nuru-Jeter adds. “I am currently a scholar with the CVD-PRIDE [Cardio Vascular Disease Program to Increase Diversity among Individuals Engaged in Health-Related Research] initiative sponsored by the National Heart Lung and Blood Institute, for example. The program is wonderful because it teaches participants about disease processes as well as how to apply for grants and ask questions that will be of interest to NIH. I’m learning to package my interests in racism-related stress in ways that will be attractive to NIH. And while we have to be careful about the compromises we make, there may be ways to focus our research without compromising integrity. I encourage other applicants to consider NIH programs such as PRIDE, they are incredibly helpful. I’ve learned a lot.”

Q: What must NIH do to reduce this disparity and fund a more diverse range of researchers?

A: “I think that the NIH program officers who are involved in the actual grant review process need more authority to intervene in that process when they see or hear things that may derail a grant application because of discrimination,” LaVeist says. “I have never heard a racist remark made in the review process, but that might just be because I was in the room. I have heard sexist remarks. Because of the way the rules are written, NIH program officers who are present cannot challenge reviewers’ comments during the review process, even if the reviewers’ remarks are inappropriate or inaccurate. Changing that rule to allow NIH program officers to correct inaccurate or biased statements from reviewers could help to improve the situation.”

Nuru-Jeter says, “One other thing NIH can do is write program announcements that solicit the kinds of research minority scholars are engaged in. This is a huge issue. The bottom line should not always be the clinical significance of the research results. There are numerous ways to intervene to improve population health. But with a very disease-focused model like the NIH model, it often comes down to what is the clinical significance? I’ve had NIH program officers ask me this and it’s very frustrating because the answer is not always clinical. The National Institute on Minority Health and Health Disparities (NIMHD) would be a logical Institute for the type of work many of us [minority researchers] do. However, the NIMHD does not currently support many R-series [large] grants. My hope is that the NIH will make real efforts to address this problem because…these disparities have been around for a very long time.”