NIH Deputy Director Gives Talk

Spring 2007, Volume 29, Number 1

Dr. Raynard Kington

“There is a growing awareness that recognizing the distinct health and socioeconomic circumstances of subpopulations within large populations is necessary if we are really going to be serious about developing interventions to reduce health disparities,” said Dr. Raynard Kington, principal deputy director at the National Institutes of Health (NIH), during an Oct. 30 lecture at Northwestern University.

Kington spoke on two themes: “The Health Status of Black Immigrants” and “NIH at the Crossroads: Current Policies and Future Directions.” His talk was sponsored by the Institute for Policy Reseearch's Cells to Society (C2S): The Center on Social Disparities and Health and Northwestern's Biotechnology Training Program. both receive NIH funding.

Black Immigrant Health and Disparities
Kington, who studies the health and socioeconomic status of black immigrants, noted that although immigrant populations have been studied broadly for a century, only in the last decade have researchers begun to examine in detail differences in immigrant subgroups, finding notable disparities.

He cited his study showing that recent black immigrants to the United States report a health status similar to that of native-born whites and better than that of native-born blacks. Once in the United States, however, their health worsens over time, possibly exacerbated by lower rates of health insurance or by changing diets. This health decline follows a similar pattern of diminishing health experienced by other immigrant groups. “The longer you stay in the United States, it seems the worse it is for your health,” Kington remarked.

Kington predicts there will be an explosion of research on smaller, heterogeneous subpopulations in the future, given the upswing in U.S. immigration, which is at its highest point since the 1930s.

He also pointed to a pressing need for such research—a small, but growing, body of scientific literature on the worsening health outcomes of second and third generation Hispanics and their potential impact on overall U.S. health rates.

“Ultimately, [we will need] more sophisticated models of understanding that account for all the causal pathways that go into health status, particularly all the different ways that psychosocial factors interact with biological factors,” he said.

NIH at the Crossroads
In his second talk, Kington addressed some of the misconceptions facing NIH. “I want to respond to what we recognize are challenging times for the research community,” he said.

Between 1999 and 2004, the NIH budget doubled, with its current budget at $28.3 billion.

“It’s unprecedented in Washington to have an agency double a budget like this in recent memory,” Kington said.

As the budget grew, so did researchers’ expectations for more research dollars. But at the same time, NIH also experienced 100 percent growth in the number of applications and a 75 percent increase in the number of applicants per year, driving down the overall success for grants by one-third.

He also discredited the idea that the NIH Roadmap is “somehow sucking up all of these dollars.” Only 1.2 percent of the total NIH budget goes to Roadmap projects, he said.

NIH, he continued, is focused on revamping itself by investing in resources such as developing small-molecule libraries, shortening the time between a discovery and its translation into real-world significance, and starting an innovative awards program to fund people, not just ideas on applications.

“At our core, we are about the discovery and generation of new knowledge and promoting public health,” Kington said.