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Research for All
NIH broadens the impact of research findings by making research more inclusive and applicable to all.
Sex as a Biological Variable
NIH established the Sex as a Biological Variable (SABV) Policy requiring that all eligible funding applicants consider the influence of sex in their research to better understand health and disease for all. Since this policy, other funding agencies adopted similar policies reflecting the importance of sex as a biological variable.
Image credit: National Institute of Mental Health, NIH
- SABV applies to funding applications proposing studies with vertebrate animals and humans, of which NIH receives tens of thousands of applications annually.
- A historical focus on the biology of men, including use of male cells and animal models, contributed to the development of medications and treatments that are less effective or potentially harmful for women.
- SABV set a standard for the scientific community, paving the way for discoveries of important sex influences in many areas, from gene expression to the symptoms, severity, and prevalence of many diseases and conditions.
Inclusion in Clinical Trials
NIH set the global standard that clinical research populations should reflect the diversity of actual patient populations, requiring the inclusion of women, individuals from underrepresented racial and ethnic minority populations, and individuals of all ages in clinical trials.
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- A person’s race, ethnicity, age, sex, and gender impact their experience with health and disease.
- Prior to the 1990s, women and people of color were largely excluded from clinical trials, meaning that individuals received medical drugs and treatment that were not developed with them in mind.
- Today, NIH requires that all clinical research applications address the inclusion of women, individuals from underrepresented racial and ethnic minority populations, and individuals of all ages. Phase 3 trials must provide plans to analyze results broken out by sex/gender and race/ethnicity.
NIH community engagement efforts with American Indian/Alaska Native (AI/AN) communities are paving new ways for revolutionizing science and making the scientific process more inclusive. Ensuring Tribal Nations have the opportunity to provide meaningful input to NIH policies, programs, and activities impacting their communities is a critical component of honoring Tribal sovereignty.
Image credit: Mona Makela/Shutterstock
- In 2021, NIH held individual Tribal Consultations with all 574 federally recognized AI/AN Tribes in all 10 HHS regions across the U.S. to ensure Tribal Nations had the opportunity to provide meaningful input to the new NIH Tribal Consultation Policy.
- Throughout the COVID-19 pandemic, NIH supported Tribal Nations in making informed decisions regarding participation in COVID-19 research and vaccine clinical trials, leading AI/AN communities to have the highest rates of vaccine uptake compared to any other racial or ethnic group.
Improvements in cancer treatments have helped more people to live longer with the disease, resulting in an increased population of cancer survivors. In 2019, about 5% of the U.S. population were cancer survivors. To support this growing population, NIH has promoted the development of a new field of research on cancer survivorship.
Image credit: Matthew Zachary
- In 2019, about 5% of the U.S. population were cancer survivors; 18% of those survivors had lived 20 years or more past diagnosis.
- In 1996, NIH created the Office of Cancer Survivorship, dedicated to research on cancer survivorship. In the 25 years it has been in existence, the office’s research portfolio has increased over 90%.
Health and Retirement
The Health and Retirement Study (HRS) is the most comprehensive population-representative study of adults over age 50 in the U.S., with 17 international HRS sister studies, supporting cross-national comparisons on more than half of the world’s population.
Image credit: National Institute on Aging, NIH
- The HRS has over 20,000 participants contributing comprehensive long-term data on health and cognitive status—including genetics, demographic, economic, and familial characteristics, along with Medicare data.
- HRS has yielded more than 5,800 journal articles, reports, book chapters, and dissertations.
- HRS researchers gather cognitive testing results and collect DNA and blood samples to ensure that the biomarkers—biological indicators of disease—being developed using these samples will be applicable to the widest range of people possible.
NIH research was critical in incorporating resilience research frameworks and tools into research plans at the federal and international level. Understanding how resilience—an individual’s capacity to resist, adapt, recover, and grow from challenges—plays a role in health is important for understanding differences in health outcomes across diverse populations.
Image credit: Fortune Vieyra on Unsplash
- NIH-supported resilience research frameworks are pioneering the science of resilience and advancing new studies to better understand how people respond to challenges—or stressors—promoting resilience.
- Strengthening health systems through the lens of resilience has reached beyond NIH to a government-wide approach—the new Federal Plan for Equitable Long Term Recovery and Resilience—and to international organizations—including the World Health Organization and the European Observatory on Health Systems and Policies.
Sex as a Biological Variable
- Mannon EC, et al. Am J Physiol Renal Physiol. 2020;318(2):F329-F331. PMID: 31904284.
- Woitowich NC, et al. J Womens Health (Larchmt). 2019;28(1):9-16. PMID: 30539677.
- White J, et al. J Clin Endocrinol Metab. 2021;106(10):3034-3048. PMID: 34137862.
- Beery AK, et al. Neurosci Biobehav Rev. 2011;35(3):565-72. PMID: 20620164
- Arnegard ME, et al. J Womens Health (Larchmt). 2020;29(6):858-864. PMID: 31971851.
- Zucker I, et al. Biol Sex Differ. 2020;11(1):32. PMID: 32503637.
Inclusion in Clinical Trials
- NIH Inclusion Data: https://report.nih.gov/RISR/#/
- National Institutes of Health. Report of the Advisory Committee on Research on Women’s Health, Fiscal Years 2013–2014: Office of Research on Women’s Health and NIH Support for Research on Women’s Health. 2015. Appendix E: Aggregate enrollment data tables and trend data. https://orwh.od.nih.gov/sites/orwh/files/docs/1IntroACRWHBiennialRepFY13-14.pdf
- NIH Inclusion Policies: https://grants.nih.gov/policy/inclusion/women-and-minorities/guidelines.htm
- Bernard MA, et al. JAMA. 2018;320(15):1535-1536. PMID: 30326521.
- Knepper TC, et al. Nature. 2018;557(7704):157-159. PMID: 29743700.
- Kuchel GA. J Am Geriatr Soc. 2019;67(2):203-204. PMID: 30693942.
- Jain N, et al. Crit Public Health. 2020;30(2):141-152. PMID: 32123487.
- Feldman S, et al. JAMA Netw Open. 2019;2(7):e196700. PMID: 31268541.
- Flores LE, et al. JAMA Netw Open. 2021;4(2):e2037640. PMID: 33606033.
- Taylor HA. Clin Trials. 2008;5(2):140-6. PMID: 18375652.
- Oh SS, et al. PLoS Med. 2015;12(12):e1001918. PMID: 26671224.
- Article: American Indians have the highest Covid vaccination rate in the US https://www.pbs.org/wgbh/nova/article/native-americans-highest-covid-vaccination-rate-us/
- Article: Despite obstacles, Native Americans have the nation’s highest COVID-19 vaccination rate https://www.latimes.com/world-nation/story/2021-08-12/native-american-covid-19-vaccination
- NIH Tribal Consultations: https://dpcpsi.nih.gov/thro/tribal-consultations
- White House Memorandum on Tribal Consultation and Strengthening Nation-to-Nation Relationships. Available at: https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/26/memorandum-on-tribal-consultation-and-strengthening-nation-to-nation-relationships/
- NIH Office of Cancer Survivorship: https://cancercontrol.cancer.gov/ocs/statistics
- Harrop JP, et al. Cancer Epidemiol Biomarkers Prev. 2011;20(10):2042-7. PMID: 21980012.
- National Institute of Health: NCI Office of Cancer Survivorship: Twenty-five Years of Progress. 2021. https://cancercontrol.cancer.gov/ocs/about/ocs-25-anniversary
Health and Retirement
- Health and Retirement Study: Aging in the 21st Century: Challenges and Opportunities for Americans. 2017. https://hrsonline.isr.umich.edu/sitedocs/databook/
- Fisher GG, et al. Work Aging Retire. 2018;4(1):1-9. PMID: 29423243.
- Health and Retirement Study International Family of Studies: https://hrs.isr.umich.edu/about/international-family-studies
- Health and Retirement Study in the News: https://hrs.isr.umich.edu/publications/in-the-news
- Health and Retirement Study Publications: https://hrs.isr.umich.edu/publications
- Hurd MD, et al. N Engl J Med. 2013;368(14):1326-34. PMID: 23550670.
- Federal Plan for Equitable Long-Term Recovery and Resilience: https://health.gov/our-work/national-health-initiatives/equitable-long-term-recovery-and-resilience
- WHO’s 7 policy recommendations on building resilient health systems: https://www.who.int/news/item/19-10-2021-who-s-7-policy-recommendations-on-building-resilient-health-systems
- European Observatory Health Systems Resilience: https://eurohealthobservatory.who.int/covid-19/policy-responses-to-covid-19/resilience
- Trans-NIH Resilience Working Group: https://ods.od.nih.gov/Research/resilience.aspx
This page last reviewed on April 17, 2023