13-06-2025
The One Area Where Trump's N.I.H. Cuts Might Actually Make Sense
I study racial disparities in health. So much of my work is — or rather, was — supported by federal grants that have now been unceremoniously suspended or eliminated thanks to the Trump administration's ever-expanding war on diversity, equity and inclusion. So it might seem surprising for me to say that while I believe these funding freezes and cuts at the National Institutes of Health are, on the whole, detrimental for the country, they also present a long-overdue chance for us to rethink how we approach health disparities research.
Racial minorities, especially Black, Latino and Indigenous people, routinely have worse health than white people. Though there are variations among racial and ethnic groups, generally speaking, minorities have higher rates of pretty much every major health problem you can think of, including diabetes, hypertension, stroke, obesity, psychotic disorders and most major cancers. These disparities are far from new. And though progress has been made in some areas, they continue to persist, cost the United States $451 billion in 2018 and will likely worsen in Mr. Trump's second term amid cuts to federal research and programs including Medicaid.
Last summer, a National Academies of Sciences, Engineering and Medicine report revealed something that should've shaken every health disparities researcher: 'The U.S. has made little progress in advancing health care equity over the past two decades.'
It's true. In 2023, I published an article in the journal Social Science and Medicine about what I call the 'health disparities research industrial complex' — the entrenched system of researchers, institutions, publications and funders that produces an endless churn of studies on health disparities without meaningfully reducing inequities. Health disparities research is an expensive parrot squawking the same things heard for years, telling us where disparities exist and why, but not much else. The new head of the N.I.H., Dr. Jay Bhattacharya, seems to agree.
The first step to dismantling this research industrial complex and tangibly improving all Americans' lives is understanding that many studies greenlit by the N.I.H. have been charged simply with identifying and explaining the existence of health disparities; comparatively fewer have studied how to solve them. This made sense years ago when we didn't yet know that factors such as family structure, environment and education were major influences on the health outcomes of racial minorities. We now understand how and why health disparities arise — yet I continue to see researchers pitch studies that are little more than proverbial bridges to nowhere.
Part of this is money-related. Some scientists studying health disparities are likely to propose studies that are more observational but easily funded instead of investigations that may actually close these gaps.
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