On the Threshold of a Bold New Era for Research
As you may have read in yesterday’s eCV, this week we announced renewed funding of the Jackson Heart Study for an additional six years by the National Institutes of Health. This largest, longest-running study of cardiovascular disease risk in African Americans is now guaranteed to reach at least its 25th anniversary!
Congratulations to Dr. Adolfo Correa for his overall leadership of the project, to Dr. Bettina Beech, who will head up a second graduate education component of the project in addition to Jackson State University’s, to a new participant the state Department of Health, and to our original partners in the JHS, Tougaloo College and JSU.
This is a timely announcement. By coincidence, I’ve been invited to participate in a meeting later this month of the Association of American Medical Colleges’ Council of Deans with leaders of the NIH, which is the principal sponsor of health sciences research in the United States. The purpose of the meeting is to recognize and reinforce the partnership between the NIH and the nation’s medical schools dedicated to our shared mission of improving health through research that truly matters.
When it comes to research, not all medical schools are created equal. About one third of schools receive between $100 million and $500 million a year from the NIH for sponsored research, led in 2017 by the University of California at San Francisco. Another third receive between $10 million and $100 million annually. The remainder receive less than $10 million.
UMMC is in the middle of the pack, receiving about $30 million per year (about one half of our total sponsored research expenditures last year of $63.5 million). In our case, we typically place a relatively greater emphasis on medical education and clinical care for an entire state than some of the research powerhouses.
My message for our friends at the NIH? All of the schools are different, but each has an important role to play in the improvement of the nation’s health. Indeed, the diversity represented in the 140 or so medical schools that conduct NIH-sponsored research should be considered one of the major strengths of the overall system.
As a representative of the schools that have relatively smaller research portfolios, among the points I would make are:
- Smaller public institutions that don't have large endowments depend heavily on NIH resources to build and maintain their research infrastructure. A sizable portion of every NIH dollar awarded for research goes to support the indirect costs incurred in carrying out the work. These funds defray the costs of labs and equipment that many schools could not otherwise afford.
- Because these schools with smaller portfolios are accustomed to operating on a lean budget, they tend to provide the NIH with a better return on investment than larger institutions. This fact was demonstrated in an analysis published in 2016, which showed that, for each research dollar invested, investigators at lower-ranked research institutions on average published twice as many scientific papers as those from higher-ranked schools.
- Many groundbreaking discoveries at smaller institutions that are outside of the canonical mainstream of research are not made with NIH support. However, such efforts should be fostered to advance medical science. A good historical example is the extensive research done here by Dr. James Hardy that laid the groundwork for organ transplantation to become standard therapy for certain conditions.
- Even though our research programs – and by extension, our state – benefit greatly from NIH support, we make our own contributions to these activities, to the tune of nearly $100 million over the last five years.
- The institutions with the highest NIH funding tend to be situated in large urban areas in wealthier states. Meanwhile, states like Mississippi bear the highest disease burden for the leading causes of death and disability. From a population health standpoint, it just makes sense to invest in the laboratory where the problem is actually located.
Although it won’t be my focus at the meeting, I’m excited about the future prospects for the research mission at UMMC. Over the last few years, under the leadership of Dr. Richard Summers, we have broadened our traditional strength in basic science research to become much better prepared to perform clinical and translational studies. Examples of that include the completion of the Translational Research Center, the development of an outpatient clinical trials unit in the University Rehabilitation Center, the construction (currently underway) of an inpatient clinical trials unit in University Hospital, the development of shared clinical trials infrastructure and protocols with the Mayo Clinic, and the establishment of the John D. Bower School of Population Health.
We’ve also invested heavily in our ability to analyze the mountains of data generated by our electronic health record to begin practicing “predictive medicine” that better anticipates the path a disease or condition may take in our patients and eventually to tailor treatments to their unique genetic profiles.
These developments at UMMC have not occurred in a vacuum. They are a deliberate response to the evolution of priorities at the NIH. Although basic biomedical research will always be fundamental to a deeper understanding of the human organism, the NIH in recent years has placed greater emphasis on the development of new treatments and cures. We have responded to that shift and are now poised to play a larger role in this effort.
The Jackson Heart Study, funded by the National Heart, Lung and Blood Institute, is perhaps the most prominent example of the projects that will be part and parcel of the future research enterprise at UMMC. But there are many more examples, including the work we are doing with Mayo on cancer and Alzheimer’s disease, our NIH-funded work in obesity, the study of environmental factors influencing children’s health, and the newly initiated effort to develop population health studies in the Mississippi Delta in collaboration with Tulane University and the University of Tennessee Health Science Center. For many, if not all of these efforts, our strong network in telehealth will be a vital tool in both data collection and clinical intervention.
Almost by definition, research is our future. Inextricably linked with our missions of education and patient care, research is part of what distinguishes us from other health care providers in our state, and an essential tool in our quest to create A Healthier Mississippi.