NIH cuts could affect new and ongoing research

Research funded by the National Institutes of Health has led to lifesaving vaccines, tests for major health risks and treatments for cancer and tuberculosis, among other advances.

But new and ongoing research could face roadblocks if $4 billion in budget cuts levied by the Trump administration are allowed to take effect. On Feb. 7, administration officials announced they were slashing funds for indirect costs that are built into grants awarded to research institutions. The move would cut the indirect cost rate from an average of about 28% to 15%.

The rate change, which would have been effective immediately, was temporarily blocked by a U.S. District Court just days later following two legal challenges. A lawsuit filed by a group of 22 state attorneys general argued the cuts would “devastate critical public health research” at universities and research institutions, while a second, filed by a coalition of university associations and research centers, branded the move “a flagrantly unlawful action” that would be a disaster for science.

Instead of being a “rip-off,” as Trump administration employee Elon Mask labeled them in a post on X, indirect costs for administration and infrastructure provide a vital foundation for research, the opponents said. University researchers need buildings, scientific equipment, cybersecurity, computer systems and biocontainment facilities for their work, as well as administrative staff to keep systems running and meet reporting obligations, according to the lawsuits.

Public health organizations predict that if the rate cut is allowed to stand, it will limit how many studies can be done, end clinical trials and slow treatments and medications for diseases.

More than a dozen health-related groups — from the American Diabetes Association and Muscular Dystrophy Association to the Science Commission and America’s Essential Hospitals — have spoken out against the rate decrease and provided examples of the potential impact.

For example, prevention and treatment options for HIV exist because of NIH funding, according to the HIV Medicine Association, which predicted that the scientific workforce and infrastructure needed for future advances “will crumble without sufficient funding.”

On Feb. 21, a judge extended the temporary restraining order, stalling the rate cut. 

Air pollution linked to health risks during pregnancy

Exposure to air pollution during pregnancy can pose health risks to both women and their growing fetuses, recent studies show.

Newborns who are exposed to air pollution late in pregnancy are more likely to be admitted to hospital neonatal intensive care units, according to findings in Scientific Reports.

Researchers linked NICU admissions with exposure to fine-particle pollution, also known as PM2.5, and nitrogen dioxide, known as NO2. The likelihood of being admitted to a NICU was as much as 35% higher among newborns who had been exposed to high levels of NO2 in the last month of pregnancy, as compared to non-exposed newborns, and as much as 22% higher for those exposed to high PM2.5 levels. The two pollutants are associated with vehicle emissions, wildfire smoke, power plants and other sources.

New research in Urban Climate also finds that exposure to air pollution and extreme temperatures can increase the risk of a prolonged pregnancy.

 Researchers examined the impact of PM2.5 and biothermal stress — a measure that combines temperature, humidity and other factors — on more than 400,000 pregnancies. While a typical pregnancy lasts about 40 weeks, women who experienced the two stressors while pregnant were more likely to have longer gestation periods.

Women who were older than age 35, pregnant for the first time, lived in an urban area or had a pregnancy with health complications were at highest risk. Prolonged pregnancy can increase risks of stillbirth, birth complications, infant mortality and cesarean sections, researchers noted.

Health care spending differs by county

Health care expenses vary widely from county to county across the U.S., even within the same state, new research from the Institute for Health Metrics and Evaluation finds.

The findings, published in JAMA and JAMA Health Forum on Feb. 14, are based on more than 40 billion health insurance claims for inpatient, pharmaceutical, dental, emergency department and other care from 2010 to 2019.

Per capita health expenditures in Nassau County, part of New York City’s metropolitan area, totaled more than $13,300, the highest in the U.S., nearly four times as high as expenditures in Idaho’s Clark County, the research found. Three counties in California had the highest expenses for ambulatory care, while counties in Texas paid 78% less for the same type of care.

Utilization rates accounted for 65% of the variation in costs, the researchers said. Price, intensity of services, age and disease prevalence were responsible for the rest.

States with the highest overall expenses were Alaska, New York and Massachusetts. By health condition, Type 2 diabetes was the most expensive, costing $144 billion. Oral disorders accounted for $93 billion of costs and ischemic heart disease expenses totaled $81 billion.

Other recent public health news of note:

• Many Medicare beneficiaries who are under age 65 lack dental, vision and hearing coverage, says an analysis from the Commonwealth Fund. Under-65 Medicare users, who make up about 13% of eligible beneficiaries, usually qualify for the program because of disabilities or other health conditions.

• A new Government Accountability Office report finds that young adults who have aged out of foster care can face barriers to enrolling in Medicaid and maintaining coverage, even though most are eligible through age 26.

• Higher humidity from climate change is fueling rapid vegetation growth, which creates more kindling for wildfires, finds a study in Science Advances. Researchers predict that each higher degree of temperature will increase the mean area burned around the globe annually by 14%.

• When companies shop for health plans, they tend to focus more on costs than on how the plans benefit employee health and well-being, research in JAMA Health Forum finds.

• A new study in Radiology shows people of color are less likely to receive timely breast cancer diagnostic services following an abnormal mammogram screening.

• Climate change is worsening pollen levels, which is increasing deaths among older adults, new science in BMC Public Health concludes.

• A petition from the Natural Resources Defense Council and other groups is calling on the U.S. Environmental Protection Agency to phase out oil refinery use of a potentially dangerous chemical. Forty-two refineries use hydrogen fluoride, a corrosive chemical that can cause toxic plumes if released, according to the petition.

• Public datasets from the Occupational Safety and Health Administration are an underused resource for preventing workplace injuries, according to a new AJPH article co-authored by David Michaels, a former U.S. assistant secretary of labor.

• People and plants with nanoplastic particles inside them can absorb more toxins, recent science in NanoImpact and Microplastics found. The presence of nano-size plastic particles in human intestines may increase arsenic uptake by nearly six-fold, researchers found.

The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.