The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
The Future of the Public’s Health in the 21st Century
National Institutes of Health
The National Institutes of Health (NIH) is the single largest source of health research funding, with a fiscal year 2000 research budget of nearly $20 billion (compared to CDC’s total research budget of $570 million) (IOM, 2002). Although NIH emphasizes biomedical research, it is increasingly funding what it terms prevention research. It has invested in large-scale community trials (Green et al., 2001), conducts research on risk factors for disease, and evaluates drugs for secondary prevention of disease.
The National Institute of Environmental Health Sciences (NIEHS) developed a program in collaboration with the Environmental Protection Agency and CDC to “promote translation of basic research findings into applied intervention and prevention methods.” NIEHS conducts multidisciplinary basic, applied research, and “community-based prevention research,” including studies on the causes and mechanisms of children’s disorders having an environmental etiology; studies to identify relevant environmental exposures; intervention studies to reduce hazardous exposures and their adverse effects; and studies to decrease the prevalence, morbidity, and mortality of environmentally related childhood diseases (NIH, 2002a).
Eight Centers for Children’s Environmental Health and Disease Prevention Research were funded to conduct the first set of studies that will focus on respiratory disease and growth and development. The National Institute of Child Health and Human Development web page (NIH, 2002b) describes several prevention research projects, which include studies designed to conduct the following activities:
Test the efficacy of a multicomponent program of school-based interventions for the primary prevention of problem behavior in a sample of middle school students;
Identify determinants of the lack of age-appropriate immunizations;
Examine the efficacy of an integrated system of office-based primary pediatric care interventions for the prevention of medically attended injuries;
Assess determinants of parent-to-child transfer of responsibility for asthma self-management;
Determine whether parent and teen expectations predict teens’ driving behaviors during their first year of driving; and
Determine relevant factors and effective interventions for family management of type 1 diabetes.
Despite the many NIH-funded research activities labeled as prevention research, these efforts tend to focus on individual health and on secondary prevention and risk factor analysis rather than on the health of populations