States, for example, funding for the National Children’s Study has met with numerous challenges (Wadman, 2012). Countries can sometimes field large surveys, but not on a regular basis. Political considerations can also influence research by dictating what gets measured and who decides.
Another challenge is the shortage of qualified investigators to conduct such research. Tenuous funding opportunities affect the training pipeline and discourage young investigators from pursuing research careers directed at the issues covered in this report. Dedicated funding for a research portfolio that includes career development awards and support for investigator-initiated studies would help to change this climate, not to mention the motivation to undertake protracted longitudinal studies.
Calls for research in this field by NIH, in particular, would be very persuasive in shifting attitudes in academia, and universities’ promotion and tenure committees might adopt more enlightened policies on scholarship that draw more young faculty into careers focused on these issues. Establishing special emphasis panels and study sections composed of reviewers with appropriate expertise and knowledge of the special methodological challenges in conducting cross-national comparative research (and who consider a wider range of analytic approaches, appropriate to the subject, than randomized controlled trials) would also cultivate career growth in this field. These changes in research culture might then find their way to professional journals and persuade editors to involve reviewers with appropriate expertise to make judgments about the worthiness of manuscripts for publication.
For their part, scientists and researchers who conduct studies of the U.S. health disadvantage—a topic with profound public policy implications—need to enhance their skills in communicating scientific findings to general audiences, to policy makers, and to stakeholders. These audiences do not generally read peer-reviewed journals or attend scientific meetings, and findings need to be presented in understandable formats and venues that are relevant to their decisions. Work by Marmot (e.g., 2010), Cutler (e.g., Meara et al., 2008), McGinnis (e.g., McGinnis et al., 2002), Woolf (e.g., Woolf, 2011), Lantz (e.g., Lantz et al., 2010), Schoeni (e.g., Schoeni et al., 2011), and Kindig (e.g., Kindig et al., 2010) among others, illustrates how to present scientific evidence about population health interventions—including returns on investment—to nonscientific policy audiences and decision makers who shape public policies.
The diversity of disciplines needed for studying and understanding the U.S. health disadvantage, ranging from biomedicine to political science, should compel scientists to enthusiastically embrace interdisciplinary collaborations. Medicine, public health, epidemiology, sociology, demography, behavioral science, economics, marketing, and other diverse disciplines and fields can all contribute to the study of the U.S. health disadvantage,