. "3 Overview of Programs of Research on Ethnic Minority and Medically Underserved Populations at the National Institutes of Health." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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percentage of minority individuals targeted in a research grant or contract. This percentage is then used to estimate the amount of funding from the project that can be added to the total funding for minority health programs. For example, if a clinical trial research grant is funded at a total of $1 million and if 30 percent of the patients in the trial are ethnic minorities, $300,000 is counted toward total institute expenditures on minority health. No such calculations or figures are reported for medically underserved populations.
Such accounting methods, however, obscure and perhaps overstate the benefits of research for minority populations. If research questions are not geared toward illuminating unique issues in cancer treatment, control, and prevention for minority populations, then the findings may be of limited value in addressing disparities in health outcomes between minority and nonminority populations. It is unclear from percent relevancy accounting methods whether such studies address unique issues for minority populations or whether subpopulation analyses are overlooked entirely. In addition, studies with very small percentages of minority populations may not provide the statistical power necessary to examine within- or between-group differences that are relevant for minority groups, yet these percentages are used in calculations of total resources allocated to minority programs.
Using "percent relevancy" accounting methods, NCI reports that $124,399,000 was allocated to MHAPs in FY 1997. Many of these research programs were summarized earlier in this chapter and include both intramural and extramural research, contract, and training programs. This figure represented approximately 5.25 percent of NCI's total budget in 1997. According to the committee's own calculations, however, inclusion of only those research programs listed as 100 percent relevant to minority populations would result in a total figure for FY 1997 of $24,234,000, or approximately 1 percent of the total NCI budget.
These projects almost certainly focus research hypotheses on issues for ethnic minority populations (i.e., that are specific to these groups), whereas NCI's report of $124.4 million may reflect both research targeted specifically to ethnic minority groups, as well as research that indirectly offers benefits to these populations (i.e., that are relevant to ethnic minority groups). Further, NCI's report of allocating $43.9 million in FY 1997 to research projects specific to "special populations" includes funding for projects targeted to elderly and blue-collar populations, groups that were not included in the committee's analysis.
The committee offers the following recommendations regarding resource allocation and accounting methods for programs of research and