Do changes in NIH grant priorities match the women's health agenda? The role of advocacy and public health needs

In the 1990s, the National Institutes of Health (NIH) came under increased pressure from advocates to prioritize women's health. Funding for breast cancer research, for example, increased dramatically. Congress doubled the NIH budget by 2003. Yet NIH officials may have resented the increased oversight of their policies and continued to use their own assessments of disease importance for funding decisions. In this era of new resources, did the NIH increase grants for a wide range of women's health priorities or only the most prominent concerns like breast cancer? This paper examines the impact of the women's health movement from 1972 to 2006 on the number of funded NIH grants for over 30 key diseases. The study utilizes a new dataset that includes measures of congressional and interest group attention, media coverage, and the public health impact of illnesses that affect women. Random effects negative binomial models examine grants decisions in the intramural and extramural programs and explore funding patterns for some key types of grants. Women's health advocacy is clearly associated with more grants, but their influence depends on the disease, other sources of political pressure, and agency preferences for scientific priorities.