Elsevier

American Heart Journal

Volume 230, December 2020, Pages 54-58
American Heart Journal

Research Letter
Geographical affiliation with top 10 NIH-funded academic medical centers and differences between mortality from cardiovascular disease and cancer

https://doi.org/10.1016/j.ahj.2020.08.014Get rights and content

Background

Community engagement and rapid translation of findings for the benefit of patients has been noted as a major criterion for NIH decisions regarding allocation of funds for research priorities. We aimed to examine whether the presence of top NIH-funded institutions resulted in a benefit on the cardiovascular and cancer mortality of their local population.

Methods and results

Based on the annual NIH funding of every academic medical from 1995 through 2014, the top 10 funded institutes were identified and the counties where they were located constituted the index group. The comparison group was created by matching each index county to another county which lacks an NIH-funded institute based on sociodemographic characteristics. We compared temporal trends of age-standardized cardiovascular mortality between the index counties and matched counties and states. This analysis was repeated for cancer mortality as a sensitivity analysis. From 1980 through 2014, the annual cardiovascular mortality rates declined in all counties. In the index group, the average decline in cardiovascular mortality rate was 51.5 per 100,000 population (95% CI, 46.8-56.2), compared to 49.7 per 100,000 population (95% CI, 45.9-53.5) in the matched group (P = .27). Trends in cardiovascular mortality of the index counties were similar to the cardiovascular mortality trends of their respective states. Cancer mortality rates declined at higher rates in counties with top NIH-funded medical centers (P < .001).

Conclusions

Cardiovascular mortality rates have decreased with no apparent incremental benefit for communities with top NIH-funded institutions, underscoring the need for an increased focus on implementation science in cardiovascular diseases.

Section snippets

Methods

Data on research center specific funding was obtained from NIH’s online repository. Annual funding of every biomedical research center from 1995 through 2014 was aggregated and the counties of the top 10 funded institutes were identified to form the index group of counties. We created a comparison cohort by matching each index county to another county which lacks an NIH-funded academic institute based on median age, sex distribution, race distribution, urban-rural distribution and median

Results

The characteristics of the index and matched counties are shown in Table I. The sociodemographic characteristics and the cardiovascular mortality in 1980 were similar in the 2 county groups.

Figure 1 shows funding amounts at the top 10 NIH-funded academic medical centers. From 1980 through 2014, the annual cardiovascular mortality rates declined in all counties.

The average decline in cardiovascular mortality rate among the index counties was 51.5 per 100,000 population (95% CI, 46.8-56.2) over

Discussion

Death from cardiovascular disease consistently and remarkably declined from 1980 to 2014 in the counties with top 10 NIH-funded medical centers. This decline was similar when compared to the socio-demographically matched counties and states with similar cardiovascular mortality at the start of the study period. Whereas oncological mortality also declined greatly during this period, the rate of decline was more pronounced in the counties that included top NIH-funded academic medical centers.

Acknowledgments

N/A.

Sources of funding

None.

Disclosures

MF, CMO, NRD, LA, FPW, RM, and TA have received funding from the NIH. All other authors had nothing to disclose.

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