Advocacy Archive

Senate Bullish on NIH, Behavioral Science

September 4, 1998

Dear Colleague:

Looking for a respite from volatile financial markets? Well, look no further than the continuing bullish run at the National Institutes of Health (NIH). Health research is hot! The leading indicator came yesterday with NIH up 14.7 percent after the Senate Appropriations Committee passed its NIH budget for fiscal year (FY) 1999. This breathtaking increase overshadows the dizzying 9 percent increase for NIH already passed by the House Appropriations Committee. The Senate increase would bring NIH to $15.6 billion (dollars, not rubles).

And it's not just the money. The Senate also invested heavily in behavioral science, addressing initiatives at many institutes as well as policies affecting behavioral science research NIH-wide. I've summarized the highlights below; the verbatim excerpts follow at the end of this message. I'm delighted to add that these items reflect issues raised by APS both in our formal testimony and in our ongoing discussions with Senate offices.

  • At the overall NIH-level, the Senate is monitoring the reorganization of behavioral science peer review, saying that the reorganization should provide an opportunity to strengthen NIH's behavioral science infrastructure.Also, prompted by NIH's lack of response to recommendations from the National Academy of Sciences to increase National Research Service Awards in behavioral science and other areas, the Senate asked the NIH Director to report on how NIH handles recommendations on training. The Senate also provided a large increase for the NIH Office of Behavioral and Social Sciences Research, citing the enormous impact of behavior on health and the inadequacy of the OBSSR budget.

  • At the National Institute of Mental Health, the Senate wants new initiatives in research and training to strengthen NIMH's basic behavioral research portfolio and its connection to mental health and prevention. This follows an NIMH reorganization that has not quite resolved issues around its basic behavioral branch.

  • The Senate asks the National Institute of General Medical Sciences to support behavioral science research training. NIGMS's primary mission is to support basic research in all areas of science, but it does not currently have a strong behavioral science program.

  • The Senate wants the National Institute on Aging to keep up the good work on cognitive aging research, and wants the National Cancer Institute to do more of its good work in behavioral science research.

  • New initiatives in behavioral science research were encouraged at both the National Institute on Child Health and Human Development and the National Institute on Alcohol Abuse and Alcoholism. In addition, the Committee commended NIAAA for its comprehensive health services research plan and urged NIAAA to adopt the B/START mechanism of grants to young behavioral science investigators.

  • The Senate recognizes the importance of behavioral interventions in treating drug addiction, and views the National Institute on Drug Abuse as a "model" of how to approach both behavioral science and public health.

The final NIH budget needs to be determined by October 1, the start of the fiscal year. With time so short, and the likelihood of some contentious (non-NIH) amendments on both the Senate and House floors, this probably means a Continuing Resolution to keep things going beyond that deadline, maybe even for the whole year. Still, we look for NIH to have generally smooth sailing, and to end up between the House and Senate figures.

Something to note: The NIH budget is part of a larger bill that receives a lump allocation divided among virtually all the federal government's health, social, education, and related programs. This sets up a competition which unfortunately means the increases for NIH come at the expense of these other very worthwhile programs. But in both the House and Senate, talks are under way to increase the overall amount for the larger appropriations bill, which could offset some of the cuts in public health and other programs. More as it happens.

Best, Alan

Excerpts from Senate FY99 Report on NIH Appropriations

Office of the NIH Director Training. - The Committee received the Director's response to the 1994 National Academy of Sciences recommendations on training needs for health research. The Committee appreciates NIH's decision to increase stipends as recommended, but is concerned that the NAS recommendations for increasing the number of awards in behavioral science, health services research, oral health, and nursing were not included in this decision. The Academy articulated compelling national needs for increased training in these areas and its recommendations were developed with every awareness of the cost implications. Given the importance of a stable supply of high-quality scientists in the areas specified in the NAS report, the Committee urges NIH to revisit the NAS recommendations. The Committee would like to receive a report on NIH's system for considering the NAS recommendations and establishing training policies in general.

Office of Behavioral and Social Sciences - The Committee has included $12,853,000 for the Office of Behavioral and Social Sciences. The Committee understands that behavioral science is an area of exceptional promise for understanding and ameliorating some of the Nation's most serious health concerns, many of which are due to behavior, and commends OBSSR for its efforts to increase the visibility of behavioral science at NIH. The Committee is concerned that OBSSR's budget is extremely limited and urges the Director to examine OBSSR's budget in order to increase the number of cross-NIH behavioral research and training initiatives.

Peer Review Reorganization. - The Committee notes with interest that NIH is in the process of reorganizing its systems for reviewing research grant proposals. This reorganization was triggered by the integration of systems of NIMH, NIDA, and NIAAA, which is adding considerably more neuroscience and behavioral science research as an opportunity for NIH to significantly strengthen its behavioral science infrastructure. Because of the enormous budgetary and public health implications of NIH grant review, the Committee will continue to monitor this reorganization, including a plan for evaluating the changes by September 30, 1998.

National Institute of Mental HealthBasic Behavioral Research. - For several years, the Committee has urged NIMH to strengthen its portfolio in basic behavioral research and prevention. The Committee continues to see basic behavioral research and prevention as two of NIMH's core responsibilities and urges the Institute to establish, in consultation with leading experts from the field, specific research and training initiatives to develop the base of theoretical knowledge on behavioral aspects of mental health, mental illness, and prevention as a means of improving the connections between basic and clinical research.

National Institute on Aging Cognitive Aging. - The Committee is pleased that NIA is examining its portfolio in cognitive psychology and in related behavioral aspects of aging. Understanding the effects of aging on such cognitive functions as memory, language, attention, and communication is critically important in addressing many of the serious health concerns of our elderly population, particularly in underserved and rural areas. The Committee strongly encourages NIA efforts in this area.

National Institute of General Medical Sciences Training. - The Committee encourages NIGMS to support behavioral research training as part of its mandate to support basic research training in all areas of health-related research.

National Institute on Drug Abuse Behavioral Science Research. - The Committee understands that in many cases behavioral intervention is the only available treatment for drug addiction, and that even in instances where medications are available, behavioral intervention is required. Recent NIDA research shows that the effectiveness of newly developed medication for cocaine addiction is contingent on having a behavioral intervention first. This example underscores the important role of behavioral intervention in addressing and preventing drug abuse and addiction. The Committee continues to support NIDA's expansion of its behavioral science portfolio and views NIDA as a model of how to approach its behavioral science and public health responsibilities.

National Institute on Alcohol Abuse and Alcoholism Behavioral Research on Alcoholism. -- The Committee understands that NIAAA is expanding its behavioral science research activities with new initiatives in the social psychology of group identification; behavioral genetics to understand the biological and environmental factors in vulnerability to alcoholism; the psychophysiology of alcoholism; and basic behavioral research on craving and on the effects of alcohol abuse on memory and cognition. The Committee strongly encourages the Institute to continue this expansion and looks forward to hearing about progress in these areas.

Training. - The Committee strongly encourages NIAAA to adopt the B/START (behavioral science track awards for rapid transition) mechanism for training new behavioral science researchers to enhance efforts to expand its basic behavioral research portfolio.

Health Services Research Plan. - The Committee understands that the National Advisory Council on Alcohol Abuse and Alcoholism has developed a comprehensive plan for health services research, Improving the Delivery of Alcohol Treatment and Prevention Services. The Committee views health services research as an essential part of alcohol treatment and prevention, and would like the Institute to report on its progress in implementing this plan during the next round of appropriations hearings.

National Institute on Nursing Research End-of-Life Health Research. - The Committee understands that NINR has been designated the lead Institute in a new NIH initiative that addresses health issues at the end of life. The NINR initiative emphasizes improved treatment for pain and improved diagnosis and treatment of behavioral symptoms such as cognitive problems, delirium, and depression. With its research in symptom management, decisionmaking for patients, care giving, and optimal environments for critically ill patients, the Committee feels that NINR brings impressive experience to this research effort and commends the Institute for its leadership in this area.

National Institute on Child Health and Human Development Behavioral Research on Child Development. - The Committee understands that NICHD has undertaken several steps to strengthen its commitment to behavioral research and training, to include an initiative entitled: "Progress and Promise in the Behavioral Sciences" and a reorganization of the Institute's behavioral research programs into a new Child Development and Behavior Branch. The Committee commends these actions and urges NICHD to develop a plan and a timetable for implementing the findings of the progress and promise initiative.

National Cancer Institute Behavioral Science Research. - The Committee is pleased to learn that cancer rates have dropped significantly, much of this due to the adoption of healthy behaviors. The Committee urges NCI to increase its investigations into the underlying factors that promote the adoption of healthy behaviors as well as those that mitigate against such behaviors.