How Well Does Climate Change and Human Health Research Match the Demands of Policymakers? A Scoping Review

Background: In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change.Objectives: To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research.Methods: We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups).Discussion: We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries.Conclusions: Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help ensure that the needs of policymakers are met.     

National Institutes of Health (NIH) activities concerning nutrition research related to food composition databases

Approximately 4% of the research expenditures for the US National Institutes of Health (NIH) is used to support nutrition research and training within NIH laboratories (intramural program) and in research institutions in the US and abroad (extramural program). In fiscal year (FY) 2000, the funding for NIH nutrition research and training was $694.9 million for 3150 projects. The research areas are broad and include the functions of nutrients and other food components in biological systems, the dietary intakes needed to prevent disease and/or promote optimal health, variables that affect nutrient functions and requirements, and genetic differences in needs and responses. The results of the many nutrition research projects and programs may help the Agriculture Research Service (ARS) of the US Department of Agriculture (USDA) establish priorities for analyzing food components and including them in USDA food composition databases. NIH research projects are described and tracked through the Human Nutrition Research Information Management (HNRIM) system. A recent search for the key word antioxidants, food components of great interest to database developers and users, identified 131 projects, many with direct relevance to specific foods. NIH, along with other government agencies, provides financial support for the ARS, USDA National Food and Nutrient Analysis Program (NFNAP), which began in 1997. NIH support for NFNAP amounted to $1 850 000 in FY 2001. NIH is currently providing support for four NFNAP complementary databases: Native American foods, USDA commodity foods, choline, and fluoride. NIH provides support for segments of the National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics (NCHS). NIH support for NHANES was about $5.3 million in FY 2001 (about 12.4% of FY 2001 costs for the survey), and discussions are underway to assure continued NIH support for this survey.     

Research Funded by the National Institutes of Health on the Health of Lesbian,Gay, Bisexual,and Transgender Populations

Objectives. We examined the proportion of studies funded by the National Institutes of Health (NIH) that focused on lesbian, gay, bisexual, and transgender (LGBT) populations, along with investigated health topics.Methods. We used the NIH RePORTER system to search for LGBT-related terms in NIH-funded research from 1989 through 2011. We coded abstracts for LGBT inclusion, subpopulations studied, health foci, and whether studies involved interventions.Results. NIH funded 628 studies concerning LGBT health. Excluding projects about HIV/AIDS and other sexual health matters, only 0.1% (n = 113) of all NIH-funded studies concerned LGBT health. Among the LGBT-related projects, 86.1% studied sexual minority men, 13.5% studied sexual minority women, and 6.8% studied transgender populations. Overall, 79.1% of LGBT-related projects focused on HIV/AIDS and substantially fewer on illicit drug use (30.9%), mental health (23.2%), other sexual health matters (16.4%), and alcohol use (12.9%). Only 202 studies examined LGBT health–related interventions. Over time, the number of LGBT-related projects per year increased.Conclusions. The lack of NIH-funded research about LGBT health contributes to the perpetuation of health inequities. Here we recommend ways for NIH to stimulate LGBT-related research.In 2010, the National Institutes of Health (NIH) commissioned the Institute of Medicine (IOM) to systematically examine the state of lesbian, gay, bisexual, and transgender (LGBT) health.1 The IOM’s report on the health of LGBT populations contributed to advancing the field of LGBT health by identifying research gaps and developing an agenda to guide NIH in enhancing its portfolio in this area.1The findings highlighted in the IOM report are stark and reflect the inadequacy of LGBT health research to date. In general, LGBT populations experience stigma associated with their sexual and gender minority status, disproportionate behavioral risks and psychosocial health problems, and higher chronic disease risk factors than their heterosexual and cisgender counterparts.1–3 (Cisgender refers to congruence between the gender category assigned to an individual at birth and the gender identity experienced by that individual.4) The greatest focus of LGBT health research to date is on the increased risk and incidence of HIV/AIDS and other sexually transmitted infections among sexual minority men.1,5–8 Research on the health of sexual minority women and transgender populations is limited.1 We know that LGBT people experience disproportionate mental health and substance use problems relative to their heterosexual and cisgender counterparts.1,9–14 Inequities have also been documented in access to and utilization of health care among LGBT populations.1,15–18 But research is lacking for many other pertinent LGBT health issues, including the effects of problematic access to care, homophobia, violence, homelessness, tobacco use, and obesity.1NIH is the largest funder of medical research in the world,19 but its contribution to the emerging body of knowledge on LGBT health was minimal from 1974 to 199220 and remains undocumented for more recent years. In response to the findings and recommendations in the IOM report, NIH in 2012 invited grant proposals for research on the health of lesbian, gay, bisexual, transgender, and intersex populations.21–23 To accomplish the Healthy People 2020 goal of health equity for LGBT populations,2 public health researchers and practitioners need a large body of evidence for appropriate and effective means of improving health in these groups. However, the number of evidence-based interventions that succeed in improving the health and well-being of LGBT populations is unknown, and the extent to which they are being developed, implemented, and evaluated at NIH has yet to be illuminated. With NIH calling for new proposals, a comprehensive assessment of its funding of LGBT health research to date is necessary to ensure that funding is targeted to fill existing gaps in research.Therefore, we aimed to understand the proportion and content areas of NIH-funded research from 1989 through 2011 that focused on the health and well-being of LGBT populations. We analyzed the overall proportions of NIH-funded studies that examined the health of LGBT populations, and we recorded the subpopulations included in these projects (e.g., sexual minority women, sexual minority men, transgender persons). We examined the content areas of LGBT health–related research for the LGBT population as a whole and by subpopulations. We also analyzed the health foci of LGBT health–related research after excluding studies about HIV/AIDS and other sexual health matters for the LGBT population as a whole and by subpopulations. We examined projects funded to develop, implement, and evaluate public health interventions that address the unique needs of the LGBT population as a whole and by subpopulations. Finally, we examined LGBT health–related projects funded by NIH over time.     

NIEHS Extramural Global Environmental Health Portfolio: Opportunities for Collaboration.

BACKGROUND: Global environmental health has emerged as a critical topic for environmental health researchers and practitioners. Estimates of the environmental contribution of total worldwide disease burden range from 25 to 33%. OBJECTIVE: We reviewed grants funded by the National Institute of Environmental Health Sciences (NIEHS) during 2005-2007 to evaluate the costs and scientific composition of the global environmental health portfolio, with the ultimate aim of strengthening global environmental health research partnerships. METHODS/RESULTS: We examined NIEHS grant research databases to identify the global environmental health portfolio. In the past 3 fiscal years (2005-2007), the NIEHS funded 57 scientific research projects in 37 countries, at an estimated cost of $30 million. Metals such as arsenic, methylmercury, and lead are the most frequently studied toxic agents, but a wide range of stressors, routes of exposure, and agents are addressed in the portfolio. CONCLUSIONS: The portfolio analysis indicates that there is a firm foundation of research activities upon which additional global environmental health partnerships could be encouraged. Current data structures could be strengthened to support more automated analysis of grantee information.     

U.S. Funding Is Insufficient to Address the Human Health Impacts of and Public Health Responses to Climate Variability and Change

Background

The need to identify and try to prevent adverse health impacts of climate change has risen to the forefront of climate change policy debates and become a top priority of the public health community. Given the observed and projected changes in climate and weather patterns, their current and anticipated health impacts, and the significant degree of regulatory discussion underway in the U.S. government, it is reasonable to determine the extent of federal investment in research to understand, avoid, prepare for, and respond to the human health impacts of climate change in the United States.

Objective

In this commentary we summarize the health risks of climate change in the United States and examine the extent of federal funding devoted to understanding, avoiding, preparing for, and responding to the human health risks of climate change.

Discussion

Future climate change is projected to exacerbate various current health problems, including heat-related mortality, diarrheal diseases, and diseases associated with exposure to ozone and aeroallergens. Demographic trends and geophysical and socioeconomic factors could increase overall vulnerability. Despite these risks, extramural federal funding of climate change and health research is estimated to be < $3 million per year.

Conclusions

Given the real risks that climate change poses for U.S. populations, the National Institutes of Health, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency, and other agencies need to have robust intramural and extramural programs, with funding of > $200 million annually. Oversight of the size and priorities of these programs could be provided by a standing committee within the National Academy of Sciences.     

Impacts of Climate Change on Indirect Human Exposure to Pathogens and Chemicals from Agriculture

Objective

Climate change is likely to affect the nature of pathogens and chemicals in the environment and their fate and transport. Future risks of pathogens and chemicals could therefore be very different from those of today. In this review, we assess the implications of climate change for changes in human exposures to pathogens and chemicals in agricultural systems in the United Kingdom and discuss the subsequent effects on health impacts.

Data sources

In this review, we used expert input and considered literature on climate change; health effects resulting from exposure to pathogens and chemicals arising from agriculture; inputs of chemicals and pathogens to agricultural systems; and human exposure pathways for pathogens and chemicals in agricultural systems.

Data synthesis

We established the current evidence base for health effects of chemicals and pathogens in the agricultural environment; determined the potential implications of climate change on chemical and pathogen inputs in agricultural systems; and explored the effects of climate change on environmental transport and fate of different contaminant types. We combined these data to assess the implications of climate change in terms of indirect human exposure to pathogens and chemicals in agricultural systems. We then developed recommendations on future research and policy changes to manage any adverse increases in risks.

Conclusions

Overall, climate change is likely to increase human exposures to agricultural contaminants. The magnitude of the increases will be highly dependent on the contaminant type. Risks from many pathogens and particulate and particle-associated contaminants could increase significantly. These increases in exposure can, however, be managed for the most part through targeted research and policy changes.     

Prevention Research at the National Institutes of Health

Prevention of disease and disability and preservation of health are compelling strategies that are endorsed by the public, health care providers, and researchers. Despite this general acceptance of the concept, the “devil is in the details.” What can and should be recommended with confidence to the public and health care providers regarding prevention and how can these recommendations be implemented? Prevention programs should be based on durable evidence of efficacy and should assure that the benefits of interventions and changes exceed the risks. The latter is particularly important for population-based primary prevention because many are influenced but fewer may benefit. Prevention research must provide the evidence of benefit and risk. The responsibility of the National Institutes of Health (NIH) is to develop the scientific basis for prevention and to train prevention scientists who are responsible for creating this science base. The interpretation and dissemination of information from research studies are important and necessary aspects to assure translation of the science into personal and public health practices. The components of prevention research are investigation of the factors that place individuals and groups at risk of disease and disability; trials of the interventions that can modify this risk; and testing the approaches that can effectively implement beneficial changes. NIH is committed to addressing these endeavors, and its individual Institutes and Centers support a broad portfolio of prevention research. This paper will provide an overview of NIH support, the functional relationships of prevention research within NIH, and background information that can be useful to those interested in research.     

Educating the Public About Research Funded by the National Institutes of Health Using a Partnership Between an Academic Medical Center and Community-based Science Museum

The NIH roadmap has among its goals, to promote studies designed to improve public understanding of biomedical and behavioral science, and to develop strategies for promoting collaborations between scientists and communities toward improving the public’s health. Here, we report findings on the impact of a partnership between the Oregon Health and Science University (OHSU) and the Oregon Museum of Science and Industry (OMSI) designed to inform the public about health research being conducted in Oregon, which was linked to a 17-week traveling exhibition of BodyWorlds3. Measures included the public’s understanding of health knowledge, attitudes, intended health behaviors, and visitor experience in their interactions with OHSU experts/volunteers, which were collected using exit surveys administered verbally. Nine hundred fifty-three surveys were included in analyses. Among those who felt that health behavior change was relevant to them, 67.4% of smokers (n = 133) intended to change their smoking behavior, 58.6% (of 677) intended to change their eating habits, 60.3% (of 667) intended to change their exercise routine, and 47% (of 448) intended to change their dental care habits. Forty-six percent of these visited the OHSU research exhibits (n = 437), and responded to how the exhibit changed their understanding about and openness to participate in health research. Greater than 85% had a much improved understanding of NIH research at OHSU and >58% reported they would be willing to participate in future research studies at OHSU. In conclusion, research partnerships between academic institutions and community-based museums appear to be viable ways to inform the public about research, stimulate their interest as future participants, and possibly influence their intention to improve health behaviors. This work was supported by the Oregon Clinical and Translational Research Institute (NCRR # U54 RR023424, Eric Orwoll, MD, PI) and SEPA (NCRR #20443; William Cameron, PhD, PI). We would like to acknowledge the staff at the Oregon Museum of Science and Industry for their work on the BodyWorlds Exhibit.     

Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead

Background: Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion.Objectives: We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public’s health from heat events and climate change.Discussion: Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified.Conclusions: The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.     

Summary of a workshop on the development of health models and scenarios: strategies for the future

A workshop was convened in July 2003 by the Global Change Research Program, Office of Research and Development at the U.S. Environmental Protection Agency, to review current strategies for developing human health models and scenarios in the context of global environmental change, particularly global climate change, and to outline a research agenda that effectively characterizes the interplay of global change with the health of human populations. The research agenda developed at the workshop focused on three issues: a) the development of health models, b) the development of health scenarios, and c) the use of health models and health scenarios to inform policy. The agenda identified research gaps as well as barriers to the development and use of models and scenarios. This report summarizes the workshop findings.     

Health equity and sustainability: extending the work of the Commission on the Social Determinants of Health

The final report of the World Health Organization Commission on Social Determinants of Health presents opportunities to promote synergies between health equity and action on sustainability, including reducing global warming. The report makes important recommendations for political and economic reform, but stops short of calling for major change to the conventional neo-liberal model of economic development and growth. Yet the challenge of global warming appears to make growth according to this model unfeasible. In this article, we explore opportunities in the work of the Commission for combining goals of health equity and sustainability, and discuss ideas for economic reforms which further challenge the dominant model, and seek to accommodate the imperatives of reversing climate change.     

Public health nurses' knowledge and attitudes regarding climate change

Background: Climate change affects human health, and health departments are urged to act to reduce the severity of these impacts. Yet little is known about the perspective of public health nurses—the largest component of the public health workforce—regarding their roles in addressing health impacts of climate change.Objectives: We determined the knowledge and attitudes of public health nurses concerning climate change and the role of public health nursing in divisions of health departments in addressing health-related impacts of climate change. Differences by demographic subgroups were explored.Methods: An online survey was distributed to nursing directors of U.S. health departments (n = 786) with Internet staff directories.Results: Respondents (n = 176) were primarily female, white public health nursing administrators with ≥ 5 years of experience. Approximately equal percentages of respondents self-identified as having moderate, conservative, and liberal political views. Most agreed that the earth has experienced climate change and that climate change is somewhat controllable. Respondents identified an average of 5 of the 12 listed health-related impacts of climate change, but the modal response was zero impact. Public health nursing was perceived as having responsibility to address health-related impacts of climate change but lacking the ability to address these impacts.Conclusions: Public health nurses view the environment as under threat and see a role for nursing divisions in addressing health effects of climate change. However, they recognize the limited resources and personnel available to devote to this endeavor.     

Integrating climate change adaptation into public health practice: using adaptive management to increase adaptive capacity and build resilience

Background: Climate change is expected to have a range of health impacts, some of which are already apparent. Public health adaptation is imperative, but there has been little discussion of how to increase adaptive capacity and resilience in public health systems.Objectives: We explored possible explanations for the lack of work on adaptive capacity, outline climate–health challenges that may lie outside public health’s coping range, and consider changes in practice that could increase public health’s adaptive capacity.Methods: We conducted a substantive, interdisciplinary literature review focused on climate change adaptation in public health, social learning, and management of socioeconomic systems exhibiting dynamic complexity.Discussion: There are two competing views of how public health should engage climate change adaptation. Perspectives differ on whether climate change will primarily amplify existing hazards, requiring enhancement of existing public health functions, or present categorically distinct threats requiring innovative management strategies. In some contexts, distinctly climate-sensitive health threats may overwhelm public health’s adaptive capacity. Addressing these threats will require increased emphasis on institutional learning, innovative management strategies, and new and improved tools. Adaptive management, an iterative framework that embraces uncertainty, uses modeling, and integrates learning, may be a useful approach. We illustrate its application to extreme heat in an urban setting.Conclusions: Increasing public health capacity will be necessary for certain climate–health threats. Focusing efforts to increase adaptive capacity in specific areas, promoting institutional learning, embracing adaptive management, and developing tools to facilitate these processes are important priorities and can improve the resilience of local public health systems to climate change.     

An Ill Wind? Climate Change,Migration, and Health

Background: Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move.Objectives: In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response.Methods: This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change.Discussion: Climate-change–related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains.Conclusions: Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change.     

Environmental Health Indicators of Climate Change for the United States: Findings from the State Environmental Health Indicator Collaborative

Objective

To develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions.

Data sources

We conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature.

Data extraction

Sources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level.

Data synthesis

We present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change.

Conclusions

A review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.     

三城市公共卫生人员对气候变化健康影响的知识、态度、行为调查

目的了解我国公共卫生专业人员气候变化相关知识、态度和行为的现状。方法采用分层整群抽样的方法,抽取3个不同地理纬度城市28家公共卫生机构的795名业务科室工作人员作为调查对象,开展自我管理式问卷调查。结果气候变化知晓率84．4％,但对气候变化这一公共卫生问题的关注率仅为43．5％。69．1％可回答3项以上热浪期间慢病患者的注意事项;58．6％可回答5项及以上中暑发生的影响因素;71．1％可回答2项及以上中暑的急救措施。75％以上的调查对象对气候变化相关工作均持肯定态度,其中84．4％认为对公众开展适应气候变化的相关健康教育很重要,但仅38．5％调查对象曾经参加过适应气候变化保护人群健康的相关活动,55％曾在热浪期间宣传慢病防治知识。大众媒体是获取气候变化及健康影响相关知识的主要途径,专业培训及会议仅占35．8％。结论我国公共卫生人员在适应气候变化保护公众健康的能力方面亟待提高,适应气候变化保护人群健康方面的工作有待进一步加强。     

Excessive Heat and Respiratory Hospitalizations in New York State: Estimating Current and Future Public Health Burden Related to Climate Change

Background: Although many climate-sensitive environmental exposures are related to mortality and morbidity, there is a paucity of estimates of the public health burden attributable to climate change.Objective: We estimated the excess current and future public health impacts related to respiratory hospitalizations attributable to extreme heat in summer in New York State (NYS) overall, its geographic regions, and across different demographic strata.Methods: On the basis of threshold temperature and percent risk changes identified from our study in NYS, we estimated recent and future attributable risks related to extreme heat due to climate change using the global climate model with various climate scenarios. We estimated effects of extreme high apparent temperature in summer on respiratory admissions, days hospitalized, direct hospitalization costs, and lost productivity from days hospitalized after adjusting for inflation.Results: The estimated respiratory disease burden attributable to extreme heat at baseline (1991–2004) in NYS was 100 hospital admissions, US$644,069 in direct hospitalization costs, and 616 days of hospitalization per year. Projections for 2080–2099 based on three different climate scenarios ranged from 206–607 excess hospital admissions, US$26–$76 million in hospitalization costs, and 1,299–3,744 days of hospitalization per year. Estimated impacts varied by geographic region and population demographics.Conclusions: We estimated that excess respiratory admissions in NYS due to excessive heat would be 2 to 6 times higher in 2080–2099 than in 1991–2004. When combined with other heat-associated diseases and mortality, the potential public health burden associated with global warming could be substantial.     

基于天气气候的健康气象预测研究展望

介绍影响人体健康的天气气候和大气环境因素、影响途径和方式,以及国内外基于天气气候的健康预测研究。气象与公共卫生部门密切的合作,开发基于天气气候的健康气象早期预警技术,增强预防干预措施,有利于降低相关疾病发生风险。     

How to contribute occupationally to ecological sustainability: A literature review

Abstract

Objective: Climate change is of great concern today, and is an important health issue. The changes are related to human occupations and, therefore, an occupational perspective can make important contributions to ecological sustainability. The aim of this scoping literature review was to explore and describe what has recently been written about how occupational therapy/therapists/science can contribute to ecological sustainability and the prevention of more severe climate change. Methods: Publications were used as data. Searches were conducted in databases, journals, reference lists, and citations. Fourteen items, with content related to the contribution of occupational therapy/therapists/science to climate change and ecological sustainability; written in English; having an occupational therapist among the authors; and published between 2008 and 2013; were included. Results: The results revealed four different ways that occupational therapists/scientists can contribute: by adapting to prevent climate change and to existing changes; by cooperating with others; by exploring people's occupational choices and the relationship between occupation and ecology; and by warning of the consequences of the changes. Conclusion: These ways of contributing can be used as a point of departure for further research on this important topic.     

Funding for rural health research from the Australian Research Council: A missed opportunity?

Objective:  To determine the number of projects, and level of funding, for rural health research from the Australian Research Council (ARC).
Design:  Analyses of ARC searchable datasets of completed, and new and ongoing projects from 2001 to 2008.
Main outcome measures:  Number of rural health research projects as a proportion of total funding; level of funding for rural health research projects as a proportion of total funding.
Results:  Only 46 of 6498 ARC completed projects were classified as rural health research projects. This represents 0.7% of the total number of projects, and 0.39% of the total funding allocated. Only 25 of 4659 ARC new and ongoing projects were classified as rural health research projects. This represents 0.54% of the total number of projects, and 0.27% of the total funding allocated. None of the 832 completed fellowships were classified as rural health. Only five (0.52%) of the 953 new and ongoing fellowships were classified as rural health.
Conclusions:  The level of under-funding for rural health research could be partially addressed by directing applications towards the ARC, in addition to the National Health and Medical Research Council. With a few exceptions, rural health researchers are not yet competitive in the national funding arena.