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

Am Heart J. 2020 Dec:230:54-58. doi: 10.1016/j.ahj.2020.08.014. Epub 2020 Sep 18.


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.

Publication types

  • Letter

MeSH terms

  • Academic Medical Centers / economics
  • Academic Medical Centers / supply & distribution*
  • Adult
  • Age Factors
  • Cardiovascular Diseases / mortality*
  • Confidence Intervals
  • Female
  • Financing, Government*
  • Humans
  • Male
  • Mortality / trends
  • National Institutes of Health (U.S.)*
  • Neoplasms / mortality*
  • Rural Health Services / supply & distribution
  • United States / epidemiology
  • Urban Health Services / supply & distribution