The face of aging in the United States is changing dramatically. Life expectancy nearly doubled during the 20th century, with a ten-fold increase in the number of Americans age 65 or older. The oldest old—people age 85 or older—constitute the fastest growing segment of the U.S. population. The challenge for the 21st century will be to make these added years as healthy and productive as possible. Our ability to reduce the burden of illness among older adults will depend on an increased understanding of the dynamics of aging and how they interact with various environmental and lifestyle factors in individuals. NIH ARRA investments in aging research focus on a gamut of important topics, including: aging independence, Alzheimer’s disease, osteoporosis and osteoarthritis, biomarkers of aging, neuroimaging, economics of aging, geriatric care, health services, complementary and alternative medicine related to aging, inflammation and aging, and nutrition and aging. More
Cancer is the second leading cause of death in the United States after heart disease. In 2009, it is estimated that nearly 1.5 million new cases of invasive cancer will be diagnosed in this country and more than 560,000 people will die of the disease. Far from being a single disease, more than 100 types of cancer have been identified based on their association with different organs and cell types.
ARRA funds are accelerating cancer research and advancing innovations that will make a difference in the lives of those affected by cancer. Investments have been made strategically based on seven key objectives.
- Accelerate and expand cancer research including the genetic basis of cancer, molecular targets, proteomics, and nanotechnology
- Advance personalized cancer treatment and prevention
- Redesign the cancer informatics infrastructure to break down the barriers related to data sharing and management.
- Revamp the clinical trial system to optimize the process of assessing potential therapies.
- Collaborate for great impact – foster team science and coordinate clinical and translational research
- Strengthen the research workforce by expanding the number of grants for first time applicants who are just beginning their careers in cancer research and recruiting new faculty at Cancer Centers.
- Improve care and quality of life for all cancer patients by investigating factors that contribute to health disparities and funding resources, such as biobanks, that are crucial to health disparities research. More
Genetics & Genomics
2011 marked the 10 year anniversary of the release of the initial sequence and analysis of the draft human genome sequence. Researchers have since discovered the molecular basis of 4,000 disorders and 1,000 genetic variations that make a small contribution to common complex diseases and point towards potential therapeutic targets. Also in 2011, the National Human Genome Research Institute (NHGRI) released a new strategic vision for the future of genomics, “Charting a course for genomic medicine from base pairs to bedside,” in which they envision scientists being able to identify genetic bases of most single-gene disorders and gaining insights into multi-gene disorders in the next decade.
NIH ARRA funding is fueling investigations of the role of genetics in diseases and disorders ranging from diabetes and obesity to mental disorders to infectious diseases. ARRA funds also are supporting work in epigenetics—chemical markers that influence whether genes are active or silent, independent of DNA sequence—and the ambitious effort to comprehensively characterize the genomic alterations and molecular pathways involved in the development of human adult cancers.
Heart disease is the leading cause of death in the United States. Coronary heart disease (also called coronary artery disease), the most common type of heart disease, occurs when plaque builds up in the arteries that supply blood to the heart muscle. Coronary heart disease can cause angina (chest pain) or a heart attack and, over time, contributes to serious disability or death. Other fairly prevalent chronic, serious cardiovascular conditions include hypertension, heart failure, atrial fibrillation, and peripheral arterial disease. The over one million annual deaths from coronary heart disease seen 30-40 years ago now have been cut by more than half due to new drugs, procedures, and prevention programs developed, in part, through NIH research. However, the aging of the population and the increased prevalence of obesity and diabetes threaten to reverse that trend.
NIH ARRA funding is fueling investigations to identify genetic and environmental risk factors, explore cutting-edge diagnostics, and develop treatments in cardiovascular research areas such as: coronary artery disease, atrial fibrillation, diabetes and cardiovascular disease, pediatric heart disease, peripheral arterial disease, and pulmonary hypertension.
Scientific and technological discoveries throughout the 20th century have improved the overall health of the Nation and generated hope for happier, healthier, and longer lives for all. However, some segments of the U.S. population continue to experience elevated morbidity and mortality, disproportionate incidence of disease and disability, and adverse outcomes in cancer, cardiovascular disease, diabetes, HIV/AIDS, infant mortality, and certain other conditions. These disparities in health are most visible in racial/ethnic minority groups, in individuals from socioeconomically disadvantaged backgrounds, and in people living in medically underserved areas including rural communities.
NIH ARRA funded grants are exploring factors contributing to health disparities including diabetes prevention and management causes of obesity, HIV/AIDS in recent immigrants, disparities in heart and lung disease, the progression of chronic kidney disease, and personalization of treatment for kidney failure.
Current estimates suggest that around 1 in 100 U.S. children have been diagnosed with an autism spectrum disorder, or ASD. ASD is a complex developmental disability associated with a wide range of developmental issues, but the core symptoms are problems with social interactions and communication skills, as well as repetitive and stereotyped behaviors, such as hand flapping or twisting. Symptoms usually start before age three and can cause delays or problems that develop from infancy to adulthood. Many fundamental questions about the biology of ASD, potential risk factors, effective treatments and interventions, and impacts throughout life remain unanswered.
NIH used ARRA dollars for a surge in its commitment to finding the causes and treatments for autism. A large portion of the ARRA investment in ASD research is funding grants under the banner “Research to Address the Heterogeneity in Autism Spectrum Disorders.” The topics of interest correspond directly to short-term research objectives detailed in the Interagency Autism Coordinating Committee’s (IACC’s) Strategic Plan for Autism Spectrum Disorder Research (http://iacc.hhs.gov/reports/2009/iacc-strategic-plan-for-autism-spectrum-disorder-research-jan26.shtml
) including developing and testing diagnostic screening tools for different populations, assessing risk from prenatal or early life exposures, initiating clinical trials to test early interventions, and adapting existing, effective pediatric treatments for older children, teens, and adults with ASD.
Mental health disorders are the leading cause of disability in the United States and Canada, accounting for 25 percent of all years of life lost to disability and premature mortality. In a given year, an estimated 13 million American adults (approximately 1 in 17) have a seriously debilitating mental illness. Moreover, suicide is the 11th leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans each year. Schizophrenia, bipolar disorder, depression, post-traumatic stress disorder, eating disorders, autism, and other mental health disorders are serious, often life-threatening, illnesses for which we need reliable diagnostic tests, new treatments, and effective strategies for prevention.
ARRA funding is helping NIH meet a wide variety of scientific opportunities in mental health research—opportunities that were scarcely imagined 10 years ago and build on new understanding of human behavior and the ways in which medicines can be used to treat illnesses; fundamental insights into how the brain works; and advanced methods for studying the interaction between the brain, behavior, and the environment. Many of the ARRA investments in mental health research focus on neuroscience, genetics, specific diseases such as schizophrenia, consequences of impaired mental health such as suicide, and mental health services.
Substance abuse (which encompasses both illicit and legal drugs) imposes an extraordinary public health burden, with an estimated 22.2 million persons (nearly 9 percent of the population) suffering with substance dependence or abuse in the past year. This translates into societal costs of over $600 billion dollars annually in increased health care costs, crime, and lost productivity.
NIH ARRA funding is focusing on several important research avenues in substance abuse research, including:
- immunotherapy approaches, such as vaccines, which work by stimulating the body’s immune system to produce antibodies,
- the testing of promising medications and alternative formulations of proven treatments,
- innovative interventions that build on recent behavioral and epidemiological research and those that take advantage of advances such as web-based technologies,
- drug abuse prevention studies targeting youths and vulnerable populations such as children in foster care,
- investigations of the mechanisms of alcohol and nicotine codependence, and
- comparative effectiveness research More