A lesson for DEI strategies from the NIH ESI policy

The Director of the NIH, in the wake of a presentation to the Advisory Committee to the Director meeting, has issued a statement of NIH’s commitment to dismantle structural racism.

Toward that end, NIH has launched an effort to end structural racism and racial inequities in biomedical research through a new initiative called UNITE, which has already begun to identify short-term and long-term actions. The UNITE initiative’s efforts are being informed by five committees with experts across all 27 NIH institutes and centers who are passionate about racial diversity, equity, and inclusion. NIH also is seeking advice and guidance from outside of the agency through the Advisory Committee to the Director (ACD), informed by the ACD Working Group on Diversity, and through a Request for Information (RFI) issued today seeking input from the public and stakeholder organizations. The RFI is open through April 9, 2021, and responses to the RFI will be made publicly available. You can learn more about NIH’s efforts, actions, policies, and procedures via a newly launched NIH webpage on Ending Structural Racism aimed at increasing our transparency on this important issue.

This is very much welcome, coming along as it does, a decade after Ginther and colleagues showed that Black PIs faced a huge disadvantage in getting their NIH grants funded. R01 applications with Black PIs were funded at only 58% of the rate that applications with white PIs were funded.

Many people in the intervening years, accelerated after the publication of Hoppe et al 2019 and even further in the wake of the murder of George Floyd at the hands of the Minneapolis police in 2020, have wondered why the NIH does not simply adopt the same solution they applied to the ESI problem. In 2006/2007 the then-Director of NIH, Elias Zerhouni, dictated that the NIH would practice affirmative action to fund the grants of Early Stage Investigators. As detailed in Science by Jocelyn Kaiser

Instead of relying solely on peer review to apportion grants, [Zerhouni] set a floor—a numerical quota—for the number of awards made to new investigators in 2007 and 2008.

A quota. The Big Bad word of anti-equity warriors since forever. Gawd forbid we should use quotas. And in case that wasn’t clear enough

The notice states that NIH “intends to support new investigators at success rates comparable to those for established investigators submitting new applications.” In 2009, that will mean at least 1650 awards to new investigators for R01s, NIH’s most common research grant.

As we saw from Hoppe et al, the NIH funded 256 R01s with Black PIs in the interval from 2011-2015, or 51 per year. In a prior blog post I detailed how some 119 awards to poorer-scoring applications with white PIs could have been devoted to better-scoring proposals with Black PIs. I also mentioned how doing so would have moved the success rate for applications with Black PIs fro 10.7% to 15.6% whereas the white PI success rate would decline from 17.7% to 17.56%. Even funding every single discussed application with a Black PI (44% of the submissions) by subtracting those 1057 applications from the pool awarded with white PIs would reduce the latter applications’ hit rate only to 16.7% which is still a 56% higher rate than the 10.7% rate that the applications with Black PIs actually experienced.

I have been, and continue to be, an advocate for stop-gap measures that immediately redress the funding rate disparity by mandating at least equivalent success rates, just as Zerhouni mandated for ESI proposals. But we need to draw a key lesson from that episode. As detailed in the Science piece

Some program directors grumbled at first, NIH officials say, but came on board when NIH noticed a change in behavior by peer reviewers. Told about the quotas, study sections began “punishing the young investigators with bad scores,” says Zerhouni. That is, a previous slight gap in review scores for new grant applications from first-time and seasoned investigators widened in 2007 and 2008, [then NIGMS Director Jeremy] Berg says. It revealed a bias against new investigators, Zerhouni says.

I don’t know for sure that this continued, but the FY 2012 funding data published by Kienholz and Berg certainly suggest that several NIH ICs continued to fund ESI applications at much lower priority scores/percentiles than were generally required for non-ESI applications to receive awards. And if you examine those NIH ICs pages that publish their funding strategy each year [see the writedit blog for current policy links], you will see that they continue to use a lower payline for ESIs. So. From 2007 to 2021 that is a long interval of policy which is not “affirmative action”, just, in the words of Zerhouni, “leveling the playing field”.

The important point here is that the NIH has never done anything to get to the “real reason” for the fact that early stage investigators proposals were being scored by peer review at lower priority than they, NIH, desired. They have not undergone spasms of reviewer “implicit bias” training. They have not masked the identity of the PI or done anything suggesting they think they can “fix” the review outcome for ESI PIs.

They have accepted the fact that they just need to counter the bias.

NIH will likewise need to accept that they will need to fund Black PI applications with a different payline for a very long time. They need to accept that study sections will “punish*” those applications with even worse scores. They will even punish those applications with higher ND rates. And to some extent, merely by talking about it this horse has left the stall and cannot be easily recalled. We exist in a world where, despite all evidence, white men regularly assert with great confidence that women or minority individuals have all the advantages in hiring and career success.

So all of this entirely predictable behavior needs to be accounted for, expected and tolerated.

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*I don’t happen to see it as “punishing” ESI apps even further than whatever the base rate is. I think reviewers are very sensitive to perceived funding lines and to reviewing grants from a sort of binary “fund/don’t fund” mindset. Broadcasting a relaxed payline for ESI applications almost inevitably led to reviewers moving their perceived payline for those applications.