President Trump’s recent initiative to allocate federal healthcare dollars directly to individuals instead of insurance companies highlights a growing desire for transparency and accountability in public funding. This scrutiny extends to government-funded medical research, a key component in many clinical practices.
In the past few years, academic medicine has seen a rise in discussions around structural racism. This notion, reminiscent of the outdated 19th-century “miasma” theory that blamed illness on “bad air,” lacks strong empirical support. Yet, more research is being conducted to explore this concept—much of it financed by uninformed taxpayers. To shift this trend, it’s critical to steer federal research funding back toward rigorous science and evidence-based healthcare.
The trend is evident: few researchers, whether emerging or seasoned, turned down funding from the NIH, particularly in areas of heavy investment.
So, how did we get here? The term “structural racism” was hardly mentioned in medical literature until about ten years ago. Now, it serves as a primary explanation within academic medicine for health outcome disparities among different racial and ethnic groups. Its prominence surged during the anti-racism movement of 2020, which permeated corporate settings and educational institutions, and has become a central theme in movements like Black Lives Matter.
This ideology didn’t spare academic medicine either. It quickly gained traction in medical education, health centers, prestigious journals, and professional societies, spreading to influence federal funding agencies.
Consequently, there has been a notable increase in research funded on the premise that racism drives health discrepancies. Nearly 2,300 articles are indexed under “structural racism” in PubMed—the major database for biomedical and health literature—with about 95% published post-January 1, 2020. The output in 2025 alone is projected to be 400 articles, nearly quadrupling what was published prior to 2020.
This growth has been fueled by a wave of federal funding from the National Institutes of Health. Between 2020 and 2025, a search through NIH databases uncovered nearly 750 projects referencing “structural racism,” together accumulating around $533 million. While 2025 appears to show a significant drop to just under $40 million for more than 70 projects compared to over $150 million for 220 projects in 2024, the funding still vastly exceeds the mere $12 million for 12 projects in 2020.
Funding trends reveal that ideology, rather than medicine, has largely influenced this increase. Top investments originated from the National Institute on Drug Abuse ($147 million), the National Institute on Minority Health and Health Disparities ($70 million), and the National Institute on Aging ($57 million)—all directing resources into research on “structural racism.”
For instance, a project by NIDA in 2025 identifies “structural racism” as a risk factor affecting infant development, alongside more tangible issues like maternal health and toxic exposure, which muddles the line between abstract social theories and concrete scientific variables.
Similarly, the NIMHD’s Clinical Research Scholar Training Program, influenced by NIH, emphasizes studying the impact of structural racism and discrimination on health disparities, restricting eligibility to those viewed as “underrepresented” in biomedical research.
Moreover, last year, the NIA supported a project linking “interconnected systems of structural racism” to Alzheimer’s disease and cognitive decline, steering attention away from established factors like genetics and medical conditions.
It appears that ideological shifts took precedence over scientific rigor long before now. Under Francis Collins, the NIH emphasized “recognizing and ending systemic racism.” The term “structural racism” gained acceptance despite its shaky foundation and lack of explanatory value.
With vague definitions and challenging measurement mechanisms, claims of “structural racism” often exceed any solid evidence. Despite this, the idea has garnered substantial traction, helping justify numerous DEI initiatives, effectively transforming the NIH into an “anti-racism” entity. Objective science has become less important; an activist position is now expected.
Supporters of this shift consider health research a chance to transition from “individual-level risks and health behaviors” to “structural-level concepts,” specifically citing “structural racism.” Research-funded tools such as the Structural Racism Impact Index are promoted to shape policies aimed at enhancing health equity.
Incentives are clear: few researchers, whether young or experienced, were likely to refuse funding in areas where the NIH showed strong support, especially when it aided publications in prestigious journals.
However, the ways of measuring “structural racism” show a critical flaw: they fail to assess racism accurately.
For example, the nine dimensions used in the SREI primarily capture socioeconomic factors like income, housing, and employment. Higher scores reflect community poverty rather than racism. A researcher linked SREI scores to health issues like high blood pressure and obesity, admitting that causality could not be established.
These health threats might stem from poverty, contribute to it, or originate from other causes. Labeling them as outcomes of “structural racism” lacks explanatory power, misinterprets economic struggles as racial in nature, and undermines personal responsibility. More significant factors—like care access, lifestyle choices, comorbidities, and genetics—are overlooked.
Nevertheless, alternative explanations for health discrepancies receive scant attention in major medical journals, often relegated to a side note. If differences are present, the default assumption suggests racism is at fault. Similarly, many medical institutions have reinforced this stance through policy papers integrating anti-racism frameworks into research.
Yet, it seems we’re witnessing a shift. The NIH’s excessive focus on “structural racism” is, at last, fading. Under Jay Bhattacharya, the agency aims to redirect efforts towards robust scientific research instead of ideologically driven projects. This shift promises to allocate taxpayer dollars to genuine advancements in health, steering away from current political trends.
Such adjustments are timely, suggesting that by 2026, the NIH could fully reclaim its original mission. This would allow America’s prominent biomedical and medical organizations to prioritize public health and responsible use of taxes.
