Social Work and National Institutes of Health Funding Decisions: Can We Democratize and Decolonize Health Science Knowledge without a Seat at the Table?

Topic: Social workers research is critical to health services research. The National Institutes of Health (NIH) is one of the most prominent funders of research that informs knowledge related to health. Most mental health services providers are social workers and social workers are active in other areas of health care. However, social workers are remarkably underrepresented on NIH review panels for grant applications that award funds for health research - over $33.3 billion in 2022 alone.

Perspectives and Knowledge: This roundtable includes social work researchers who serve as NIH program officers and reviewers and will discuss 1) social work researchers’ participation on review panels, 2) personal experiences on review panels, 3) social work reviewers’ role in promoting anti-racist and anti-oppressive research, and 4) the role of social work values and ethics in the review process.

A review of NIH study section chartered membership panels conducted in 2023 identified the 33 standing study sections (N = 138) most relevant to social work research. Only eight included reviewers from schools of social work represented less than 1.8% (n = 11) of reviewers comparted to medicine (52.6%, n = 329; 35.6%, n = 117 in psychiatry), psychology (12.8%, n = 80), public health (10.9%, n = 68), and nursing (4.3%, n = 27). Reviewers with credentials representing community and lived expertise were nonexistent. Findings show the underrepresentation of social work researchers, values and ethics in funding decisions that inform health policy and practice knowledge.

NIH Center for Scientific Review data also shows representation of social work values and ethics is lacking. US census data indicates 50.5% of citizens are female, 18.9% Hispanic/Latino, 13.6% Black/African American, 6.1% Asian, 2.9% two or more races, and 1.3% American Indian/Alaskan Native. However, in 2022 only 41.1% of NIH reviewers were female, 7.1% were Hispanic/Latino, 3.7% were Black/African American, 1.8% reported more than one racialized identity, and 0.3% were American Indian. Whites (70.3%) and Asians (24.4%) were overrepresented. Similar disparities exist in funding. Data on “well-funded� investigators (three or more grants) shows men are more consistently represented that women with disparities increasing over time. Principal investigators in 2021 were largely white (55.6%) or Asian (24.1%), with Hispanic (4.8 %) and Black (2.6%) investigators underrepresented. The racialized identity of 11.7% was “unknown� and multiracial and Indigenous investigators were omitted.

Implications: To democratize and decolonize knowledge, particularly knowledge related to health, we must be part of decisions impacting research. Funding is tied to the development of health knowledge and research. We cannot advance social work as a discipline or center racial equity and social justice if we are absent in systems that drive the development of knowledge through research funding. When we are not at the table, research that represents our professional values of social justice and centering community are underrepresented. Research lacking our professional wisdom and values has far reaching implications for all areas of social policy and practice.