MAY 23, 2006 -- Among the proposed budget cuts at the National Institutes of Health (NIH) that has aroused the most concern at the Senate Appropriations Labor-HHS Subcommittee is one that would shelve a huge national study of children's health.
"It was going to be the largest long-term study of children's health ever conducted in the United States," Sen. Tom Harkin, D-Iowa, noted at a May 19 subcommittee hearing on the NIH budget. "We've already spent about $50 million" and four to five years planning the project, he said. "I just can't believe that we're just going to stop it."
Mandated by the Children's Health Act of 2000, the study is designed to track 100,000 American children from conception to age 21. The 100,000 participants are meant to be a nationally representative sample of all children in the United States.
"The study will assess and evaluate the environmental exposures these children experience in the womb, in their homes, in their schools, and in their communities," said one of the researchers planning the project. The goal "is to identify the preventable environmental causes of pediatric disease and to translate those findings into preventive action and improved health care," said the researcher, Philip J. Landrigan, a professor of pediatrics at the Mt. Sinai School of Medicine in New York City.
Diseases and conditions targeted by the study include asthma, obesity, diabetes, premature birth, birth defects, leukemia, and neurodevelopmental disorders such as autism, dyslexia, mental retardation, and attention deficit hyperactivity disorder, Landrigan said in written testimony.
He added that there's strong concern among pediatricians that "these rapidly rising rates of disease may create a situation unprecedented in the 200 years of our nation's history, in which our current generation of children may be the first American children ever not to enjoy a longer life span than the generation before them."
Without research such as the National Children's Study, "we are actually at risk of losing hard-won ground in children's health," he said.
Harkin said only $70 million would be saved in fiscal 2007 by shelving the study, and he noted the huge payoff from a similar study that tracked women's health for 15 years. Among the findings of the project, according to NIH testimony, was that heart disease is the No. 1 killer of women and that different diagnostic tests and treatments are sometimes needed to save lives.
But NIH Director Elias Zerhouni told Harkin that the $70 million would lead to a series of other expenditures. "If you committed to that expenditure, Senator, then you committed to the $3.2 billion, or thereabout, over the total study," Zerhouni said. "Why? Because once you launch the study, you have to continue recruitment of the 100,000 children, their parents and so on.
"So the issue is really an issue of prioritization" in a tough budgetary climate, Zerhouni said.
Landrigan said in his testimony that six of the diseases that are the focus of the study—obesity, injury, asthma, diabetes, autism, and schizophrenia—cost the nation about $642 billion each year. "If the study were to produce even a 1 percent reduction in the cost of these diseases, it would save $6.4 billion annually, 50 times the average yearly costs of the study itself," he said.
But the project could save even more, he said, noting that risk factors for cardiovascular disease identified in the Framingham study, which tracked heart disease, were poorly understood when that project began in 1948. That program saved millions of lives and billions of dollars by identifying smoking, hypertension, diabetes, and elevated cholesterol as "powerful" risk factors for cardiovascular disease, Landrigan said. By focusing on multiple childhood disorders, the National Children's Study could save even more lives, he said.
"We've just got to find the money to put back in there," Harkin declared at the hearing.