OMB Grant Proposal Could Defund Health Disparities
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- The White House Office of Management and Budget proposed a 412-page overhaul of federal grant rules, with Section 200.218 prohibiting federal funds from 'Promot[ing] or Support[ing] Theories of Disparate-Impact Liability' — language health disparities researchers say could disqualify research comparing outcomes across racial and protected groups.
- Health disparities researchers, including social epidemiologist Nancy Krieger, warned the rule would prevent researchers from understanding 'distributions of exposures, distributions of health outcomes' by group, with nearly 200 of the thousands of public comments on the proposal mentioning 'health disparities.'
- The National Institutes of Health had already terminated many health-equity-touching projects in early 2025, and current grant applicants told STAT they are avoiding terms like 'disparities' and 'social determinants of health' to evade being flagged, creating what bioethicist Faith Fletcher of Baylor called 'moral distress.'
- An OMB spokesperson defended the rule by citing past grants to study 'engaging Black sexual and gender minority youth social media influencers' and 'Addressing Social Determinants of Health Among Racially Diverse Trans Women in the Deep South' as 'woke and wasteful projects' that 'ends now.'
- Georgetown Law's Andrew Twinamatsiko argued the rule's colorblind logic mirrors legal reasoning the administration has used against the Voting Rights Act, saying 'the very law that was designed to advance civil rights is now being used to entrench white supremacy.'
- Wake Forest health equity researcher Tiarney Ritchwood said researchers will continue the work despite political headwinds: 'We're resourceful. … I'm never going to abandon the communities that I partner with.'
Why it matters: The proposal would shift grant-awarding power from peer review to political appointees and bar funding tied to disparate-impact theory — the legal framework underpinning civil rights enforcement. Researchers and clinicians warn that communities already bearing disproportionate disease burden would lose both research attention and the federal dollars that flow to organizations serving them, with one foundation CEO saying the rule would hit groups 'that already don't get a lot of attention.'
