Over 83% of major diseases are environmentally mediated. These environmental factors include access to clean air and water, nutritional food, adequate shelter and access to health care. As health care systems across the globe struggle to include not only preventive health, but also health literacy in their approaches, it has become apparent that the most feasible system to combine all of these necessities is the universal health care/coverage (UHC) approach.

Prior research has shown a serious lack of research transparency resulting from the failure to publish study results in a timely manner. The National Institutes of Health (NIH) has increased its use of publication rate and time to publication as metrics for grant productivity. In this study, we analyze the publications associated with all R01 and U01 grants funded from 2008 through 2014, providing sufficient time for these grants to publish their findings, and identify predictors of time to publication based on a number of variables, including if a grant was coded as a behavioral and social sciences research (BSSR) grant or not. Overall, 2.4% of the 27,016 R01 and U01 grants did not have a publication associated with the grant within 60 months of the project start date, and this rate of zero publications was higher for BSSR grants (4.6%) than for non-BSSR grants (1.9%). Mean time in months to first publication was 15.2 months, longer for BSSR grants (22.4 months) than non-BSSR grants (13.6 months). Survival curves showed a more rapid reduction of risk to publish from non-BSSR vs BSSR grants. Cox regression models showed that human research (vs. animal, neither, or both) and clinical trials research (vs. not) are the strongest predictors of time to publication and failure to publish, but even after accounting for these and other predictors, BSSR grants continued to show longer times to first publication and greater risk of no publications than non-BSSR grants. These findings indicate that even with liberal criteria for publication (any publication associated with a grant), a small percentage of R01 and U01 grantees fail to publish in a timely manner, and that a number of factors, including human research, clinical trial research, child research, not being an early stage investigator, and conducting behavioral and social sciences research increase the risk of time to first publication.

Health economics is one of the interdisciplinary sciences that the National Institutes of Health (NIH) supports in order to pursue its overall mission to improve health. In 2015, NIH guidance was published to clarify the type of health economics research that NIH would continue to fund. This analysis aimed to determine if there were changes in the number of health economics applications received and funded by NIH after the release of the guidance. Health economics applications submitted to NIH both before and after the guidance was released were identified using a machine learning approach with input from subject matter experts. Application and funding trends were examined by fiscal year, method of application (solicited vs. unsolicited), and activity code. This study found that application and funding rates of health economics research was decreasing prior to guidance. Following publication of this guidance, the application and funding rate of health economics applications increased.