The NIH childhood adversity portfolio: unmet needs, emerging challenges

Despite the significant increase in pediatric funding, an important question is whether recent changes in the burden of disease and conditions (child and adolescent mortality and nonfatal health loss) are reflected in the National Institutes of Health's (NIH) allocation process. As it sets future priorities, NIH acknowledges "a need to scan the landscape for unmet needs and emerging challenges" so that supported "research translates into meaningful health benefits." Our focus is to scan the pediatric budgetary landscape, report research funding for childhood adversity and adverse childhood experiences, and to illuminate gun violence, suicide, and drug abuse/overdose as prime examples of pediatric unmet needs and emerging challenges. Our findings suggest that pediatric researchers must reconceptualize gun violence as a form of childhood adversity and adverse childhood experiences, as we also need to do for other leading causes of child and adolescent mortality such as suicide and drug abuse/overdose. As it relates to the leading cause of death for children and adolescents, pediatric-related gun violence research spending remains only 0.0017% of the NIH pediatric portfolio. IMPACT: New data on NIH spending on ACEs and childhood adversity. New data to assess the relationship of spending to pediatric burden of disease. New data on pediatrics-related gun violence, suicide and drug abuse/overdose spending.