Prevention Research on Extreme Weather and Health: A Portfolio Analysis of NIH Funded Studies, 2015-2024.

INTRODUCTION: The public health burden from extreme weather is significant and research to prevent related adverse health impacts is needed. This study's objective was to characterize the portfolio of extreme weather and prevention research funded by NIH for fiscal years (FY) 2015-2024 and identify research gaps and opportunities. METHODS: Within a broad portfolio of NIH-funded extreme weather-related grants, a coding schema was developed to identify prevention projects focused on six extreme weather hazards. A prevention research taxonomy was applied to categorize projects according to several study variables. RESULTS: A total of 243 projects focused on specific extreme weather hazards. Among these, 78% (n=189) were considered prevention research, primarily consisting of primary prevention. Of these, the largest proportion of projects focused on heat (39.4%), followed by hurricanes/floods/precipitation (31.7%). Projects assessed a range of health outcomes, and approximately 30% of the projects within the portfolio included a focus on one of the ten leading causes of death in the United States. The majority of projects were observational studies, compared to interventional. Children, the elderly, or low-income populations were each represented in about 20-25% of funded projects. However, some vulnerable populations, such as populations experiencing homelessness, were not represented in the portfolio. CONCLUSIONS: A large portion of the research funded by the NIH in FY 2015-2024 addressing extreme weather and health focused on prevention. An increased focus on longitudinal research, as well as interventional research to mitigate the health impacts from extreme weather, with attention to highly vulnerable populations, is needed.