WASHINGTON, D.C. — The White House Office of Management and Budget (OMB) issued a 412-page proposal to overhaul federal grant awards, which would diminish peer review and restrict funding for research on health disparities and theories of disparate impact. The proposal followed the termination of many National Institutes of Health (NIH) projects related to health equity in early 2025.

The proposed regulation, specifically Section 200.218, prohibits the use of federal funds to promote or support theories of disparate-impact liability. Separately, the proposal would transfer authority for determining grant funding from peer review to political appointees. An OMB spokesperson said, "In the past, unaccountable deep state bureaucrats have funded woke and wasteful projects like, '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,' under the guise of studying health disparities." The spokesperson added, "That ends now." The spokesperson also said, "With this new rule, the Trump Administration will bring much-needed accountability to the grantmaking process and ensure taxpayer dollars are spent wisely."

After its issuance last month, the proposal received thousands of public comments. Nearly 200 of these comments specifically mentioned health disparities. Social epidemiologist Nancy Krieger said, "If this rule is taken to mean that you're not supposed to compare groups because some of them have quote-unquote protected status, then you're ruling out actually understanding what's truly going on in the population about distributions of exposures, distributions of health outcomes, and what the causes of these patterns are." Faith Fletcher, a bioethicist and public health researcher at Baylor College of Medicine, said, "It's moral distress at so many levels, to be in a position where people were calling on health disparities researchers to comment during the height of the Covid-19 pandemic." Fletcher said, "Then where we are now, you potentially are losing grant funding." She also said, "But from a personal perspective, what's deeply troubling for me is being really committed to this work … and now being told when I work on grants that I need to remove [the words] 'disparities' and 'social determinants of health.'" Fletcher said, "It's just ethically problematic." Davena Longshore, CEO of the Cummings Foundation for Behavioral Health, submitted a comment opposing the OMB proposal.