NIH awards UA $44 million contract to study children's health

The University of Arizona has won a six-year, $44 million contract to join the National Children's Study (NCS), which asthma researcher Fernando Martinez predicts could be "one of the most important scientific enterprises ever started regarding children's health."

Dr. Martinez, director of UA's Arizona Respiratory Center, will serve as the principal investigator for the contract from the National Institutes of Health. UA is one of 36 study centers now participating in the NCS, authorized by the Children's Health Act of 2000 and designed to investigate environmental influences on the health of children throughout the United States. The study calls for following 100,000 children, from as many as 105 urban and rural study locations, beginning before birth and continuing until age 21.

"The NCS will encompass a nationally representative sample, designed to be a composite of the U.S. population," said Duane Alexander, director of the National Institute of Child Health and Human Development. "It will include children throughout the United States, from rural, urban, and suburban areas, from all income and educational levels, and from all racial groups."

Arizona's initial study locations will be Apache and Pinal Counties, with Maricopa County as a likely addition. Beginning in January 2009, initial recruitment will begin at two "Vanguard Centers," in southern California and Minnesota, that will test procedures for recruitment of study volunteers and sampling methods. Study designers then plan a first wave of nationwide recruitment, including in Arizona, in the summer of 2010.

"The advantage of a long-term study of development is that it will yield important health information at virtually every phase of the life cycle," said NIH Director Elias A. Zerhouni. "Eventually, it will provide greater understanding of adult disorders. In the immediate future, however, we expect it to provide insight into the disorders of birth and infancy."

Among many other concerns, researchers will be examining the relationship between uterine infection and preterm birth, links between the use of assisted reproductive technologies and certain prenatal complications and developmental disabilities, and the correlation between pre- and postnatal exposure to pesticides and poor neurobehavioral and cognitive skills.

As participants age, study planners expect to add investigations in realms such as asthma, obesity, the development of antisocial behavior, and family and community influences on health. The complexity of such problems--with multiple hereditary and environmental contributors--requires the enormous scope of the NCS.

"What is really exciting is you are going to have the environment, genetics, and outcome studied in a standardized way," Dr. Martinez said in the Arizona Republic.

Thanks to that standardization, researchers will be able to identify commonalities and distinctions among children from dramatically different study locations--Dallas, Manhattan, and Apache County, for instance. Study designers are also establishing ties with investigators around the world who are leading other longitudinal studies; one group that has formed, the International Childhood Cancer Cohort Consortium, will compare data on over 700,000 children in an effort to understand rare cancers that affect children.

Dr. Martinez anticipates that the NCS could usher in a future where scientists understand the interplay of genetics and environmental conditions much better, and can make far more precise recommendations to parents about how to protect their children from disease.

"We will know much better which children should avoid certain exposures to prevent disease," he said, "and in which children other exposures foster wellbeing and promote better health."

In the nearer term, the process of identifying children for inclusion in the NCS presents researchers an unprecedented chance for outreach.

"The NCS contract represents a wonderful opportunity for the UA to work collaboratively with communities in Pinal and Apache counties to generally raise awareness about the determinants of children's health," said Francisco Garcia, a professor of obstetrics and gynecology at UA and one of the study's lead investigators.

If the NCS continues to receive full funding--it requires Congressional authorization on an annual basis--it will ultimately cost $3.2 billion. From 2000 to 2007, around $200 million was spent on the study; another $111 million was authorized for fiscal year 2008 alone. UA's contract of $44 million is one of the largest of the 27 new contracts that were announced by the NIH earlier this month. The only larger contracts went to multi-institutional consortiums in Michigan and Florida.

"This tremendously important study will lead to discoveries that will improve children's health in Arizona and the nation," said Fayez K. Ghishan, chair of the UA pediatrics department. "We are very proud of the hard work Dr. Martinez and his team accomplished to make UA one of the new study centers."

Contracts for projects like the National Children's Study are typically recognized as distinct from federal research grants. Where grants are awarded to support projects proposed by researchers, contracts are awarded to complete specific tasks outlined by the funding agency. The NIH awards around $5 billion annually in contracts, compared to the $22.8 billion it awarded in grants in fiscal year 2007.

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For more information:

"UA researchers get $44 million for study," Arizona Republic, 10/06/2008

UA news release, 10/03/2008

NIH news release, 10/03/2008