How research cuts and data infrastructure changes impact rural communities

Federal research funding, data, and related infrastructure are critical to ensuring the stability of our rural health services and the vitality of our rural communities. The first four months of 2025 have been marked by termination of ongoing federal research grants, cuts to indirect costs for research, and shuttering and reorganization of key divisions and agencies within the Department of Health and Human Services (HHS). These cuts and changes have the potential to have detrimental impacts on rural health research and our rural health service infrastructure and communities. Thus, the National Rural Health Association along with other organizations have advocated for sustained research funding and infrastructure to support rural health research.

As of May 1, 2025, more than 50 ongoing HHS grants with “rural” in the title have been terminated. This includes dozens of CDC grants to address COVID-19 disparities within specific populations, including rural residents, as well as Food and Drug Administration (FDA) and National Institute of Health (NIH) grants on important topics such as childhood vaccination, HIV, suicide, substance use, mental health, and dementia in rural populations. The Risk Underlying Rural Areas Longitudinal (RURAL) Cohort Study, aimed to understand the underlying factors contributing to higher rates of heart, lung, and other related disease in rural areas, has also had its funding terminated. The RURAL Cohort study focuses on recruiting rural residents from remote areas of Alabama, Mississippi, Louisiana, and Kentucky, which have some of the worst health outcomes in the country. The recently proposed budget from the Trump administration proposes to cut NIH funding by 40% for Fiscal Year 2026, which also includes eliminating funding for the National Institute on Minority Health and Health Disparities (NIMHD) within NIH; rural populations are among the disparity populations that are a focus for NIMHD.

Additionally, the administration has cut indirect costs for research grants substantially from what is often around 50% of direct costs to a maximum of 15%. While a federal judge has at least temporarily blocked these cuts, they will have a devastating domino effect if implemented, as is proposed in the Trump administration’s proposed budget. Indirect costs are funds that accompany direct costs for research that help support the research operations beyond research supplies and personnel, such as expenses for utilities, administrative support, and shared resources like IT. These cuts would not only impact the institution during research itself, but may have ripple effects such as preventing rural cancer patients from accessing clinical trials, as well as economically impact the broader surrounding rural communities. For example, Southern Illinois University, a regional university in the rural community of Carbondale, Illinois and a key source of both higher education opportunities and employment in rural southern Illinois, would lose $4.5 million if proposed cuts were made. SIU ranks in the top 25 for medical school graduates practicing in rural areas. More broadly, research funding has a wide-ranging labor and economic impact. United for Medical Research estimates that the nearly $37 billion awarded to researchers throughout the United States supports 407,782 jobs and nearly $95 billion in economic activity—in other words, every dollar of NIH funded research yields $2.56 of economic activity in local communities.

Beyond cuts to research funding, cuts and changes to the public health data infrastructure will have a profound, negative impact on not only rural research, but also rural health organizations’ ability to use data for obtaining funding, evaluating programs, and making decisions. The administration has proposed to merge the Agency for Healthcare Quality and Research (AHRQ) and the Assistant Secretary for Planning and Evaluation (ASPE), both of which have key roles in information health care planning and quality and have both experienced sizable reductions in staff. The resulting changes in data analysis and research capabilities are concerning as AHRQ has identified rural as one of its priority populations and has focused its work both internally and externally on rural disparities, including in important areas like access to obstetric care.

Other cuts to federal staff and programming have led to the (at least temporary) suspension of data collection in many critical areas, including through the Pregnancy Risk Assessment Monitoring System (PRAMS), which had provided key information on maternal health and birth outcomes. Such cuts will prevent researchers and others from monitoring these health outcomes in which rural populations experience notable disparities. Within the Substance Abuse and Mental Health Services Administration (SAMHSA), all staff running the National Survey on Drug Use and Health (NSDUH) were fired in early April. NSDUH is the only national survey on substance use and mental health. Such data are critical for monitoring mental health in rural communities. With pending budgetary discussions, there are also concerns of funding cuts to cancer registries, which provide critical information to monitor trends in cancer incidence, staging, and some aspects of treatment. These data are not solely from large, urban health centers, but are critical to understanding cancer in rural areas, as registries collect information on all cancer cases within states or smaller jurisdictions. Data from such registries have shown that rural populations have higher rates of cancer incidence than their urban counterparts, information that can then be used by policy makers to address rural health disparities.

As leaders of the NRHA Research and Education Constituency Group and the Statewide Resources Constituency Group, we call on the executive and legislative branches of government to fund and sustain the research resources and infrastructure to ensure the health of our rural communities.