Understanding the Intersection of Social Inequities to Optimize Health and Reduce Health Disparities: The Axes Initiative (R01 Clinical Trial Optional) | RFA NR 25 004

Opportunity Information: Apply for RFA NR 25 004

The National Institutes of Health (NIH) is offering an R01 grant opportunity called "Understanding the Intersection of Social Inequities to Optimize Health and Reduce Health Disparities: The Axes Initiative (R01 Clinical Trial Optional)" under funding opportunity number RFA-NR-25-004. The core idea behind this initiative is that health outcomes are not shaped by a single factor like income or race in isolation. Instead, large and persistent health disparities often emerge from the intersection of multiple social positions and lived realities, such as race and ethnicity, socioeconomic status, sexual orientation, disability or ability status, and related social identities. The opportunity is designed to fund research that examines how overlapping systems of privilege and oppression operate together to create unequal exposure to risks, unequal access to resources, and ultimately unequal health outcomes.

This funding call emphasizes research that takes intersectionality seriously as a scientific framework, meaning applicants should move beyond single-axis comparisons and instead study how combinations of social statuses and structural conditions jointly influence health. The work supported through the Axes Initiative is meant to improve understanding of health at these intersections by analyzing contributions from social determinants of health and other relevant determinants (for example, neighborhood conditions, discrimination, policy environments, health care access and quality, educational opportunity, employment conditions, environmental exposures, and other upstream drivers). The overall goal is not only to document disparities, but to generate knowledge that can inform smarter strategies for optimizing health and reducing unfair and avoidable differences in health outcomes across populations.

The mechanism is an R01 research project grant, and clinical trials are optional, which means applicants may propose studies that do or do not include a clinical trial component, as long as the research aligns with the initiative's purpose and meets NIH requirements for the chosen study design. The funding activity category is listed under education and health, and the opportunity is associated with CFDA numbers 93.242, 93.313, 93.361, and 93.399. The stated award ceiling is $500,000, indicating the maximum amount expected per award (typically expressed in direct costs per year in many NIH contexts, though applicants should follow the specific instructions in the full announcement for budgeting rules).

A wide range of applicant organizations are eligible. These include state, county, city or township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; public housing authorities and Indian housing authorities; and Native American tribal organizations that are not federally recognized tribal governments. The opportunity is also open to nonprofit organizations both with and without 501(c)(3) status (as long as they are not institutions of higher education in that specific category), for-profit organizations other than small businesses, small businesses, and other eligible entities. The announcement also highlights additional eligible applicant types that NIH encourages, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), eligible federal agencies, faith-based or community-based organizations, regional organizations, U.S. territories or possessions, and Indian/Native American Tribal Governments that are not federally recognized.

At the same time, there are important restrictions related to foreign participation. Non-domestic (non-U.S.) entities (foreign organizations) are not eligible to apply as the primary applicant organization, and non-domestic components of U.S. organizations are also not eligible to apply. However, "foreign components" as defined in the NIH Grants Policy Statement are allowed, which generally means a U.S.-based applicant can include certain substantive project elements conducted outside the United States if they are justified, properly documented, and compliant with NIH policy.

The opportunity is categorized as discretionary and uses the grant funding instrument type. The original closing date is March 10, 2025, and the opportunity record shows a creation date of January 8, 2025. In practical terms, prospective applicants should be prepared to present a clear intersectional conceptual model, specify which social statuses and structural drivers are being examined, justify why those intersections matter for the health outcome(s) of interest, and describe methods capable of capturing joint and interacting effects rather than treating each axis of inequity as separate or interchangeable. The initiative is fundamentally aimed at producing actionable, rigorous evidence about how intersecting inequities shape health, so that future interventions, policies, and systems changes can be better targeted to reduce health disparities and improve health equity.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Understanding the Intersection of Social Inequities to Optimize Health and Reduce Health Disparities: The Axes Initiative (R01 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242, 93.313, 93.361, 93.399.
• This funding opportunity was created on 2025-01-08.
• Applicants must submit their applications by 2025-03-10. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $500,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA NR 25 004

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