The Impact of State Investment in Cancer Research Capacity and Infrastructure: A Mixed Methods Study

The aim of this mixed-methods study is to understand the fiscal and practical impact on a state’s biomedical research ecosystem when state policymakers decide to invest substantially in cancer research capacity and infrastructure. It posits that an investing state is more likely to realize a greater share of contract and grant dollars from the National Cancer Institute (NCI) for its researchers and cancer centers. The quantitative portion of the study, employing a multiple regression analysis of data from all 50 states, finds that investment in cancer research capacity and infrastructure does improve a given state’s relative share of NCI support, with the presence and number of NCI-designated cancer centers in a state having an even stronger correlation. A closer examination of the case of Florida uses an interrupted time series analysis to evaluate the impact of three identified state policy interventions on NCI support, finding statistically significant increases in NCI dollars directed to entities in the state due to those legislative enactments. The qualitative component of the study finds consensus that, in addition to increased federal support, Florida’s biomedical research ecosystem has experienced substantial positive change resulting from state investment in this arena. Semi-structured interviews with key Florida stakeholders, ranging from lawmakers to research administrators to leaders of cancer centers and advocacy groups, informs the qualitative component of the study. Examined through the lenses of state-level policy diffusion and pressure groups, the study fills a gap in the literature on the topic of cancer research capacity and infrastructure funding. It also has practical significance, as answers to questions involving the impact and return on investment of related appropriations can help inform decisions by future policymakers and appropriators, whether in Florida or elsewhere.