The National Institutes of Health announced today it is launching what it calls the Environmental Influences on Child Health Outcomes (ECHO) study, a seven-year initiative aimed at better understanding the impacts of environmental factors like air pollution, stress, sleep, and diet on childhood health and disease — from the womb through adolescence. The study will track tens of thousands of children, the agency has said, with the goal of identifying links between certain environmental exposures and cognitive and nervous system development, respiratory function, obesity, and other health outcomes.
The NIH has awarded $157 million to a coordinated web of clinics, hospitals and research centers to bring the program online in 2016. The money will be used to enroll more than 50,000 children drawn from existing cohort studies, and from “diverse racial, geographic and socioeconomic backgrounds,” the agency noted in a press release – adding that the ECHO program “will analyze existing data as well as follow the children over time.”
The ECHO funding will also be used to create a central coordinating center at Duke University, and a data analysis group at Johns Hopkins University. Other laboratories, researchers and NIH programs have also received awards to support ECHO, including NIH’s Institutional Development Awards program, tasked with building out pediatric clinics in rural, underserved areas.
ECHO is an ambitious undertaking and many will see it as a rebooting of the NIH’s now-infamous National Children’s Study. In 2014, that long-term, multibillion-dollar health study — which was supposed to track the health of 100,000 children from before birth to the age of 21 — was shut down after more than a decade of failed attempts to get off the ground. An investigation published by Undark last May explored the reasons why:
[T]he NCS was canceled … after a 14-year history during which it burned through $1.3 billion in taxpayer dollars without generating much in the way of useful information. The study’s collapse barely registered with the national media, and unlike other major taxpayer-funded failures that have become political bludgeons on Capitol Hill, reaction in Washington has been muted. But the study’s collapse left a bitter legacy of anger and frustration among those who worked on the NCS for years, only to see their efforts wasted on a bungled enterprise that critics say went nowhere and accomplished nothing. Sources interviewed for this story gave a range of reasons for the study’s demise: deep scientific divisions over how it should have been carried out, partisan bickering, and even charges of deliberate dissembling over just how much such study would ultimately cost, to name just a few.
“There is no single factor that led to the failure of the NCS to achieve its goals, but rather a persistent set of challenges facing the design, management, and costs of the study,” said Francis Collins, director of the NIH, in an email message defending his decision to terminate the program.
Still, many critics say those challenges were a result of dysfunctional management, an ever-shifting set of objectives, and even lack of support at the highest levels of the National Institutes of Health.
The NIH admits to some overlap between ECHO and NCS, but promises that the populations, support and technology needed to pull off the initiative are now in place.
“The underlying concepts, the scientific concepts, remain, and that is about early environmental influences on child health outcomes,” said Matthew Gillman, an epidemiologist and ECHO’s director. “But really, the organizations, the study designs, the people involved are quite different. I must say that I spend very little time thinking about the National Children’s Study.”
“We’ve all given a great amount of thought to that in the past and recognized its strengths and its many limitations,” Gillman added, “and I think we’ve moved quite a bit beyond that.”
This post has been updated to clarify that ECHO program will be drawing its target population of 50,000 children from existing cohort studies.