Measuring what matters: case for a national benchmarking framework for neurological disparities research

ABSTRACT Importance Neurological disease disproportionately burdens racial, ethnic, socioeconomic, and geographically underserved populations in the United States (US), yet no standardized, public accountability mechanism exists to track how academic neurology departments invest in and produce research addressing these disparities. Objective To present the scientific and organizational-behavior evidence supporting potential development of BEACON (Benchmark for Equity, Access, and Contributions to Outcomes in Neurology), a composite annual scoring framework that ranks US academic neurology departments on the funding, output, quality, and community engagement of their neurological disparities research. Evidence Review We synthesize epidemiologic evidence of neurological health disparities, documented inequities in National Institutes of Health (NIH) funding allocation, and the sociological and health-services literature demonstrating that public institutional rankings reliably change organizational behavior. Findings Multiple independent literatures spanning legal education, hospital quality reporting, and NIH policy converge on the same mechanism: public, comparative, institution-level measurement reliably redirects institutional investment toward the measured domain. No equivalent measurement currently exists for neurological disparities research specifically. Conclusions and Relevance A composite ranking such as BEACON could be a scientifically grounded, low-cost lever to redirect institutional attention, philanthropic investment, and faculty recruitment toward reducing neurological health disparities in the US.