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Top 50 NIH-Funded Institutions of 2020

Four states account for nearly half of the agency’s funding recipients

Source: NCI/NIH

A new federal fiscal year (FY) begins October 1, but lawmakers at deadline haven’t even agreed on stopgap funding needed to keep Washington fully functioning next month, let alone come to terms on a new budget for FY 2021.

As a result, nobody yet knows how much funding the NIH will have net fiscal year. President Donald Trump began the budget process in February, weeks before COVID-19 led to shutdowns nationwide, by proposing a record $4.9 trillion spending plan that would have cut the NIH’s budget by 7%, from $41.7 billion to $38.4 billion.

After those shutdowns, Congress approved a combined $3.6 billion in “emergency” funding for the NIH in four stimulus bills passed between March and April, and signed into law by Trump.

On July 31, the Democratic-majority U.S. House of Representatives passed largely along party lines (217–197) a spending plan for NIH, its parent agency the Department of Health and Human Services, and nine other federal departments. The spending plan followed the recommendation of the House Committee on Appropriations, which approved a 13% or approximately $5.5 billion increase in NIH funding, to just under $47 billion, with every institute and center approved for budget increases of at least 7%.

Among institutes and centers:

• The National Cancer Institute was approved for $6.9 billion, up just over $1 billion or 7.3% from $6.4 billion this fiscal year. Trump had proposed $5.9 billion an 8.7% reduction.
• The National Institute of Allergy and Infectious Diseases (NIAID) , the institute led by Anthony S. Fauci, MD, fared even better, receiving an 8.6% budget boost to about $6.4 billion, up from $5.9 billion in FY 2020. Trump’s proposal would have shrunk NIAID’s budget by 7.5%.
• The National Heart, Lung, and Blood Institute was approved for about $3.9 billion from $3.6 billion in FY 2020, also up 7.3%. Trump’s spending plan called for a 9% reduction.
• The National Human Genome Research Institute was approved for $650.6 million from $606.3 million, another 7.3% increase. Trump had proposed $550.1 million, a 9.3% cut.

The U.S. Senate’s Committee on Appropriations at deadline had yet to come out with its own budget proposal for the agency, which would be within a spending bill covering the departments of Labor, Health and Human Services, and Education.

As Michael Lauer, MD, NIH’s Deputy Director for Extramural Research, wrote on the agency’s website in May , about 75% of the agency’s FY 2019 budget supported extramural research. That fiscal year, NIH issued 55,012 competing and non-competing extramural research awards totaling about $29.466 billion— up $2.354 billion from FY 2018 (an 8.68% increase), with 2,369 more grants funded. NIH extramural dollars supported research conducted at 2,738 organizations—including universities, medical schools, and other research institutions in every U.S. state and worldwide.

About 10% of the NIH’s budget supports projects conducted by approximately 1,200 Principal Investigators and more than 4,000 Postdoctoral Fellows in its own laboratories, most of which are on the NIH campus in Bethesda, MD.

Below is a list of 50 universities (including medical schools), research institutions, and teaching hospitals ranked by how much in NIH funding they have received during the current 2020 federal fiscal year, through September. FY 2020 ends on September 30. Also included for each NIH grant recipient is the number of grant awards funded in FY 2020, which was not a factor in the ranking.

Among the 25 states with at least one institution among the top 50 listed here, California leads the nation with seven institutions in each state receiving NIH grant funding. Next-highest are Massachusetts and New York, each with six NIH-funded institutions, followed by North Carolina with four. These four states combined accounted for nearly half (23) of the top 50 NIH-funded institutions in the current 2020 federal fiscal year.

Of the remaining states in the top 50, seven received NIH grants for two institutions each (Illinois, Maryland, Minnesota, Ohio, Pennsylvania, Texas, and Washington state). Another 13 states have a single NIH-funded institution among the top 50 listed here—most notably the University of Florida, which just missed the top 50 in last year’s GEN A-List .

Some notable institutions ranked 55 through 51 this current fiscal year: Cincinnati Children’s Hospital Medical Center, University of Virginia, Harvard Medical School, The University of Texas MD Anderson Cancer Center, and University of Rochester (NY), just missed the top 50 with $166,132,138 through 370 awards.

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• NATURE INDEX
• 19 June 2019
• Correction 12 August 2019

Top 10 institutions for life sciences in 2018

PhD researcher Alanna Gannon in Doug Melton’s lab in the Harvard Department of Stem Cell and Regenerative Medicine. Credit: B. D. Colen/Harvard University

The life-sciences rankings are remarkably stable, with the top six for 2018 remaining unchanged from 2017’s rankings. Some jostling occurs in the lower half of the top 10, with the University of Cambridge entering the rank this year, rising five slots from 14th place last year.

The University of Pennsylvania regains its 10th position in 2018, after being absent from the top 10 for the previous two years. See the 2019 Annual Tables Top 100 institutions for life sciences in 2018.

1. Harvard University

Fractional count*: 621.64 (−7.7%) † , Article count ‡ : 1,637

Harvard University owes two-thirds of its research output to contributions made in the life sciences, thanks in no small part to the Harvard Medical School , which employs almost 10,000 full-time faculty members and counts 15 Nobel prize winners among its staff and alumni.

High-profile researchers include stem-cell biologist, Steven Gygi , one of the leading authors in the biomedical sciences and jointly credited for the BioPlex network — the largest open-access resource for studying protein interactions — and Albert Hofman , a world leader in the epidemiology of common neurological and vascular diseases such as dementia, stroke and Alzheimer’s.

Immunology continues to be a big focus for the university as the potential of advanced cellular therapies such as CAR T-cell therapy is tested. While researchers pursue innovations such as diagnostic devices powered by CRISPR–Cas, major collaborative efforts, such as with the Broad Institute of MIT and Harvard , will push the boundaries of disease detection and treatment.

2. National Institutes of Health

Fractional count: 348.12 (−6.6%), Article count: 821

With a budget of US$37 billion (2018), the US National Institutes of Health (NIH) is the largest single public funder of biomedical research in the world. It comprises 27 separate institutes and centres of various biomedical disciplines, and is led by physician-geneticist, Francis Collins, former head of the NIH’s Human Genome Project (HGP), the world's largest collaborative biological project.

Nature Index 2019 Annual Tables

Since launching in 1990, the HGP has resulted in about US$1 trillion of economic growth — a 178-fold return on investment — at a cost of only US$2 per year for each US resident, according to an analysis cited by the NIH. Other significant NIH-supported research includes the discovery of fluoride to prevent tooth decay; the use of lithium to manage bipolar disorder; and the creation of vaccines against hepatitis, Haemophilus influenzae and human papillomavirus.

The NIH has maintained the second spot in the Nature Index top 10 table for life sciences for the past four years, with approximately half the fractional count of Harvard, which consistently tops the charts in this category.

3. Stanford University

Fractional count: 300.65 (1.4%), Article count: 733

Life sciences is a major contributor to Stanford University ’s high-quality research output, as tracked by the Nature Index. It is home to pioneering work in DNA synthesis, stem-cell isolation, and the first successful human heart and lung transplant.

The Stanford School of Medicine , which has more than 2,000 full-time faculty members, dominates the university’s life-sciences output, and with US$381 million in NIH funding, claims the highest funding per researcher ratio in the United States.

In the Nature Index Biomedical Sciences 2019 supplement, Stanford bioengineer and neuroscientist, Karl Deisseroth was named one the field’s most prolific authors in high-quality journals. He is credited with the development of optogenetics, a method that uses light to genetically alter brain-cell activity.

Key life-sciences initiatives at Stanford include Bio-X, where doctors, scientists and engineers work collaboratively to unravel the complexity of the human body.

4. Max Planck Society

Fractional count: 292.64 ( − 1.1%), Article count: 1,017

With 27 institutes and 7 research facilities dedicated to biology and medicine, the Max Planck Society is a formidable player in the life sciences.

Across the society’s institutes, researchers explore a diverse range of questions, from how insects evolved their sense of smell, to figuring out how to connect nerve cells to semiconductor chips. At the Max Planck Institute for Biological Cybernetics , researchers use computer simulations and experimental methods to tease apart how humans and other animals process information.

In 2018, Max Planck researchers were part of an international team that produced the first monkey clones ( Cell ).

5. Chinese Academy of Sciences

Fractional count: 252.84 (12.3%), Article count: 784

In the past four years, the Chinese Academy of Sciences (CAS) has been the only Chinese institution in the Nature Index’s top 10 for life sciences. Peking University , the second highest placed Chinese institute in this category, is ranked 39th for life sciences in the 2019 Annual Tables.

As in the other categories, many of CAS’s 105 institutes are focused on life-sciences research, the top player of which is the Shanghai Institutes of Biological Sciences (SIBS). The formation of SIBS in 1999 brought together eight Shanghai-based CAS life-sciences institutes, including the Shanghai Institute of Neuroscience, which published key papers in 2018 on the neural mechanisms that underlie itchiness ( The Journal of Neuroscience ) and more targeted gene-editing using CRISPR–Cas9 ( Nature Neuroscience ).

“CAS has many research teams in the different areas of the life sciences, so it’s easier to perform cross-academy collaboration in life-science research,” says Qiu Zilong, senior investigator at the CAS Shanghai Institute of Neuroscience.

6. Massachusetts Institute of Technology

Fractional count: 208.54 (−3.1%), Article count: 817

The Massachusetts Institute of Technology (MIT) has an annual budget of more than US$3.5 billion (2018), a strong entrepreneurial culture, and an emphasis on interdisciplinary collaboration. It’s where the first chemical synthesis of penicillin was achieved in 1957, and, more recently, where researchers devised a miniaturized system that can deliver tiny quantities to specific regions of the brain just 1 cubic millimetre in size.

Now the new Stephen A. Schwarzman College of Computing and the Koch Institute for Integrative Cancer Research are teaming up to bring together life scientists, engineers and AI experts with the shared goal of finding more effective approaches to cancer diagnosis and treatment.

“MIT fosters collaboration with an emphasis on solving the problem and bringing together disciplines to make this happen,” says vice-president for research, Maria Zuber.

MIT appears in several top 10 lists in Nature Index’s 2019 Annual Tables, including physical sciences and chemistry, and is ranked third overall among global academic institutions.

7. University of California, San Francisco

Fractional count: 200.65 (10.2%), Article count: 547

Gaining five spots to re-enter the top 10 for life sciences in the Nature Index, the University of California, San Francisco , (UCSF) has made its mark in the advancement of new cellular therapies and gene-editing techniques.

Since 2018, UCSF researchers have devised a safer and cheaper way to genetically engineer immune cells ( Nature ); modified CRISPR to treat genetic diseases without making permanent changes to the genome ( Science ); and waded into a decades-long debate with the finding that adult human brains do not produce new neurons ( Nature ).

Key programmes under way are the ImmunoX Initiative, which is exploring entirely new areas of immunology, and the Center for Digital Health Innovation, which is partnered with high-profile enterprises such as the US$600-million Chan Zuckerberg Biohub . These projects exemplify UCSF’s passion for collaboration, says executive vice-chancellor and provost, Daniel Lowenstein.

“The truly rare ingredient in UCSF’s ‘special sauce’ is generosity — a genuine wish by senior and junior investigators alike to see everyone succeed. Our research community’s greatest pleasure is in celebrating our collective achievements.”

8. Yale University

Fractional count: 192.08 (0.1%), Article count: 439

Founded in 1701, Yale University is the third-oldest higher-education institution in the United States . With the Yale School of Medicine opening in the early nineteenth century, the university’s strength in the life sciences runs deep.

Yale’s research in the life sciences is set to make even bigger leaps, with the launch of the Center for Biomedical Data Science early in 2018. In addition to organizing and storing vast amounts of data, the centre brings together biomedical researchers and data scientists to help improve health-care systems, treatments methods and diagnosis.

In 2018 , Yale researchers reported the results of the most comprehensive genomic analysis of the human brain ever undertaken, revealing the changes it undergoes through development, how it varies among individuals, and the roots of neuropsychiatric conditions such as autism spectrum disorders and schizophrenia.

9. The University of Cambridge

Fractional count: 187.76 (11.6%), Article count: 583

Although the University of Cambridge dropped out of the Nature Index physical-sciences top 10 this year, it entered the life-sciences top 10 at rank 9 — a big leap from its 2017 spot at 14th for life sciences.

High-profile researchers in the life sciences at Cambridge include Nobel prize-winning biologist, Martin Evans, who with his colleague, Matthew Kaufman, was the first to culture and cultivate mice embryonic stem cells in 1981. Developmental biologist, John Gurdon, was the joint recipient of the 2012 Nobel Prize in Physiology or Medicine for the discovery that mature cells can be converted to stem cells.

Rising stars include Rogier Kievit, who studies neurodevelopmental changes in cognitive abilities such as reasoning, problem-solving and goal management, and Hannah Critchlow, who has been named as a Top 100 UK scientist by the Science Council for her work in science communication and as one of the university’s most “inspirational and successful” women.

10. University of Pennsylvania

Fractional count: 186.31 (1.6%), Article count: 483

The University of Pennsylvania (UPenn) is home to the Perelman School of Medicine , the oldest medical school in the United States. Life sciences accounts for around 60% of the university’s papers in journals tracked by the Nature Index.

The Center for Global Health at UPenn aims to tackle inequities in health care in 65 countries, including Sudan , Argentina and Vietnam . The centre’s Botswana–UPenn Partnership, which has been operating for two decades, is working to improve health care in the region and is conducting research on HIV/AIDS.

Last year, UPenn was involved in the development of a blood test that identified pregnant women at risk of delivering prematurely. The paper, published in Science , was among the institution’s most-talked about articles in 2018.

Index metrics

*Fractional Count is assigned to institutions based on the contributions of their affiliated authors to articles in the 82 journals tracked by the Nature Index database, with all authors on each article considered to have contributed equally, and a maximum combined FC for any article of 1.0.

† The bracketed figure shows the percentage change in the institution’s Fractional Count in the subject in 2018.

‡ An institution is given an article count of 1 for each article that has at least one author from that institution in one of the 82 journals that make up the Nature Index.

doi: https://doi.org/10.1038/d41586-019-01925-w

Pre-2018 rankings may have changed owing to adjustment for a small annual variation in the total number of articles published in the journals.

This article is part of Nature Index 2019 Annual Tables , an editorially independent supplement. Advertisers have no influence over the content.

Updates & Corrections

Correction 12 August 2019 : The original version of this article used incorrect fractional counts, percentage changes and article counts to derive the rankings, which meant that some institutions were ranked incorrectly. The data and rankings have now been corrected.

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Institutes at nih, list of institutes and centers, nih institutes.

National Cancer Institute (NCI) — Est. 1937 NCI leads a national effort to eliminate the suffering and death due to cancer. Through basic and clinical biomedical research and training, NCI conducts and supports research that will lead to a future in which we can prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases.

National Eye Institute (NEI) — Est. 1968 The National Eye Institute’s mission is to conduct and support research, training, health information dissemination, and other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight, and the special health problems and requirements of the blind.

National Heart, Lung, and Blood Institute (NHLBI) — Est. 1948 The National Heart, Lung, and Blood Institute (NHLBI) provides global leadership for a research, training, and education program to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives. The NHLBI stimulates basic discoveries about the causes of disease, enables the translation of basic discoveries into clinical practice, fosters training and mentoring of emerging scientists and physicians, and communicates research advances to the public.

National Human Genome Research Institute (NHGRI) — Est. 1989 NHGRI is devoted to advancing health through genome research. The Institute led NIH’s contribution to the Human Genome Project, which was successfully completed in 2003 ahead of schedule and under budget. Building on the foundation laid by the sequencing of the human genome, NHGRI’s work now encompasses a broad range of research aimed at expanding understanding of human biology and improving human health. In addition, a critical part of NHGRI’s mission continues to be the study of the ethical, legal and social implications of genome research.

National Institute on Aging (NIA) — Est. 1974 NIA leads a national program of research on the biomedical, social, and behavioral aspects of the aging process; the prevention of age-related diseases and disabilities; and the promotion of a better quality of life for all older Americans.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) — Est. 1970 NIAAA conducts research focused on improving the treatment and prevention of alcoholism and alcohol-related problems to reduce the enormous health, social, and economic consequences of this disease.

National Institute of Allergy and Infectious Diseases (NIAID) — Est. 1948 NIAID research strives to understand, treat, and ultimately prevent the myriad infectious, immunologic, and allergic diseases that threaten millions of human lives.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) — Est. 1986 NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.

National Institute of Biomedical Imaging and Bioengineering (NIBIB) — Est. 2000 The mission of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) is to transform through engineering the understanding of disease and its prevention, detection, diagnosis, and treatment.

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) — Est. 1962 NICHD leads research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all.

National Institute on Deafness and Other Communication Disorders (NIDCD) — Est. 1988 NIDCD conducts and supports biomedical research and research training on normal mechanisms as well as diseases and disorders of hearing, balance, smell, taste, voice, speech, and language that affect 46 million Americans.

National Institute of Dental and Craniofacial Research (NIDCR) — Est. 1948 NIDCR provides leadership for a national research program designed to understand, treat, and ultimately prevent the infectious and inherited craniofacial-oral-dental diseases and disorders that compromise millions of human lives.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Est. 1950 The mission of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is to conduct and support medical research and research training and to disseminate science-based information on diabetes and other endocrine and metabolic diseases; digestive diseases, nutritional disorders, and obesity; and kidney, urologic, and hematologic diseases, to improve people’s health and quality of life.

National Institute on Drug Abuse (NIDA) — Est. 1974 The mission of the National Institute on Drug Abuse (NIDA) is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health. 

National Institute of Environmental Health Sciences (NIEHS) — Est. 1969 The mission of the National Institute of Environmental Health Sciences is to discover how the environment affects people in order to promote healthier lives.

National Institute of General Medical Sciences (NIGMS) — Est. 1962 The National Institute of General Medical Sciences (NIGMS) supports basic research that increases understanding of biological processes and lays the foundation for advances in disease diagnosis, treatment and prevention. NIGMS-funded scientists investigate how living systems work at a range of levels, from molecules and cells to tissues, whole organisms and populations. The Institute also supports research in certain clinical areas, primarily those that affect multiple organ systems. To assure the vitality and continued productivity of the research enterprise, NIGMS provides leadership in training the next generation of scientists, in enhancing the diversity of the scientific workforce, and in developing research capacities throughout the country.

National Institute of Mental Health (NIMH) — Est. 1949 NIMH provides national leadership dedicated to understanding, treating, and preventing mental illnesses through basic research on the brain and behavior, and through clinical, epidemiological, and services research.

National Institute on Minority Health and Health Disparities (NIMHD) — Est. 2010 NIMHD has a long history, beginning in 1990 as an Office and later designated a Center in 2000. The mission of NIMHD is to lead scientific research to improve minority health and eliminate health disparities. To accomplish its mission, NIMHD plans, reviews, coordinates, and evaluates all minority health and health disparities research and activities of the National Institutes of Health; conducts and supports research in minority health and health disparities; promotes and supports the training of a diverse research workforce; translates and disseminates research information; and fosters innovative collaborations and partnerships.

National Institute of Neurological Disorders and Stroke (NINDS) — Est. 1950 The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. To accomplish this goal the NINDS supports and conducts basic, translational, and clinical research on the normal and diseased nervous system. The Institute also fosters the training of investigators in the basic and clinical neurosciences, and seeks better understanding, diagnosis, treatment, and prevention of neurological disorders.

National Institute of Nursing Research (NINR) — Est. 1986 The mission of the National Institute of Nursing Research (NINR) is to lead nursing research to solve pressing health challenges and inform practice and policy—optimizing health and advancing health equity into the future.

National Library of Medicine (NLM) — Est. 1956 NLM collects, organizes, and makes available biomedical science information to scientists, health professionals, and the public. The Library’s Web-based databases, including PubMed/Medline and MedlinePlus, are used extensively around the world. NLM conducts and supports research in biomedical communications; creates information resources for molecular biology, biotechnology, toxicology, and environmental health; and provides grant and contract support for training, medical library resources, and biomedical informatics and communications research.

NIH Centers

NIH Clinical Center (CC) — Est. 1953 The NIH Clinical Center, America’s research hospital, provides a versatile clinical research environment enabling the NIH mission to improve human health by investigating the pathogenesis of disease; conducting first-in-human clinical trials with an emphasis on rare diseases and diseases of high public health impact; developing state-of-the-art diagnostic, preventive, and therapeutic interventions; training the current and next generations of clinical researchers; and, ensuring that clinical research is ethical, efficient, and of high scientific quality.

Center for Information Technology (CIT) — Est. 1964 CIT incorporates the power of modern computers into the biomedical programs and administrative procedures of the NIH by focusing on three primary activities: conducting computational biosciences research, developing computer systems, and providing computer facilities.

Center for Scientific Review (CSR) — Est. 1946 CSR is the portal for NIH grant applications and their review for scientific merit. CSR oversees and implements peer review for over 75% of the more than 88,000 applications submitted to NIH each year, as well as for some other components of HHS. The mission of CSR is to see that NIH grant applications receive fair, independent, expert, and timely scientific reviews — free from inappropriate influences — so NIH can fund the most promising research.

Fogarty International Center (FIC) — Est. 1968 FIC promotes and supports scientific research and training internationally to reduce disparities in global health.

National Center for Advancing Translational Sciences (NCATS) — Est. 2011 The mission of NCATS is to catalyze the generation of innovative methods and technologies that will enhance the development, testing, and implementation of diagnostics and therapeutics across a wide range of human diseases and conditions.

National Center for Complementary and Integrative Health (NCCIH) — Est. 1999 The mission of NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and health care.

This page last reviewed on July 12, 2023

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Sidra Medicine Ranked in the World’s Top 101-250 Academic Medical Centers

In a first-of-its-kind research survey, by Brand Finance, five hospitals from Qatar have been ranked in the world’s top 250 Academic Medical Centers (AMC); marking Qatar with the highest number of hospitals out of all the Gulf Co-operation Council countries. Sidra Medicine’s ranking is within the 100-250 range of AMC hospitals.

The study, featuring input from 2,500 leading global healthcare, is a peer-driven analysis of the performance of the world's leading AMC hospitals based on patient treatment, medical research, and training and education.

Commenting on the significance of the study, HE the Minister of Public Health Dr. Hanan Mohamed al-Kuwari said: "Having five Qatar hospitals ranked among the world's top 250 academic medical centers is an incredible achievement and highlights the commitment of Qatar's health sector to a deliver excellent care to our patients, on a par with the world's very best hospitals. I congratulate the healthcare teams at all five hospitals for this remarkable accomplishment."   Read the complete report here

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Mayo Clinic again recognized as ‘World’s Best Hospital’ in Newsweek rankings

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ROCHESTER, Minnesota — Mayo Clinic in Rochester was again ranked No. 1 in the world by Newsweek in its 2022 list of the " World's Best Hospitals ." The ranking is a tribute to the work of staff across Mayo Clinic.

The Newsweek rankings are based on patient survey results, hospital recommendations from peers gathered through an international survey of more than 80,000 health care professionals, and key performance metrics such as patient safety, hygiene measures and quality of care .

The hospitals named in the rankings stand out for their consistent excellence, including distinguished physicians, top-notch nursing care, and state-of-the-art technology, according to Newsweek.

"What has set the world's leading hospitals apart is their continued ability to deliver the highest-quality patient care and conduct critical medical research, even as they focused on battling COVID-19," according to Newsweek. "Consistency in excellence is the hallmark of these institutions, with familiar names dominating the list and top spots."

About Mayo Clinic

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

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2023-2024 Best Medical Schools: Research

Ranked in 2023

A medical career starts with finding the program that best fits your needs. With the

A medical career starts with finding the program that best fits your needs. With the U.S. News rankings of the top medical schools for research, narrow your search by location, tuition, school size and test scores. Footnotes below specify schools that declined to fill out the U.S. News statistical survey. Please review our methodology to see how those schools' data were used in the ranking. Read the methodology »

For full rankings, MCAT scores and student debt data, sign up for the U.S. News Medical School Compass .

Here are the 2023-2024 Best Medical Schools: Research

Harvard university, johns hopkins university, university of pennsylvania (perelman), columbia university, duke university, stanford university, university of california--san francisco, vanderbilt university, washington university in st. louis.

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• # 1 in Best Medical Schools: Research

$66,284 (full-time) TUITION AND FEES

699 ENROLLMENT (FULL-TIME)

Its tuition is full-time: $66,284. The faculty-student ratio at Harvard University is 14.6:1. The Medical School has... Read More »

TUITION AND FEES

$66,284 (full-time)

ENROLLMENT (FULL-TIME)

Mcat total score.

Baltimore , MD

• # 2 in Best Medical Schools: Research

$59,700 (full-time) TUITION AND FEES

470 ENROLLMENT (FULL-TIME)

The School of Medicine at Johns Hopkins University has an application deadline of Oct. 15. The application fee at Johns... Read More »

$59,700 (full-time)

Philadelphia , PA

• # 3 in Best Medical Schools: Research

$61,586 (full-time) TUITION AND FEES

626 ENROLLMENT (FULL-TIME)

The Perelman School of Medicine at University of Pennsylvania (Perelman) has an application deadline of Oct. 15. The... Read More »

$61,586 (full-time)

New York , NY

• # 4 in Best Medical Schools: Research

$66,816 (full-time) TUITION AND FEES

577 ENROLLMENT (FULL-TIME)

The College of Physicians and Surgeons at Columbia University has an application deadline of Oct. 15. The application... Read More »

$66,816 (full-time)

Durham , NC

• # 5 in Best Medical Schools: Research  (tie)

$63,310 (full-time) TUITION AND FEES

507 ENROLLMENT (FULL-TIME)

The School of Medicine at Duke University has an application deadline of Oct. 15. The application fee at Duke... Read More »

$63,310 (full-time)

Stanford , CA

$63,747 (full-time) TUITION AND FEES

491 ENROLLMENT (FULL-TIME)

The School of Medicine at Stanford University has an application deadline of Oct. 3. The application fee at Stanford... Read More »

$63,747 (full-time)

San Francisco , CA

$38,073 (in-state, full-time) TUITION AND FEES

$50,318 (out-of-state, full-time) TUITION AND FEES

680 ENROLLMENT (FULL-TIME)

The School of Medicine at University of California--San Francisco has an application deadline of Oct. 15. The... Read More »

$38,073 (in-state, full-time)

$50,318 (out-of-state, full-time)

Nashville , TN

$64,882 (full-time) TUITION AND FEES

407 ENROLLMENT (FULL-TIME)

The School of Medicine at Vanderbilt University has an application deadline of Nov. 1. The application fee at... Read More »

$64,882 (full-time)

St. Louis , MO

$65,001 (full-time) TUITION AND FEES

448 ENROLLMENT (FULL-TIME)

The School of Medicine at Washington University in St. Louis has an application deadline of Nov. 30. The application... Read More »

$65,001 (full-time)

Cornell University (Weill)

• # 10 in Best Medical Schools: Research  (tie)

$62,650 (full-time) TUITION AND FEES

451 ENROLLMENT (FULL-TIME)

The Weill Cornell Medical College at Cornell University (Weill) has an application deadline of Oct. 16. The application... Read More »

$62,650 (full-time)

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Best Universities for Oncology and Cancer research in the World

Updated: February 29, 2024

• Art & Design
• Computer Science
• Engineering
• Environmental Science
• Liberal Arts & Social Sciences
• Mathematics

Below is a list of best universities in the World ranked based on their research performance in Oncology and Cancer research. A graph of 160M citations received by 5.15M academic papers made by 3,216 universities in the World was used to calculate publications' ratings, which then were adjusted for release dates and added to final scores.

We don't distinguish between undergraduate and graduate programs nor do we adjust for current majors offered. You can find information about granted degrees on a university page but always double-check with the university website.

1. Harvard University

For Oncology and Cancer research

2. University of Texas MD Anderson Cancer Center

3. Johns Hopkins University

4. University of California - San Francisco

5. University of Michigan - Ann Arbor

6. Stanford University

7. University of Pennsylvania

8. University of Toronto

9. Heidelberg University - Germany

10. Cornell University

11. Mayo Clinic College of Medicine and Science

12. University of California - Los Angeles

13. Baylor College of Medicine

14. Sun Yat - Sen University

15. University of Washington - Seattle

16. Yale University

17. University of North Carolina at Chapel Hill

18. University of California-San Diego

19. Karolinska Institute

20. University of Texas Southwestern Medical Center

21. University College London

22. Washington University in St Louis

23. University of Chicago

24. University of Southern California

25. Northwestern University

26. University of Tokyo

27. Ohio State University

28. University of Pittsburgh

29. Columbia University

30. Peking Union Medical College

31. Shanghai Jiao Tong University

32. Nanjing Medical University

33. Emory University

34. New York University

35. Osaka University

36. Indiana University - Purdue University - Indianapolis

37. University of Wisconsin - Madison

38. University of Alabama at Birmingham

39. Massachusetts Institute of Technology

40. University of Minnesota - Twin Cities

41. Icahn School of Medicine at Mount Sinai

42. University of Oxford

43. Vanderbilt University

44. Kyoto University

45. Fudan University

46. Peking University

47. University of Cambridge

48. Huazhong University of Science and Technology

49. University of British Columbia

50. Charite - Medical University of Berlin

51. McGill University

52. Sichuan University

53. Pierre and Marie Curie University

54. Radboud University

55. Central South University

56. Seoul National University

57. University of Sydney

58. Case Western Reserve University

59. Catholic University of Leuven

60. Wayne State University

61. Kyushu University

62. Yonsei University

63. Oregon Health & Science University

64. Lund University

65. University of Melbourne

66. University of Colorado Denver/Anschutz Medical Campus

67. Zhejiang University

68. University of Munich

69. University of Hong Kong

70. Duke University

71. Boston University

72. Georgetown University

73. University of Miami

74. University of Utah

75. Thomas Jefferson University

76. Imperial College London

77. University of Illinois at Chicago

78. Medical University of Vienna

79. University of Maryland, Baltimore

80. China Medical University

81. University of Milan

82. Chinese University of Hong Kong

83. University of Helsinki

84. University of Texas Health Science Center at San Antonio

85. Rutgers University - New Brunswick

86. University of Hamburg

87. Sungkyunkwan University

88. University of Turin

89. University of Arizona

90. University of Virginia

91. University of Manchester

92. University of California - Davis

93. University of Florida

94. University of Tubingen

95. Southern Medical University

96. University of South Florida

97. Nagoya University

98. Harbin Medical University

99. National University of Singapore

100. Tufts University

Medicine subfields in the World

The Top 10 Best Research Institutes in The World

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Awaken your inner Hawking

Hey there, future inventors and academic aspirants, looking for the best research institutes in the world? Ready to study at the best of the best and make a name for yourself amongst the stars, standing toe to toe with pioneers such as Stephen Hawking, Albert Einstein and Marie Cury? Get prepared to reshape the boundaries and break all barriers by studying at the best research universities. Whether you’re a budding scientist or an avid sociological surveyor, these top 10 research institutes in the world are the perfect avenues for you to grow and maybe even create something out of nothing! 

1. Chinese Academy of Sciences (Beijing, China)

Nature Index ranking: #1

Average fees: 40,000 RMB - 45,000 RMB ($5,500 - $6,200) per year

Acceptance rate: 58%

Popular subjects: Chemistry, Environmental Sciences, Physical Sciences

The Chinese Academy of Sciences is one of the best research institutes in the world, if not the best. As the world’s largest research institute, CAS has over 100 research institutes, a total of three universities, and over 70 thousand full-time employees working towards maintaining its glowing reputation. Students especially interested in Chemistry, Physical Sciences, and Environmental Sciences should look forward to the amazing research.

2. Harvard University (Cambridge, USA)

Nature Index Ranking: #2

Average fees: $70,000 - $80,000 per year

Acceptance rate: 4%

Popular subjects: Biological Sciences, Health Sciences, Physical Sciences

Perhaps the first institute that must have popped up in your head is the Massachusetts-based Harvard University. As one of the best research universities one can ever hope to stumble across, Harvard has harboured tens of thousands of brilliant minds globally who have worked to change the tides of how our society has progressed. The university’s elite research facilities and societies make it worthy enough to make it into our list of the top 10 research institutes in the world.

3. Max Planck Society (Munich, Germany)

Nature Index Ranking: #3

Average fees: 0 tuition fees, $2,500 - $3,000 per year semester fees

Acceptance rate: undetermined

Popular subjects: Physical Sciences, Biological Sciences, Chemistry

Located in the German capital of Munich, the Max Planck Society or Institute is one of the most elite research institutions in the world, let alone Germany. Boasting more than 80 research institutes and over 20,000 full-time employees, students searching for the best research institutes in the world can rest assured that their growth is in safe hands if they choose to study and research here. In the year 2021, the budget of the Institute reached numbers such as 1.97 billion euros, most of which was contributed by the federal government.

4. National Center for Scientific Research (Paris, France)

Nature Index Ranking: #4

Average fees: $150 - $250 per year

Popular subjects: Chemistry, Physical Sciences. Environmental Sciences

Based in the city of love, the French National Center for Scientific Research is a premier offering our list of the top 10 best research institutes in the world. With over 30,000 full-time employees and sleek world-class research facilities, the institute is a dream for any graduate student looking for research opportunities. From complex biological and chemical research to studying Roman law and gender stereotypes, the CNRS has something for everyone. 

5. Stanford University (California, USA)

Nature Index Ranking: #5

Average fees: $80,000 - $90,000 per year

Acceptance rate: 3.9%

Another quality entry from the United States in our list of the top 10 research institutes in the world, Stanford has long since established itself as a step above the rest globally. Recognised for honing some of the sharpest minds who have made their place in some of the biggest positions in the world, it comes as no surprise that the research opportunities at Stanford are a cut above the rest, too. The 33km+ campus boasts over 20 research institutes focusing on the various facets of the human condition. Considering how low the university’s acceptance is, check out our blog on navigating Stanford University's Acceptance Rate .

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6. Massachusetts Institute of Technology (Cambridge, USA)

Nature Index Ranking: #6

Average fees: $55,000 - $65,000 per year

Acceptance rate: 4.1%

Popular subjects: Physical Sciences, Chemistry, Health Sciences

The city of Cambridge (not to be confused with the city of Cambridge in England) has produced yet another slot in our list of the best research institutes in the world. MIT was founded in 1861 and since then has produced over 90 Nobel laureates and established its presence as a haven for future researchers and scientists. Named as the number 1 global university by QS World Rankings for 2024, MIT should be one of the top names if you wish to explore tier 1 research universities. 

7. Helmholtz Association of German Research Centres (Bonn, Germany)

Nature Index Ranking: #7

Average fees: 0 tuition fees

Popular subjects: Physical Sciences. Environmental Sciences. Chemistry

Constituting 18 research centers, the Helmholtz Association is truly one of the best research institutes in the world. With its strategic location in one of the most technologically advanced countries in the world, Germany, aspirants have the chance to learn in a study-focused environment. 

8. The University of Cambridge (Cambridge, England)

Nature Index Ranking: #8

Average fees: $25,000 - $50,000 per year

Acceptance rate: 21%

Popular subjects: Biological Sciences, Chemistry, Environmental Sciences

This Cambridge, unlike the one that houses MIT and Harvard, is situated in the UK and has habilitated the future owners of about 1,500+ tech start-up companies. The University of Cambridge makes it to our list of the top 10 research institutes in the world for obvious reasons, such as being at the forefront of the research behind the identification of a DNA’s structure and splitting of an atom. Being one of the best research universities and even making it into the list of tier 1 research universities, Cambridge University’s research department focuses on an interdisciplinary approach. Learn more about Cambridge University in our blog about its history, courses, fees and more.

9. The University of Tokyo (Tokyo, Japan)

Nature Index Ranking: #9

Average fees: $3,000 - $5,000 per year

Acceptance rate: 34.2%

As one of the oldest functioning universities in modern-day Japan, the reason why the University of Japan makes it on our list of the best research institutes is its top-of-the-line research facilities as well as notable alumni such as Masatoshi Koshiba and Ei-ichi Negishi. The university, in addition, receives about $2.3 billion in funding from the government to carry out its research activities. Become a part of the academic revolution taking place in the Land of the Rising Sun by joining one of the best research universities.

10. Peking University (Beijing, China)

Nature Index Ranking: #10

Average fees: $14,000 - $25,000 per year

Acceptance rate: 28-30%

Popular subjects: Biological Sciences, Chemistry, Environmental Sciences.

Last but not least is Peking University, located in the heart of China’s capital, Beijing. As an important entry on our list of the best research institutes in the world, Peking University boasts 8 great research facilities where you will have the chance to interact and grow with the smartest minds in China and the world. In 2018 and 2019, the overall budget of the research conducted by the university stood at around $1.82 billion and $2.75 billion, respectively, signaling trust in the capabilities of one of the best research universities.

That wraps up our list of the top 10 research institutes in the world. From CAS in China to the Max Planck Society in Munich, these tier 1 research universities and research centers can end up becoming your destination for premier research opportunities. If you are truly invested in the field, consider where your research interests lie and then consider further research on which institute meets your needs the best. Also if you are really planning to study in any of these universities, you will need to clear GRE entrance exam , majority of these universities consider Gre scores arevital for graduate programs worldwide.

Frequently Asked Questions

What is the acceptance rate for harvard university, how many research centres can i choose from in the max planck society, do german universities take tuition fees, who are some notable alumni from the massachusetts institute of technology, what is the average tuition fee at the university of cambridge.

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Marquette ranked in top 5.5% of universities worldwide by Center for World University Rankings 

• May 13, 2024
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Marquette is ranked in the top 5.5% of more than 20,000 universities worldwide in the Center for World University Rankings’ 2024 edition of the outcome-based Global 2000 list. 

The Center for World University Rankings publishes the largest academic rankings of global universities. Objective indicators are used for all four key pillars underlying the methodology of the ranking — education, employability, faculty and research — with no reliance on surveys or university data submissions. This year’s rankings are based on 62 million data points. 

The Center for World University Rankings is a leading consulting organization providing policy advice, strategic insights, and consulting services to governments and universities to improve educational and research outcomes. 

Marquette is additionally ranked 56th in the country in the Wall Street Journal/College Pulse 2024 Best Colleges in the U.S. list and 83rd among national universities by U.S. News & World Report . 

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How to Find the Best Assisted Living Community Near You: A Checklist

If you're considering moving into an assisted living community, it's important to understand what your options are and do your research. Read our checklist for advice on how to select the right facility.  

This article is based on reporting that features expert sources.

Checklist for Moving to Assisted Living

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As time marches onward, many older adults start to need a little assistance with the tasks of daily living, such as cooking meals, shopping and grooming.

In these instances, you may be considering a move to an assisted living facility. If and when it comes to that, you’ll no doubt have dozens of questions.

Picking the right assisted living facility should mirror how we select a college or career path earlier in life.

"We do our homework," says Dr. Susann Varano, a geriatrician consultant with Maplewood Senior Living, a Westport, Connecticut-based senior living residence company. "We do our due diligence. We see if our interests match what the school has to offer. Then we find out, can we get into the school? Can we afford it? What’s the cost? The location? What’s the reputation? I don’t know why we don’t do that for assisted living.”

Start Your Assisted Living Search Early

The most important thing to know is that the sooner you begin the process, the better.

“You can really separate the good from the bad places when you dig,” points out Anthony Cirillo, a North Carolina-based health, aging and caregiving expert and president of The Aging Experience.

No one wants to move during a crisis, and this next place for your loved one may be their forever home, adds Nora O’Brien, executive director of Willow Towers Assisted Living and Willow Gardens Memory Care in New Rochelle, New York.

“Their health care needs can change through the rest of their years," she explains. "If the loved one can age in place , that’s very important, because once you decide to make this move, you want to make sure you don’t have to make a different move again.”

Use This 14-Point Checklist to Find the Best Assisted Living Facilities

This 14-point assisted living checklist can help you break down the process to make sure you’re not leaving anything to chance or leaving any question unasked:

• Consider your needs and preferences.
• Research assisted living facilities that match your needs.
• Book a tour of the assisted living facility.
• Look into what types of units are available.
• Get the details about fees and services.
• Find out about policies.
• Ask about staffing ratios and tenures.
• Check on the health care options.
• Learn about activities and resident enrichment opportunities.
• Talk about transportation.
• Ask about unforeseen events. 
• Ask about safety, hygiene and infection control.
• Don't forget about social and spiritual needs.
• Make a selection.

Find the best assisted living near you

Search by state, city or ZIP code to find the right assisted living community for you.

1. Consider your needs and preferences

There are core differences to consider when you're searching for an assisted living facility: location, size, services, cost and health care needs. Let's walk through them.

The importance of the assisted living facility’s location depends on each potential resident and their preferences.

“Many prefer to stay in the community where they were living, so they can remain close to friends and familiar surroundings,” says LaShuan Bethea, executive director of the National Center for Assisted Living in Washington, D.C. "Residents and families may also want to consider the assisted living community’s proximity to other health care providers, like a hospital or doctor’s office, to be prepared for when additional health care is needed.”

Another factor to keep in mind is whether your loved one prefers a suburban or city lifestyle.

The average number of licensed beds in an assisted living facility is 39, according to NCAL . Communities vary widely in size, from small facilities with four to 10 beds to extra-large facilities with more than 100 beds.

Staff-to-resident ratio matters too (and more on that later on). Group homes , also known as adult family homes or board-and-care homes, are an emerging type of assisted living facility that generally has fewer residents and as many as one staff member per five or six residents. These small group homes are typically located in residential neighborhoods.

Size can also affect the types of services offered. Large communities, for instance, may be more likely to offer amenities – such as movie theaters and swimming pools – or specialized units for memory care .

Services and next-level care

Residents in assisted living tend to need help with just a few activities of daily living , such as bathing, dressing and walking, and do not require 24/7 skilled nursing care like nursing home residents, Bethea notes.

While the typical assisted living facility offers dining services, housekeeping and exercise and wellness programs, some also provide tailored services based on specific health needs.

“These may include – but are not limited to – Alzheimer's disease or other forms of dementia, such as memory care units , intellectual and developmental disabilities and particular medical conditions, such as Parkinson's disease or other needs,” Bethea says.

Whether or not you can afford an assisted living facility – and how you intend to pay for it – is a major factor to consider. Your budget also may dictate the room size or if you’ll have a private or shared room.

“Assisted living is largely paid for through personal resources, while most nursing home residents are covered by Medicare or Medicaid , due to the way those government programs currently cover long-term care,” Bethea says.

Depending on the policy, long-term care insurance may help cover assisted living.

“Check your schedule of benefits,” advises Nancy Avitabile, owner of Urban Eldercare, a geriatric care management practice in New York City. “Be very clear on what would be considered assisted living.”

If you’re not receiving caregiving help with at least some activities of daily living, for instance, your living situation may not qualify as assisted living for insurance purposes.

Facilities can also differ in how you pay for them. Approaches may involve an upfront cost, monthly rent, a la carte services or a tiered system.

Health care needs

Consider your loved one's health care needs, both now and in the future. Are they having memory issues but haven't progressed to an official dementia diagnosis? Do they need assistance with grooming, going to the bathroom or getting dressed? What are their chronic conditions ?

Make sure to check whether the assisted living communities you're considering can address the spectrum of needs your loved one may have.

2. Research assisted living facilities that match your needs

Once you’ve narrowed down your list of possible assisted living sites to choose from, it’s time to reach out for more information. Thoroughly review everything, and narrow the options based on your needs and costs.

As part of your due diligence, make sure to look into state safety records. While the federal government regulates nursing homes, states regulate assisted living facilities. You can contact your state health department or social services office to find out the track record of an individual facility.

Assisted living facilities also need to be licensed to operate, and state agencies regularly inspect or survey these communities to investigate if a complaint is filed. These surveys can turn up information about violations or citations, which is publicly available and should be easily accessible to anyone who requests them.

"If a facility will not share with you the most current survey results, run away," says Amie Clark, a Portland, Oregon-based senior care expert at AgingToday.com and founder of Clark Fork Media.

3. Book a tour of the assisted living facility

The only real way to get a sense of a community is to visit. Find out when you can visit, and plan to see everything that’s on offer. While you’re there, consider the atmosphere:

• Is the facility bright, clean and odor-free?
• Are there obvious safety features, such as call buttons or handrails?
• Do residents seem happy and engaged?
• How do staff and residents interact?
• How are the grounds and buildings maintained?
• What types of rooms, apartments or units are available? How do they compare in price and comfort?
• How does the place make you feel?

"Because of the individuality and uniqueness of each assisted living community, we strongly encourage prospective residents and their families to visit communities they're interested in," says Brian Doherty, president and CEO of the Massachusetts Assisted Living Association.

In addition to taking a formal tour and asking a representative of the community all the questions you have, you should see the community when they aren’t expecting you.

“I always recommend going in unannounced and just showing up," Varano says. "You want to see it in real time. You don’t want them prettying up the place for you and having everyone on their best behavior because they know a tour is coming in. You want to show up at nighttime and on the weekends. Show up during meal time. You want to see if it’s organized, if it’s chaotic.”

Speak with as many people in the community as you can

Many facilities want you to speak primarily with their sales team. However, you should also push to speak with other staff members, such as the health care professionals, and residents to get a less varnished look into what life will really be like in that community.

Doherty recommends that prospective residents and family members meet with the community marketing professional, as well as staff responsible for resident care and direct care to get a clear understanding of how staff interact with residents and their families, how they may handle emergency situations and how responsive and welcoming staff are to any unscheduled needs.

While visiting a community, observe how staff and residents interact with each other.

Try the food

Have a meal while you’re touring each facility to see if the food fits your palate.

Mary Sue Patchett, strategic advisor for new business with Patriot Angels, a Hendersonville, Tennessee-based company that helps veterans secure funding for senior living expenses, says you should ask: How many meals a day do I get, and do I have choices on the menu? Is there a café or bistro on site? How does the food taste?

"Most communities would offer for you to have lunch or dinner on-site,” she adds.

With many older adults needing special diets , it’s critical to find out whether the facility you’re considering can handle tastes, preferences and medically necessary dietary needs.

Other questions you might ask include:

• When and where are meals served, and what sort of variety is available?
• Can residents cook for themselves in their rooms or units?
• Can the community cater to special dietary preferences or needs?
• Is the food good, and do residents seem well-fed and happy with the food options?
• How nutritious are the meals, and who’s doing the meal planning for residents?
• Does the community employ a registered dietitian to help with planning healthy, well-balanced meals ?

4. Look into what types of units are available

Consider what types of rooms, apartments or units are available and how they compare in price and comfort. Other aspects to consider include:

• Do units include kitchens or kitchenettes?
• Are the rooms and bathrooms private?
• What kind of furnishings are there?
• What kind of safety features will be available?
• Will you be able to grow a garden or walk out on a patio?

5. Get the details about fees and services

You should also make sure you understand fully what you’re getting for your money and what hidden costs might crop up later, whether you’re opting for a less expensive community or the priciest.

"Before signing a contract, make sure you ask about any additional deposits and fees or move-in or move-out costs," Clark says. "Also, make sure you understand your obligations in the event of needing to move out," whether that’s to move to a different community or in the event of a hospitalization or rehab stay.

For example, you should ask:

• If the resident is hospitalized, what are your options for payment while no one is staying in the apartment?
• What services are included in the monthly rental fee?
• Are utilities included?
• Are deposits refundable?
• How much do services cost, how many are included and how are they billed?
• As a resident's needs increase, how high can costs go in an assisted living unit? What about in a memory care unit?
• What pricing structure does the community use? Are any services charged a la carte?

6. Find out about policies

Ask about policies, such as:

• Can residents come and go at will?
• Can you bring your own furniture or pets?
• When and how are visitors permitted?
• What happens if the resident runs out of money?

"Always ask for a copy of the contract in advance so that you and/or your attorney have time to review it," Clark adds.

7. Ask about staffing ratios and tenure

Staffing at assisted living facilities has long been a challenge, as there’s a lot of turnover among employees across the industry. But for many communities, staffing concerns were exacerbated by the COVID-19 pandemic .

According to Patrick Crump, president and CEO of Morningside Ministries Senior Living Communities in San Antonio, the staffing pressures on nursing homes , assisted living communities and other long-term care facilities grew during the pandemic as staffers regularly tested positive for the illness.

Such issues, which are still ongoing in some communities, create a huge challenge for facility operators as they scramble to ensure that they’ve got enough qualified staff on-site to assist and care for residents as needed.

If you’re looking to enter a new community or find a placement for your loved one, ask about the ratio of staff members to residents. It's also a good idea to see how long staff members have remained at that assisted living facility. Chances are, if employees have been there for the long term, your odds of receiving consistent care from the same staff member are high.

8. Check on the health care options

The allure of a pretty facility can sometimes mask that the health care services offered just aren’t right for a particular senior, says Dr. Tanya Gure, section chief of geriatrics and clinical professor of internal medicine at the Ohio State University Wexner Medical Center in Columbus.

“It’s nice to have all the bells and whistles, but it’s also important to consider the quality of the services that are offered here,” she points out.

Keep in mind that levels of care in assisted living can vary among communities. These care levels include:

• Lower levels . Residents require less intensive care and may need minimal assistance with daily tasks.
• Higher levels . Residents have more complex medical needs and may need more hands-on assistance.
• Memory care . Residents with Alzheimer's disease or another form of dementia can receive specialized care .

As you're considering where your loved one may fit within a community, ask these questions:

• What kinds of residents are currently living in that community, in terms of care needs?
• How many residents live there?
• What is the proximity to good health care services that are unaffiliated with the facility but able to provide additional care as needed?
• Can you continue with your primary care physician or other specialists in the community?
• What medical personnel and services are available on campus?
• How much do on-site services cost?
• Are those fees part of the whole package or charged a la carte as needed?
• Are services tiered so that an aging resident can stay in the community as health needs change?
• What policies are in place around medications, and is there an on-site prescribing doctor?
• Can you meet any/all medical staff working there?

All of this information can help you determine if a specific community is the right choice in the long term.

In addition, be sure to ask how long the average stay is at a facility to get more insight into a community's levels of care.

“If they say the average expectancy is three years and it’s not due to medical (needs), then you’re going to want to ask, ‘What need did they have that you couldn’t handle here?’" Varano says. "If you have a disease state that they can’t handle, that might not be the right place for you or you might look for a different assisted living community that has a stronger medical model.”

Other questions include:

• How are medications dispensed and managed for adults who need assistance?
• Can my loved one’s condition be appropriately managed at this facility?
• How is this condition expected to evolve, and can this facility manage those anticipated changes?
• What palliative, end-of-life or hospice care options are available?
• Does the facility offer physical, occupational or speech therapy? Who provides that? What’s their success rate, and are they dementia-trained?
• Is there any nursing care available? If so, is it provided by a registered nurse or a licensed practical nurse? Is this care available only during the day? What happens during the night? What is the facility’s frequency tolerance of calling 911 or going to the ER? How much can be handled in-house?

9. Learn about activities and resident enrichment opportunities

One way that assisted living facilities differentiate themselves is through the activities and amenities they offer. Look for amenities you know you want, such as a pool or other outdoor spaces, library or computer rooms, hair and nail salon or barbershop on-site.

It's important to find out not only what sort of activities are available – books clubs and shuffleboard or a wider variety of options and outings – but also when they're scheduled, says Jennifer Cook-Buman, owner of referral agency Portland Senior Housing in Oregon. Limited time offerings may mean some residents will miss out on these important socializing and enriching opportunities.

In addition, find out how the activity coordinator is tapping into what residents want to do.

"Good activity people really set the tone of a facility," Cook-Buman says. "(Ask) how well attended activities are, what outings are offered and how they're managed."

Also consider these questions:

• Does the community have a dedicated activities director?
• How often are activities available, and are they of interest to the prospective resident?
• Is there a resident council, and are residents encouraged to get involved?
• Can residents share their expertise and knowledge by teaching others?

10. Talk about transportation

Transportation options can vary widely. If the community is based in a more remote or rural location, consider how your loved one will get around.

• How will your loved one get to a doctor’s appointment off-site or to other events and locations?
• Are there extra fees involved with accessing transportation?

11. Ask about unforeseen events

How do professionals at the assisted living facility you’re considering handle emergencies?

"What if there’s a fall? What is the reporting like? Do people automatically go to the ER?" Avitabile asks. "Who makes those decisions?"

Other questions to ask include:

• What types of events or circumstances will the family be notified about and how will those notifications be made?
• What happens if the resident needs to move away within a short timeframe? How many days/months of notice are required?
• What happens if a prolonged hospital stay is necessary? How are fees assessed?
• If my loved one needs a higher level of care, how much notice do I need to give? How much notice will I be given if fees or care charges are subsequently increased?

Sometimes you need to choose an assisted living community quickly, such as when you’re being discharged from the hospital and need a brief respite stay.

“If you are in a rush, make sure you understand the leasing requirements,” Avitabile advises. “Typically, when you have a respite stay, you might still be required to give a 60- or 30-day notice to avoid being charged for another month (on leaving).”

If you have a medical emergency that requires hospitalization for a prolonged period of time, how long will you be able to keep your apartment before the facility wants to turn it over to a new resident? And will you be charged for that apartment while you’re in the hospital?

“If they will hold your apartment for you, how much do you have to pay? Is it the full monthly fee? Is it prorated? Are you paying for the room but not paying for the care because you’re not receiving it? Those are very fine details that should be evaluated before versus after,” Varano says.

12. Ask about safety, hygiene and infection control

The three biggest safety concerns for seniors are falls, wandering and infections.

According to the Centers for Disease Control and Prevention, falls are a leading cause of injuries – both fatal and nonfatal – among those age 65 and older. To minimize the risk of falls , assisted living communities can adjust medications to reduce drowsiness, provide physical and occupational therapy, control bed heights and decrease clutter, for example.

Additionally, residents with Alzheimer’s disease or other forms of dementia may have issues with wandering out of the facility or into unsafe spaces. Assisted living communities can take steps, like installing monitoring equipment at entrances and exits and making them more secure. They can also provide alarm bracelets that are activated at detectors.

Ask the assisted living facility about what protocols they have in place to prevent falls and wandering.

Finally, although the COVID-19 situation is always changing, virus variants are still a threat for seniors. Outbreaks of infectious conditions, such as the flu or respiratory syncytial virus , also remain an ongoing challenge for any residential setting. While pandemic-specific restrictions have eased, how facilities limit exposure and spread of infectious diseases is an important factor to consider.

Each facility should be able to answer questions about vaccinations, hygiene protocols, testing and outbreak mitigation steps.

During your visit, keep an eye out for how clean the facility is and whether regular hand-washing and cleaning policies are followed.

13. Don't forget about social and spiritual needs

Combating loneliness and providing a social outlet for seniors is a key reason many people move into an assisted living community . Loneliness is detrimental to physical and mental health. Find out what the community you’re considering does to help residents feel less isolated .

For some seniors, finding a spiritual home is just as important as health care and food, so ask how the community caters to these needs. See if worship services are offered on-site or if transportation is provided to nearby churches, temples, mosques or other places of worship.

14. Make a selection

As you're narrowing down potential assisted living communities, make sure to include your loved one in the process.

“Residents should still be able to make choices and be part of their own destiny,” O’Brien says. “The assisted living model was built on choice.”

Frequently Asked Questions

A great place to start your search for the right assisted living community is by contacting your local Area Agency on Aging . These nonprofit organizations can help you find out more about facilities in your area that might be a good fit.

Assisted living communities are designed for older adults who need some help with completing activities of daily living, such as toileting, bathing and meal preparation. They do not provide 24/7 nursing care. A nursing home, on the other hand, does offer round-the-clock care, which is intended for individuals who need ongoing health care in addition to assistance with activities of daily living.

Assisted living fees can vary widely depending on a range of factors, including the location of the community and the services provided. It can be expensive , and Medicare does not cover the cost of assisted living. According to Genworth Financial's 2021 Cost of Care survey (the most recent data available), an average monthly cost of an assisted living community is $4,500.

Assisted living facilities provide daily support for individuals who are unable to complete the activities of daily living on their own, such as toileting, grooming and cooking. They also provide many opportunities for socialization, entertainment, education and other forms of enrichment that can make living there much more enjoyable.

Experts agree: The sooner you start your search, the better your outcome will be. If you’re forced to make a rushed decision, you won’t have the time to ask as many questions and compare multiple properties. Some experts say you should try to compare at least six facilities before selecting one. That rule of thumb can be difficult to accomplish when there’s urgency around making the move because of a rapid decline in the senior’s condition.

Finding the right assisted living community may take some time and research. Your best bet for making sure you’re making a good choice is to visit and take a tour. While there, talk to everyone you can about how the facility operates and what living there is like. You can also research online to find out whether there have been any complaints about the facility.

In addition, you'll need to consider what will fit into your budget, along with other factors, such as how close the community is to family members and what sorts of activities they offer. When you’ve done all that, asked all the questions and carefully reviewed the contract, you can feel confident that you’re making a good choice of assisted living community.

Assisted Living Room Types

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Avitabile is the owner of Urban Eldercare, a geriatric care management practice in New York City, and a past president of the Aging Life Care Association. She is based in New York.

Bethea is the executive director of the National Center for Assisted Living in Washington, D.C.

Cirillo is a North Carolina-based health, aging and caregiving expert and president of The Aging Experience, a company that provides consulting, keynote speaking and products for the senior living industry and older adults.

Clark is a Portland, Oregon-based senior care expert at AgingToday.com and founder of Clark Fork Media. She previously co-founded TheSeniorList.com, a website that connects seniors and caregivers with resources, products and services.

Cook-Buman is owner of referral agency Portland Senior Housing in Oregon.

Crump is president and CEO of Morningside Ministries Senior Living Communities in San Antonio.

Doherty is president and CEO of the Massachusetts Assisted Living Association, a not-for-profit association dedicated to professionally operated assisted living residences in Massachusetts that provide housing and services for individuals with varied needs and income levels.

Gure is section chief of geriatrics and clinical professor of internal medicine at the Ohio State University Wexner Medical Center in Columbus.

O'Brien is executive director of Willow Towers Assisted Living and Willow Gardens Memory Care in New Rochelle, New York.

Patchett is strategic advisor for new business with Patriot Angels, a Hendersonville, Tennessee-based company that helps veterans secure funding for senior living expenses. She was formerly executive vice president of Brookdale Senior Living.

Varano is a geriatrician consultant with Maplewood Senior Living, a Westport, Connecticut–based senior living residence company.

Tags: assisted living , senior health , nursing homes , aging , senior citizens

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Fortune/PINC AI 15 Top Health Systems 2024

In recent decades, there’s been a slow but significant shift in the way American health care is organized. Financial, regulatory, and technological forces have all tended to push hospitals and other medical providers into the fold of larger, integrated health systems. According to the American Hospital Association, 68% of U.S. hospitals are now system-affiliated. To address that trend, the 100 Top Hospitals program, which for decades has ranked America’s best-performing hospitals in an effort to drive industry-wide improvement, launched a list that applies the same rigorous analysis to the nation’s growing number of health systems 16 years ago.

For this year’s Fortune/PINC AI 15 Top Health Systems , researchers from PINC AI—the technology platform for the health care company Premier—drew from a study of 355 health systems across the U.S. using publicly available Medicare data. (Systems had to have at least two general, acute care hospitals to be included in the study). 

The analysis took into account data from every hospital within a system, and considered eight performance indicators, like inpatient mortality and average length of stay, that measure an organization’s clinical outcomes, operational efficiency, and patient experience. The top-ranking systems, divided into three groups—large, medium, and small—outperformed their peer systems on all eight measures. These were meaningful differences: rates of hospital-acquired infections and inpatient mortality, for example, were both 21% lower for winning systems than non-winning peers. For the best-performing large systems, inpatient mortality was 32% lower according to the study.

If all health systems performed as their top-rated peers, the analysis found, there would be 220,000 fewer patient deaths and 196,000 fewer patients to suffer complications during their hospital stay. In addition, the typical patient would spend half a day less in the hospital and the costs of their care would be 2% less. Most of the winning systems have been recognized on this list before; the Mayo Clinic , which ranks second among large systems this year, has appeared 12 times.

As is always the case, health systems do not apply for the 15 Top Health Systems selection process, and winners do not pay to market their honor.

5 Top Large Health Systems

1. intermountain health.

Location: Salt Lake City Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 2 Website

2. Mayo Clinic

Location: Rochester, Minn. Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 12 Website

3. Houston Methodist

Location: Houston Clinical outcomes: ★★★★★ Operation efficiency: ★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 2 Website

4. HCA Continental Division

Location: Denver Clinical outcomes: ★★★★★ Operation efficiency: ★★★ Patient experience: ★★★★ Total number of years on 15 Top list: 4 Website

5. Sutter Health

Location: Sacramento Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★ Total number of years on 15 Top list: 2 Website

5 Top Medium Health Systems

1. hca mountain division.

Location: Cottonwood Heights, Utah Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★ Total number of years on 15 Top list: 2 Website

2. CHI Saint Joseph Health

Location: Lexington, Ky. Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★ Total number of years on 15 Top list: 2 Website

3. Saint Francis Health System

Location: Tulsa Clinical outcomes: ★★★★★ Operation efficiency: ★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 1 Website

4. Munson Healthcare

Location: Traverse City, Mich. Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 2 Website

5. Ascension Sacred Heart Health System

Location: Pensacola Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★ Total number of years on 15 Top list: 1 Website

5 Top Small Health Systems

1. chi memorial.

Location: Chattanooga Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 3 Website

2. Franciscan Sisters of Christian Charity Sponsored Ministries

Location: Manitowoc, Wis. Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★ Total number of years on 15 Top list: 3 Website

3. Olathe Health

Location: Olathe, Kan. Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★★ Total number of years on 15 Top list: 1 Website

4. Ascension St. Vincent’s HealthCare

Location: Jacksonville Clinical outcomes: ★★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★ Total number of years on 15 Top list: 1 Website

5. ThedaCare

Location: Appleton, Wis. Clinical outcomes: ★★★★ Operation efficiency: ★★★★★ Patient experience: ★★★★ Total number of years on 15 Top list: 1 Website

Fortune   partnered with PINC AI on the 2024 rankings of the 100 Top Hospitals, 50 Top Cardiovascular Hospitals, and the 15 Top Health Systems in the U.S. Learn more about the lists and see which community and teaching hospitals ranked high among their peers below.

• 15 Top Health Systems: Methodology 100 Top Hospitals: Introduction
• 40 Top Teaching Hospitals
• 60 Top Community Hospitals
• 50 Top Cardiovascular Hospitals

PREMIER, PINC AI, 100 TOP HOSPITALS, 15 TOP HEALTH SYSTEMS, and 50 TOP CARDIOVASCULAR HOSPITALS are registered/unregistered trademarks of Premier Healthcare Alliance, L.P. in the United States.

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• Handwashing
• Hand Hygiene as a Family Activity
• Hand Hygiene FAQs
• Handwashing Facts
• Publications, Data, & Statistics
• Health Promotion Materials
• Global Handwashing Day
• Clean Hands and Spaces: Handwashing and Cleaning in Educational Facilities
• Life is Better with Clean Hands Campaign
• Clinical Safety
• Healthcare Training
• Clean Hands Count Materials

About Hand Hygiene for Patients in Healthcare Settings

• Patients in healthcare settings are at risk of getting infections while receiving treatment for other conditions.
• Cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics, and protects healthcare personnel and patients.
• Patients and their loved ones can play a role in asking and reminding healthcare personnel to clean their hands.

Your hands can spread germs.

• Hands have good germs that your body needs to stay healthy. Hands can also have bad germs on them that make you sick.

Alcohol-based hand sanitizer kills most of the bad germs that make you sick.

• Alcohol-based hand sanitizers kill the good and bad germs, but the good germs quickly come back on your hands.

Alcohol-based hand sanitizer does not create antimicrobial-resistant germs.

• Alcohol-based hand sanitizers kill germs quickly and in a different way than antibiotics.
• Using alcohol-based hand sanitizers to clean your hands does not cause antimicrobial resistance.

Steps to take

When patients and visitors should clean their hands.

• Before preparing or eating food.
• Before touching your eyes, nose, or mouth.
• Before and after changing wound dressings or bandages.
• After using the restroom.
• After blowing your nose, coughing, or sneezing.
• After touching hospital surfaces such as bed rails, bedside tables, doorknobs, remote controls, or the phone.

How to clean hands

With an alcohol-based hand sanitizer:.

• Put product on hands and rub hands together.
• Cover all surfaces until hands feel dry.
• This should take around 20 seconds.

With soap and water:

• Wet your hands with warm water. Use liquid soap if possible. Apply a nickel- or quarter-sized amount of soap to your hands.
• Rub your hands together until the soap forms a lather and then rub all over the top of your hands, in between your fingers and the area around and under the fingernails.
• Continue rubbing your hands for at least 15 seconds. Need a timer? Imagine singing the "Happy Birthday" song twice.
• Rinse your hands well under running water.
• Dry your hands using a paper towel if possible. Then use your paper towel to turn off the faucet and to open the door if needed.

Clean Hands Count Campaign Materials‎

Ask your healthcare provider to clean their hands.

• Wearing gloves alone is not enough for your healthcare provider to prevent the spread of infection.
• "Before you start the exam, would you mind cleaning your hands again?"
• "Would it be alright if you cleaned your hands before changing my bandages?"
• "I didn't see you clean your hands when you came in, would you mind cleaning them again before you examine me?"
• "I'm worried about germs spreading in the hospital. Will you please clean your hands once more before you start my treatment?"

Speak up for clean hands in healthcare settings

• Clean your own hands and ask those around you to do the same.
• Don't be afraid to use your voice: it's okay to ask your healthcare provider to clean their hands.
• "I saw you clean your hands when you arrived some time ago, but would you mind cleaning them again?"

Frequently asked questions

Is there such a thing as too clean.

• Germs are everywhere. They are within and on our bodies and on every surface you touch. But not all germs are bad. We need some of these germs to keep us healthy and our immune system strong.
• Your hands have good germs on them that your body needs to stay healthy. These germs live under the deeper layers of the skin.
• Your hands can also have bad germs on them that make you sick. These germs live on the surface and are easily killed/wiped away by the alcohol-based hand sanitizer.
• Using an alcohol-based hand sanitizer is the preferred way for to keep your hands clean.

Washing with soap and water: 15 versus 20 seconds

• Wash your hands for more than 15 seconds, not exactly 15 seconds.
• The time it takes is less important than making sure you clean all areas of your hands.
• Alcohol-based hand sanitizers are the preferred way to clean your hands in healthcare facilities.

Which one? Soap and water versus alcohol-based hand sanitizer

An alcohol-based hand sanitizer is the preferred method for cleaning your hands when they are not visibly dirty because it:

• Is more effective at killing potentially deadly germs on hands than soap.
• when moving from soiled to clean activities with the same patient or resident.
• when moving between patients or residents in shared rooms or common areas.
• Improves skin condition with less irritation and dryness than soap and water.

Guidelines for Hand Hygiene in Healthcare Settings Published 2002

Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings

What CDC is doing

CDC's Clean Hands Count campaign offers posters, factsheets, and brochures for healthcare providers and patients.

Keep reading: Clean Hands Count materials

Healthcare personnel

When and how to practice hand hygiene. Learn more .

New Training and Education Resources available for Healthcare Professionals.

Hand Hygiene in Healthcare Settings Video Series link: Education Courses | Hand Hygiene | CDC

Clean Hands

Having clean hands is one of the best ways to avoid getting sick and prevent the spread of germs to others.

For Everyone

Health care providers.

Energy Drinks

Plain water is the best hydrating beverage for most people, but sports and energy drinks are advertised to appeal to those who exercise or need a boost of energy to get through the day.

Though sometimes confused with sports beverages , energy drinks are a different product entirely. They are marketed to increase alertness and energy levels, containing significant amounts of caffeine and as much or more sugar as in soda. Many energy drinks pack about 200 mg of caffeine, the amount in two cups of brewed coffee. Other substances purported to increase energy may be added, like B vitamins and herbs such as ginseng and guarana. Most concerning is a lack of regulation about the safety of these drinks, as well as aggressive marketing tactics geared toward adolescents. [1] The Centers for Disease Control and Prevention reported that in 2007, 1,145 adolescents ages 12 to 17 went to the emergency room for an energy drink-related emergency. In 2011 that number climbed to 1,499. [2]

After water, sugar is the main ingredient in energy drinks. A nutritional comparison shows that a 12-ounce cola drink contains about 39 grams of sugar, 41 grams of sugar in an energy drink. Research has found that consuming high-sugar drinks of any kind can lead to weight gain and an increased risk of type 2 diabetes, cardiovascular disease, and gout.

Because of the amount of sugar and stimulant ingredients, there is concern that these beverages may not be helpful, and even worse, harmful to adolescents and people with certain health conditions.  

Energy Drinks and Health

Sipping a beverage that offers quick energy may appeal to people who feel fatigued or who believe the caffeine can provide an edge when exercising or playing competitive sports. Although statements on the websites of energy drinks warn that these beverages may not be suitable for children, youth are among their largest consumers. An energy drink may be used by adolescents or college students cramming for exams through the night, or by a young athlete before an important game. While it is true that some controlled trials have shown temporary improved alertness and reversal of fatigue after taking energy drinks, as well as enhanced physical performance in young athletes, the majority of studies show an association with negative health effects. These include increased stress, aggressive behaviors like fighting, alcohol/cigarette abuse, increased blood pressure, increased risk of obesity and type 2 diabetes, poor sleep quality, and stomach irritation. [1]

A typical energy drink may contain the following: carbonated water, around 40 grams of sugar (from sucrose and/or glucose), 160 mg or more of caffeine, artificial sweetener , and herbs/substances associated with mental alertness and performance but that lack scientific evidence with controlled trials (taurine, panax ginseng root extract, L-carnitine, L-tartarate, guarana seed extract, B vitamins).

Special concerns with energy drinks:

• Amplified negative health effects in adolescents. Children and teens may experience heightened effects from the high amounts of caffeine, added sugars including high fructose corn syrup, low-calorie sweeteners , and herbal stimulants, partly due to their smaller body size. [3]
• Marketing tactics towards youth. Estimates show more than a 240% increase in U.S. and worldwide sales of energy drinks. It is a $21 billion industry, with marketing campaigns targeting youth and being sold in places that are easily accessed by this age group. [1,4] Youth are exposed to energy drink advertising on children’s websites, computer games, television, supermarkets, and sporting events. [5] Research has shown that adolescents lack maturity in key areas of the brain and are more likely to engage in risk-taking behavior, making them vulnerable to risky behaviors sometimes portrayed in energy drink marketing. Youth are attracted to energy drinks due to effective marketing, influence from peers, and lack of knowledge about their potential harmful effects. [4]
• Negative health outcomes. Emerging evidence has linked energy drink consumption with negative health consequences in youth like risk-seeking behaviors, poor mental health, adverse cardiovascular effects, and metabolic, renal, or dental problems. [1]
• Excessive caffeine. Too much caffeine from any beverage, particularly when several are taken in one day in sensitive individuals, can lead to anxiety, insomnia, heart problems like irregular heartbeat and elevated blood pressure, and in rare cases seizures or cardiac arrest. Some energy drinks may contain as much as 500 mg per can (the amount in 14 cans of cola). [4.6]
• High sugar content. Because of the excessive sugar content in some energy drinks, they carry the same health risks associated with other sugar-sweetened beverages. See Sugary Drinks .
• Dangers with alcohol. A greater danger is introduced if energy drinks are combined with alcohol, a trend largely seen in underage drinkers and associated with binge drinking. Studies suggest that drinking this type of cocktail leads to a greater alcohol intake than if just drinking alcohol alone. This may be because energy drinks increase alertness that masks the signs of inebriation, leading one to believe they can consume even more alcohol. [1] In case reports, high consumption of energy drinks—especially when mixed with alcohol—has been linked to adverse cardiovascular, psychological, and neurologic events, including fatal events. [2]
• Lack of regulation. The Food and Drug Administration (FDA) does not regulate energy drinks but enforces a caffeine limit of 71 mg per 12 ounces of soda; energy drinks typically contain about 120 mg per 12 ounces. However, energy drink manufacturers may choose to classify their product as a supplement to sidestep the caffeine limit. For companies that classify their energy drinks as beverages, the American Beverage Association published voluntary guidelines that advise accurate listings of caffeine content, restriction of marketing to children, and reporting of adverse events to the FDA. However, compliance to these guidelines has been found to be low. [1]
• The International Society of Sports Nutrition (ISSN) issued a position statement on energy drinks after analyzing their safety and efficacy. (8) They concluded that consuming energy drinks 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and endurance in adults, largely through the effects of caffeine. However, other ingredients in these drinks require more study to demonstrate their safety and effects on performance. ISSN cautioned that higher-calorie energy drinks can lead to weight gain, and that their high glycemic load could negatively affect blood glucose and insulin levels. They discouraged use of energy drinks for children and adolescents unless under careful parental monitoring, and for people with diabetes or cardiovascular disease who could be negatively affected by the stimulant ingredients.
• The American Academy of Pediatrics’ Committee on Nutrition and the Council on Sports Medicine and Fitness encourage pediatric health care providers to discourage the use of and discuss potential health risks of stimulant ingredients in energy drinks with youth and parents, and to limit or avoid sugar-sweetened beverages of any kind in youth due to risk of excessive calorie intake and weight gain, as well as dental erosion. [7]  

Bottom Line

Water that is calorie-free and accessible without cost to most people is the beverage of choice taken with and between meals. Energy drinks are a source of caffeine that people may choose as an alternative to coffee or tea. However, they also contain high amounts of sugar, vitamins, and herbs that may not be necessary for the average person. Energy drinks can pose a health risk in vulnerable groups including children, teenagers, pregnant women, and those with medical conditions like diabetes and cardiovascular disease. Adults who choose to consume energy drinks should check the label for caffeine content and avoid high consumption (over 200 mg of caffeine per drink); consumption in combination with alcohol should be avoided. [9] Pediatricians should discuss the use of energy drinks with their young patients and parents to ensure that all are aware of the health risks, and if used, are monitored carefully. [7]  

Sugary Drinks Sports Drinks

• Al-Shaar L, Vercammen K, Lu C, Richardson S, Tamez M, Mattei J. Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review. Front Public Health . 2017;5:225.
• Ehlers A, Marakis G, Lampen A, Hirsch-Ernst KI. Risk assessment of energy drinks with focus on cardiovascular parameters and energy drink consumption in Europe. Food and Chemical Toxicology . 2019 Aug 1;130:109-21.
• Centers for Disease Control and Prevention. The Buzz on Energy Drinks.  https://www.cdc.gov/healthyschools/nutrition/energy.htm Accessed 8/21/19.
• Pound CM, Blair B; Canadian Paediatric Society, Nutrition and Gastroenterology Committee, Ottawa, Ontario. Energy and sports drinks in children and adolescents. Paediatr Child Health . 2017 Oct;22(7):406-410.
• De Sanctis V, Soliman N, Soliman AT, Elsedfy H, Di Maio S, El Kholy M, Fiscina B. Caffeinated energy drink consumption among adolescents and potential health consequences associated with their use: a significant public health hazard. Acta Biomed . 2017 Aug 23;88(2):222-231.
• Wiggers D, Asbridge M, Baskerville NB, Reid JL, Hammond D. Exposure to Caffeinated Energy Drink Marketing and Educational Messages among Youth and Young Adults in Canada. Int J Environ Res Public Health . 2019 Feb 21;16(4).
• Schneider MB, Benjamin HJ. Sports drinks and energy drinks for children and adolescents: Are they appropriate? Pediatrics . 2011;127(6):1182–9.
• Campbell B, Wilborn C, La Bounty P, Taylor L, Nelson MT, Greenwood M, Ziegenfuss TN, Lopez HL, Hoffman JR, Stout JR, Schmitz S, Collins R, Kalman DS, Antonio J, Kreider RB. International Society of Sports Nutrition position stand: energy drinks. J Int Soc Sports Nutr . 2013 Jan 3;10(1):1.
• van Dam RM, Hu FB, Willett WC. Coffee, Caffeine, and Health.  NEJM .  2020 Jul 23; 383:369-378

Last reviewed July 2020

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