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The Milbank Memorial Fund works to improve population health and health equity by collaborating with leaders and decision makers and connecting them with experience and sound evidence.

05/22/2025

We are no longer active on FB but encourage you to visit us on LinkedIn.

Milbank Memorial Fund | 1,495 followers on LinkedIn. Using evidence to improve population health | The Milbank Memorial Fund is a foundation that works to improve population health and health equity by collaborating with leaders and decision makers and connecting them with experience and sound evide...

11/05/2024

The cost of childbirth and postpartum health care results in significant, ongoing financial hardship, particularly for lower-income families with commercial insurance, according to a new Milbank Quarterly study.

Researchers Heidi L. Allen, PhD, of the Columbia University School of Social Work, Jamie Daw, PhD, of the Columbia University Mailman School of Public Health, and colleagues surveyed people with Medicaid or commercial insurance about a year after they gave birth and found:

Over half of respondents with commercially insured births spent more than $1,000 out of pocket on childbirth and nearly 40% reported being somewhat or very worried about paying health care bills

Lower income people (with annual incomes of less than about $60,000) with commercially insured births reported particularly high financial strain: nearly half still owed money for childbirth costs, 16% had not made any payments yet, and 1 in 5 had medical debt in collections.

Overall, Medicaid was financially protective for birthing families relative to private insurance because only 20% had any out-of-pocket spending on childbirth or health care in the postpartum year. However, any cost-sharing was associated with outstanding medical debt.

The authors propose several policy solutions, including eliminating all cost-sharing for pregnant and postpartum people in Medicaid and allowing lower-income birthing people with private insurance to apply for supplemental Medicaid coverage.

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11/04/2024

A trip home to help with Appalachian mountain relief work in the wake of Hurricane Helene brought lessons on trust and community for Morgan McDonald, Milbank’s National Director of Population Health and Health Equity Leadership. In a new View from Here, Dr. McDonald reflects on what she witnessed through the lens of her years in public health — and what it means for people in government.

Preparing for emergency scenarios takes dedicated and ongoing federal, state, and local funding, as well as attention to building relationships that are put to the test during a pandemic or in a flood recovery, McDonald says.

10/30/2024

Social isolation, a culture of self-reliance, a lack of access to mental health care, and ready access to fi****ms are factors that contribute to high su***de rates in Mountain West states like Utah. Steve Eliason, a 2023-24 Milbank Fellow serving his 14th year in the Utah House of Representatives, has sought to bring down those rates, particularly among youth, over the last decade.

In a new article, Marjorie Cortez describes how Eliason has become Utah’s leading legislator on su***de prevention and related issues. By skillfully navigating Utah’s political landscape and working with gun owners, he has sponsored nearly 60 successful pieces of legislation addressing gun safety, education, and behavioral health care expansion. The vast majority of his legislation has passed unanimously— and data shows improvement in Utah’s youth su***de rates.

News article: The first time Utah state Rep. Steve Eliason was asked what he was going to do about a rash of youth su***des in his suburban Salt Lake County

10/25/2024

Join a Milbank Quarterly webinar, Wednesday, October 30, 1 p.m. to 2 p.m. ET, about new research on policy opportunities to improve prevention and access to obesity treatment in the United States in the context of new anti-obesity medications. William Dietz of George Washington University will moderate a discussion with Liz Ruth, the director of policy at the National Association of Chronic Disease Directors, and the authors of two recent Milbank Quarterly articles to discuss the findings and policy implications.

Speakers include:

William Dietz, Professor and Director of Research and Policy, Global Food Institute, George Washington University (moderator)

Neil Mehta, Professor and Associate Dean for Research, School of Public and Population Health, The University of Texas Medical Branch, author of the recent MQ article obesity as a main threat to population health

Fatima Cody Stanford, Associate Professor and Director of Diversity, Nutrition Obesity Research Center at Harvard, Harvard Medical School, author of the recent MQ article on increasing access to effective obesity therapeutics

Liz Ruth, Director of Policy, National Association of Chronic Disease Directors

This Milbank Quarterly webinar will cover findings from two recent studies on obesity prevention and policies to improve access to new medications. Join the authors and William Dietz, professor of Exercise and Nutritional Sciences at the Milken Institute School of Public Health and Director of Resea...

10/24/2024

States increasingly are taking advantage of the Medicaid Reentry Section 1115 Demonstration Opportunity that provides prerelease and transition services to incarcerated individuals. In a new Milbank Quarterly article, Elizabeth T. Chin of the Johns Hopkins Bloomberg School of Public Health and coauthors estimated the size of the eligible population in prisons and jails, and the prevalence of disease within this population, to inform state Medicaid plans.

The authors found that rates of behavioral health conditions, hepatitis C, and chronic kidney disease were much higher in the incarcerated population than in the existing civilian Medicaid population. Additionally, if the new Medicaid eligibility rules were broadly applied, there would be a sizable increase in enrollments in smaller rural states.

These findings suggest that state Medicaid programs, health plans, and providers may benefit from advanced planning to prepare for program implementation, the authors say.

Context: As states expand prerelease and transition services for incarcerated individuals under the Medicaid Reentry Section 1115 Demonstration

10/22/2024

Traditional implementation and enforcement of public health laws, such as those covering to***co sales to youth or housing safety, is often reactive rather than proactive. These practices often rely on complaints and incident reporting and can exacerbate socioeconomic disparities given underreporting, fear of retaliation, and limited knowledge of laws among people who face discrimination because of their educational attainment or income, for example.

In a new blog, Maya Hazarika Watts of ChangeLab Solutions and Elizabeth Tobin-Tyler of Brown University describe these harms and offer several recommendations, including prioritizing enforcement of laws that proactively protect health and supporting community-based programs that empower individuals and communities to exercise their legal rights.

Public health laws affect health not only through their substance and design but also through implementation and enforcement. Equitable policymaking requires implementation that respects and works…

10/18/2024

Rising rates of adolescent depression and suicidal ideation have led to concern among policymakers and the public. In a new Milbank Quarterly Opinion, Dalton Conley of Princeton University suggests that while part of the increase can be attributed to an actual increase in adolescent mental health problems, much of it may be due to changes in how we identify and report depression and suicidal ideation in adolescents. Conley urges researchers to report trends with caution.

“Expanding access to mental health screenings and care is essential, but so is ensuring that changes in diagnostic practices do not disproportionately affect certain groups or inflate trends in ways that mislead public health efforts,” Conley says.

In recent years, there has been a growing focus on a perceived mental health crisis among adolescents, as embodied by the alarming rise in reported cases

10/17/2024

This spring, Delaware took a bold step to mitigate hospital spending growth by creating the Diamond State Hospital Cost Review Board, tasked with reviewing and regulating budgets of hospitals that fail to address excessive spending.

In a new blog post, Sarah Kinsler of Bailit Health explains that the new Review Board supports Delaware’s health care cost growth benchmark, which is a target for statewide annual growth. Kinsler says the board offers a new paradigm for addressing high hospital prices, which health care cost growth benchmark programs in Delaware and other states have consistently identified as a leading cost driver.

“The Review Board could be a powerful tool to help Delaware achieve its cost containment goals and improve health care affordability for Delawareans,” Kinsler says.

This spring, Delaware took a bold step to mitigate hospital spending growth. HB 350, signed into law in June, creates the Diamond State Hospital Cost

10/16/2024

Despite recent drops in e-cigarette use among US youth, va**ng rates among teens in North Carolina are three times the national average. In a new blog, Nikhil Patel and Suman Mohanty, Cornelius Vanderbilt Scholars and undergraduate students at Vanderbilt University, discuss teen va**ng, including at Patel’s own former high school in Wake County, as well as the higher prevalence of va**ng outlets near schools and in low-income areas.

The authors offer policy recommendations, including supporting local ordinances in states that establish distance requirements for v**e outlets near schools. They also explain why it is important for all states to implement the federal regulation prohibiting the sale of to***co products to youth under the age of 21.

“Building on the successes of public health interventions and extending them to underserved communities will be essential,” the authors say. “By enacting targeted policies and providing the necessary resources, we can ensure that all residents of Wake County — and beyond — benefit from this progress.”

Many high schools in Wake County, North Carolina, are situated in economically vulnerable areas, so there is also a correlation between the density of outlets and Wake County's most vulnerable areas.…

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