The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis to advance state health leadership, strong primary care, and sustainable health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest posts from our staff and guest authors.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a foundation that works to improve population health and health equity.
August 13, 2026
Quarterly Article
Mark D. Hayward
Mateo P. Farina
Jun 4, 2026
May 31, 2026
March 2026
Back to The Milbank Quarterly
Policy Points:
Context: In this perspective, we have reviewed the historical evidence on the association between education and health in the United States, arguing that attention to public policies related to both education and technology are fundamentally important in understanding historical changes in the educational divide in life expectancy.
Methods: Our assessment of the literature suggests that the relatively narrow educational gap in life expectancy throughout much of the 20th century until 1970 reflected a rapid expansion of education in the population combined with the deployment of technologies that benefitted the majority of Americans. In the latter part of the 20th century and into the 21st century, however, life expectancy for Americans with less than a college degree stalled, whereas the life spans of college-educated Americans grew at a rapid pace.
Findings: We argue that the faster pace of technological change compared to educational changes in the population fueled the rise in life expectancy of college-educated persons, with life expectancy among less-educated persons being increasingly contingent on state policies focused on employment and health opportunities.
Conclusions: The implications of these findings suggest that the educational divide in adult health is likely to grow even greater in the decades ahead with continued rapid technological advances.