2024 Racial Equity Statement of Purpose

Race, Population Health, and Equity

The Board of Directors and staff of the Milbank Memorial Fund acknowledge and affirm that laws, practices, and societal norms that have categorized people by race — a concept with no biological basis — have harmed people of color in general and Black populations in particular for centuries in the United States. They have resulted in inadequate access to and use of high-quality health care, differences in patient experience, disparate health outcomes, and a medical and health care system that for many is not worthy of trust. 

We believe that addressing inequities in health status, access to care, and outcomes of care that continue to harm historically under resourced and under represented groups in society is fundamental to improving population health. Moreover, it is not possible to achieve health equity for all populations without addressing broader social inequities that disadvantage members of racial and ethnic minority groups and Black populations in particular. These inequities in education, employment, housing, and other social and environmental factors directly influence population health. 

Our Legacy

The Milbank Memorial Fund has a 100-plus-year history of making advances toward its stated mission of improving population health. Yet, like many organizations, we must acknowledge all of our history. 

Some of our organization’s own actions have reinforced and perpetuated the systemic racism that contributes to fundamental health inequities in this country. Historically, our efforts to improve population health in our programming and publications have not prioritized improving health equity. The racial and ethnic composition of our state health policymaker networks has not resembled the populations they serve. In our organization, disproportionate numbers of staff members, board members, partners, and network members, as well as the authors and reviewers of our publications and The Milbank Quarterly, have been white and socioeconomically advantaged. 

Most egregiously, the Fund played a role in the United States Public Health Service (USPHS) syphilis study at Tuskegee and Macon County, Alabama. Specifically, from 1935 to 1972, the Fund paid for services associated with the burials of men who died over the course of the study when their families agreed to autopsies. We acknowledge our role in creating this legacy. We deeply regret and apologize for the harm caused to study participants, their descendants, and all those affected by the study, and for taking five decades to acknowledge our involvement publicly. 

A comprehensive external audit of all Fund programming and publications since 1921 has identified that the Fund also supported, with funds or staff, six other studies that may have violated current standards of clinical research ethics. In these studies, requisite informed consent was not obtained and available remedies were not provided at the end of the study. These studies involved troubling lapses of ethical standards that we deeply regret. The most troubling was involvement in a survey conducted from 1942 to 1944 on the dietary habits and nutritional status of 400 indigenous persons conducted by the Canadian government in Northern Manitoba. 

Obligations

This legacy of racist and unethical studies is not in keeping with our mission, vision, and values, and it compels certain obligations. In all our work we must: 

Commitments

In light of our obligations, we are committed to pursuing strategies in our own organization, our programming, and our publications that address ongoing health inequities among members of racial and ethnic minority groups and Black populations in particular. 

Specifically, we have undertaken or committed to the following actions: 

2024 Initiatives

In light of these obligations and commitments and our revised organizational mission, vision, and values, the following Milbank Memorial Fund initiatives will be implemented in 2024. (An assessment of progress on our 2023 initiatives is available.) 

Organizational 

State health policy leadership programs 

 Population health programs 

Communications