Top 10 Milbank Quarterly Articles of 2023

We are pleased to present our top 10 most-read Milbank Quarterly articles of 2023. 

1. Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation  

Marco Thimm-Kaiser, Adam Benzekri, Vincent Guilamo-Ramos 

This study identifies eight principles unifying social determinant of health (SDOH) mechanisms, such as the theory that SDOH operate intergenerationally, and introduces a conceptual model to translate scholarly SDOH work into evidence-based and targeted policy and programming.    

2. A Population Health Impact Pyramid for Health Care 

Philip Alberti, Heather H. Price  

This Perspective from the centennial anniversary issue of The Milbank Quarterly, The Future of Population Health, reimagines the Health Impact Pyramid by centering population health and collaboration between health care organizations and communities to achieve health and health equity.  

3. The Perils of Medicalization for Population Health and Health Equity 

Paula M. Lantz, Daniel S. Goldberg, Sarah E. Gollust 

This centennial issue Perspective argues that a medicalized view of health in the US has led to the conflation of “health” and “health care” and an emphasis on individual social needs rather than social, political, and economic determinants of heath. The authors recommend educating clinicians, health care managers, journalists, and policymakers about the negative consequences of medicalization.  

4. The Future of Social Determinants of Health: Looking Upstream to Structural Drivers 

Tyson H. Brown, Patricia Homan 

Structural oppression systematically excludes marginalized groups from power, resources, and opportunities in social, political, cultural, legal, and economic institutions. In this centennial issue Perspective, the authors reflect on the past three decades of research on the social determinants of health and call on research to look further upstream at what structural conditions drive population health.  

5. Upstream Policy Changes to Improve Population Health and Health Equity: A Priority Agenda 

Rashawn Ray, Paula M. Lantz, David William 

This Perspective from the centennial issue sets a public policy agenda to address upstream social determinants of health that lead to inequities across race, gender, and social class lines. The authors offer public policy reforms to address the well-being of children, the legacy of racial segregation, and structural racism in social systems and institutions. 

6. The Role of Primary Care in Improving Population Health 

Kurt C. Stange, William L. Miller, Rebecca S. Etz 

Primary care is associated with health equity, health care quality, and reduced health care spending. In this open-access Perspective from the centennial issue, the authors provide policy solutions to improve population health through primary care.  

7. The Water Surrounding the Iceberg: Cultural Racism and Health Inequities 

Eli K. Michaels, Tracy Lam-Hine, Thu T. Nguyen, Gilbert C. Gee, Amani M. Allen   

Cultural racism, or the values that protect Whiteness and White social and economic power, produces and maintains racial health inequities. This open-access study offers recommendations for future research, including better measuring cultural racism, empirically testing the interactive relationship between cultural and structural racism, and developing interventions to reduce cultural racism and create pathways to health.   

8. Abortion Policy in the United States: The New Legal Landscape and Its Threats to Health and Socioeconomic Well Being 

Paula M. Lantz, Katherine Michelmore, Michelle H. Moniz, Okeoma Mmeje, William G. Axinn, Kayte Spector-Bagdady 

This centennial issue Perspective discusses the new legal landscape for abortion in the wake of the historic 2022 Supreme Court decision overturning Roe v. Wade. The authors emphasize the significant and inequitable health harms associated with restrictive abortion policies.  

9. Building High Performing Primary Care Systems: After a Decade of Policy Change, Is Canada Walking the Talk? 

Monica Aggarwal, Brian Hutchison, Reham Abdelhalim, G. Ross Baker 

In this open-access study, researchers examine policy changes to enhance primary care from 2012 to 2021 in 13 Canadian jurisdictions. The researchers find that policies facilitated adopting electronic medical records, quality improvement training and support, and interprofessional team development. Yet, improvements in governance, system coordination, patient enrollment, and systematic evaluation were constrained by policy legacies and limited physician autonomy.   

10. Fifty Years of Trust Research in Health Care: A Synthetic Review 

Lauren A. Taylor, Paige Nong, Jodyn Platt 

The Covid-19 pandemic highlighted how trust deficits in health care in the United States negatively impacted population health by delaying Covid-19 care, routine care, and vaccine uptake. This study reviewed 725 health services and health policy articles on trust from the past 50 years to examine how trust is defined and measured.