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 blogs from our thought leaders, including Fund President Christopher F. Koller.
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.
September 2025 Isaac Weldon, Kathleen Liddell, Kevin Outterson,
Antimicrobial resistance (AMR) is a pressing global health crisis rooted in complex collective action problems. Despite the urgency, policy responses have not kept pace with the escalating threat of drug resistance. By recognizing the similarities between AMR governance and other shared-resource challenges in environmental governance, this article examines potential strategies for AMR governance. More
September 2025 Pankaj Jain, Bhav Jain, Rushabh Doshi, Urvish Jain, Henry Claypool, Ariana Aboulafia, Bonnielin K. Swenor,
Throughout the last 50 years, the disability rights movement has made significant progress in providing statutory protections for people with disabilities in the United States. More
September 2025 Alan B. Cohen,
The Trump administration’s efforts to eliminate all manner of diversity, equity, and inclusion (DEI) practices from government agencies, universities, and private sector workplaces has been coupled with steep funding cuts to key health agencies and the cancellation or freezing of medical research grants and contracts. It’s not just the careers of promising scientists and medical researchers that are at stake, but also the nation’s preeminent standing in the scientific community. Science unfortunately has become the latest victim in the culture wars taking place in the United States. More
August 2025 ASHLY E. JORDAN, RABIAH GAYNOR, CAROL MOORES, YOLANDA CANTY, CHINAZO O. CUNNINGHAM,
In the United States, substance use disorder (SUD) is a significant public health and public safety challenge. Up to two-thirds of individuals who are incarcerated meet SUD criteria, compared with 16.7% of the general population. Individuals who have opioid use disorder (OUD) are also overrepresented in criminal legal settings: approximately 15.0% to 30.0% of individuals who are incarcerated have OUD, compared with 3.7% of the general population. Furthermore, individuals who are incarcerated are at high risk for fatal overdose both inside carceral facilities and upon reentry to the community. Overdose is the third leading cause of death in jails, and overdose deaths have increased more than six times over the past two decades in prisons. Among those reentering the community, fatal overdose is the leading cause of death. The risk of fatal overdose within the first two weeks following reentry is more than 100 times higher than in the general US population. More
August 2025 David H. Jernigan,
Alcohol is a causal factor in more than 200 disease and injury conditions in the human body. The Centers for Disease Control and Prevention (CDC) define excessive drinking as binge drinking (4 or more drinks for women, 5 or more for men on one occasion in the past month), heavy drinking (8 or more drinks for women, 15 or more for men in a week), and any drinking during pregnancy or by persons younger than age 21 years. More
August 2025 Philip M. Alberti,
For more than 2 years, I have started my speaking engagements with a simple message: “Health equity benefits all communities.” Although the message may be straightforward, health equity–focused scientists and advocates like me have done an inadequate and ineffective job making that point clear and believable through stories, data, and messaging. More
August 2025 John Billimek, Melina Michelen, Patricia J. Cantero, Noraima Chirinos, Rocio Salazar, Mary Anne Foo, Samantha Peralta, Brittany N. Morey, Jacqueline J. Chow, Salvador Zarate, Sora Park Tanjasiri, Alana M. W. Lebrón,
Community health workers (CHWs) are frontline public health workers who support the well-being and capacity building of residents disproportionately affected by health inequities. The purpose of this study is to examine diverse perspectives on the conditions for CHW success as CHWs were engaged in rapidly implemented, highly responsive education, vaccination, and recovery efforts during the COVID-19 pandemic in a large county in Southern California. More
August 2025 David B. Joyce, Jeffrey Swanson,
Extreme Risk Protection Orders (ERPOs) are an effective legal tool for reducing firearm suicide by temporarily removing access to firearms for certain individuals who exhibit dangerous behavior. Unlike most state laws restricting access to firearms based on status, ERPOs are predicated on the assessment of future risk of harm to self or other, as determined by civil court file finding. Emerging research indicates that separating those in crisis from lethal means reduces firearm mortality. We assess Maine’s unique approach and consider whether it is a replicable policy option for other states or should be modified to comport with other states’ more broadly applicable model. More
July 2025 BRANDON D. L. MARSHALL, Kristen Pendergrass, Sara Whaley,
The US overdose crisis is one of the most severe and devastating public health problems of the 21st century. Since 1999, more than one million Americans have lost their lives to accidental drug overdose. More
July 2025 Corey Davis, Amy Lieberman, Czarina Behrends,
The United States continues to experience a nearly unprecedented level of drug-related health harms, with over 105,000 Americans dying of overdose in 2023 alone. Although overall overdose deaths declined slightly from 2022 to 2023, rates for Black people continued to rise. Stimulants such as cocaine and methamphetamine are increasingly involved in overdose deaths, and xylazine and other contaminants continue to be prevalent in the illicit drug supply. More
July 2025 Hannah L.F. Cooper, Anna L. Mullany, Snigdha Peddireddy, Simone Wien, Melvin "Doug" Livingston, Whitney S. Rice, Anne L. Dunlop, Michael R. Kramer, Madison Haiman, Lasha S. Clarke, Natalie D. Hernandez-Green, Angélica Meinhofer,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers… More
July 2025 Noa Krawczyk, Hillary Samples,
The United States is facing an ongoing mental health and substance use crisis. In 2023, 58.7 million US adults had a past-year mental illness, 46.3 million had a substance use disorder (SUD), and 20.4 million had both. More
June 2025 Magdalena Cerdá, DANIEL B. NEILL, ELLICOTT C. MATTHAY, JOHNATHAN A. JENKINS, BRANDON D. L. MARSHALL, Katherine Keyes,
People in the United States are dying at record numbers from overdose. Overdose deaths increased from fewer than 17,000 deaths in 1999 to an estimated 100,000 deaths approximately 25 years after, with a peak of almost 108,000 deaths in 2022. Racial/ethnic minoritized groups are now particularly affected: in 2023, the highest rates of overdose were among non-Hispanic Black and American Indian/Alaska Native Americans. Although overdoses increasingly involve both opioids and stimulants, opioids contribute to over three-quarters of all overdose deaths, primarily driven by illegally manufactured synthetic opioids like fentanyl. More
June 2025 Marco Thimm-Kaiser, Katherine Keyes,
The potential adverse effects of social media use for adolescents have received substantial attention. In response, a growing number of state-level social media regulations are emerging in the United States. These policy interventions are being implemented in the context of mixed scientific evidence, forcing policymakers to weigh the need for proactive regulation against the limitations of extant research. We explore policymakers’ publicly stated rationales for social media regulations and contextualize their claims within extant scientific literature. More
June 2025 Annette M. Dekker, Adrian Yen, Andrea Larco Canizalez, Yesenia Perez, David Salazar, Bita Ghafoori, Dorit Saberi, Breena R. Taira,
The Trauma Recovery Center (TRC) model brings comprehensive care to underserved victims of crime, with improvements in PTSD symptoms and quality of life. Funding concerns were the central limitation in model implementation according to TRC staff. More
May 2025 Kate McEvoy, Hannah Maniates,
Medicaid has both greatly advanced the scope and integration of mental health and substance use disorder services among payers and remains a work in progress with respect to scaling and funding these services across the country. More
April 2025 Rachel Donnelly, Mateo P. Farina,
Mental health (e.g., anxiety, depression) continues to be a major public health concern in the United States that impacts millions of individuals, their families, and communities. Approximately 21% of adults 18 years and older, or 55 million adults, reported symptoms of recent depression in 2022, demonstrating the wide reach of mental health challenges. More
April 2025 Jonathan Purtle, Amanda I Mauri, David Frederick,
In this article, we provide an overview of emergent models for funding crisis systems in the United States and the policy and service contexts related to these models. Our review assesses the status of crisis system financing recommendations proposed by Hogan and Goldman proposed in 2020 and complements prior reports about financing crisis services. More
April 2025 Briana S. Last, Jane M. Zhu,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers Do? Access… More
April 2025 Jane M. Zhu, Ruth Rowland, Inga Suneson, Deborah J. Cohen, K. John McConnell, Daniel Polsky,
Behavioral health access gaps are well documented in Medicaid, in which managed care now covers most enrollees, and for which there are typically fewer options for going out-of-network for care. Despite the growing role of managed care organizations (MCOs) in financing and delivering behavioral health services, little is known about MCO levers that can improve access to care. More
April 2025 Brendan Saloner,
This Perspective examines the role of Medicaid in the innovation of substance use disorder (SUD) treatment. In 2023, an estimated 49 million Americans met criteria for an SUD and more than 100,000 people died of a drug overdose. Compared with the general population, people with SUD experience worse self-rated health, a higher burden of other chronic diseases, and more hospital care. More