The Milbank Quarterly | A Multidisciplinary Journal of Population Health and Health Policy

December 2025  (Volume 103)

From the Editor

Perspective

  • Health Equity Benefits All Communities (Including White Ones)

    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

  • Digital Health: An Opportunity to Advance Health Equity for People With Disabilities

    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

  • Now What? Neighborhood Nursing’s Answer to the US Health Care Paradox of Spending More but Getting Less

    André Nogueira,  MARGARET M. FITZPATRICK,  ASHLEY GRESH,  KENNEDY MCDANIEL,  TIFFANY J. RISER,  TERRANCE LINDSAY,  RANDI WOODS,  ADEDOYIN EISAPE,  LISA STAMBOLIS,  ALICIA COOKE,  BRUCE LEFF,  ELIANA PERRIN,  REGINA HAMMOND,  Sarah L. Szanton, 

    Despite spending more per capita on healthcare than any other nation, the United States experiences declining life expectancy and increasing chronic disease burden—a paradox reflecting fundamental limitations in the current treatment-centered, facility-based care system. This paper introduces Neighborhood Nursing, an innovative universal care infrastructure designed to shift the US healthcare toward proactive, prevention-centered care organized geographically in neighborhoods.   More

Original Scholarship

  • Policy Options for Antimicrobial Resistance: Exploring Lessons From Environmental Governance

    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

  • People Versus Product: Conditions for Success for Community Health Workers as Sustainable Members of the Public Health Workforce

    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

  • County-Level Immigration Policy and Health Insurance Among Latino Adults and Youth

    Maria-Elena De Trinidad Young,  Danielle M. Crookes,  Sarina Rodriguez,  Fabiola Perez-Lua,  Ninez A. Ponce,  Alexander N. Ortega, 

    Federal and state immigration policies influence access to health insurance for Latino populations. Local jurisdictions also have immigration-related policymaking power, but there has been limited study of their influence on health care access. We examined the relationship between county-level immigration policy contexts and health insurance coverage of Latino adults and youth in California using two measures that capture local-level policy decisions and immigration policy–related social inequity.  More

  • Measuring Primary Care Productivity in the Era of Interprofessional Team Care: Stakeholder, Scoping Review, and Implementation Perspectives

    LISA V. RUBENSTEIN,  SYDNE J. NEWBERRY,  ISHITA GHAI,  ANEESA MOTALA,  IDAMAY CURTIS,  PAUL G. SHEKELLE,  TODD H. WAGNER,  L. DIEM TRAN,  STEPHEN D. FIHN,  KARIN M. NELSON, 

    Current primary care productivity measures do not account for investment in interprofessional primary care teams in relation to primary care goals and thus are insufficient for assessing and improving primary care efficiency and productivity. We explored alternative productivity measurement methods.  More

  • Providing Health Care to People Experiencing Homelessness: Strategies and Challenges for Cross-Sector Initiatives

    Michael J. Yedidia,  Joel C. Cantor, 

    Cross-sector collaborations among health care and housing services organizations promise more efficient use of resources and delivery of more coherent and effective services to people experiencing homelessness (PEH).  More

  • Determinants of When Community Behavioral Health Clinics Partner With Emergency Response Systems: The Role of Capacity in 911 Referral and Co-response Models

    Amanda I. Mauri,  Zoe Lindenfeld,  Charley Willison,  THERESE L. TODD,  Jonathan Purtle,  DIANA SILVER, 

    Individuals with behavioral health disorders are more likely to experience substantial harm from a police encounter, prompting reforms to minimize encounters between police and people experiencing a behavioral health crisis. One strategy involves expanding partnerships between certified community behavioral health clinic (CCBHC) mobile crisis teams and emergency response systems, often through two models: 911 referral, wherein a CCBHC’s behavioral health practitioner–only team responds to 911 calls, and co-response, wherein a CCBHC clinician joins a police or emergency medical services (EMS) team.   More

  • Health Effects of the 2021 Earned Income Tax Credit Expansion on Young Adults Without Children

    Abdinasir K. Ali,  Emily C. Dore,  Rita Hamad, 

    In 2021, Congress expanded the earned income tax credit (EITC)—the largest US poverty alleviation program—to young adults without children who had previously been ineligible.   More

  • Trends in Long-Term Care Ombudsman Program Funding and Its Relationship to Nursing Home Resident Care

    Katherine A. Kennedy,  Cyrus Kosar,  Madison S. Williams,  Kali S. Thomas, 

    Funded partially by the Older Americans Act, state Long-Term Care Ombudsman Programs (LTCOPs) provide a critical role in serving as advocates for older adults in long-term care (LTC) facilities. Ombudsmen regularly visit residents, resolve disputes, and assist with discharge planning. In 2022, the National Academies of Sciences, Engineering, and Medicine called for increased LTCOP funding to improve nursing home (NH) quality.   More